Monday, November 14, 2011

Weekly Australian Health IT Links – 14th November, 2011.

Here are a few I have come across this week.
Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

An interesting week with, again, lots of indications that we are going to see a very interesting period leading up to July 1, 2012.
All over the world I would suggest that there is increasing recognition that delivery of e-health is a good deal harder than anyone fully appreciates.
The excellent study cited below from St Vincent’s Hospital shows just how long it takes and how hard it is to make real progress. if it is this hard to implement a single application in one hospital contemplating national implementation of an unproven and untested system in a great rush is clearly nonsense!

Call for e-Health scrutiny

Updated November 12, 2011 15:33:00
West Australian doctors are calling for an independent body to review the Federal Government's planned e-Health system.
The call follows an international report which found while the United States government was spending billions of dollars in incentive payments to encourage doctors to adopt electronic health records, those records could in some instances threaten patient safety.
The Institute of Medicine in the US is now recommending an independent agency be set up to monitor health information technology.

Authority to release e-health development plan

THE National e-Health Transition Authority will publish a Specifications and Standards development plan for the $500 million personally controlled e-health record system next week.
A NeHTA spokeswoman has told The Australian the plan would be released “within the next seven days”.
The organisation recently announced a series of “tiger teams” to fast-track critical technical specifications needed for the PCEHR build.
There is a November 30 deadline for their work, with the national PCEHR infrastructure project already under way.

PCEHR puzzles aged care industry

  • by: Karen Dearne
  • From: Australian IT
  • November 11, 2011 6:24AM
THE Aged Care Industry IT Council says providers cannot establish whether they will be able to participate in the Gillard government’s $500 million personally controlled e-health record system due to lack of information.
The council, which represents the peak Aged and Community Services Australia and the Aged Care Association of Australia, said draft legislation for the PCEHR’s introduction contains very little detail.
“The regulations and rules have not yet been drafted and may vary over time, yet they are to contain significant particulars of the PCEHR system and will be incorporated under the Act,” it said in its submission to the exposure draft PCEHR bill.

Virtual clinic offers anxiety sufferers assistance

E-therapy found to significantly improve anxiety management in sufferers
A new online psychology clinic has been found to help people with anxiety disorders to better manage their symptoms.
The five self-help e-therapy programs, offered via Swinburne University of Technology’s Anxiety Online, showed significant improvements in anxiety management across 21 of 25 measures.
Each program — tailored to people suffering from generalised anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic attacks (PD/A), post-traumatic stress disorder (PSTD) and social anxiety disorder (SAD) — consisted of 12 modules using text-based and multimedia materials such as audio, video and animated graphics and online activities.

WorkCover confirms e-health bullying investigation

NSW WorkCover has investigated complaints of bullying at the National e-Health Transition Authority's Sydney headquarters, and is working with the organisation "to ensure bullying does not take place".
The complaints came to light last month at a Senate estimates hearing, when new Victorian Nationals senator Bridget McKenzie asked if Nehta had been investigated following a complaint.
Nehta chief executive Peter Fleming replied: "There was just a very brief investigation.
"I believe a WorkCover officer came and had a talk to our head of personnel and I believe that issue was dealt with to their satisfaction immediately," Mr Fleming said.
WorkCover has confirmed an investigation took place, and "we are continuing to work with the employer to ensure that appropriate measures are in place to limit the workplace bullying and prevent a recurrence", a spokesman said.

E-health record plan must be uniform, says privacy commissioner

PRIVACY Commissioner Timothy Pilgrim has called for a unified approach to privacy protections in his response to the Gillard government's draft legislation for its $500 million personally controlled e-health record program.
"The legislation should contain clear privacy protections and should clarify how different commonwealth, state and territory privacy laws will apply," he says in a submission detailing 22 needed changes and "clarifications".
"The civil penalty provisions will not apply to health information originally obtained from the PCEHR system where such information 'was stored in such a way that it was capable of being obtained' by other means."
Protection of data held in local systems instead falls under state and territory health and privacy laws, where these exist.
"We are unsure of the policy reasons for this exemption," Mr Pilgrim said.

NEHTA reports strong financial results

The National E-Health Transition Authority (NEHTA) has reported a strong growth in financials for the year ending June 30, 2011.
The federally funded agency is charged with overseeing Australia’s ehealth journey. The organisation’s annual report states it finished its financial year 2011 with a cash surplus of $32.7 million dollars, up from $7.6 million the previous year.
Total gross assets for the year were $77.4 million, while total liabilities were $21.2 million. Total net assets clocked in at $56.16 million.

St. Vincent’s Hospital, Sydney - an electronic medication management pioneer

Thursday, November 10, 2011 - iSOFT, a CSC company  
SYDNEY, NSW - Medication error is a frequent, harmful and expensive problem in Australian Hospitals, and yet, most hospitals continue to use paper based systems that rely on the vigilance and skill of staff. More than six years ago, St. Vincent’s Hospital, Sydney, began the journey from paper to electronic medication management. A paper published this week in the Medical Journal of Australia describes how collaboration between the hospital and the software vendor resulted in the successful implementation of the MedChart system from iSOFT, a CSC company, leading to a 50% reduction in prescribing errors.
Clinical systems are some of the most difficult to implement. While technical resources and skills are essential foundations, project leadership must come from clinicians. Change management is typically the most challenging aspect of these projects. With most of the change impacting clinical staff, engagement and extensive consultation with clinical teams are required.

Implementing electronic medication management at an Australian teaching hospital

Richard O Day, David J Roffe, Katrina L Richardson, Melissa T Baysari, Nicholas J Brennan, Sandy Beveridge, Teresa Melocco, John Ainge and Johanna I Westbrook
MJA 2011; 195 (9): 498-502
doi: 10.5694/mja11.10451


·         We describe the implementation of an electronic medication management system (eMMS) in an Australian teaching hospital, to inform future similar exercises.
·         The success of eMMS implementation depends on:
o    a positive workplace culture (leadership, teamwork and clinician ownership)
o    acceptance of the major impact on work practices by all staff
o    timely system response to user feedback
o    training and support for clinicians
o    a usable system
o    adequate decision support.
Medication errors are a continuing and seemingly intractable challenge for our health care system. The incidence and annual costs are staggering, and most errors are classed as preventable.2 All steps of the process of medication management (ordering, dispensing and administration) are subject to error, but prescribing is recognised as the greatest source of error.3 Use of an electronic medication management system (eMMS) — including computerised physician order entry, a computerised decision support system, and medication administration and pharmacy review components — has been shown to reduce medication errors, although evidence for this is variable.4,5 It is acknowledged that the health system has been resistant to the promise of, and investment in, electronic information and communication technologies, but that the momentum for uptake is unstoppable.6 We describe our experience of implementing an eMMS in an Australian teaching hospital, in the hope that it will inform similar exercises that are contemplated or in process.

Dentists ready for ehealth surgery: Dr Hewson

Dental is one of the health sector’s unheralded areas. Yet according to the Australian Bureau of Statistics, approximately 12,000 dental surgeries are located across Australia.
Because of this widespread role in the community, the oral health profession has much to gain from forthcoming ehealth developments, argues Dr Neil Hewson, who sits on the Australian Dental Association’s special purpose committee on ehealth.
“The ADA has a good understanding of ehealth,” said Dr Hewson. “While there’s a huge focus on the PCEHR, that’s just [one] part of it. Secure messaging is also very important to us, along with e-prescriptions and e-referrals.”
According to ADA figures, 87 percent of dental practices are computerised, a number a few percentage points lower than in the GP sector. And of those computerised practices, 62 percent use digital charting.

Electronic nose to sniff out TB in India

  • From: AFP
  • November 08, 2011 9:38AM
INDIAN researchers have said they were close to developing an "electronic nose" to sniff out tuberculosis on the breath - offering rapid diagnosis that could save hundreds of thousands of lives.
The "E-Nose" is a battery-operated, hand-held unit, similar to a police breathalyser used to catch drunk drivers.
A patient blows into the device and sensors pick up TB biomarkers in the breath droplets, resulting in an almost instantaneous and highly accurate diagnosis.
The "E-Nose" is a collaboration between the International Centre for Genetic Engineering and Biotechnology in New Delhi and Next Dimension Technologies in California.

State snapshot: Queensland’s ehealth journey

The first in a series of state and territory snapshots, Joshua Gliddon examines Queensland’s ehealth investments.
As one of Australia’s fastest growing, yet geographically dispersed and demographically diverse states, Queensland has distinct needs when it comes to ehealth.
In 2007 the Queensland government invested $243 million in its ehealth strategy, leading to the roll-out of the Electronic Medical Viewer application. The Viewer, as it is known, is currently being deployed and due for completion in the middle of 2012.
According to Queensland Health’s chief information officer, Ray Brown, the Viewer is intended to facilitate better informed clinical decisions which in turn will lead to better patient outcomes.

Medical software group raises e-health safety issues

  • by: Karen Dearne
  • From: Australian IT
  • November 10, 2011 12:00AM
The peak medical software group is concerned about the Healthcare Identifiers service.
THE Medical Industry Software Association has warned unresolved patient safety and liability concerns relating to the year-old Healthcare Identifiers service leave members at risk of liability "for any and all adverse outcomes" arising from use of the service.
"Implementers should take legal advice with respect to potential liability, inform their software indemnity insurers and ensure end-users sign comprehensive waivers," the MSIA says in a white paper adopted by members at its annual CEO Forum last month.
The eight-page white paper -- obtained by The Australian -- was provided to all members of the Healthcare Identifiers (HI) stakeholders working group, including the National e-Health Transition Authority, federal Health department and Medicare, for their consideration.

Privacy of millions at mercy of a USB device

Leonie Wood
November 8, 2011
Data abuse is part of a 'depressing' trend, writes Leonie Wood.
THE privacy and financial records of millions of shareholders who use Computershare's global share registry system were placed at risk this year when a Boston employee quit the company, allegedly taking with her thousands of pages of highly sensitive and confidential documents.
The employee resigned in September last year but did not return a work laptop for three weeks. When Computershare retrieved the laptop, the company claimed internal documents and emails had been copied without authorisation to a USB flash drive and later to the employee's home computer.
What is most disturbing about the case is that the woman was formerly employed in Computershare's risk management and internal audit department, which is responsible for scrutinising the vulnerabilities of the group's internal systems.

Unforgiving Aussies are willing to act on privacy breaches

AUSTRALIAN consumers are among the most unforgiving in the world when it comes to organisations that are careless with their private data, according to a new study.
Nearly nine out of every 10 Australians would stop dealing with a company or another large organisation if they became aware it allowed their private data to be breached, Unisys found in its multi-country biannual security index.
The study found that 85 per cent of the 1025 Australians polled would stop dealing with organisations that allowed their private data to be breached. A further 47 per cent would take legal action.
Unisys Asia Pacific security director John Kendall said the result indicated that, of residents in the 12 countries surveyed, Australians were the most disapproving of privacy breaches.

Australians would speak out against a company data breach: Survey

Unisys Security Index finds 64 per cent would publicly expose companies if their information was compromised
Legal action, exposure and closing accounts are some of the responses Australians would take if their data was compromised by a company, according to a global survey conducted by Unisys.
The Security Index 2011 which was conducted during September with 1,205 people, found 85 per cent of respondents would take their business elsewhere, while 47 per cent would take legal action and 64 per cent would expose the issue in a public forum.
When asked if they would continue dealing with the same company while not using online services, only 24 per cent of Australians said that they would continue doing so.
In addition, 88 per cent of respondents would change passwords on the affected organisation’s website and any others they had concerns about.

Police warn of sophisticated plan to steal identities

Nick Ralston
November 9, 2011
POLICE are concerned about the potential for criminals to steal a child's identity off social networking sites, store the data for years and then use it to obtain fraudulent credit cards and bank loans when their victims become adults.
The Australian Federal Police has evidence that storing stolen personal and financial data for a period before it is exploited - a process known as warehousing - has become a trend among more sophisticated criminals.
Ben McQuillan, the national co-ordinator of the AFP identity security strike team, said a perpetrator warehoused the information for a time, such as six months, to make it harder for a victim or bank to trace where and when the data was stolen.
He said there was now a potential risk that criminals could target users of Facebook and other social networking sites who were unaware of the potential risks of sharing personal information.

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