Monday, November 21, 2011

Weekly Australian Health IT Links – 21st 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

The following paragraph (from ehealthspace.org) shows just how really bizarre the e-Health Standards Process has become in Australia.
“NEHTA’s document indicates once all comments are resolved and a consensus reached, the specification will be classified as a NEHTA Managed Specification (NMS). This NMS will be approved by the NEHTA Design Authority to signify that it is “implementation ready.”
The intent is that the NMSs will then be, over time, turned into real Standards.
That an organisation that really lacks implementation skills (they outsource it to Accenture, Medicare and all the wave sites etc.) thinks it can work out something is ‘implementation ready’ is really a joke!
I also love that we have a new acronym - a NMS!
Oh dear, oh dear!
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Health: Remember your record

BY MARK CONNORS
16 Nov, 2011 01:00 AM
AS we get older, it can become harder to remember our medical history - when we started taking blood pressure tablets or had that knee operation.
And that's why a new online record system may be the answer some older Australians are looking for.
The Personally Controlled Electronic Health Record (PCEHR) system will be launched by the federal government next year.
The online system will enable patients to choose which information they would like to be recorded electronically.
If you choose to have an eHealth record, you will be able to enter details about yourself, such as medications taken and any allergies you may have
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NEHTA releases final e-health Specifications and Standards Plan

Confirms move away from current development strategy to strategy involving the establishment of "tiger teams"
The National e-Health Transition Authority (NEHTA) has published its final Specifications and Standards Plan for the Federal Government’s $466.7 million Personally Controlled Electronic Health Record (PCEHR) project.
The document, based on the finalised PCEHR Concept of Operations paper released in September, outlines NEHTA’s plan for the project, which is scheduled for delivery by 1 July 2012.
The plan confirms that NEHTA will do away with its current development strategy which uses two separate but related processes — the NEHTA specification process and the Standards Australia Development Process — as it is too slow.
“The current NEHTA specification process is rigorous, with high levels of stakeholder consultation,” the plan reads. “There is often a considerable amount of time between the completion of the NEHTA Work Package Specification Stage and the start of the Standards Australia Working Draft Stage.
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NEHTA rounds up tiger teams

NEHTA has confirmed the use of “tiger teams” to drive standards development for the forthcoming personally controlled electronic healthcare record.
The teams are outlined in the PCEHR System Specifications and Standards Plan, released this week.
The publicly available document cites the use of tiger teams in the aerospace industry as a precedent, describing them as, “a group of experts assigned to investigate and/or solve technical or systemic problems.”
NEHTA’s PCEHR team is forming the teams in consultation with the organisation’s Reference Group co-chairs. Members of the teams will be pulled from sources as varied as subject matter experts, vendors, the national infrastructure partner, and lead site implementation partners, among others.
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11th November 2011
By: Australian Medicine by Dr Steve Hambleton
The AMA is optimistic about the innovations that the PCEHR may offer and we want to help deliver them. The e-health future is bright but we have to get it right. The challenge will be in getting it right in a system that will be initially cumbersome to work with.
The AMA has always maintained that a PCEHR designed around an opt-out policy would have been much simpler to implement, and simpler for healthcare providers to use on a day-today basis. 
The privacy settings available on the PCEHR make it extremely complex to use. Patients will inevitably ask their medical practitioners to help them get set up. Consumers rightly are in the driver's seat, but it is critical that they are active participants and that they understand the importance of getting the right privacy controls on their PCEHR.
The AMA has never advocated for medical practitioners to have access to the entire PCEHR. We understand patient’s rights to privacy and we acknowledge patients don't always tell us everything.
However, to achieve one of the objects of the PCEHR - reducing the occurrence of adverse medical events and the duplication of treatment - the AMA has always maintained that treating medical practitioners need access to pathology and diagnostic imaging results, current medications, and discharge summaries.
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Constructive DoHA meeting to discuss PCEHR

Recently, the RACGP met with Department of Health and Ageing (DoHA) representatives and a ministerial advisor to further discuss the College’s concerns regarding the personally controlled electronic health records (PCEHR) roll-out. This discussion included the need for incentives for GPs to support the additional workload with creating and maintaining the shared health summary for the PCEHR and mechanisms to ensure the implementation targets those consumers who will benefit most from a PCEHR. The RACGP is very pleased that the department took on board some of our concerns and confirmed that they would regularly consult with the College in the lead-up to the PCEHR launch.
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Health information in a cloud - is it all blue skies and clear flying or are there storms ahead?

Background The term ‘eHealth’ means the ‘combined use of electronic communication and information technology in the health sector’.
Cloud computing is the provision of computing services over the internet from a remote location, rather than services from a desktop, laptop, in-house server, local areas network, smart phone, tablet or other mobile device. As an alternative to providing services in-house, the individual or organisation will contract with a provider for the delivery of applications and storage via the internet. In short, provided internet access is available, computer applications and information are available to the user regardless of where they are physically located.
In the last edition of the Health Alert, we reported on the draft eHealth records legislation and the proposed personally controlled electronic health record (PCEHR) system. The proposed PCEHR system, encompassing eHealth, aims to provide patients and their medical advisers with internet access to their health records. The government claims that the proposed PCEHR system will protect individual privacy through legislation, technical security and access controls. Access to records will only be available to health care providers and those that are authorised to have access to an individual health identifier and the associated PCEHR.2
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Script use an issue

CLARE QUIRK
02 Aug, 2011 05:00 AM
A Victorian coroner’s call to stamp out prescription shopping has the support of a Bendigo woman whose brother died after overdosing on prescription drugs.
Coroner John Olle said the problem of people addicted to prescription drugs visiting different doctors and chemists to have multiple drug scripts filled could be resolved by establishing a central database.
Yesterday Mr Olle urged the state government to fix the problem within a year and not wait for the federal government to implement a similar program.
The Coroner’s Court is investigating seven prescription-related deaths, including the death of Bendigo man Shane Hassett.
Mr Hassett, 29, died after overdosing on prescription drugs just before Christmas last year, leaving a wife and six-month-old baby.
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Clinical Informatics Standards

Posted on November 16, 2011 by Grahame Grieve
While I was in Singapore, there was a panel discussion of the degree to which clinicians need to be involved in the formation of healthcare IT standards. I was somewhat surprised to hear that the outcome of the discussion was that there is no need for clinicians to be involved in them at all.
Now while there were particularly local factors involved in the context of the discussion, and it’s resolution, I’ve been thinking about that a lot since. If, by Healthcare IT standards, you mean exchange and persistence infrastructure and base level logical models, then there is no particular reason for clinical users to be involved in the standards development process. Obviously, you need to properly gather requirements from clinically knowledgeable users – and that includes, but is not confined to, clinical users. But these standards are primarily engineering constructs, and clinical users bring no value, or negative value, to this process because they do not understand the nature of the thinking required at this level. (On the other hand, clinical users who have also learnt to think this way are more useful – it’s not the clinical knowledge that is negative, but the lack of knowledge of how to build systems).
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Microsoft enlisted for Mater Health Services health consortium

QUEENSLAND'S Mater Health Services has added Microsoft to its roster of "smart hospital consortium" partners IBM, Intel and Cisco, advancing its plan to tap global expertise through strategic relationships with big players.
Mater chief information officer Mal Thatcher said it had taken the private hospital provider some time "to convince the Microsoft juggernaut that we're a valuable partner, but that has been achieved" with the signing of an agreement last week.
"This instrument of collaboration is a recognition by both parties that there's a lot to be done in health IT, and to get any real traction we need a degree of innovation," Mr Thatcher said.
"Mater has sought out these industry partners because they're multinational organisations with tentacles spread across the world, they are focused on the health sector as a vertical, and they all invest quite significantly in research and development, particularly in life sciences.
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Mater pushes portals for PCEHR growth

Mater Health Services is one of nine Wave 2 lead implementation sites for the PCEHR. Mater’s CIO, Mal Thatcher, gave eHealthspace.org some insight into the ups and downs of the ongoing project.
The Challenge: Become a lead implementation site focusing on maternity patients for the PCEHR.
The Approach: Create portals for clinicians, specialists and patients, and provide connectivity and information sharing between stakeholders.
The Outcomes: Better information sharing has resulted between specialists and GPs.
The Lessons Learned: Preparation and communication between stakeholders ensures the project will proceed on track.
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Missing Components in Discharge Summaries to Subacute Care Centers

Delayed discharge summary creation and lack of training are associated with omissions.
Patients who are discharged to subacute care settings often are medically complex, debilitated, and cognitively impaired. Hospital discharge summaries often serve as templates to direct care of these vulnerable patients during their care transitions.
Investigators used a systematic literature review process to compile 32 expert-recommended components that should be included in a discharge summary. The components were grouped into four categories: historical components (such as hospital course), patient's functional and cognitive ability at discharge, actionable components and future plan of care, and contact information. The researchers reviewed 489 discharge summaries for patients with hip fractures or strokes who were discharged to U.S. subacute care facilities between 2003 and 2005.
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Ultra-fast NBN has sluggish take-up with only one in nine connected

  • by: Mitchell Bingemann and Annabel Hepworth
  • From: The Australian
  • November 19, 2011 12:00AM
ONLY one in nine homes where the National Broadband Network has been rolled out has signed up for its services, and the take-up rate has been as low as 2 per cent in the seat of key rural independent Tony Windsor.
NBN Co has confirmed that the $36 billion network - which so far passes about 18,000 homes - has attracted about 2000 paying customers nationally, representing a connection rate of about 11 per cent.
The Weekend Australian can reveal that internal NBN Co figures from mid-October show the take-up rate has been as low as one in 50 homes at Armidale in Mr Windsor's NSW seat of New England, where Julia Gillard, Communications Minister Stephen Conroy and NBN Co chief executive Mike Quigley launched the first mainland NBN service in a ceremony that cost taxpayers $138,000.
The low take-up rates emerged as one of the nation's most respected business figures, Optus chief executive Paul O'Sullivan, called for a cap on price rises by NBN Co to encourage consumers to take up the NBN.
Mr O'Sullivan warned that NBN Co would probably become one of the most powerful monopolies the nation had seen, and said it must be curbed by tough regulatory measures including Reserve Bank-style requirements to publish board minutes.
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How to lock down your wireless network

Securing your wireless network is a simple process that costs nothing and could save you from a disastrous network breach down the road.
  • Alex Wawro (PC World (US online))
  • 12 November, 2011 01:30
If you operate a wireless network for your home or business, it's important to ward it against opportunistic hackers seeking to steal your data or hijack your Wi-Fi for their own nefarious purposes. We spoke to Steven Andrés, CTO of security consulting firm Special Ops Security, to learn about the best ways to lock down your Wi-Fi. To get started, you'll need to log in to your router's administrative console by typing the router's IP address into your Web browser's address bar. Most routers use a common address like 192.168.1.1, though alternatives like 192.168.0.1 and 192.168.2.1 are also common. Check the manual that came with your router to determine the correct IP address; if you've lost your manual, you can usually find the appropriate IP address on the manufacturer's website.
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Enjoy!
David.

1 comment:

Anonymous said...

Ain't it marvellous. I bet a big international consulting firm convinced the silly suckers at NEHTA that Tiger teams would solve their problem and let them fly like eagles or ...... turkeys maybe!?

The publicly available document cites the use of tiger teams in the aerospace industry as a precedent, describing them as, “a group of experts assigned to investigate and/or solve technical or systemic problems.”