Monday, April 23, 2012

Weekly Australian Health IT Links – 23rd April, 2012.

Here are a few I have come across the last week or so.
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 MJA Articles on the safety of the NEHRS (PCEHR) and mobile health tools and apps were the big news of the week. Both articles were covered on Monday here:
and here:
Other than that the news flow has focussed on the continuing countdown to the launch of a patient registration scheme for some future NEHRS.
The next couple of weeks will be dominated by Budget Speculation. The Budget is released on May 8 and it will be very interesting to see just what is announced in terms of base NEHRS funding and in practitioner involvement incentives. It is only about 2 weeks away and I am sure this Budget will be pivotal to the future - see recent blog
At a general level the Government announcements on Aged Care for the future where also pretty important. This link provides discussion and background.
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Doctor shopper scheme praised

17 April, 2012 Sarah Colyer
A new opioid script-tracking website is making it easier for GPs to identify patients who genuinely need emergency painkillers, according to early trials of the system.
In a new push to tackle doctor-shoppers, the Federal Government recently committed to expanding the technology from Tasmania to the rest of Australia from July this year.
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Plibersek defends script alert system

  • by: Karen Dearne, IT writer
  • From: The Australian
  • April 21, 2012 12:00AM
HEALTH Minister Tanya Plibersek has dismissed a Victorian coroner's concerns that a proposed $5 million electronic system to alert doctors and pharmacists to prescription-shoppers is flawed.
This is despite the fact that e-prescription software and exchange services offered by independent providers such as MediSecure and Pharmacy Guild-owned eRX can provide instant reporting.
Earlier this year, Plibersek promised to establish a national electronic recording and reporting of controlled drugs system to combat abuse of prescription medications.
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GPs want more money for e-health

  • by: Karen Dearne
  • From: Australian IT
  • April 20, 2012 7:01AM
THE peak GPs' body has restated its funding position on the Gillard government’s personally controlled e-health records system, following confusion over whether doctors will be paid to establish and maintain electronic health summaries for their patients.
"General practice is in an ideal position to be at the forefront of e-health and implementation of the PCEHR," the Royal Australian College of General Practitioners says in a statement released this week.
"Funded and protected time for data cleansing and data quality improvement will ensure that the patient record is accurate and current.
"This will require an ongoing business investment by general practice, not just a one-off payment.
"With more than 125 million GP consultations taking place annually in Australia, and 83 per cent of the population consulting a GP at least once a year, the flow-on to the whole health sector will be substantial."
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‘False optimism’ over e-health funding

The Federal Health Minister has been accused of creating “false optimism” by declaring GPs could claim MBS items to fund their role in creating e-health summaries for patients.
Last month, both the RACGP and the AGPN gave an enthusiastic welcome to a speech by Tanya Plibersek where she “confirmed” that level B, C and D items could be used by doctors “creating or adding to a shared health summary, which involves taking a medical history as part of a consultation”.
It emerged later, however, that doctors were being asked to absorb the costs of setting up the personally controlled e-health record summaries, with the government offering no new money to fund the additional workload.
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Roxon flags online identity checks

  • by: Karen Dearne
  • From: Australian IT
  • April 20, 2012 2:40PM
THE Gillard government is looking at introducing a real-time identity verification system, Attorney-General Nicola Roxon told the Commonwealth Lawyers Association regional conference in Sydney.
"Document verification may not sound particularly sexy, but it is now a critical tool to control the validity of online transactions," she said this morning.
"Just think of how your personal and financial security is reliant on secure transfer and validation of information from our banking and finance sectors, Australia's large superannuation sector and maritime and aviation security.
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Amplilatwatja health records go online

Posted April 17, 2012 13:43:36
The health centre at the remote central Australian community of Amplilatwatja has become the first in Australia to adopt a new e-health system.
The system will place patient health records online so that health professionals are able to access information remotely.
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Govt should fund e-health: Psychologists add their voice

19th Apr 2012
PSYCHOLOGISTS have joined GPs and physiotherapists in calling on the government to fund the administration of e-health records, estimating the cost of setting up the necessary software alone at $3000 per provider.
Australian Psychological Society (APS) executive manager of professional practice David Stokes said allied health professionals, including psychologists, needed assistance to help ensure the viability of the personally controlled health care record (PECHR) system.
Mr Stokes, who was also a NEHTA clinical lead representing allied health, said the whole initiative “is underpinned by the idea that relevant health service providers can access the system to upload reports or letters at their patient’s request and review relevant information to enhance care”.
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The connective tissue of modern health

17 April, 2012
David Ramli
As patients enter Melbourne’s Western Hospital, it’s probably impossible for them to spot the electronic heart that helps them be treated.
They are greeted by a triage nurse who judges the severity of injuries and decides how soon they’ll see a doctor. As the process progresses, they’re cared for by medicos who ask questions about allergies and monitor conditions, moving between scores of beds, as they have for decades.
But just below the surface of all these interactions sits up to $10 million of electronic health technology designed to reduce errors and boost the chances of patients surviving.
Western Health’s executive director of information and communications technology, Jason Whakaari, said the upgrade started as a way to cut down on paper records and cope with rapidly rising patient numbers.
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NSW Health eyes cloud in data centre reform

Recruitment points to long-awaited action.

NSW Government plans to consolidate its 130-odd data centres appear to have borne fruit, with several developments suggesting its largest Departments - Health and Education - have agreed to participate.
NSW Health has advertised for a director of data centre reform to lead the consolidatation of three existing data centres into two, "enabling their use of ... cloud technologies while maintaining service availability".
The NSW Government started scoping a whole-of-government data centre reform project in 2009, based a review of data centre capacity a year earlier.
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Time is key to specialist buy-in to PCEHR, not money

By Professor Martin Culwick
In general, anaesthetists are early adopters of technology and we work under a considerable time pressure. This is partly because in hospitals, patients are admitted on the same day of surgery and we have between five and fifteen minutes to assess them.
How we assess them can be the difference between life and death.
Obviously that assessment depends on the information, so the quality of the information is a very important safety factor. This is why we are very interested in the PCEHR.
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Privacy concerns over mobile apps

DOCTORS using clinical software on their smart phones or tablet computers may be inadvertently putting patient confidentiality at risk, according to a privacy expert.
Dr Juanita Fernando (PhD), part of the mobile health research group at Monash University, told MJA InSight she had been contacted by several patients who had suffered “direct dire consequences” as a result of privacy breaches after doctors used clinical apps on their mobile devices.
She cited the case of a doctor who had updated and uploaded a patient record at home using a clinical app. This was then cached by a metasearch engine, effectively publishing the data in the public domain.
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Apps pose medicolegal risks

17 April, 2012 Sophie Cousins
Clinical software being used by doctors on their smartphones and tablets could be putting patient privacy at risk and threatens the reliability of medical information, a leading academic warns.
In an article in the Medical Journal Australia online, Dr Juanita Fernando (PhD) of the Australian Privacy Foundation warns of the medicolegal risks of doctors using apps, amid the proliferation of programs such as iStethoscope and MedCalc.
Some applications alter the protective settings on the user's smartphone or tablet "threatening the reliability and so security, of medical information read on these," she said.
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Doctors' health apps pose a security risk

THERE's an urgent need for government regulation of clinical software being used by doctors on their smartphones and tablets, according to Juanita Fernando, from Monash University's Mobile Health Research Group.
Doctors using apps like iStethoscope, Flipboard and MedCalc on a wide range of personal mobile devices face liability and security risks not addressed in current legislation, Dr Fernando warns in a Medical Journal of Australia article published today.
"Risks include transmission of user log-ons and address-book details, message interception and activity tracking," she says.
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Safety warning on "unregulated and unmonitored" e-health

16th Apr 2012
Experts have called for an independent monitor of e-health clinical safety and governance to mitigate the patient harm they say will inevitably result from use of the personally controlled e-health record system (PCEHR).
Centre for Health Informatics director Professor Enrico Coiera told MO while the PCEHR system rollout was getting headlines, e-health also included “every GP's desktop, every pharmacy and hospital that has software installed which is currently uncertified”.
Professor Coiera, Flinders University Professor Michael Kidd and NEHTA national clinical lead Dr Mukesh Haikerwal have used an article in the Medical Journal of Australia to underscore the seriousness of the issue, warning “e-health in Australia is unregulated and unmonitored”.
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Dangers of proposed e-health system: Expert warning

Published on April 17, 2012 at 6:26 PM
By Dr Ananya Mandal, MD
Experts warn that patient safety can be in jeopardy under the proposed Australian electronic health records system. The electronic health record scheme, due to start on July 1, is yet to provide safeguards to prevent mistakes with doctors software.
Three experts including Chief clinical adviser to the e-health transition agency Mukesh Haikerwal warn the lack of a national clinical safety system to deal with computer glitches, and electronic devices means that “it is not yet possible to make any definitive statement about whether the personally controlled electronic health record is safe or not.”
The new system has been subject to growing criticism on concerns of privacy and security attributable to the unreliable performance of the National e-Health Transition Agency NEHTA, responsible for the e-Health rollout. Complaints have come from industry, “ranging from accusations of ineffective oversight and failure of administrators to acknowledge design flaws, to warnings that the system will not succeed because its implementation has been ill-considered and rushed.” This comes from an analysis by the Parliamentary Library.
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E-health safety protocols off to a shaky start

Broadcast:
Monday 16 April 2012 6:20PM (view full episode)
Electronic health records have been billed as a way to cut through red tape and improve the level of care that we all receive.
But a group of experts have warned that arrangements need to be made to ensure that our very personal records don't become compromised in any way.
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Concerns raised about e-health records

Updated April 18, 2012 09:36:00
Concern has been raised in the Medical Journal about the move toward electronic health records in Australia.
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Experts warn against E Health

Updated: 08:55, Tuesday April 17, 2012

Patient safety under the proposed electronic health records system cannot be guaranteed, warn experts.
The electronic health record scheme, due to start on July 1, is yet to provide safeguards to prevent mistakes with doctors software.
Three experts including Chief clinical adviser to the e-health transition agency Mukesh Haikerwal warn the lack of a national clinical safety system to deal with computer glitches, and electronic devices means that 'it is not yet possible to make any definitive statement about whether the personally controlled electronic health record is safe or not.'
The E Health scheme has been subject to growing criticism on concerns of privacy and security attributable to the unreliable performance of the National e-Health Transition Agency, responsible for the e-Health rollout.
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Experts warn about e-health safety

E-HEALTH experts have called for safety arrangements to minimise harm caused by health IT initiatives like the Gillard government's personally controlled e-health record system.
While e-health systems can foster safer care, an editorial published in today's Medical Journal of Australia warns that problems in design or operation can also lead to patient harm or death.
"The handful of local studies on e-health safety all point to clear evidence of past harms and future risks," says Enrico Coiera, director of the University of NSW's Centre for Health Informatics, along with co-authors executive dean of Flinders University's Faculty of Health Sciences Michael Kidd and National E-Health Transition Authority clinical lead Mukesh Haikerwal.
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Concern for patient safety with e-records

Mark Metherell
April 16, 2012 - 12:07AM
PATIENT safety under the proposed electronic health records system cannot be guaranteed less than three months before it is scheduled to start.
Safeguards to prevent and correct snafus with doctors' software, such as medication mistakes, have yet to be provided for in the national e-health scheme beginning on July 1.
The warning has come from three experts, including Mukesh Haikerwal, chief clinical adviser to the e-health transition agency.
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E-health policing plan pulled

13 April, 2012 Sarah Colyer  
The Department of Health and Ageing has been forced to pull a "shocking" draft plan giving bureaucrats powers to search general practices and scrutinise their records.
Under the draft proposals GPs wanting to take part in the personally controlled electronic health records (PCEHR) scheme being rolled out from July 1 would have had to sign a contract allowing the department search and seizure powers under the proposal.
A leaked draft of the contract stated that the system operator - currently the department of health - "may at reasonable times on giving reasonable notice to you: access your premises; access your information technology systems; require the provision by you of records and information;… inspect and copy documentation;… interview and require a meeting with any of your employees."
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Aussies Consider Date of Birth on Guard IDs ‘Excessive Personal Information’

By Carlton Purvis
04/16/2012
The overhaul of identification cards for security personnel in New South Wales in December came after complaints that information on current IDs violated privacy statutes, according to recently released documents.
Early last year, a person only identified as a member of the New South Wales security industry made a complaint to the NSW Office of the Privacy Commissioner about the requirement for security personnel to wear and display license cards while on duty. The complainant expressed concerns about physical and financial safety because of the amount of information listed on the cards and said ID cards showing names and birthdate violated NSW privacy laws, according to recently released investigation report by the privacy commissioner.
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NBN blowout is inevitable, warns analyst

  • by: Annabel Hepworth, Mitchell Bingemann
  • From: The Australian
  • April 19, 2012 12:00AM
THE furore over the National Broadband Network has intensified amid fresh claims that the $36 billion project is 15 months behind schedule because of "fundamental" shortcomings in Labor's policy and that cost blowouts are inevitable.
Telecommunications analyst Kevin Morgan argues that, while delays in the multi-billion-dollar deal between the Gillard government, NBN Co and Telstra have been blamed for missed targets
on the NBN rollout, the main reason has been "fundamental shortcomings and miscalculations" in the policy behind the NBN.
Mr Morgan, who served on Keating government communications minister Kim Beazley's committee on telecom reform on behalf of the ACTU, says these miscalculations included a $43bn "guesstimate" of the cost to build the NBN in 2009 that had led to "unreasonable" expectations about the price that should be paid to contractors.
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Scientist beams up a real 'Star Trek' tricorder

April 16, 2012 - 8:26AM
A scientific measurement device based on Star Trek's "tricorder" handheld, used by characters in the series as early as 1966 for data sensing, analysis and recording
Starships, warp speed, transporters, phasers. Think Star Trek technology is only the stuff of fiction? Think again.
Dr. Peter Jansen, a PhD graduate of the Cognitive Science Laboratory at McMaster University in Hamilton, Ontario, Canada, has developed a scientific measurement device based on the tricorders used by Captain Kirk, Spock, Dr. McCoy and other space adventurers on the classic TV series that has spawned numerous spin-offs in more than 45 years.
"Star Trek inspired me to be a scientist" said Jansen, who has been formally working on his tricorder prototypes since 2007, but toying with the idea of making a functioning device since he was "a kid in high school."
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Space mining start-up set for launch in US

Published 11:21 AM, 21 Apr 2012
AAP
A corporate start-up evidently devoted to mining asteroids for metals is to make its public debut on Tuesday in the US northwest city of Seattle.
X Prize founder Peter Diamandis and a former NASA astronaut are slated to unveil Planetary Resources, which boasts an impressive list of backers including Google co-founder Larry Page and famed film-maker James Cameron.
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Enjoy!
David.

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