Monday, May 21, 2012

Weekly Australian Health IT Links – 21st May, 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

This week started slowly and got more interesting as we moved through the week.
We had a speech from the Federal Health Minister (Tanya Plibersek) which can be found here:
and we had the formal killing off of HealthSMART with an admission of failure.
All in all a lot happening when you consider the marketing thrust now being rolled out for the NEHRS - especially when all you will be able to do is to register to access an essentially empty shell.

E-health rollout likely to be slow: Labor

  • From: AAP
  • May 16, 2012 5:17PM
FEDERAL Health Minister Tanya Plibersek has admitted the take up of electronic health records will likely be slow in the first few years.
People can register to have an e-health record from July, however, doctors have long argued the opt-in system could prove problematic.
"There are only so many times doctors are going to stop and look to see if their patient has opted in and given them access to their personally-controlled electronic health record (PCEHR)," Australian Medica Association (AMA) president Steve Hambleton said.
"If doctors were to find most of their patients had a PCEHR they would be more likely to keep using the system."

Hospital IT bungle costs $500 million

  • Lucie van den Berg
  • From: Herald Sun
  • May 18, 2012 12:00AM
A BUNGLED state hospitals IT scheme that has swallowed almost $500 million is being dumped.
The amount spent on the doomed HealthSMART system - dubbed the myki of health - is equal to a year's income tax from about 37,000 battler families, or enough to pay for two Monash children's hospitals.
The cost of establishing a working alternative could run to another $300 million.
The IT system joins a string of waste-plagued state Labor projects, including the $1.35 billion myki, the $24 billion Wonthaggi desalination plant and the abandoned $750 million north-south pipeline.

State government scraps $500m e-health project

  • From: AAP
  • May 18, 2012 1:38PM
VICTORIA'S $500 million e-health system, aimed at creating electronic patient records and prescriptions, has been dumped and will be replaced with a patchwork approach.
Health Minister David Davis confirmed the Government had scrapped a further rollout of HealthSMART, the project to modernise the health system's information and communications technology (ICT).
He said the Government would now work on a hospital-by-hospital basis to set up individualised systems.

Vic scraps HealthSMART system

The Victorian Government has made the decision to scrap its HealthSMART system, which was years overdue and had run hundreds of millions of dollars over budget.
HealthSMART was launched in 2003 and had been designed to run as a single electronic foundation for the state's public health service. The single platform would combine a finance system, as well as patient-management and clinical-applications services.
However, Health Minister David Davis today confirmed that the government had scrapped the continuation of the roll-out of HealthSMART, with the government to now work on a hospital-by-hospital basis, to set up individualised systems.

Coroner calls for restrictions on sleeping pills

A CORONER has called for restrictions on sleeping and anxiety pill prescriptions after it was revealed they account for more deaths than illicit drugs.
Coroner Audrey Jamieson said the drugs - known as benzodiazepines - needed to be reclassified to stop patients doctor shopping and overdosing.
She ordered a report into drug deaths while investigating the overdose of David Trengrove in 2010.

Medicare Locals in $50m ehealth rollout deal

Medicare Locals will share in a $50m funding pool to assist in the roll-out of the forthcoming PCEHR. The funding is in addition to the $233m measures announced in the May federal Budget.
The money is to assist Medicare Locals provide practitioner training in the PCEHR, and to drive consumer awareness at a regional level.

Minister defends government approach to e-health

Federal Health Minister Tanya Plibersek has used a speech on e-health reform to justify the government’s 2012-13 Budget spend and approach to the PCEHR.

Speaking at the Committee for Economic Development of Australia (CEDA), the minister put last week’s $233.7 million funding boost for the national eHealth program in context, saying the government  had spent the last two years “building the foundations for the national eHealth records system”.

Online system doubles flu vaccine uptake

16 May, 2012 Michael Woodhead
Flu immunisation rates can be more than doubled with a system that gives patients information and a ‘Book Now’ option for a vaccination consultation, Australian research has shown.
And the positive impact seen with a web-based “personally controlled health management system” may also apply to other areas of preventive health, say researchers from the University of NSW.
In a study involving almost 750 staff and students at the university, those given access to the ‘’ online health management system had more than twice the rate of flu vaccination (12% vs 5%) of a control group.

E-health budget about efficiency: Plibersek

By Suzanne Tindal, on May 16th, 2012
Federal Minister for Health Tanya Plibersek has addressed criticism of how the government has reallocated funds for its planned e-health system in a speech to the Committee for Economic Development of Australia (CEDA).
In the 2012-13 Budget, the government had to find money to continue its personally controlled electronic health record (PCEHR) scheme, which will see the roll-outs of electronic records to all Australians who opt in from 1 July. The funds that it had already provided were to run out in June.
When the Budget was released, the government allocated another $233 million to the scheme, on top of the $466 million that it had already allocated in the 2010 Budget.

Mouse click a day will keep doctors away

09:06 AEDT Wed May 16 2012
Australians would rather get their health information from the internet than a doctor, according to new research.
A survey commissioned by non-profit association Epilepsy Action Australia found just 47 per cent of respondents rated a visit to the doctor as their preferred way of getting information or training about health conditions.
This compared to 62 per cent who said they preferred going online, 40 per cent who favoured community groups as an information source and 31 per cent who visited libraries.

Doctors no longer first choice for health advice

16 May, 2012 AAP  
Australians would rather get their health information from the internet than a doctor, according to new research.
A survey commissioned by non-profit association Epilepsy Action Australia found just 47% of respondents rated a visit to the doctor as their preferred way of getting information or training about health conditions.
This compared to 62% who said they preferred going online, 40% who favoured community groups as an information source and 31% who visited libraries.

Paralysed woman uses thought-controlled robot to lift a drink to her lips

  • by: Tom Whipple
  • From: The Times
  • May 17, 2012 10:09AM
FIFTEEN YEARS after a stroke left her unable to move or speak, a paralysed woman has done something she thought she would never do again: lift a cup of coffee to her mouth and take a sip.
In a pioneering US trial she did so using a robotic arm that was controlled, despite being unattached to her, by her thoughts.
The clinical trial of the system, known as BrainGate, is the most advanced use of computer-brain interfaces to control movement. A tiny implant was placed on the motor cortex of 58-year-old Cathy Hutchinson, turning her thoughts into instructions for movements in much the same way as they did when she still had use of her arms.

AusCERT 2012: Lack of security aiding medical fraud, identity theft

Medicare cards have no identifiers while prescription slips can be easily forged, says Queensland Health investigations officer
Queensland Health Drugs of Dependence Unit (DDU) investigations officer, Rebecca Thompson, has highlighted security flaws within the Australian health system, such as the lack of a photo or PIN on Medicare cards, which is allowing drug addicts to potentially use lost or stolen cards to obtain powerful prescription drugs.
Thompson, speaking at the AusCERT security conference on the Gold Coast, told delegates that Medicare cards do not currently have unique identifiers such as a photo, signature or PIN meaning that potentially anyone could present the card to a pharmacist.
“You just have a green piece of plastic with some names embossed on it. If the card was lost or stolen would you know if your medical identity had been compromised?,” she said.

AusCERT2012: Calls for real-time drug reporting

By James Hutchinson on May 18, 2012 11:43 AM

Pseudoephedrine blocks not enough.

An investigations officer at Queensland Health's Drugs of Dependency Unit has called for pharmacies to expand the drug classifications used in real-time reporting systems, in an effort to limit the growing trend of prescription drug addicts.
Rebecca Thompson, who investigates use of identity theft to obtain prescription drugs, said the prevalence of doctor shopping - addicts visiting multiple doctors to get multiple prescriptions for the same drug - was being exacerbated by a lack of real-time reporting between pharmacies.
"It is not illegal for a person to see multiple prescribers and obtain multiple prescriptions," she told attendees at the AusCERT 2012 conference on the Gold Coast this week.

PCEHR $233m commitment welcomed

15th May 2012
EXPERTS have welcomed the government’s continued commitment to the personally controlled e-health records system but questioned the wisdom of forcing GPs to participate by threatening to withdraw practice incentive payments.
The government announced in last week’s budget it will spend $233.7 million on e-health over the next two years; $67.4 million on the National E-Health Transition Authority, $161.6 million on the PCEHR and another $4.6 million on privacy and security safeguards for the system.
But that money will come from a total of $257.5 million stripped out of the existing telehealth initiative, which will now end on 30 June next year instead of in 2015 as originally planned, and the HealthConnect program, which was designed to standardise secure electronic messaging.

MSIA: The eHealth paradigm and the PCEHR

Written by Emma Hossack on 18 May 2012.
This article first appeared in the May 2012 edition of Pulse+IT Magazine.
The 2008 National eHealth Strategy set out a number of noble aims that were supported by industry and government alike. Industry confidence was at a high when then-Health Minister Nicola Roxon outlined her plans for a national eHealth system. Things have not progressed according to the plan, however, and there are a number of lessons that we can all learn to ensure this doesn’t happen again.
“A healthy population underpins strong economic growth and community prosperity. Australians therefore have a strong incentive to ensure that our health system is operating efficiently and effectively, and continues to deliver a high standard of care that aligns with both community and individual priorities[1]. One of the ways to realise this is through eHealth. The benefits of eHealth are clear[2] and Australia’s current health expenditure is not sustainable if it remains on the current trajectory[3]. Consultations and reports on the need for eHealth in Australia have been persistent and bipartisan since 1994 and many have been calling for an end to all the talk, and for eHealth to begin with more than unsustainable pilot programs.

Where is the personal control in the PCEHR?

15th May 2012
Like many GPs I have been watching the development of Australia’s personally controlled electronic health record (PCEHR) with interest, especially as the key implementation date of 1 July 2012 approaches.
This has been a frustratingly long time coming for general practice. GPs successfully implemented clinical computer use over a decade ago and have been waiting for much of the rest of the nation’s health systems to catch up so we can realise the benefits for our patients of safe, secure sharing of health information.  
In 2001–2004, I chaired the Australian government’s MediConnect project that investigated the implementation of electronic transmission of prescriptions from general practice to pharmacy. An important element of MediConnect is that it was underpinned by a sound evaluation process. This allowed us to identify what did and did not work and to measure improvements in clinical care.  

AMA flags problems with E-records, six weeks before roll-out

Sabra Lane reported this story on Thursday, May 17, 2012 12:18:00
ELEANOR HALL: The Australian Medical Association is warning today of a major problem with the Federal Government's plan to have a new Patient Controlled Electronic Health Records (PCEHR) system.
The system is due to start on July 1st.
But the AMA's president Dr Steve Hambleton says that doctors won't have access to anything clinically useful until a long time after that because most of them don't have the right software to access the database.
The Government says that the "foundation" of the scheme will be in place in July this year, and that it's paid doctors millions of dollars to upgrade their computer systems.

Doctors seek urgent answers on 'budget sleepers'

15 May, 2012 10:28 AM
The Rural Doctors Association of Australia (RDAA) is “very concerned” about additional cuts announced in last week’s federal budget and is seeking urgent clarification from the Federal Government on them.
“The Government has been trying to sell this budget as a big win for health, but we are worried about the devil in the detail on a number of fronts” RDAAPresident, Dr Paul Mara, said.
"For starters, we are very concerned at the Government’s cuts to the GP immunisation incentive. This flies in the face of the proven effectiveness of this incentive in encouraging the strong uptake of childhood immunisation in Australia, and can only lead to further imposts on general practice in providing this service.
“And to rub more salt into the wound, the Government will now require medical practices to participate in the Personally Controlled Electronic Health Record (PCEHR) system in order to continue to receive the ePIP (a Practice Incentive Payment intended to encourage the adoption of new e-health technology by practices).

Feds phone in changes to telehealth

The 2012-13 Federal Budget delivered a mixed bag of spending cuts and new investments in telehealth.
On the one hand nearly $184 million in incentive payments for practitioner adoption of video technology has been redirected to the National e-Health Program. On the other, the government has given the green light to over $30 million in new telehealth trials to expand into new technical areas outside of video conferencing.
Speaking with Dr Mike Civil, Telehealth Standards Taskforce Chair of RACGP said the $183.9 million funding change to the uptake of telehealth consultations is disappointing. “We are not even twelve months into telehealth consults having MBS (Medicare Benefit Schedule) items.”

GPs don’t expect e-health consults to take off

15 May, 2012 Michael Woodhead
 GPs are sceptical of the benefits of e-health consultations and don’t expect email and video technologies to replace face-to-face consultations with patients in the near future, Australian research suggests.
Interviews with 36 Victorian GPs have found that most had occasionally communicated with their patients via email and text messaging but none did so routinely and did not expect to start doing so even with the rollout of programs such as the National Broadband Network.
Lack of reimbursement and medico-legal concerns were perceived as barriers to e-health consultations, but many GPs also thought that consulting via email or video was a poor substitute for dealing with patients in person.

eHealth Information Security

National eHealth Security and Access Framework (NESAF):

The National eHealth Security and Access Framework has been developed as a control mechanism to ‘increase certainty that health information is created and accessed in a secure and trustworthy manner’.   It aims to ensure:
  • Access to consumer health information is consistently controlled and monitored as it transitions through independent organisations, business processes and systems in the Australian Health Sector.
  • The provenance of all electronic health information is traceable from its creation at a verifiable trusted source through its transition and possible augmentation on route to its destination.

Telstra cloud pilot in e-health system

TELSTRA is hoping a new $1.9 million cloud contract will help it carve out a niche in the emerging e-health sector.
The contract will allow the carrier to provide a private cloud service to Healthways Australia for three years and build on its partnership with the telehealth specialist on a smartphone-based system to monitor diabetics.
Under the terms of the deal Healthways will move its backend servers into Telstra's private cloud and lease its network capacity.

Case Study: South Australia goes large to transform care

South Australia Health is in the middle of the largest e-health project in the state’s history. Will Turner reports.
The Challenge: Deliver a state-wide information rich electronic health record and clinical support system.
The Approach: Customise a globally successful off the shelf solution with SA Health clinician-led teams.
The Outcomes: Transformation of how healthcare professionals do their work via a higher degree of information at point of care.
The Lessons Learned: Clinician engagement and leadership in major e-health projects is vital to success.

Plibersek launches e-health marketing blitz

14th May 2012
The government has a launched a charm offensive aimed at creating momentum for its personally controlled e-health record system, with the launch of an “online learning centre” for patients and practitioners.
The Health Department’s Twitter feed included 11 separate messages promoting the site and the PCEHR system over the weekend, all aimed squarely at consumers.
“Sick of retelling the same story to every doctor you see? An #eHealth record can help you” said one, while others promoted the personal control ("Learn how you can be at the centre of your own healthcare") and portability ("Love to travel? Over 65? You’ll benefit from one of these") of the system.

Government launches ehealth education push

The federal government has launched an online ehealth education portal aimed at giving consumers and health providers information about the forthcoming national ehealth system.
The site launch follows the recent topping up of ehealth funds, to the tune of $233 million, in last week’s federal budget.

Seminars push health supply chain reform

May 14, 2012
National health supply chain reform will be a key topic discussed at seminars held by GS1 Australia and the National E-Health Transition Authority (NEHTA) in Melbourne and Sydney this month.
NEHTA Supply Chain Manager Mark Brommeyer says the seminars will focus on the introduction of medical supply chain management innovations, such as the National Product Catalogue (NPC), in public and private healthcare.

Why computers find it so hard to understand meaning

Konstantin Kakaes
May 14, 2012 - 12:00AM
Recently, on the eighth floor of a Washington office building, Rachael held her finger down on a Dell Streak touchscreen and asked Aziz whether he knew the village elder.
The handheld tablet beeped as if imitating R2-D2 and then said what sounded like, "Aya tai ahili che dev kali musha." Aziz replied in Pashto, and the Streak said in a monotone: "Yes, I know." Rachael asked: "Would you introduce me to him?" Aziz failed to understand the machine's translation (though he does speak English), so she asked again: "Could you introduce me to the village elder?" This time, there was success, after a fashion. Aziz, via the device, replied: "Yes, I can introduce myself to you." Aziz, who is at most middle-aged and was wearing a sweater vest, was not the village elder.

Apple ships first Leopard security update in nearly a year

No bug fixes for Mac OS X 10.5, but instead issues Flashback scrubber and disables outdated copies of Flash Player
Apple on Monday issued its first security-related update for OS X 10.5, or Leopard, in nearly a year, to disable long-outdated versions of Adobe's Flash Player.
Security Update 2012-003 does not patch any known vulnerabilities, but is instead a Leopard-specific version of what Apple released last week for OS X 10.6, or Snow Leopard, and the newer OS X 10.7, better known as Lion.
Like those updates, 2012-003 for Leopard removes versions of Flash Player older than Adobe issued that edition of Flash in November 2010. It was also the final version Apple delivered to its customers before it stopped maintaining Flash.

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