Monday, June 25, 2012

Weekly Australian Health IT Links – 25th June, 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

There was really only one bit of news this week - and that was the passage through both houses of the PCEHR legislation.
Now all we have to just wait and see what is delivered in about a week or so and to see, after a year or so if there is any measurable impact on the health of the Australian populace.
I would be interested to hear from readers any suggestions for metrics we could use to assess the success or not of the overall program.

Plotting a path to the PCEHR

Electronic health records go “live” on 1 July. Will everything change?
The much trumpeted personally controlled electronic health record (PCEHR) officially launches on 1 July, but if you’re feeling a little underprepared, you’re not alone.
The $467 million project to provide a seamless source of patient health data has hit a few obstacles along the way.
As a result the PCEHR  “go-live” date is likely to pass by quietly and without fanfare - something most medical practitioners will be grateful for.
There are a few hoops to jump through to participate in the PCEHR: once a practice is registered, doctors will need to familiarise themselves with the web-based system, upgrade their clinical software to integrate with the system and, ultimately, create and manage patients’ shared health summaries.

Defiant doctors force e-Health backdown on PCEHR liability

TWO weeks before the introduction of the Gillard government's $1 billion e-Health scheme not one medical practice has signed up to use it, forcing Canberra to back down on a move to compel doctors to accept full liability for problems with the initiative.
The Department of Health and Ageing this week agreed to remove contentious contract conditions that would have made doctors liable if one of their employees leaked information contained in a patient's electronic health record.
It has also amended a clause that would have allowed government officials to raid surgeries and remove computers and records when a breach of the e-Health system was being investigated.

Medical insurers still refusing to endorse e-health records

18th Jun 2012
A HEALTH department backdown has freed GPs of liability for “compromised or hacked” e-health records but the government is still demanding GPs obtain permission from the author of every document they upload to the system before doing so.
The issues of liability and intellectual property management are the main impediments to medical insurers endorsing the participation agreement practices will be required to sign in order to use the system.
MDA National president Professor Julian Rait told MO the department had agreed last week to waive its original demand that practices accept liability for the security of the system but had yet to provide a solution to the problem of how to handle intellectual property issues.
“Under the PCEHR bill… a GP would have to obtain consent from the author [of a specialist report, for example] before uploading any document to the system, which would be an absurd level of work,” he said.
“We don’t have an easy answer for [how intellectual property issues should be resolved], but until it is worked out, we won’t recommend our clients be involved.”

Last minute talks trigger 'breakthrough' in e-heath endorsement

21st Jun 2012
DOCTORS' groups and MDOs are ready to endorse the government’s e-health records contract almost three months after MO’s report on the first draft of the contract sparked outrage across the profession.
In April, MO reported AMA secretary general Francis Sullivan had warned the department that the first draft of the participation agreement was so onerous it would “deter every medical practice in Australia from participating”.
The draft agreement required practices using the system to assume all legal liability and to grant government officials unrestricted access to their premises and records, while GPs were required to obtain permission from the author of every document they uploaded.

E-Health: are we ready for this brave new world?

On July 1, Australia is going to "change the world", "dive in the sand" and "realise the dream".
The date represents "our big chance to make a difference", and apparently we have to compare it to "putting a man on the moon". Exciting, isn't it? Surely we are finally going to Mars, initiate world peace or establish brotherhood amongst men? Or not, of course.
When Peter Fleming uttered these inspirational words last August, he was unfortunately not talking about finding a cure for cancer, but about the start of a national electronic health system in Australia.

e-health record grinds to July deadline

Ten days from now Australians should be able to sign up for a personally controlled electronic health record – the centrepiece of the Federal government’s e-health programme which has already cost it $467 million. However the peak body representing GPs in Australia has yet to finalise the terms and conditions for healthcare providers actually using the records and a $23 million key security system being built by IBM won’t be ready by 1 July.
The Government has always said that from 1 July 2012 Australians would be able to opt in and sign up to have their own PCEHR. While that deadline is still in place it now seems likely that while Australians will be able to register for a PCEHR, they won’t be able to do much more.

E-health record service delayed by incomplete infrastructure

PLANS for Health Minister Tanya Plibersek to mark the start of the $1.1 billion e-health record service are on hold, as key parts of the system are not ready for the much-feted July 1 launch.
Sources who declined to be named say a ceremony planned at St Vincent's Hospital in Sydney on Monday, July 2 -- the first working day of the new system -- has been cancelled.
The minister's office was tight-lipped when The Australian asked whether the event had been postponed to a later date.
"We look forward to the launch of e-health, an important government reform that will cut down on medical errors and mean patients won't have to repeat their medical history every time they see a new doctor," her spokesman said.

Jobs may go as Health Solutions Group abandoned by Microsoft in favour of joint venture

MICROSOFT has confirmed it is ditching the Australian operation of its Health Solutions Group as it shifts gears to a joint venture with General Electric.
The joint venture, announced in the US last year, aims to offer platform support along with system-wide crunching of data to assist organisations manage health data across populations.
Microsoft's Health Solutions Group in contrast mainly sought to sell software tools aimed at "people, clinics, hospitals, research institutions, and governments", according to Microsoft's website.

E-health 'bank-strength' secure, but online registration scrapped

20th Jun 2012
THE government has assured consumers the national e-health record system would feature “bank-strength” security, but grudgingly admitted online registration has been scrapped, as its e-health legislation passed the Senate last night.
Coalition senators supported the legislation but raised a number of concerns about the implementation of the system and the security of patient information.
Parliamentary Secretary for Disabilities and Carers Senator Jan McLucas assured consumers’ privacy and security were “fundamental to the effectiveness of an e-health record system”, which she said would have “bank-strength security features, including extremely strong encryption and firewalls”.

E-health records' security at risk

Fran Molloy
June 19, 2012 - 11:18AM
The national electronic health record database to be launched on July 1 has both medical and security experts calling for better e-health controls.
Australia has no co-ordinated approach to e-health safety and security – and with the national Personally Controlled Electronic Health Record (PCEHR) just weeks away, the risk of a safety crisis is growing daily.
People who choose to register for a PCEHR from July 1 will have access to a range of their medical data from Medicare, and over time also doctor's summaries, pathology results, scans and prescriptions.

E-health records laws pass Parliament

BILLS governing the operation of the personally controlled e-health record system have been passed just 10 days before the scheme is set to go-live, albeit in a limited capacity.
After the PCEHR Bills were passed by the Senate with 32 amendments on Monday, the lower house has today agreed to the changes.
Health Minister Tanya Plibersek said it was "a once in a generation opportunity to deliver these important reforms" and "make it easier for consumers to receive the right care when and where they need it".
Coalition e-health spokesman Andrew Southcott said the opposition would not oppose the "sensible" amendments, which arose from the Senate inquiry into the PCEHR Bills requested by the opposition.

E-health records laws pass Parliament

  • From: AAP
  • June 19, 2012 8:52PM
PATIENTS will no longer have to repeatedly re-tell their medical histories to doctors after legislation passed Parliament to set up an electronic health record system.
The Federal Government says the system will bring the management of health records into the 21st century and provide life saving information in emergencies.
The legislation passed the Senate this evening with the support of the Coalition despite the concerns about privacy from some Opposition senators.

E-health laws pass parliament

By AAP, on June 20th, 2012
The legislation required to set up the government's planned personally controlled electronic health record (PCEHR) system passed parliament yesterday.
The Federal Government said that the system will bring the management of health records into the 21st century, and will provide life-saving information in emergencies.
The legislation passed the Senate with the support of the Coalition, despite concerns about privacy from some opposition senators.
The system aims to reduce the number of hospital admissions from medication errors, which equate to around 190,000 per year, as well as cutting down on medical errors because of inadequate patient information.

PCEHR passes Senate after sides lay cards on table

The Australian Senate has passed legislation necessary for the PCEHR to be instituted as part of Australia’s health system. The go ahead followed a debate where Labor, Opposition and Greens Senators summarised their stance on the major national ehealth reform.
Labor senator Carol Brown restated the need for the PCEHR as part of an “accountable, affordable and sustainable” future for healthcare, while senator Jan McLucas defended the development of Labor’s handling of implementation, saying there had been “extensive consultation with clinicians, consumers and the health IT industry.”

Website to help paramedics avoid hospital bottlenecks

Updated June 21, 2012 07:55:21
SA Health will set up a real-time monitoring system aimed at improving the flow of patients from ambulances to hospital emergency departments.
It will advise on the number of patients being treated, average waiting times and the occupancy and expected discharge times for inpatient beds.
The website will go live on Friday and is similar to other emergency department and inpatient information available electronically.

AMA calls for e-Health penalty delay until 2014

THE withdrawal of incentive payments to doctors who fail to sign up to the e-Health scheme must be delayed until 2014, says the AMA because of the multiple problems dogging the scheme ahead of its July 1 launch date.
Australian Medical Association president Dr Steve Hambleton said as things stood doctors would be penalised for failing to sign up to a system that is far from operational.
Eleven days before the launch of the new system that will see patient medical records digitalised, legislation underpinning it is still before the parliament.
The system needed to authenticate the identity of doctors using it is not ready and no doctors are signed up to use it.

Call to delay cuts to e-health PIP

20 June, 2012 AAP and Paul Smith
Moves to pull up to $50,000 in funding from general practices who do not sign up to the personally controlled electronic health record (PCEHR) should be shelved because of the delays blighting its rollout, the AMA has urged.
The Federal Government announced in the budget that practices would not receive any e-health Practice Incentives Program payments from next February unless their IT infrastructure was compatible with the $467 million PCEHR system. About 4200 practices currently claim the incentives.

e-Records database slated for a slow, incomplete start

Fran Molloy
May 28, 2012
The July 1 launch of the national Personally Controlled Electronic Health Record (PCEHR) is likely to be more fizz than fireworks, with only data from Medicare available to new registrants.
More functionality is expected later in the year, provided the government-funded National eHealth Transition Authority (NEHTA) can placate various interest groups including the doctor's lobby group Australian Medical Association (AMA).
"Given what was attempted in the timeframe, it wasn't reasonable to expect a sophisticated solution would be available by July 1," says Medical Software Industry Association (MSIA) President, Jon Hughes.

E-health boost in Tassie bail-out

By Suzanne Tindal, on June 18th, 2012 
As part of a $325 million rescue package for the Tasmanian health system, Health Minister Tanya Plibersek has pledged $36.8 million to roll out the government's planned personally controlled electronic health record system.
The Federal Government decided to reach out a helping hand to Tasmania, because the state's system wasn't coping with its older population and higher rates of chronic disease. Funding has been found for areas of need, including additional surgery facilities, chronic disease management and training, as well as e-health.

$11.5 billion PCEHR benefit conservative: Deloitte

The organisation responsible for the federal government's economic modelling of the personally controlled electronic health record (PCEHR) has confirmed the business case for the national system is strong.
Adam Powick, lead partner of Deloitte Australia's Consulting practice, told the recently released figure of $11.5 billion in benefit to Australia by 2025 is an estimate based on global research and robust economic modelling.

Victorian Government moves to fix Labor's $1.44b mistake

The Victorian Government has introduced the Victorian Information and Communications Technology Advisory Committee to provide advice on a new ICT strategy.
The Victorian Government has moved to fixed key weaknesses in the state's ICT strategy following a critical report by the auditor-general on Victoria's ICT frameworks and policies.
The revised strategy follows the November 2011 release of the Victorian Ombudsman's report into the state's ICT which slammed the then Labor government's management of ICT projects and investments.
Assistant treasurer, Gordon Rich-Phillips, said the revised ICT strategy will align processes across departments with a clear set of governance, accountability and direction.

New Vic Govt strategy to end IT disasters

By Suzanne Tindal, on June 21st, 2012
The Victorian Government has started work on a whole-of-government IT strategy, in an attempt to avoid wasting taxpayers' money on over-budget projects that have missed deadlines.
"The previous Labor government adopted a piecemeal approach to ICT that saw at least $1.44 billion of taxpayers' money wasted in cost blowouts on projects like HealthSMART, Myki and the LEAP database," Victorian Minister for Technology Gordon Rich-Phillips said.

Coalition to support e-health bills in Senate

THE opposition will support passage of the Gillard government's legislation for its $1.1 billion personally controlled e-health record system in the Senate, but expects a debate over amendments to be tabled today.
Opposition e-health spokesman Andrew Southcott said the Coalition would not vote against the legislation in the Senate, "consistent with what we did in the House of Representatives".
He told The Australian: "We are supporting this legislation, but we do think it should be debated.

Hospital league tables likely within months

THE National Health Performance Authority's chief Diane Watson says she's determined to name and shame underperforming hospitals, and will start publishing hospital league tables and mortality rates later this year.
"Our role is to create competition among the leading hospitals about who will be No 1," she tells Weekend Health.
"I want to point the community to where they need to work with organisations (hospitals and Medicare locals) on lifting their game."
Watson was appointed to head the new watchdog a week ago and her work at the Health Council of Canada and the NSW Bureau of Health Information makes her an expert on how health organisations try to dodge accountability.

Evidence-based medicine

19th Jun 2012
This week’s Update explores the efficacy of evidence-based medicine in clinical practice.
What is the evidence for evidence-based medicine?
Unfortunately, this is a very common question and one that is asked most often by a cynical member of the audience looking to score a point at an evidence-based medicine (EBM)
On the other hand, answering this question is a good chance to highlight the main issues involved in this topic.

Microsoft announces its own tablet computer at keynote in Los Angeles

MICROSOFT has announced it will release its own line of tablet computers at a keynote event held in Los Angeles this morning.
The new line of tablets is called Surface, and will come in ARM and Intel processor versions with the Intel version sporting a Core i5 Ivy Bridge processor.
The Surface has a 16x9 inch format, a magnesium case, USB 2.0, weighs 675 grams and is 9.3 mm thick.
It has a 1080p full HD display and has two digitisers, one for touch and one for digital ink.
It also has a unique multi-touch keyboard cover called the touch cover that snaps to the device like an iPad cover, but has an integrated keyboard. The touch cover includes an accelerometer that can deactivate the keyboard when it is folded back.


Anonymous said...

"I would be interested to hear from readers any suggestions for metrics we could use to assess the success or not of the overall program."

Number of consumers registered.
Number of providers registered.
Number of clinical documents posted by providers, and by consumers.
Number of clinical documents viewed by providers.
Number of health summaries posted.

What about a survey of providers /consumers after viewing a record - e.g. did you find this viewing useful? etc

Anonymous said...

Some other metrics should be often the PCEHR is useful and how often it has bad data:

- number of documents retrieved
- number of summaries retrieved
- number of accesses for patients where PCEHR was not found
- number of accesses where PCEHR contained no useful information
- number of documents associated with the wrong patient
- number of views of documents associated with the wrong patient
- time to repair of documents associated with the wrong patient
- number of documents that contain inaccurate or incorrect data
- number of documents that contain obsolete data
- time to repair documents that contain inaccurate, incorrect or obsolete data

Cris Kerr said...

The success of the program should be assessed against a continuous cycle of measurable improvement in public health, medical, and research outcomes through prioritizing and directing national public health and medical research funding to where it can contribute the greatest value to;

 improving long term quality and sustainability of life, to;

 minimize unnecessary suffering, and;

 fulfil unmet public health and medical research needs;

to enhance national productivity and economic sustainability of government subsidized public health and medical research, treatment and care.