Monday, June 04, 2012

Weekly Australian Health IT Links – 4th 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

Two big things caught my eye this week. First we had the Senate Estimates Hearings on E-Health during the week - which I covered yesterday and second we had announcement of long term continuing support for SA Health’s E-Health Program.
The top link is also important as it goes to helping, over time, to making sure we have the best tools for our practitioners to use in delivering care. To those using systems I would encourage getting involved.
Finally there are all sorts of interesting things going on at the periphery of e-Health that I thought were worth linking as technology impacts emerge in all sorts of unexpected ways.
-----

Welcome to the website for the TechWatch Study

We are tracking computer problems that affect the safety of Australian general practice
The TechWatch Study is the world’s first study of critical incidents specifically involving information technology and patient safety in general practice. Information technology has many benefits for clinical medicine. But problems with computer use can introduce new errors that affect the safety and quality of clinical care and may risk patient harm.
Over 4000 general practitioners from across Australia have been invited to join the TechWatch Study and help identify and track safety and quality issues arising from the use of computers in general practice.
-----

System not ready for e-Health, say GPs

29/05/2012
Emma Connors
Doctors have called on the government to delay the roll-out of electronic health records, warning the technology is not ready and the business case for GPs is non-existent.
“We share the vision but the process and the timing is terrible. If general practices and hospitals won’t be able to use it by July 1, why this headlong rush?” said Australian Medical Association president Steve Hambleton.
“If it needs some more stimulation to get it to critical mass, then let’s do that. Otherwise we will be relying solely on individuals who are motivated and prepared to pay – and that is not going to work,” he said.
-----

Official Australian e-health info page defaced

infEktard by anti-government, anti-monopoly protestors.
  • Liam Tung (CSO Online (Australia))
  • 30 May, 2012 11:41
An apparent trio of ‘hackers’ operating under the LatinHackTeam banner has claimed the Australian Government’s Department of Health and Ageing eHealth education site as its 13,789th ‘defacement‘ victim.
The group’s latest record on Zone-H, a site that archives website vandalisations, is the department’s eHealth education site, publicleanring.ehealth.gov.au.
The site is a learning portal aimed at preparing consumers and healthcare professionals for the July 2012 launch of eHealth records in Australia.
-----

Health reveals e-health record slippages

Online registration won't meet 1 July deadline.

Delays in core aspects of the personally controlled electronic health record initiative could prevent consumers and practitioners from using the e-health records before September this year.
The $628.3 million project was expected to deliver e-health records from 1 July.
But Department of Health and Ageing deputy secretary Rosemary Huxtable told a Senate estimates hearing this week that consumers would only be able to register for a personal record in Medicare offices and via phone from that date.
-----

Stay informed

An eHealth record will be more convenient, save you time, and help you manage your health better.
If you would like to be reminded when registrations open, or to receive more information please click here
-----

Software Developers start achieving PCEHR Connectivity

Fourteen software houses are well underway in achieving PCEHR connectivity after attending a Master Class hosted by NEHTA on 17 May.
The workshop was designed so that NEHTA could work closely with a range of software developers helping them to achieve integration with the system.  Over twenty representatives were in attendance on 17 May and were taken through a range of web services from certification to complete integration with the system.
-----

Region GPs say e-health no bitter pill

Posted May 29, 2012 04:57:34
The Southern General Practice Network says doctors in the New South Wales south east are prepared for a new online medical system despite concerns from sections in the profession.
A National e-health records system is due to be rolled out in five weeks.
The Australian Medical Association's president, Steve Hambleton, yesterday said many GPs are not geared up for the system and do not know how to use it.
-----

Poorest and sickest lack access to e-health

28 May, 2012 Michael Woodhead
The poorest, sickest and most marginalised Australians lack access to online and digital health information and may be further disadvantaged as the government promotes e-health programs such as the PCEHR, a study in the Australian Health Review (online May 25) suggests.
A focus group survey of 80 people from low income backgrounds in South Australia found that their access to computers, the Internet and mobile phones was often limited by their circumstances.
-----

Digital technology use among disadvantaged Australians

Implications for equitable consumer participation in digitally-mediated communication and information exchange with health services

Read the full text

25 May 2012
The ability to access information and communication technologies (ICTs), particularly via the Internet and mobile phones, is increasingly vital to full participation in economic, social, and political life.
This is particularly so as institutions move towards greater ICT-mediated provision of services, support and Journal compilation. There is also increasing focus on encouraging digitally-mediated consumer-to-provider and consumer-to-consumer connection in the health sector (within ‘e-health’), and more recently through ‘m-health’ (via mobile devices, including mobile phones).
-----

South Australia plans three new e-health systems

Public service shrinks.

The South Australia Government will spent $191.7 million to develop and roll out three new electronic healthcare systems in a bid to deliver a single access point for patient records and medical imaging.
Despite an otherwise tight 2012-2013 budget for the state, the government committed to developing a "digital health system" that tied together patient records and test results from disparate systems and hospitals.
Funding for the programs includes $30.4 million over two years toward a new digital system for pathology testing, providing a state-wide storage system for all test results.
-----

SA pledges $192m for e-health systems

By Michael Lee, ZDNet.com.au on June 1st, 2012
South Australia's journey into e-health has been all but cemented, with the state setting aside $191.7 million in funding to upgrade and implement IT healthcare systems.
South Australia Health secured $142.6 million over the next 10 years to roll out its Enterprise Patient Administration System (EPAS).
The funding, revealed in the state's 2012-13 Budget, will allow EPAS to be used in all metropolitan public hospitals, GP Plus Centres and two of the state's country general hospitals. The scope of the system has changed since the government went to tender at the beginning of 2010. At that time, the system was meant to include eight metropolitan hospitals, multiple community clinics, 63 country hospitals and the state ambulance service.
-----

South Australia receives a $191.7m e-health funding boost

Three new e-health systems in South Australia will receive funding from the SA government
E-health has received an investment boost in South Australia, with a total of $191.7 million to be spent across three major e-health projects in the state.
The initiative was announced in yesterday’s SA budget.
The Enterprise Patient Administration System (EPAS) makes up the bulk of the SA e-health budget spend, with $142.6 million to be invested over 10 years.
-----

Healthlink to be rolled out in Canada

System that enables GPs to send referrals to private specialists has gone live in Canada
By Randal Jackson | Wellington | Thursday, 31 May, 2012
HealthLink’s GP-specialist e-referral system has gone live in Canada.
The system enables GPs to send referrals to private specialists. It has been rolled out at four medical practices in Kelowna, British Colombia.
“Following the successful trial in Kelowna, we hope to implement the system right across Canada as swiftly as we can,” says HealthLink Canada business development manager Mark Douglas.
“There is a significant demand for this kind of service, and we’ve had a lot of encouragement from medical practices, provincial health authorities and other interested parties.”
-----

GP services and jobs to be cut with Medicare Locals

29 May, 2012 Michael Woodhead
The Federal government is said to have ignored pleas from a division about the loss of GP services and jobs with the transition to Medicare Locals.
The Melbourne-based  Greater Eastern Primary Health (formerly Knox Division)  says current primary care services such as mental health nurse referral, psychology support and diabetes prevention programs are at risk because of lack of funding following  the establishment of the Eastern Metropolitan Medicare Local on 1 July 2012.
-----

Division to run parallel with ML

29th May 2012
Byron Kaye 
A VICTORIAN division won a Medicare Local contract then decided to keep the division running alongside it because it did not believe its own ML would represent GP interests at current levels.
PivotWest Division told MO it has been surviving on saved non-core funding since it switched its programs and staff to the Macedon Ranges and North Western Melbourne ML, for which it led the successful tender, in January.
The division is now considering a move to offer fee based GP-specific services such as help with accreditation and IT support as well as GP ‘quality of life’ initiatives to its 300 member GPs.
-----

Sprogis’ promise as interim AMLA chair: I’ll fight for more ML funds

29th May 2012
AGPN director Dr Arn Sprogis has pledged to campaign for every possible aspect of primary care to be handed to Medicare Locals – and quickly – after being appointed interim chair of its new organisation, Australian Medicare Local Alliance (AMLA).
Dr Sprogis, who previously criticised AGPN for failing to convince Canberra to commit more funding to MLs, said he would instil a sense of “urgency” in the federal government and in the health department as he rallied them to “decentralise” control of primary care and shift it into MLs.
He said his first move would be to “search through all the expenditures in the primary health care area and ask ‘what is the good reason not to hand these things over?’”
-----

Broadband to help palliative care

The national network aims to give people the choice to spend their final days, or months, at home. Beverley Head reports.
Aged and palliative care are two of the key focus areas for a $20.6 million pilot program announced by the federal government in April. The national broadband network enabled Telehealth Pilots Program will provide funding for innovative schemes over the next two years.
The government hopes that the ability to harness technology to support high quality palliative care in home or aged care settings could deliver massive economic benefits, while responding to patient preferences regarding their ability to die in their own homes.
-----

e-Records database slated for a slow, incomplete start

Fran Molloy
May 28, 2012 - 9:23AM
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.
-----

PCEHR safety report identifies "acceptable risks"

30 May, 2012 Michael Woodhead
The PCEHR system needs fine tuning to fix several clinical safety risks such as the potential for inappropriate access and a patient’s records becoming  inaccessible, a NEHTA review has found. 
A Clinical Safety Case Report concluded there were no major clinical hazards with the PCEHR Release 1a, but that there were some “tolerable” risks to be addressed.
One concern identified in the review was that records might be inappropriately viewed or modified because authorisation for PCEHR access was an organisational responsibility, whereas an ideal system would have individual identification certificates. The review also raised concerns that only organisations rather than individual practitioners were enabled to attest to the validity of clinical documents.
-----

Inviting you to the FHIR connectathon

Posted on May 27, 2012 by Grahame Grieve
On Saturday September 8, we will be holding a FHIR connectathon in Baltimore, MD (USA) as a prelude to the next HL7 Working Group Meeting, where we’ll practice interoperability using FHIR.
It’s still early in the development cycle, and no one’s going to be using FHIR for real clinical systems yet… but we already have full implementations of the specification. A connectathon will be a way to find out exactly whether FHIR is as easy and practical as we intend to be, and to learn how to make it even easier, if possible. Also, it’s our chance to start building an enthusiastic user community around FHIR.  We’re going to be testing implementations around RESTful use of Profile and person – servers, mobile clients, pub/sub using Atom (i.e. mashing up blogs and operational registries), and especially focused on a clinical template registry infrastructure. The exact details are still being clarified.
-----

Emergency workers scan QR codes to quickly access health information

A year-long test between government agencies and private company, Lifesquare, is going on in Marin County, California.
QR codes are being used for more than just advertisements in Marin County, California. There, paramedics hope the stickers could help save lives in emergency situations.
Lifesquare, a Silicon Valley start-up, has partnered with two emergency response agencies in Marin County to run a year-long pilot program. Lifesquare wants residents to input personal information about their medications into its website, then place corresponding QR code stickers where emergency responders can scan them with an iPhone. The secure link from the sticker will then provide paramedics and firefighters with information they need during a medical response call.
-----

The 'outrageous' surgeon

June 1, 2012 - 1:16PM
Suspended animation. Mind control. Operations performed over the internet. Dr Richard Satava, pioneer of 'outrageous surgery', believes all this - and much more - will soon be possible. Alex Hannaford reports.
You have 2.5 billion heart beats in a lifetime. Imagine if you could choose how to spend them. Imagine being able to control an artificial limb or even an external machine - a car, perhaps - with your brain.
Imagine a battlefield where a solider, mortally wounded, is given an injection to put him into suspended animation, flown to a hospital thousands of miles away, operated on, and then brought back to life.
-----

Tool-wielding robots crawl in bodies for surgery

May 30, 2012 - 6:55AM
Imagine a tiny snake robot crawling through your body, helping a surgeon identify diseases and perform operations.
It's not science fiction. Scientists and doctors are using the creeping metallic tools to perform surgery on hearts, prostate cancer, and other diseased organs. The snakebots carry tiny cameras, scissors and forceps, and even more advanced sensors are in the works. For now, they're powered by tethers that humans control. But experts say the day is coming when some robots will roam the body on their own.
"It won't be very long before we have robots that are nanobots, meaning they will actually be inside the body without tethers," said Dr. Michael Argenziano, the chief of adult cardiac surgery at New York-Presbyterian Hospital and Columbia University Medical Centre in New York.
-----

Smart technologies for older people

A systematic literature review of smart technologies that promote health and wellbeing of older people living at home
23 May 2012
Addressing the challenges faced by an ageing population, this report discusses how smart technologies can support older people to remain in their homes.
Australia has an ageing population. In 1901 the average life expectancy in Australia was 47 years. By 2025 it will be over 80. In 2050, 25% of Australians will be aged over 65, with 5% over 85. The growing number of older Australians leads to increased demand for aged services in health, social support, transport and housing.
-----

Technology skills essential in project management

by: ACS: Nick Tate
From: The Australian
May 22, 2012 12:00AM
TWO experts, Gene Kim, founder and former chief technology officer of Tripwire and co-author of an upcoming book, When IT Fails: The Novel, and Mike Orzen, who wrote Lean IT, have estimated that the cost of failed IT projects is $3 trillion a year.
This huge figure is perhaps put in perspective if we consider that the estimated cost of cybercrime last year was $109 billion. If these figures are correct, IT project failures cost 27 times as much as cybercrime.
We are all aware of the many programs to tackle cybercrime, but project failures sometimes seem to produce a collective shrug of the shoulders. Why is this?
-----

ACCC in a twist to banish network's rivals

Peter Martin
May 30, 2012
The Optus high-speed cable internet network is a national asset. Comprising 25,000 kilometres of coaxial cable strung across 550,000 poles in Sydney, Melbourne and Brisbane, it provided Telstra with its first genuine competition, putting its own wires directly into half a million homes.
Telstra fought back with Foxtel, Optus got burnt and has probably never recovered the cost of stringing the cables. But from an economic point of view, what's important is that the asset exists. Its costs have been sunk. What Optus has now is an asset that costs relatively little to operate and can deliver peak download speeds of 100 megabits per second - far faster anything on Telstra's copper wires.
Right now it has 496,000 customers. It is within connecting distance of another one million, meaning that for very little cost, Optus or a buyer of the network could provide a very fast, very cheap internet service to as many as 1.4 million households - a service far faster than ADSL.
-----

Rat cure offers hope for spinal cord recovery

PARALYSED rats have been taught to walk, run and climb after treatment with chemical stimulants and electric signals, opening the prospect of repairing the human spinal cord.
The rats learned to walk when placed in a support harness, and moved their hind legs to reach a chocolate treat, a study to be published today in Science says.
Chemicals that trigger cell responses in the spinal column were injected into the rats to replace the neurotransmitters released by the brainstem in healthy rats.
-----

Jet-injected drugs may mean the end of needles

Sarah Kessler
May 28, 2012 - 9:13AM
MIT scientists are developing a needle-less injection that could make getting a flu shot as painless as a mosquito bite.
The device shoots a tiny, high-pressure jet of medicine through the skin as fast as the speed of sound.
According to the Centres of Disease Control and Prevention, hospital healthcare workers incur about 385,000 needle-related injuries every year. Meanwhile, fear or discomfort from needles prevents many patients from complying with doctors’ orders.
-----

The new underbelly

Eileen Ormsby
June 1, 2012 - 12:28AM
It's called the Dark Web and once you are in you can buy people, drugs, guns and even have someone killed. The problem is: what can law enforcers do about it? 
Deep in cyberspace is a web of private networks hosting sites that Google will never find and videos that YouTube will never play. Within this web, drugs and guns are bought and sold, hitmen advertise their services, hackers can be hired to attack an enemy's computer and pornographic images to satisfy the most depraved tastes can be downloaded.
It is a place where freedom of speech is absolute and unconstrained. It is the Dark Web, the parallel internet that can be found only through encrypted private networks, unknown by many and accessed by few.
-----
Enjoy!
David.

2 comments:

Cris Kerr said...

re PCEHR safety report identifies "acceptable risks", 30 May, 2012 Michael Woodhead

My understanding with regard ' ... Unauthorised Access and Healthcare Provider Authentication (Section 8.1.4.1 and 8.1.4.5) ... ' is...
http://www.nehta.gov.au/component/docman/doc_download/1491-clinical-safety-case-report-pcehr-release-1a

'Inappropriate access' risks associated with individual ehealth records remain, and one of those risks is due to the plan for the ehealth system to record access by Healthcare Provider Identifier - Organisation (HPI-O) only - because the ehealth system will not record an audit trail of individual healthcare provider (HPI-I) access.

Patients will be able to view an audit trail of healthcare provider organisation (HPI-O) access. Their audit trail will not reveal who or how many individual healthcare providers (HPI-I) within each organisation (eg hospitals, large GP practice groups, pathology providers, etc) have accessed their ehealth record.

The recommendation infers healthcare provider organisations are responsible for their own internal policies and procedures associated with individuals accessing ehealth records, monitoring/recording access, and complying with legislated access restrictions.

In my Feedback on the Draft Concept of Operations, 31 May 2011 I raised concern about this privacy and security issue. I also proposed an example privacy and security framework based on an hierarchical structure underpinning individual access:
http://yourhealth.gov.au/internet/yourhealth/blog.nsf/247FAB32617E207FCA2578DA00084E37/$FILE/Case%20Health%20submission.doc

###

Unauthorised Access and Healthcare Provider Authentication (Section 8.1.4.1 and 8.1.4.5)

There is a risk that the PCEHR could be accessed inappropriately with the possibility of a PCEHR document being withdrawn or a new document posted, that may result in harm to an individual. The likelihood of such a risk will be impacted by specific implementations.

This is due to the healthcare provider authentication/authorisation to access the PCEHR being made an organisational responsibility. Therefore it is dependent on an organisation and the connecting clinical systems to establish and implement internal management controls eg. Role based access to verify, provide and maintain access for individuals working in an organisation. Version 1.1 11/4/12 Clinical Safety Case Report PCEHR Release 1a Uncontrolled if printed Page 7 of 39

http://www.nehta.gov.au/component/docman/doc_download/1491-clinical-safety-case-report-pcehr-release-1a
http://www.6minutes.com.au/news/latest-news/pcehr-safety-report-identifies-acceptable-risks

Anonymous said...

and where is it defined as to how big or small an 'organisation' is? So it could even be a group of hospitals, not just one, with thousands of staff? "Acceptable Risk" - that's debatable.