Monday, August 27, 2012

Weekly Australian Health IT Links – 27th August, 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 are some interesting news items this week. What surprises me is, again, all the different initiatives we are seeing outside the NEHRS / PCEHR program.
Clearly the Government deciding to help defray the time costs for GPs with the NEHRS is big as well - as is the Audit Reports on HealthSMART and Myki.
I especially liked this quote from the MyKi report:
“THE former state Labor government failed to properly investigate other smartcard ticket systems around the world when preparing to introduce myki, leading to a costly underestimation of the project's complexity, a state inquiry has heard.” Remind you of something?
And on HealthSMART this was a ripper:
“The proposal for Victoria's abandoned $500 million e-health system was cavalier and more of a concept than a properly developed business case, a senior bureaucrat says.”
Oh dear - it seems the lessons are never learnt!
Lastly - Vale Neil Armstrong. I remember the black and white pictures and more so the sense of awe at what had been done - as well as sense that most things were possible. I wonder have we lost our way a little since those heady days?
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Online chat offers new help for suicide prevention

Date August 23, 2012

Dan Harrison

A NEW service which uses online chat to prevent suicides is providing support to people in distress who are unwilling to use telephone counselling services.
Launching Lifeline's Online Crisis Support Chat service yesterday, the Federal Minister for Mental Health, Mark Butler, said the service would be of great benefit to men and younger people, who were less likely to seek help in person or over the phone, and people in areas where conventional services were not available. Four in five Australians were using the internet to seek health information, he said.
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Mater Health Services Uses InterSystems HealthShare to Create an eHealth Record for Mothers
Breakthrough Healthcare Information System, Meeting Federal EHR Standards, Was Delivered in Just Nine Months
SYDNEY, Aust. - August 23, 2012 - InterSystems Corporation, a global leader in software for connected care,  today announced that Mater Health Services has used the InterSystems HealthShare™ healthcare informatics platform to rapidly develop an eHealth Record for expectant mothers.
By offering an electronic alternative to the paper-based Pregnancy Health Record currently issued by Queensland Health to public maternity hospitals, the new system is already benefiting both patients and clinicians. In a recent example, when a pregnant woman was rushed to Mater's Pregnancy Assessment and Observation Unit, Mater staff were able to expedite her critical treatment by having immediate access to the patient's obstetric record and latest test results due to her private obstetrician electronically sharing the information through his practice system.
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InterSystems deployed to create eHealth records for mums

Queensland’s Mater Health Services has used a system from global healthcare systems provider, InterSystems, to rapidly develop an eHealth record for expectant mothers.
Mater's Chief Information Officer, Mal Thatcher, said that by offering an electronic alternative to the paper-based Pregnancy Health Record currently issued by Queensland Health to public maternity hospitals, the new system was already benefiting both patients and clinicians.
According to Thatcher, in a recent example, when a pregnant woman was rushed to Mater's Pregnancy Assessment and Observation Unit, Mater staffs were able to expedite her critical treatment by having immediate access to the patient's obstetric record and latest test results due to her private obstetrician electronically sharing the information through his practice system.
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Doctors agree to update practices to share e-health data

Date August 24, 2012

Mark Metherell

Mark Metherell is health correspondent

THE long-awaited e-health scheme has locked in the support of doctors, but full operation of the electronic record system is still months away.
The government has won the agreement of big doctors' groups, including the Australian Medical Association, to new arrangements that will allow doctors to claim as much as $100 from Medicare for collating health records with their patients. But as part of the agreement the government has also agreed to postpone the deadline for doctors to meet e-health capability requirements until next May, after originally proposing February.
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Government unveils $5m telehealth project in South Australia

The mental health project includes 100 new videoconferencing units.
A $5 million telehealth project aims to enhance delivery of mental health care in South Australia. The project, announced today, is funded by the Commonwealth and the South Australian government under the $20 million digital regions initiative.
The mental health project includes more than 100 new videoconferencing units to upgrade call and image quality for more than 80 sites around the state, the Department of Broadband, Communications and the Digital Economy said. The project aims to reduce patient travel time, enable online access to health services, connect patients with family members living far away and “deliver rount the clock emergency triage and liaison services,” the department said.
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HCN Launches Integration Framework for Medical Director

HCN Launches Integration Framework for Medical Director

Health Communication Network (HCN), the developers of market leading clinical software, Medical Director, have today announced the launch of an Integration Framework for Medical Director.  The launch will take place at the Hyatt in Sydney today.
The framework manifests as the MD Sidebar in Medical Director. Partner companies can now develop Widgets (applications) which can be downloaded by Medical Director customers from the Widget store.  The MD Sidebar will be launched to Medical Director customers in a November 2012 release.
Australia’s eHealth strategy has created a real need in the market for robust, supportable communication and information sharing mechanisms.  The Integration Interface launch today is about collaboration and creating a real opportunity for clinicians and health care organisations to improve this information sharing and through those mechanisms make a real difference in patient care.  On the other side of this is the time poor clinician who needs tools and information at their fingertips, it needs to be fast, secure and reliable. 
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BREAKING NEWS: MBS item for PCEHR

23 August, 2012 Megan Reynolds
The AMA has welcomed the government's announcement that doctors will be paid for transferring patients to the PCEHR scheme.
Full details of the new arrangements can be seen on the Medicare website here.
According to the site:
The time spent by a medical practitioner on the following activities may be counted towards the total consultation time:·
Reviewing a patient's clinical history, in the patient's file and/or the PCEHR, and preparing or updating a Shared Health Summary where it involves the exercise of clinical judgement about what aspects of the clinical history are relevant to inform ongoing management of the patient's care by other providers; or
Preparing an Event Summary for the episode of care.
Preparing or updating a Shared Health Summary and preparing an Event Summary are clinically relevant activities.  When either of these activities are undertaken with any form of patient history taking and/or the other clinically relevant activities that can form part of a consultation, the item that can be billed is the one with the time period that matches the total consultation time.
MBS rebates are not available for creating or updating a Shared Health Summary as a stand alone service.
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E-health billing gets green light

23rd Aug 2012
GPs have finally been given clear permission to bill Medicare for the time they spend organising a patient’s e-health record, with new explanatory notes added to the MBS that doctors’ groups have hailed as a breakthrough.
Health Minister Tanya Plibersek originally announced GPs would be able to bill for the preparation of shared health summaries on the new system, but the item number billed had to be justified on the basis of the complexity of the consultation.
Last night, speaking at the AMA’s annual parliamentary dinner in Canberra, the minister announced e-health billing would now be time-based instead and that the e-health PIP would be extended until May 2013.
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Doctors to be paid for e-health work

  • AAP
  • August 22, 2012 9:09PM
THE Gillard government has relented to a demand by doctors that they be paid for helping to set up patients' electronic health records.
Health Minister Tanya Plibersek announced on Wednesday that GPs will be able to receive Medicare payments for preparing shared health summaries and event summaries as part of a consultation.
"In deciding which item to bill, GPs will only have to consider the reasonable time it would take - not the complexity of the consultation," Ms Plibersek said in a statement.
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PCEHR infrastructure finished

The national infrastructure for the PCEHR has been completed, with the final components allowing doctors to upload and view ehealth records.
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GPs may be forced to use PCEHRs

21 August, 2012 Sarah Colyer
Federal bureaucrats have recommended mandating GPs’ use of the national e-health record system, after finding many senior GPs are opposed to the system.
The advice is contained in a report released under Freedom of Information this month, which was prepared by the Department of Health and Ageing last November before the system was ‘soft launched’ in July this year.
Based on a survey of 800 GPs, the report said most GPs were “generally positive” about the Personally Controlled Electronic Health Records Scheme (PCEHR), but that 21% remained “unconvinced”.
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Victoria takes e-health national

A Victorian government-funded electronic health service will be offered to every Australian with a chronic illness
A Victorian government-funded electronic health service will be offered to people with chronic illnesses across Australia, following the announcement that 10,000 patients had signed up for the service.
Victorian health minister David Davis announced that the Collaborative Care Cluster Australia (CCCA) is now a national program that “empowers patients to work collaboratively with their GPs, specialists, pharmacists and other healthcare professionals to manage their own health issues using a new online capability.”
Davis was referring to the CCCA’s Chronic Disease Management Network (cdmNET), an online system that links patients with their own care plan and helps an entire healthcare team share information.
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Chronic disease care goes online

21 August, 2012 Michael Woodhead
An online support site has been launched to help GPs caring for patients with chronic diseases such as diabetes.
Chronic Disease Management-Net (cdmNet), enables patients, GPs and allied healthcare professionals to develop care plans, share medical histories, test results, updates on patients’ conditions, send referrals, and set appointment reminders, says Professor Leon Piterman of Monash University.
 “What cdmNet has done is provide an efficient clinical information system that makes health records available and accessible electronically,” Professor Piterman said.
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New technology helps sufferers

TELECONFERENCING at Hervey Bay Hospital is helping combat breast cancer and manage its treatment.
Leading surgeon Clement Wong said new technology meant regional cancer sufferers had access to expert opinion without having to travel to larger centres.
"If you asked me what is the best sort of cancer to have I would have to say 'breast cancer'," Dr Wong said.
"Treatments now include surgery, radiography, chemotherapy and hormone treatments.
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Identifying Humans

Posted on August 24, 2012 by Grahame Grieve
The third requirement for interoperability is good identification policies. And the most common problem in healthcare identification is identifying people.
Identifying humans, especially patients, is stupefyingly hard. Even after too many years of healthcare interoperability, I still can’t believe how hard it is. One of the reasons it’s so hard to grasp is because as humans, we are intrinsically good at identifying other humans. But it just doesn’t scale when it comes to successfully identifying humans in distributed systems with more than a few people who must perform the identification.
Many people look to biometrics to solve this problem. The common candidates are finger prints, retinal patterns, some form of phenotyping and most of all, genetic sequences.  But all these suffer from problems (and see particularly http://www.schneier.com/essay-019.html).  Given the expense and reliability problems associated with biometric markers, most healthcare institutions rely on social identifiers. These typically are a selection taken from the candidates listed in the following table, which briefly discusses the issues associated with them.
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Sue Ieraci: IT doubts

THERE has been a lot of discussion recently about the Personally Controlled Electronic Health Record, particularly concerns about whether it is ready and who will manage it, privacy risks and potential errors.
However, overall there seems to be agreement that this is a step in the right direction.
It’s easy to get swept up in the enthusiasm for new technology. But can we be confident that the new is always better than the old? Is electronic always better than manual?
There are lessons from the live information system experiment that has been ongoing in Australian hospital emergency departments (EDs) since the early 1990s.
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HealthSMART system cavalier: Vic auditor

14:14 AEST Tue Aug 21 2012
The proposal for Victoria's abandoned $500 million e-health system was cavalier and more of a concept than a properly developed business case, a senior bureaucrat says.
The HealthSMART rollout began in 2003, costed at $360 million under the previous state Labor government, but is fully operational at just four health services across Victoria.
The coalition government scrapped it last May after $500 million had already been spent.
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Vic e-health system difficult: hospital

  • AAP
  • August 23, 2012 10:34AM
VICTORIA'S abandoned multi-million-dollar e-health system implemented in just a handful of hospitals was overly ambitious and has not improved patient safety, an inquiry has been told.
The HealthSMART rollout began in 2003, costed at $360 million, under the previous state Labor government, but is fully operational at just four health services across Victoria, including Melbourne's Royal Eye and Ear Hospital.
Hospital chief executive Ann Clark said it would have been better to have different information technology systems to suit individual hospitals but develop a set of common rules so information could be shared.
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ALP 'did not investigate myki problems' in planning stage

Date August 22, 2012

Adam Carey

THE former state Labor government failed to properly investigate other smartcard ticket systems around the world when preparing to introduce myki, leading to a costly underestimation of the project's complexity, a state inquiry has heard.
The myki ticket system was initially supposed to be running by March 2007, but more than five years later it is still being introduced at a total cost of $1.52 billion - more than half the cost of NASA's recent Mars mission.
Transport Ticketing Authority chief executive Bernie Carolan said the authority and the former government should have looked more closely at the problems other systems had struck. ''There wasn't so much effort, with hindsight, in taking jurisdictional soundings … either elsewhere in Australia or overseas to canvass the pitfalls of implementing a new smartcard system,'' Mr Carolan told a hearing at State Parliament.
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Melbourne researchers rewrite Big Bang theory

Date August 21, 2012 - 9:52AM
Melbourne researchers believe they may be on the brink of rewriting the history of the universe.
A paper being published in a US physics journal suggests it may be possible to view "cracks" in the universe that would support the theory of quantum graphity - considered to be the holy grail of physics.
The team of researchers from the University of Melbourne and RMIT say that, instead of thinking of the start of the universe as being a big bang, we should imagine it as a cooling of water into ice.
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Neil Armstrong, first man on the moon, dies at 82

Date: August 26, 2012 - 7:47AM
Tributes are flowing in for Neil Armstrong, the quiet, self-described nerdy engineer who became a global hero when he stepped on to the moon.
“As long as there are history books, Neil Armstrong will be included in them, remembered for taking humankind's first small step on a world beyond our own”
Armstrong died on Saturday aged 82 from complications following heart surgery earlier this month.
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Enjoy!
David.

8 comments:

Anonymous said...

So - overall VIC big government HealthSmart project failed. And these fools keep pouring Victorian taxpayers' money - squillions of dollars - into the national DOHA PCEHR NEHRS project - for what?

The Victorian Premier and Health Minister Davis should be telling us why?

Anonymous said...

not just Vic - every other state is struggling to fund previous Labor over spending and they continue to fund this huge white elephant!

Earl Hose said...

In 'Australian Story' last night, we were reminded by Nicola Roxon & Kevin Rudd of how difficult was their task of bringing more integration to Federal-State roles in health. Maybe they began at the wrong place, maybe they were swamped by the "big picture", maybe there were elements at play of sheer bloody-mindedness.
Whatever, it's instructive to read Atul Gawande's Big Med, his commentary in the LiveChat follow-up, then Cheesecake Factory Medicine in WSJ and then Joe Klein's The Wall Street Journal’s Cheesecake Fallacy.

Earl Hose said...

Do any e-health sites offer 2-factor authentication?

Paul Fitzgerald said...

@Earl, I don't believe any are at this point, but they will need to when the new privacy laws come in. I understand that they will become law as soon as next month when the Senate passes the legislation, then with a phase in period. I know a few vendors are looking at integrating security technology into their offering (we are talking to a couple now, but some of the big guys seem to have their heads in the sand.

Earl Hose said...

Thanks, Paul. My last experience with the Prescriber Shopping desk at Medicare was for them to ask my university of qualification, not exactly a secret question.
My GP complains that the local hospital will not release any information about his patients over the phone.
Recently, during a walk, we both smelled gas. I called the company to report it and he asked for my name, street address & a contact number. Maybe he was looking up his database at the same time to check whether it may have been a crank call. I was half expecting him to ask for the registration number of a vehicle that I own. It could have been an impersonator, of course, since all that info is in public domain.
I wonder how the new privacy regs will interfere with the free flow of patient details that are passed between practitioners during a telephone consultation. For example, when pathologist A phones surgeon B with results of a biopsy, will both be required to authenticate to each other?
Trevor

Paul Fitzgerald said...

Trevor, we could take this offline - paulf@meridienhealthcare.com, but in theory, yes, they should both be authenticated.

Anonymous said...

A Victorian government-funded electronic health service will be offered to every Australian with a chronic illness ...... CDMnet patients with chronic illnesses can access their care plan with their pharmacist in the pharmacy using a simple barcode.

Can someone explain what the pharmacist will do with this?

Will the system be profitable? In other words who will pay how much to CDMnet developers?