Monday, September 03, 2012

Weekly Australian Health IT Links – 3rd September, 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

A surprisingly busy week as I come to review it.
The announcement of a national dental scheme was the biggie for me - but I really do wonder what will be cut to pay for it. Any bets on the PCEHR when the scheme starts in 2014.

No axe in hunt for health savings: govt

  • AAP
  • August 30, 2012 8:01AM
HEALTH Minister Tanya Plibersek has promised the federal government won't be taking the axe to the health budget to find cash for a landmark dental scheme.
Children and disadvantaged adults will have better access to government-funded dental care from 2014 under a $4.1 billion package announced by the Gillard government.
The deal has been welcomed by most health experts, who've previously criticised Labor for ignoring teeth while boosting funding for aged care and the mentally ill.
Other than that the item that most caught my eye was the scale of information leak from the UK NHS. One wonders just what we will see when there is any substantial use of the PCEHR.
Does anyone know the present level of information leaks is from the Australian Health System? I have to say I have never seen any information.
Setting up a system where investigators can snoop on GP electronic records does not fill one with a high degree of confidence.

UK data-blurt cockups soared 1,000 PER CENT over last five years

That was supposed to be a secret but it got out
The number of times Brits' sensitive data has been lost or leaked in the UK has risen 1,000 per cent over the past five years. Councils recorded the biggest increase in breaches of data protection law, according to figures obtained by a Freedom of Information Act request.
The stats from the Information Commissioner’s Office (ICO) revealed a huge jump in the number of self-reported bungles each year since 2007. Local government data law breaches increased by 1,609 per cent over that period of time. The average increase across Blighty's private and public sectors is 1,014 per cent.

Bionic eye goes live in world first by Australian researchers

Date August 30, 2012 - 9:03AM

Kate Hagan

A blind woman can now see spots of light after being implanted with an early prototype bionic eye, confirming the potential of the world-first technology.
Australian researchers have been working for years to develop the bionic eye, in which electrodes are inserted into the retina of vision-impaired patients.
Dianne Ashworth, 54, was the first patient fitted with the device in surgery at the Royal Victorian Eye and Ear Hospital in May.

PSR software will extract GP patient records

29 August, 2012 Michael Woodhead
The Professional Services Review is to use a clinical data extraction program to pull patient records from the desktop software of GPs whose claiming patterns are being investigated.
In an “invitation to tender” notice sent to software developers, the PSR says it wants “a solution that can extract a requested selection of patient records from general practice clinical software systems and return them to PSR in an agreed PDF format”.
According to the tender requirements, the extraction tool is aimed at simplifying the process of extracting the relevant data from patient records. At present, the PSR relies on the doctor under review submitting hard copy printouts of the patients’ medical records, which then have to be transported, collated and scanned in by the PSR.

Canberra admits PCEHR delays

THE Gillard government has confirmed that key components of the personally controlled e-health records program missed the crucial June 30 deadline, but says the entire system has now been "implemented".
Some items have yet to be properly tested, which means complete rollout will take a few more months.

Threat to privacy in e-Health records

PATIENTS who want to keep private a visit to a psychiatrist, the use of a mental health medicine or an abortion under the new e-Health online system will have to ensure Medicare and pharmaceutical subsidy data is not linked to the new record.
The only other way to keep the information private would be to pay the full cost of the treatment and refuse Medicare and pharmaceutical subsidies - or use a fake name, a privacy expert said yesterday.

Privacy fears raised over PCEHR

28 August, 2012 Nick O'Donoghue
Patients may forgo PBS subsidies for medication in order to keep their use of treatments for mental health issues from appearing on their electronic health record, an expert believes.
Julie Zetler, an ethics and legal expert at Macquarie University told The Daily Telegraph that consumers were concerned over how private health data stored on the Personally Controlled e-Health Record (PCEHR) would be treated.
With the PCEHR set to be accessed by doctors, pharmacists and other health professionals, Ms Zetler said the only way patients, who have opted-in to the scheme, to keep details of mental health consultations and medication for such conditions, would be by not accessing Medicare rebates, or PBS subsidies.

Real time database on doctor shoppers goes live

30 August, 2012 Michael Woodhead
GPs can now check up on suspected "doctor shoppers" by accessing a secure real time database that gives details of all prescriptions a patient has received in the last three months.
Medicare has extended its Prescription Shopping Program to provide up-to-date information on the prescription history of a patient accurate up to the last 24 hours.
The new service, modelled on a system pioneered in Tasmania, is available via a 24-hour phone line and also via a secure internet connection.

Don't forget the people in e-health: NSW Health CIO

Summary: NSW Health's CIO is pushing for a change in how IT is used in healthcare systems, after having personally felt the consequences of a system that forgets clinicians and patients.
By Michael Lee | August 28, 2012 -- 05:44 GMT (15:44 AEST)
Augmenting a state's complex health system with technology requires large projects to allow systems to work with each other — and although these are important, they are not what the state now needs to focus on, according to NSW Health CIO Greg Wells.
Speaking to an audience of IT professionals at the Australian Information Industry Association's (AIIA) NSW healthcare briefing this morning, Wells walked through the story of "Pip", a mother of three boys, one of whom was diagnosed with a brain tumour last June.

Why I am withdrawing from the Australian Delegation to Baltimore

Posted on August 30, 2012 by Grahame Grieve
The Australian government has a program that supports Australian delegate’s travel expenses for the purpose of attending international standards meetings and representing Australia. We contribute our own time, but the government reimburses our direct expenses. In exchange, we must represent Australian interests and agreed positions, and we must contribute to a published report about what happened at the meeting. I’ve discussed the usefulness of this report before.
As part of the funding conditions, we are required to sign a “Moral Rights Deed Poll” that assigns the copyright of the report to Standards Australia so they can distribute it as they need to – that makes perfect sense, and I’d be fine with that. However this year, I can’t sign it. Not because of what the intent is, but because of what it says.

Telehealth: the future for better medical care

28th Aug 2012
THE relentless rise in medical subspecialisation over the past 40 years is colliding with an immutable reality: chronic comorbidity and the affordability of health systems.
Ageing populations, technology and the rise of chronic non-communicable disease are placing strains on health budgets that, quite simply, cannot be met.
In an older era, ‘all-rounder’ GPs, faced with a tough diagnostic or clinical management challenge, sought the counsel of a consultant colleague who possessed specific specialist expertise. These professional relationships were symbiotic, referrals judicious and patients enjoyed the benefit of comprehensive whole-person medicine supplemented by targeted expert advice when required.

OAIC seeks comment on PCEHR privacy, data breach investigations

Australians invited to agree or disagree with Information Commissioner’s proposed enforcement of the Personally Controlled Electronic Health Records System (PCEHR)
The Office of the Australian Information Commissioner (OAIC) is requesting feedback from the Australian public on its draft Enforcement Guidelines for the Personally Controlled Electronic Health Records System (PCEHR) Act.
To help Australians prepare comments, the OAIC has published a consultation paper (PDF) called eHealth record system OAIC Enforcement Guidelines on its website.

Information Commissioner polls on e-health privacy enforcement

Summary: The Information Commissioner has set out guidelines on how it will deal with organisations that breach the Privacy and PCEHR Acts, and is asking the public to see if they are appropriate.
By Michael Lee | August 29, 2012 -- 05:42 GMT (15:42 AEST)
The Office of the Australian Information Commissioner (OAIC) is reaching out to the public for feedback on how it should enforce privacy regulation related to personally controlled electronic heath records (PCEHR).

BREAKING NEWS: Penalties for PCEHR privacy breaches

29 August, 2012 Michael Woodhead 
Draft guidelines on the enforcement of penalties for PCEHR privacy breaches have been released by the Office of the Australian Information Commissioner (OAIC).
The guidelines say fines may be imposed for unauthorised collection, use or disclosure of health information in a consumer's PCEHR and for failing to provide sufficient information to identify an individual who makes a request for access to a consumer's PCEHR.

About Cancer Directory Website

The Cancer Directory Website provides the community and health professionals with a useful, comprehensive online directory of trusted Australian cancer care resources that have been published since 2000 in print, audiovisual (AV) or electronic formats.
This website has been developed to enable you to:
  • search for the printed, audiovisual and electronic resources that best fit your needs
  • submit a resource that your organisation has published
  • suggest a resource another organisation has produced that you have found useful
  • sign up to receive an electronic newsletter that provides updates on new resources and developments
  • give feedback on the listed resources and website.
This site aims to make it easier for you to access credible cancer care resources from around Australia, specifically those published by the Commonwealth, State and Territory Government departments, Cancer Councils, major health services and major not for profit organisations.

Press Release: iCare Solutions Pty Ltd acquires UK Community Care company, h.e.t. software

22 Aug 2012
iCare Solutions is pleased to announce the acquisition of h.e.t. software, a leading provider of community care software in the UK, with a presence in Australia.
The acquisition enables iCare to bring community care software into its portfolio and integrate this functionality with its existing Clinical, Care and Medication Management solution. iCare will now be delivering the most complete electronic healthcare record across the continuum of care for the Australian aged care industry.
The acquisition builds on a long term relationship with h.e.t. software and provides a significant presence for iCare in the UK, where the uptake of software solutions by residential aged care providers is growing exponentially. iCare entered the UK market in 2007 and has experienced strong growth since. The combination of the two organisations will enable the delivery of a comprehensive software solution in the UK to create greater efficiencies in the social and home care markets.

Auditor-General gives regional fibre the thumbs up

Summary: The Auditor-General has found no faults in the regional broadband roll-out, finding only one recommendation to give the government to turn good into great.
By Michael Lee | August 31, 2012 -- 04:56 GMT (14:56 AEST)
The Australian National Audit Office has completed its performance audit of the Regional Backbone Blackspots Program (RBBP), giving it a clean bill of health and offering just one recommendation.
The RBBP is part of the Federal Government's plan to fast-track the expected long task of rolling out fibre to regional Australia, passing through about 100 regional towns and connecting 400,000 people through 6000km of fibre. Although the project has suffered some delays, the Auditor-General's report (PDF) noted that these were due to extreme weather events, including flooding in 2011-12.

IPad management, security crucial in hospital tablet roll out

Tablets, especially iPads, have become a way of life at the University of California, Irvine Medical Center, which now issues the tablets to incoming medical students and just last month, the hospital's Department of Emergency Medicine said it's giving iPads to all 18 of its resident physicians as part of a patient-care initiative.
The incoming class of 100 medical students now routinely receives an iPad, thanks to private funding, says Adam Gold, director of emerging technologies at UC Irvine Medical Center, which has a hospital in Orange County and also functions as a teaching center for UC Irvine School of Medicine. The IT department there has set up document-sharing via SharePoint as part of this effort. "The entire curriculum is on the iPad," Gold says.

eHealth CCA Community

Welcome to the Australian eHealth Compliance, Conformance & Accreditation (CCA) community website.
This site provides a library of news and technical information for anyone interested in the national conformance assessment process for medical and health software. It explains the general framework for assessment and accreditation as well as specific requirements for different types of software products and systems.
Sponsored by the eHealth CCA Governance Group, the site demonstrates a close working partnership between leading government policy and design agencies, standards authorities and the medical and health software industry, who have come together to build an effective national scheme designed to improve the connectedness of our healthcare system, the quality of our industry and, above all, the safety of patients.

Departments splurge $10m on monitoring the media

FEDERAL government departments and agencies are spending more than $10.3 million a year checking what is said about them in the media.
The hefty monitoring bill from external companies would pay for more than 100 full-time staff each earning $100,000 a year.
An analysis by The Australian revealed the Department of Health and Ageing ploughs more than any other department or agency into monitoring -- with a bill of $940,000 for press clippings and transcripts in 2011-12.

Windows 7 overtakes XP; Mac OS X steams ahead of Vista

Summary: At long last, Microsoft Windows 7 has overtaken the 11-year-old Windows XP on Netmarketshare's web-based tracking network, while Mac OS X is now a percentage point ahead of Vista. There are also new numbers for mobile operating systems and browsers.
By Jack Schofield for Jack's Blog | September 1, 2012 -- 17:03 GMT (03:03 AEST)
Microsoft Windows 7 has finally overtaken the 11-year-old Windows XP operating system on web-based market share figures from Netmarketshare. Also, Apple's Mac OS X has overtaken Windows Vista this summer, if all versions of Mac OS X are combined.

Robot ethics: Thou shalt not kill?

Military departments around the world are capitalising on improving robotics technology to help them with war efforts.
Where wars were once fought in hand-to-hand combat or soldiers shooting it out, the reality of wars these days mean operators in the US can decide whether people live or die in Pakistan at the touch of a button.
Robots could also one day replace humans on the battlefield, but how far away are we from this type of robotic warfare and what are the ethical implications?
The move to free-thinking robots
The US is a significant user of military drones, unmanned aerial vehicles. Its arsenal of drones has increased from less than 50 a decade ago to around 7000, according to a report by the New York Times[1], with Congress sinking nearly $5 billion into drones in the 2012 budget.


Freddy said...

"The announcement of a national dental scheme was the biggie for me - but I really do wonder what will be cut to pay for it."

The current Chronic Disease Dental Scheme costs about $1bn per year (and even though the Minister called it inequitable is available to all Australians). This scheme will be scrapped before the end of the year.

The new scheme will also cost about $1bn per year. Parts of this new scheme is effectively means tested (FTB A), but apparently is equitable.

The new scheme won't start until 2014, so for 2013 the government will pocket the $1bn cut from the Chronic Disease Dental Scheme.

Also, if the Chronic Disease Dental Scheme was such a failure set up in the dying days of the Howard government as the minister described, why did they let it run for 5 years under their watch?

That's my $0.02 on it

Earl Hose said...

Will any of the changes to IT in QLD affect e-health?

Bernard Robertson-Dunn said...

Earl Hose said...

"Will any of the changes to IT in QLD affect e-health?"

Don't know, but the lessons from not funding maintenance should.

As a rough guide, in the light of no other information (in other words, my estimate is probably light-on), DOHA should have assumed that the cost of support (including an accrual for replacement of physical infrastructure and the applications at end of life), per annum, equals that of development.

According to

"Over the next two years, the government will provide $161.6 million to Health to operate the PCEHR and support its gradual enhancement and adoption," the tender says

$80 million a year seems a bit low to me. DOHA could be in the process of creating for itself the very problem that QLD is now facing.

Evidence that I've got this wrong is more than welcome.

Cris Kerr said...

Do(public)HA has been given oversight of the ehealth/PCEHR program for 2 years, which may mean long-term plans for ehealth/PCEHR, including its governance, remain non-transparent for 2 years.

As it's in everyone's best interests, I had hoped the Australian voting public would be given an opportunity during an election year (before they vote in 2013), to scrutinize public ehealth/PCEHR long-term govt intentions; public health plans and strategies, program ownership, frameworks, governance, and procedures, etc, etc.

Unfortunately, the average Australian voter continues to remain in the dark with most unaware that this program even exists, let alone its potential for good... or bad.

It would be great to see a progressive media scale up to better inform the voting public, heighten awareness, and ensure a majority of Australians can understand all the potential benefits and risks associated with our nation's public ehealth/PCEHR program, because like it or not, ehealth will have a role in all their lives, and their children's lives, for decades to come.

Anonymous said...

9/07/2012 07:59:00 AM I think that view is altruistically unreal, impractical, naive and out of touch with the way the real world works. Given the amount of so-called public consultation events over the last 5 years it should be abundantly apparent by now that the approach you proffer is impractical and futile.

Cris Kerr said...

Hi Anon (9/07/2012 09:24:00 AM),

I think the real world works best when people are respectful of each other and are well-informed, so they can then make well-informed decisions.