Monday, November 19, 2012

Weekly Australian Health IT Links – 19th November, 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

Well it has really been a quiet week with virtually nothing in the e-health space being reported.
We are now 4.5 months since launch of the live NEHRS, NEHTA says their job is done but there is still essentially no use of the ‘billion dollar baby’.
I wonder is the quiet due to some tricky technical issues not being quite resolved as I am occasionally hearing or something else....time will tell I guess.
My weekly visit to my NEHRS has shown that the performance again seems to be very slow. I am not sure just why this is, given the trivial number of users at this point. If anyone knows why it is seemingly so slow comments are welcome.
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E-health supplier link to data fears

THE Gillard government's national e-health system supplier Accenture may have breached data sovereignty regulations if it used servers located overseas.
It would be a move legal experts say would be "troubling" for such a large organisation.
The government's National E-Health Transition Authority found that "use of offshore Accenture mail servers by the PCEHR (personally controlled electronic health records) system may be in breach of legislative requirements".
NEHTA deemed this as high-risk, with major consequences. It said an individual's privacy could be compromised as a result of the actions.
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Lack of national complaints reporting crippling health system progress

12 November, 2012 Kate Aubusson
A national database for healthcare complaints is urgently needed to improve services and minimise harm, according to new research that exposes patchwork reporting, “crippling” any chance of thorough national analysis.
A comparison of complaint statistics for all state and territory health commissions (HCCs) over five years found data was shared for only four out of 18 types of complaints, the University of Sydney researchers reported.
“This means that it is not possible to benchmark complaints, make definitive state-by-state comparisons or establish best practice in relation to time frames for assessment conciliation or investigation,” they wrote in the Australian Review of Public Affairs
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Growing frustration with national e-health program

14th Nov 2012
CLINICIANS advising on the national e-health program say they are dissatisfied with the level of engagement by the National E-health Transition Authority (NEHTA), with MO understanding some are reconsidering their involvement.
A number of the 64 clinical leaders – listed on NEHTA’s website – approached by MO, confirmed there was growing frustration among the group.
One clinical leader, who wished to remain anonymous, said there had been a “communication blackout from NEHTA for quite some time” and that they were aware some other clinical leaders were “dissatisfied with the amount of engagement by NEHTA”.
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Lines out: $134m cut kills telehealth plans

13th Nov 2012
A DISTRICT of Workforce Shortage (DWS) with plans for an $800,000 Commonwealth tele­health project has been declared ineligible for telehealth Medicare rebates because of controversial spending cuts in the recent mini-budget.
The federal government has committed to a budget surplus this financial year and in a round of mid-year spending cuts said it would save $134.4 million over four years by scrapping telehealth rebates for people in outer metropolitan areas and major regional cities.
GPs in semi-metro areas far from major hospitals had already started rolling out telehealth facilities for specialist consults after the government announced a rebate 16 months ago, but have begun to rethink those plans following news of the latest cuts.
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Plibersek and states exchange fire over health funding

12th Nov 2012
AAP
HEALTH ministers from Queensland, Victoria and NSW reacted angrily when their federal counterpart gate crashed their media conference in Perth on Friday, fuelling a heated argument about state health funding.
They have accused federal Health Minister Tanya Plibersek of a "dodgy" interpretation of Australian Bureau of Statistics population data that would cut state health funding, claims that she vehemently rejected.
The stoush comes as Ms Plibersek remains at loggerheads with premiers of key states including NSW and Victoria over the issue of intern places for medical graduates, with WA, Queensland and the ACT so far the only juristictions to agree to a deal from the federal government to have the positions jointly funded in order to prevent a training shortfall.
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POSTMAN POT: Drug users turn to world weed web

  • By Daniel Piotrowski
  • news.com.au
  • November 08, 2012 3:47PM
  • Why is there a boom in cannabis detections at our borders?
  • "Weed parties" blatantly organised in public
  • Users getting drugs in discreet packages via encrypted websites
POT smokers usually grow marijuana in their backyards or buy from their dealer mates. But now for many Australians, it's their postie delivering them the stuff from overseas.
The latest Customs figures show a boom in the number of cannabis detections in international mail at the border, with drug experts reporting that Aussies are turning to encrypted online stores to purchase what were once backyard drugs.
Dr Monica Barratt, a research fellow at the National Drug Research Institute, said they’re likely turning to online marketplaces like the so-called “Ebay of drugs”, The Silk Road website.
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Doctors prescribe iPad Mini - a perfect lab coat fit

Glad that iPad Mini sticks with same interface as its bigger brother
One in three physicians planned to buy the iPad Mini even when its existence was just a rumor, according to a poll of doctors by medical app developer Epocrates.
According to 90% of respondents to the survey, the smaller size of the iPad Mini is their main motivation. The 50 physicians surveyed indicated the iPad Mini will be easier to tote around between exam rooms and on hospital rounds because it fits nicely into the pockets of their lab coats.
Lab coat pockets are 8.5-in. high and 7.5-in. wide. The iPad Mini is 7.87-in. high and 5.3-in. wide.
The use of tablets by physicians for professional purposes almost doubled since 2011, reaching 62% this year, with the iPad as the dominant device. Half of tablet-owning physicians have used their devices at the point of care, according to a study by market research and advisory firm Manhattan Research.
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Pay-for-performance closer

AS Australian authorities consider whether to include quality and safety measures in local hospital funding formulae, a UK analysis shows a pay-for-performance program has delivered a small but clinically significant reduction in mortality.
The study, published in the New England Journal of Medicine, found a 1.3% drop in 30-day, in-hospital, risk-adjusted mortality in 134 435 patients admitted to 24 hospitals for pneumonia, heart failure or acute myocardial infarction. Data were compared with 722 139 patients admitted for the same three conditions to 132 other hospitals in England. (1)
The 24 hospitals, all based in the north-west of England, had implemented a quality improvement program developed in the US — the Medicare Premier Hospital Quality Incentive Demonstration (HQID) program. An earlier assessment of that program found improved process-quality measures initially, but a 6-year follow-up found no effect on 30-day mortality. (2)
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GPs back new quality indicators

13 November, 2012 Paul Smith
GPs have backed the RACGP’s list of 22 clinical indicators that measure the performance of practices which were first mooted in March this year.
The indicators — which include reviews of antibiotic prescribing and audits of avoidable delays in diagnosing malignancies — were devised by some of Australia’s leading experts to boost quality and safety across the discipline.
In an RACGP survey completed by 500 GPs, every indicator won majority support, with only a minority of respondents — about 20% — saying they either “disagreed” or “strongly disagreed” with them.
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Patients clog emergency wards despite phoneline advice

A study into national triage and advice line healthdirect has sparked debate over its effectiveness in alleviating demand on hospital emergency departments (ED).
Published in the Medical Journal of Australia (MJA), the report found 52 percent of patients who had been given advice by a healthdirect registered nurse to stay put or seek treatment in a non-emergency setting nevertheless presented to an ED.
The report also found 73 percent of healthdirect referrals to emergency departments to have been appropriate, compared with an almost identical number for people presenting of their own accord.
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NBN satellite ground station to be built at Broken Hill

NBN Co has now announced the location for nine satellite ground stations for the NBN.
A National Broadband Network (NBN) satellite ground station will be built at Broken Hill in New South Wales.
The facility will comprise two 13.5 metre-wide satellite dishes and will service Menindee, Purnamoota, Yanco Glen and Kanbara.
The satellite ground station is expected to be operational by 2015.
“Broken Hill is ideally situated to play a central role in delivering better broadband to the outback,” Matt Dawson, NBN Co’s program director, satellites, said in a statement.
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Web's freedom threatened by 'worrisome' rules

Date November 15, 2012
The US faces a tough debate with emerging nations such as India and Brazil at an upcoming UN conference discussing global rules for the internet, the US delegation chief says.
Terry Kramer, who heads the US delegation for the December gathering of the UN's International Telecommunications Union, said on Wednesday he has seen a number of "surprising" and "worrisome" proposals.
The discussions are being held ahead of the ITU's World Conference on International Communications opening next month in Dubai where global telecom rules are to be updated for the first time since 1988.
US officials and lawmakers, along with a number of internet activists, have expressed concern that proposals from China, Russia and other nations could threaten the open model of the internet by giving the UN agency a greater role.
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Enjoy!
David.

4 comments:

Anonymous said...

David

re: "My weekly visit to my NEHRS has shown that the performance again seems to be very slow. I am not sure just why this is, given the trivial number of users at this point. If anyone knows why it is seemingly so slow comments are welcome"

Have a look at this article, it might offer some clues:

http://www.smh.com.au/technology/technology-news/ato-scales-back-new-computer-system-cancels-contract-20100607-xo3i.html
ATO scales back new computer system, cancels contract.

And then, in a different application area:
http://www.ejfi.org/Voting/Voting-95.htm

And some people are really annoyed:
http://accentureischeatingonitsclients.blogspot.com.au/2009/12/three-ways-accenture-is-cheating-on-its.html

Of course, NEHTA must have been fully aware of all these allegations and reports and have mitigated the risk to the PCEHR. You would think...

Anonymous said...

Judging by the amount NEHTA has paid its "Consultants" with taxpayers money over its existence, it would seem Accenture, led by its insider at large "Andrew Howard", has done exceedingly well from its NEHTA contracts.

It would be of interest to see: 1) exactly how much of NEHTA's profligate Consulting spend has ended up in Accenture's coffers, and 2) How many ways did Accenture "cheat" NEHTA to get its hands on taxpayers "millions", including funds directly paid from DOHA for the PCEHR?

Two questions serious inquisitors at Senates Estimates hearings should table to NEHTA and DOHA!

Anonymous said...

Hi David - I think you missed this one:

Green tick for the PCEHR in acute care

Bernard Robertson-Dunn said...

re: Green tick for the PCEHR in acute care

Quote: Other hospitals might decide to do it differently, ...

So, every hospital has to do it for themselves, probably differently.

Does that mean then, that when patients and health professionals go to a different hospital, they have to learn how that particular hospital does it?

Seems like a waste of duplicated effort, not to mention an impediment to widespread uptake.

There's more to standards than HL7.