Monday, December 02, 2013

Weekly Australian Health IT Links – 2nd December, 2013.

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 issue this week - reading the views of others on the PCEHR.
It now seems the Enquiry might take a little longer than expected - and just squeak in before the end of the year - when there is just no news happening.
I do hope we get some sort of outcome before the New Year rolls round….
The top entry below has a great set links to all the responses we have found.

Personally Controlled Electronic Health Record

On 3rd November 2013, newly appointed Commonwealth Health Minister Peter Dutton announced a review of the PCEHR, appointing a 3 member panel headed by Richard Royle Executive Director of the UnitingCare Health group in Queensland and assisted by Dr Steve Hambleton, President Australian Medical Association and Andrew Walduck, Chief Information Officer of Australia Post. An invitation for submissions was sent on 12th November to individuals and organisations who had made prior submissions to PCEHR design or legislation inquiries. The invitees were asked to focus on the following areas:-
  • The gaps between the expectations of users and what has been delivered
  • The level of consultation with end users during the development phase T
  • he level of use of the PCEHR by health care professions in clinical settings
  • Barriers to increasing usage in clinical settings
  • Key clinician and patient usability issues
  • Work that is still required including new functions that improve the value proposition for clinicians and patients
  • Drivers and incentives to increase usage for both industry and health care professionals
  • The applicability and potential integration of comparable private sector products
  • The future role of the private sector in providing solutions
  • The policy settings required to generate private sector solutions
A number of submissions to the PCEHR Review have been publicly released through other channels, and some of those links are collated here.

Doctors accused of secretive e-health control

27th Nov 2013
A STOUSH has erupted over the level of control doctors should have over personally controlled e-health records (PCEHR) with the AMA accused of taking a “secret doctors' business” approach to patient data.
The accusation, from the Consumers Health Forum of Australia (CHF), followed the release of the AMA’s submission to the review of the billion dollar program being carried out at the request of Health Minister Peter Dutton.
AMA president Dr Steve Hambleton is involved in the review, which is due to report to Mr Dutton in mid-December.
In its submission to the review, the AMA criticised the level of patient control over information in the record arguing that “patient control of health information presents practical clinical limitations for the treatment of the patient, even for the most skilled medical practitioner”.

Reports, submissions and outcomes

RACGP submission to personally controlled electronic health record review panel

27 November 2013
The Royal Australian College of General Practitioners (RACGP) has provided input to the personally controlled electronic health record (PCEHR) review panel on the issues impacting general practice and GP’s use of the PCEHR. Representing the vast majority of Australia’s general practice profession with over 23 600 members working in or towards a career in general practice, the RACGP is in the optimum position to deliver input to government and other stakeholders on what the RACGP sees as a project that has the potential to affect the delivery of primary healthcare across Australia.
28 November 2013, 2.47pm AEST

Electronic health records review set to ignore consumer interests

Merle Spriggs
Research Fellow at the Children's Bioethics Centre at the University of Melbourne and at Murdoch Childrens Research Institute
Disclosure Statement
Merle Spriggs has conducted research funded by the Institute for a Broadband-Enabled Society (IBES), University of Melbourne. In 2010 and 2011, she has had travel and accommodation paid for on her behalf by the National E-Health Transition Authority (NEHTA) to attend round table discussions on the Personally Controlled Electronic Health Record (PCEHR).
The rollout of the Australia’s Personally Controlled Electronic Health Record (PCEHR) has encountered various problems since its inception. But it all got worse when the new health minister, Peter Dutton, recently ordered a review of the project. Unfortunately, it seems consumer interests may be neglected in the inquiry.
The PCEHR contains a summary of your health information such as diagnoses, allergies and medications. It’s expected to improve health outcomes, save time and money, reduce medical errors, and allow people to be more involved in their own care.
Whether you choose to have a record is up to you, as is what goes into it, and who can access it. This secure online record, according to the eHealth website, can be shared with your doctors, hospitals and other health-care providers “to provide you with the best possible care”.

Submission to the PCEHR Review Committee 2013

November 29, 2013
Professor Enrico Coiera, Director Centre for Health Informatics, Australian Institute of Health Innovation, UNSW
Date: 21 November 2013
The Clinical Safety of the Personally Controlled Electronic Health Record (PCEHR)
This submission comments on the consultations during PCEHR development, barriers to clinician and patient uptake and utility, and makes suggestions to accelerate adoption. The lens for these comments is patient safety.
The PCEHR like any healthcare technology may do good or harm. Correct information at a crucial moment may improve care. Misleading, missing or incorrect information may lead to mistakes and harm. There is clear evidence nationally and internationally that health IT can cause such harm [1-5].

Forum slams doctor PCEHR e-health record control

THE Consumers Health Forum has slammed the Australian Medical Association's proposal for full doctor control over e-health records but backed calls for the system to be opt-out.
The AMA yesterday said that the information held in the $1 billion personally controlled e-health record system couldn't be trusted as patients, not clinicians, had control over their data.
In its submission to the PCEHR review, the peak health body said that if the PCEHR was an opt-out service, it would boost consumer participation.
But according to CHF spokesman Mark Metherell, the AMA's demands to drop patient control was "a refusal to accept that the world has moved on from the 'secret doctors' business" of paper-based records that patients rarely see".

HISA & HIMAA release their joint submission to the PCEHR inquiry

Wednesday, 27 November 2013  
Posted by: Sam Bruinewoud
Representatives of HISA and HIMAA recently submitted their report to the PCEHR inquiry. The report is based on the responses of e-health professionals in the extended networks of the two organisations to a survey they co-created.
HISA and HIMAA wish to extend our appreciation and acknowledgement to the 673 individuals who contributed to this survey.
(Thanks also to the 4 people who are primarily responsible for all this question writing and analysis work; you know who you are – you rock!)
The report is now available to view here on our website.

Make health record system 'opt-out', says AMA

CLINICIANS cannot trust the information held in the $1 billion national e-health record system as patients are able to amend their own data, Australia's peak health body says.
The Australian Medical Association said the personally controlled e-health record system should be an opt-out -- not opt-in -- service to boost consumer participation.
It said the personally controlled aspect of the e-health record system was a double-edged sword.
"The AMA supports individuals taking responsibility for their own health and recognises that personally controlled electronic health records could empower and encourage patients to do this," the AMA said in its submission to the government's PCEHR review.

Too much personal control reduces the effectiveness of the PCEHR

AMA Vice President, Professor Geoffrey Dobb, said today that the overriding emphasis on ‘personal control’ of the Personally Controlled Electronic Health Record (PCEHR) has stalled its implementation.
The AMA’s views on the way forward for the PCEHR are detailed in its submission to the Federal Government’s Review of the PCEHR, released today.
Professor Dobb said that there should have been equal emphasis on clinical utility in the development of the PCEHR.

Fridayfacts newsletter: 29 November 2013

RACGP’s submission to PCEHR review panel

In its submission to the Personally controlled electronic health record (PCEHR) review panel, the RACGP has called for the adoption of 10 key recommendations it believes will better facilitate the development and adoption of the PCEHR into clinical practice. The submission, written in response to the Federal Government’s call to review the PCEHR after it came under fierce public and professional scrutiny, highlights the issues impacting general practice and GPs’ use of the current PCEHR system. The RACGP has always believed that improved accuracy, availability and timeliness of communication will lead to better health outcomes. Whilst the PCEHR has held this promise, its success is dependent on appropriate clinical input at all stages of development to ensure it is fit for purpose

eHealth Clinicians User Guide

This eHealth Clinicians User Guide includes material that is relevant to both general practices and private specialist practices, however other healthcare professionals, e.g. allied health and in aged and community care, may also find this guide useful.
The eHealth Clinicians User Guide supports medical practices in navigating the complexities of eHealth (including the national eHealth record system) from planning, preparation, registration and implementation through to meaningful use. It covers key eHealth topics of interest to medical practices (including quality improvement) and focuses on the foundation products (e.g. Healthcare Identifiers, NASH, Secure Message Delivery), the national eHealth record system and other functionality currently available and being released by software vendors. Importantly it includes practical step-by-step implementation advice.

A new evaluation activity from ACHI PES

Wednesday, 27 November 2013
Posted by: Sam Bruinewoud

A request from Dr Chris Bain

Subject: ACHI Program Evaluation Subcommittee - Biannual Evidence Review
ACHI PES have recently announced a biannual HI evidence review.
The first one will be on "Patient accessible healthcare records”
To contribute to this review they are seeking articles (or links to them) that demonstrate:
· high quality research
· interesting methodologies or
· interesting / useful outcomes
from amongst the peer reviewed and grey literature on the specific topic of "Patient accessible healthcare records”

Poor data and systems hamper health service delivery

Summary: Disjointed and outdated systems, poor data quality and project failures are hampering health initiatives in New Zealand.
By Rob O’Neill | November 24, 2013 -- 20:19 GMT (07:19 AEST)
Efforts to boost collaboration across regional health authorities in New Zealand have been stymied by a lack of robust data and poor information technology, the Auditor-General has found.
A new audit report (pdf) has found a “widespread awareness” of issues of data quality in the sector leading to a lack of confidence in the data available.
A lack of robust data leads to imprecision and inaccuracy, the report says. This, in turn, can lead to false assumptions, followed by poor decision-making.

Australian Privacy Commissioner won’t be taking “softly, softly approach” with privacy reforms

Timothy Pilgrim will be able to seek civil penalties of up to $1.7 million for companies if there is a serious breach of privacy
Australian Privacy Commissioner Timothy Pilgrim has warned enterprises and government agencies that he won’t be taking a “softly, softly approach” to privacy investigations when his new powers come into effect on 12 March 2014.
Under the Privacy Amendment (Enhancing Privacy Protection) Bill 2012 which was passed by Parliament in November 2012, Pilgrim will be able to seek civil penalties of up to $340,000 for individuals or up to $1.7 million for companies in the case of a serious breach of privacy.
Speaking at the iaapANZ Privacy Summit in Sydney this week, Pilgrim said he had been asked by people if he will take a cautious approach after implementation of the privacy reforms.
“I have never been known to be subtle so the answer to that question is probably no,” Pilgrim said.

Medical examinations used to access your private information

Date November 27, 2013

Leanne Nicholson

Under the Privacy Act's Information Privacy Principles you must be told why your personal information is being collected and whether it can be given to anyone else.
Private information of thousands of Australian jobseekers harvested through medical examinations and stored for profit has raised legal and applicant concerns about the protection and use of personal data.
Australia's largest publicly-listed health and risk management provider, Konekt, has collected the personal data of jobseekers since 2007 through medical examinations on behalf of private companies and government agencies as part of employment selection processes.

Labor spent $4m on ML ad blitz in last days of power

25th Nov 2013
THE Department of Health and Ageing spent $4 million advertising Medicare Locals and e-health in the last month of the Labor government, a Senate hearing has been told.
The expenditure, which averages more than $100,000 a day, was revealed in a Senate estimates hearing last week as new health minister Peter Dutton prepared sweeping reviews of both Labor-led initiatives.
The $10 million, two-year publicity blitz was first revealed in the May budget as Labor contemplated electoral wipeout amid consistently poor polling.
Asked last week how much of that money had already been spent, department communications boss Adam Davey told a Senate estimates hearing it had spent $4,066,393 in the 2013—14 financial year. He confirmed the money was spent between 1 July and the start of the election campaign on 6 August, when the government went into caretaker mode, a period of 37 days. Most of the money, $3,678,758, was spent placing advertisements in media.

Confidential briefing: NBN unlikely to meet Coalition's deadline

Date November 29, 2013 - 12:01AM

David Braue

The Coalition’s national broadband network model will prove inadequate for many businesses, is poorly planned and is unlikely to be completed on time, according to NBN Co’s internal analysis for the incoming Abbott government.
Obtained by Fairfax Media, the analysis casts doubts over the timing and cost-effectiveness of the government’s proposed fibre-to-the-node model, highlighting numerous legislative, construction and technical challenges likely to blow out the Coalition’s 2016 and 2019 delivery deadlines.
The draft document also slashes revenue projections important for the project’s commercial viability by up to 30 per cent by 2021.
Under the Coalition policy, fibre optic cables would be installed to nodes, or street cabinets. From there, existing copper wires would complete the connection to homes and businesses.

Ziggy Switkowski warns of more NBN cost blowouts as services of the future in doubt

Date November 29, 2013 - 10:12PM

David Braue

The chairman of the national broadband network has warned of further cost blowouts in rolling out fibre-optic cables throughout the country, while an NBN Co analysis warns the Coalition’s ‘‘cheaper, sooner’’ network would strip up to $1.8 billion from its projected revenues.
New details of the draft document prepared by the NBN Co for the incoming government also reveal the slower transmission speed under the new model would compromise the provision of telehealth, distance education, internet TV and other business applications.
NBN Co executive chairman Ziggy Switkowski told a Senate hearing on Friday the Coalition’s $20.4 billion costing for the project could be proved wrong.
 ‘‘When you go out into the field, you talk to contractors, you look at the stats around how the work is being done, [it] confirms that the costs are higher than people had hoped they would be,’’ he said.

1 comment:

Trevor3130 said...

If you don't mind a brief diversion, David, Garry Kasparov has made a pretty good observation.

"Garry Kasparov ‏@Kasparov63 7h
Sebelius telling people to use Obamacare website on off-peak hours reminded me of a classic Soviet joke: "

Observers of our NEHR need to watch what's happening in the Education portfolio. The Govt seems to be "funding" some of its' changes by knocking off the "command & control" of education by "Canberra".
This theme could be followed in Health, that is, downgrading the monitoring agencies. Too late, and too easy, for me to say, but if there had been a concerted effort to make the 'metadata' of HealthIT readily available, the NEHR would be on a much stronger footing.