Monday, April 14, 2014

Weekly Australian Health IT Links – 14th April, 2014.

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

Really quite an interesting week. We have NEHTA coming out and agreeing there are some security problems with EHRs and the PCEHR, Dubbo being recruited to using the PCEHR and some really interesting and successful private sector e-Health initiatives.
Still no news from the PCEHR Review and it is now less than a month till Budget night.
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IT spend on healthcare continues apace in Asia Pacific

Australia is up there with other Asia Pacific countries in continuing a steady increase in IT investment in the healthcare sector. China is the fastest growing IT spender, with a new market report showing an expected APAC region annual growth rate in IT spending on healthcare of 8%.
China is predicted to outstrip other APAC countries over the next five years, with a compound annual growth rate of 11.7% on IT spending in its healthcare sector.
In its latest Health Insights report, IDC says that Australia, China, India, Singapore and South Korea represented close to 90% of Asia Pacific IT healthcare IT spending last year.
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Privacy minefield

8th Apr 2014
SHARING or secrecy? E-health is forcing GPs to wrestle with competing demands while trying to protect patient privacy.
It's good to share, right? 
Think again.
As kids we might have faced a slap on the wrist for not sharing properly. Now, under the new Australian Privacy Principles, we face a $1.7 million slap in the face.
But that’s just not fair, I hear you cry. How am I supposed to play with the 900,000 medical apps available on iTunes without making a bit of a mess? And how do I know all my stuff is safe when I lock it up at night in the great national information cupboard?
There was a day when patient confidentiality was almost child’s play. Now, with enticing opportunities for improved sharing of information through telehealth advances but draconian penalties facing those who break the sharing rules, GPs are caught between a rock and a hard place, otherwise known as the personally controlled electronic health record (PCEHR).
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New e-recall program kicks off

8 April, 2014 Chris Brooker
The recall process for therapeutic goods is set to be streamlined for pharmacists with the launch of GS1 Recallnet Healthcare – an electronic product recall notification management system.
Developed over four years by GS1 Australia, in association with the National E-Health Transition Authority (NEHTA), the TGA, state and territory health departments and medical device and pharmaceutical suppliers, GS1 Recallnet Healthcare went live on 1 April.
It is an online portal that will allow users to create recall and non-recall notifications that follow the uniform recall procedure for therapeutic goods guidelines, as well as submit recall notifications directly to the TGA for review and approval.
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Update On Clinical Document Architecture And E-Health Records

Created on Wednesday, 09 April 2014
The National E-Health Transition Authority (NEHTA) and our partners are aware of potential issues citing security vulnerabilities which could affect eHealth systems worldwide. NEHTA, the Department of Health, and the PCEHR System Operator identified and considered these issues some time ago and as a result put in place actions to either negate or mitigate them.
The issues are around the use of the Clinical Document Architecture (CDA) standard, via style sheets, and in particular the Health Level Seven International (HL7) supplied style sheets, and all deal with the potential for malicious content to be exposed through the clinical documents.
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No more missed test results: Hospital tracking system a success

11th Apr 2014
A QUEENSLAND hospital system that raises the alarm if test results and x-rays are not viewed by a specific deadline has delivered perfect follow-ups of 27,354 records for 6855 patients over a 13-month period.
The system at Mater Mothers' Hospital in Brisbane scored a life-saving 100% in a University of New South Wales (UNSW) assessment.
"It is an unprecedented result," said Associate Professor Andrew Georgiou from the Australian Institute of Health Innovation, which is based at the university.
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eHealth records up and running across district

By KIM BARTLEY

April 12, 2014, 4 a.m.
GEOFFREY and Judith Smith feel more confident about travelling away now they have registered for a free eHealth Record.
They were among the patients of Boundary Road's Dubbo Family Doctors who took advantage of a visit by staff off the Western NSW Medicare Local (WML) yesterday.
The practice and WML joined forces to promote the secure and electronic record that brings together key patient information from sources such as general practices, hospitals, imaging centres, specialists and allied health practices.
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A digitally-enabled health system

What will our healthcare system look like, once the full potential of the digital era is harnessed?
  • 26 March 2014
Australia's health system faces significant challenges including rising costs, an aging population, a rise in chronic diseases and fewer rural health workers. Treasury estimates even suggest that at current rates of growth, and without significant change, health expenditure will exceed the entire state and local government tax base by 2043. We need to look at new ways to make the health system work smarter. Digital technologies and health service innovation promise that.
This report A Digitally-enabled Health System looks at how the Australian health system can reduce costs and deliver quality care.
Some of the technology identified in the report includes telepresence robots taking rural health workers on city rounds, wireless ID wristbands monitoring patients in real time, mobile health apps assisting with at-home rehab and smart software that knows what patients will be turning up to emergency departments, 6-12 months in advance.
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Data Role

Technology will be a key factor controlling the exponential rise of healthcare costs in Australia’s future, according to the newly-released CSIRO paper, A Digitally Enabled Health System. 
The paper was released during the Health-e-Nation 2014 Summit, and Dr David Hansen, who is CEO of the Australian e-Health Research Centre (AEHRC), a CSIRO and QLD government joint-venture, says that it will be a talking point that spurs future research collaborations.
“There’s been a lot of downloads of the document,” he says. “We have had serious numbers of hits on it.”
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Security cases for EHR systems

Posted on April 8, 2014 by Grahame Grieve
Well, security is the flavor of the week. And one thing we can say for sure is that many application authors and many healthcare users do not care about security on the grounds that malicious behaviour is not expected behaviour. One example that sticks in my mind is one of the major teaching hospitals in Australia that constantly had a few keys on the keyboard wear out early: the doctors had discovered that the password “963.” was valid, and could be entered by running your finger down the numeric keypad, so they all used this password.
So here’s some examples of real malicious behaviour:
Retrospectively Altering Patient Notes
A Queensland-based GP retrospectively changed his notes to falsely claim that a patient refused to go to hospital – then submitted those notes as evidence in an inquest, has been found to have committed professional misconduct and been suspended from practising medicine for 12 months including six months plus another six if he breached conditions within three years – and banned him from conducting most surgical procedures except under supervision for at least a year.
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3D printing a new face, or liver, isn't that far off

Surgeons see a day when skin, organs and bones will all be printed
Sixty years from now, we'll look back on today's 3D-printed tissue and organ technology and think it's as primitive as the iron lung seems to us now.
Six decades out, replacing a liver or a kidney will likely be a routine procedure that involves harvesting some patients cells, growing them and then printing them across artificial scaffolding.
Dr. Anthony Atala, director of the Wake Forest Institute for Regenerative Medicine, spoke at the Inside 3D Printing Conference in New York about where the technology is today, and what hurdles it still must overcome.
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Bionic revolution to ‘keep us active well into old age’

  • Hannah Devlin
  • The Times
  • April 07, 2014 9:30AM
BIONIC limbs and 3-D printed organs will keep people in good enough shape to play tennis beyond the age of 100, one of Britain's leading materials scientists has predicted.
Professor Mark Miodownik, of University College London, believes that rapid progress in biomedical engineering will transform old age by allowing people to "upgrade" failing body parts such as kidneys, livers and bones.
"The difference between animate and inanimate materials is getting more blurred and the body is going to become much more bionic," he said. He envisages the transformations to be as subtle as today's dental fillings rather than a case of people morphing into Robocop-style cyborgs.
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Doctors' robot reduces spine surgery risk

  • April 09, 2014 10:15AM
  Clifford Fram, AAP National Medical Writer
  AAP
SURGEONS have been using GPS-based devices for some time, but a Sydney operating theatre has been fitted with the medical equivalent of park-assist.
It's a leap forward, says neurosurgeon Dr Jonathon Ball, who is using the new robotic system to make his already exacting spine operations more precise.
Apart from reducing risk and improving accuracy, the Israeli-designed Renaissance guidance system improves recovery time and reduces pain.
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Jawbone’s UP24 bracelet raises the bar on health goals

IT’S a year since I reviewed Jawbone’s UP health bracelet. It measures your steps and sleeping patterns, and vibrates to wake you when it detects you in light sleep around alarm time.
Now Jawbone has released the UP24. It remains a rubber bracelet that fits snugly on your wrist, it’s water resistant and it still lacks a display. That has not been a big issue with the UP, which seeks to help you manage your activity habits rather than offer instant performance data.
There is one major change: the UP24 syncs to your smartphone wirelessly via Bluetooth 4. The old UP required you plug the end into a smartphone to upload its data. The UP24 syncs data about every 20 minutes to the UP app.
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Push for GP software to default to generics

9th Apr 2014
AN INFLUENTIAL political think tank wants to reduce the influence of brands on GP prescribing and referrals for diagnostic testing as part of a drive to cut costs for patients.
In a submission to the Senate enquiry into out-of-pocket expenditure on healthcare, the Australian Institute (AI) proposed two measures to reduce the estimated $1.3-$1.7 billion patients spent on GP visits plus brand premiums on medications and diagnostic testing in 2012–13.
It also recommended an update of the 2008 Australian Bureau of Statistics survey on the negative impact of costs on access to health services before any decision was made to charge a standard co-payment for GP visits.
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Case study: security vulnerabilities in C-CDA display

Apr07
For background, see my previous blog post describing the details of three security vulnerabilities in C-CDA Display using HL7′s CDA.xsl.
Last month I discovered a set of security vulnerabilities in a well-known commercial EHR product that I’ll pseudonymously call “Friendly Web EHR”. Here’s the story…

The story: discovery and reporting

I was poking around my account in Friendly Web EHR, examining MU2 features like C-CDA display and Direct messaging. I used the “document upload” feature to upload some C-CDAs from SMART’s Sample C-CDA Repository. At the time, I was curious about the user experience. (Specifically, I was bemoaning how clunky the standard XSLT-based C-CDA rendering looks.) I wondered how the C-CDA viewer was embedded into the EHR. Was it by direct DOM insertion? Inline frames? I opened up Chrome Developer Tools to take a look.
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Tech-Savvy Australian seniors want digital tools to manage health, according to Accenture survey

SYDNEY, Australia; 08 April 2014 – Driven by increasing healthcare demand from Australia’s aging population, a recent survey from Accenture (NYSE:ACN) found a growing number of tech-savvy seniors (63 per cent) are seeking digital options for managing their health.
The latest figures from the Australian Bureau of Statistics reveal that Internet participation has nearly doubled among Australia’s growing population of seniors since 2003, showing 41 per cent of older citizens are active online users.  Although roughly three-quarters (77 per cent) of seniors surveyed by Accenture say that online access to their health information is important, only 17 per cent say they can currently access their records. 
“While prior generations were commonly more resistant to technology, the explosive growth of digital tools are enabling more options for seniors to remain connected and manage many areas of their lives from home,” said Leigh Donoghue, managing director of Accenture’s health business in Australia.  “Older Australian’s are increasingly online, and just as they turn to the Internet for banking, shopping and entertainment, they also expect to be able to manage certain aspects of their healthcare services virtually.”
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Suspension of GP Super Clinics program the right move for general practice

9 April 2014
The Royal Australian College of General Practitioners (RACGP) welcomes the Federal Government’s plans to suspend any further expansion of the GP Super Clinics program, detailed in media reports yesterday.
The $650 million GP Super Clinic program was implemented by the previous Government as a strategy to build a stronger primary healthcare system, with the announcement yesterday set to re-coup some of the costs of the controversial program.
The revoked funding, allocated for the development of Super Clinics in Darwin, Rockingham and Brisbane is set to save the Government around $25 million.
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Do robots have a role in dementia care?

10 April, 2014 Kate Aubusson
From Alien to Terminator, Blade Runner to The Matrix — science fiction has long taught us never to trust robots, androids or cyborgs.
But surely even Sigourney Weaver would be won over by Paro, a cuddly robotic baby seal designed to improve quality of life in dementia.
Researchers hope the $9000 mechanised harp seal will ease agitation among elderly patients and reduce the need for restraints in aged care facilities.
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Coalition orders ‘technology mix’ to officially replace Labor’s NBN plan

THE Abbott government has officially repealed the blueprints issued under the Labor government to build the National Broadband Network using fibre-to-the premise technology.
It has issued new instructions to the NBN Co to use a variety of new and existing broadband technologies to save money and time on the $41 billion project.
Communications Minister Malcolm Turnbull and Finance Minister Mathias Cormann last night handed down a new statement of expectations to the board of NBN Co to lock in the government’s “optimised multi-technology mix”.
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GOLDMAN: These 7 Tech Trends Are Changing The World

Mamta Badkar Apr 9, 2014, 7:07 AM
Goldman Sachs has a cool feature on its website titled “25 Ways We Saw The World Change,” which comes from the bank’s 2013 annual report.
The list includes seven “concurrent revolutions within the technology space.” Disruptive technology is having a huge impact on global businesses and the economy that we can’t ignore.
We’ve highlighted the seven key tech trends they think are about to impact the global economy.
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Australian internet speeding up

Date April 8, 2014 - 3:34PM

Paddy Wood

Australian internet is speeding up and people are downloading more than ever before, new figures show.
The number of Australians accessing download speeds of 24 megabits-per-second (Mbps) passed 2 million for the first time in the three months to December, according to the Bureau of Statistics.
That's an increase of about 27 per cent on the number of people accessing the fastest category of internet service since the same period in 2012.
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How to protect yourself from the 'Heartbleed' bug

A new security bug means that people all across the Web are vulnerable to having their passwords and other sensitive data stolen. Here's what consumers can do to protect themselves.
A major new security vulnerability dubbed Heartbleed was disclosed Monday night with severe implications for the entire Web. The bug can scrape a server's memory, where sensitive user data is stored, including private data such as usernames, passwords, and credit card numbers.
It's an extremely serious issue, affecting some 500,000 servers, according to Netcraft, an Internet research firm. Here's what you can do to make sure your information is protected, according to security experts contacted by CNET
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Enjoy!
David.

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