Tuesday, May 27, 2014

Weekly Australian Health IT Links – 27th May, 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

The release of the PCEHR Review could have been expected to remove all other news from the airwaves bit it didn’t and we have all sorts of interesting stuff as well. A separate blog will review the PCEHR Review coverage.
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Why most health IT procurement fails and how to fix it

A strange thing happens in health IT solution procurement, and by extension government initiatives that seek to influence it. See if you can disagree with the following characterisation of health provider organisations as solution purchasers.

Think You’re Getting What You Want?

CIOs and CMOs have known for years if not decades that:
  • the data used inside their institution are their most important asset – either as a productive resource, or at least as an object of risk management. Most today would understand it as both.
  • the data used inside their institution is not all produced inside their institution – lab data often comes from external lab companies; they obtain or would like to obtain GP data such as medications lists, problem lists and so on;
  • their main vendor solution never supports the data richness actually required by clinicians - it is well known for example that most hospitals contain dozens if not hundreds of hidden specialist’s databases, often referred to as the ‘Access Database problem’;
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How to save our sick health system without GST hikes

At this point, Australia does NOT -- repeat NOT --  need an increase in GST to fund the shortfall in health.
The waste in health administration is so immense that there is enormous scope to cut costs and improve services.
Most attempts to reduce the health system’s costs have failed, but two recent events provide real hope that we are close to a breakthrough and can realise the sector’s cost-cutting potential. Only after we have fully pursued both of these new avenues should we consider increasing the GST.
The Australian health system is made up of about 100,000 small enterprises plus a few big hospitals, medical funds and, of course, government organisations. And in most sectors, apart from money matters, they don't talk to each other electronically, so the data collection duplication costs are mind-blowing. It could represent 20 or 30 per cent of costs. This is compounded by the paper-based internal workings of most hospitals. 
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Written by Renai LeMay on Wednesday, May 21, 2014 16:36

SA e-Health system could cause fatalities

blog It used to be pretty rare that Australia would see an IT system implemented or maintained so poorly that it had the potential to cause fatalities or serious injury. But not any more. This year we’ve seen three such cases in Victoria alone, linked separately to failing IT systems at Victoria Police (which actually did result in several deaths), a Victorian hospital and, most worryingly, with relation to children’s safety under the care of the Department of Human Services. Well, last week South Australia got its own potentially fatal IT system. Adelaide news site InDaily writes about the state’s new Enterprise Patient Administration System (we recommend you click here for the full article).
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Tiny breakthrough in medical implants

STANFORD University researchers have developed injectable power suppliers for pacemakers and nerve stimulators, opening the door to a new generation of microscopic medical implants.
The breakthrough, reported today in the journal PNAS, could lead to a new branch of medicine that treats diseases with electronics rather than drugs.
Most electronic implant components are now small enough to fit on tiny silicon chips but miniaturisation of power sources has not kept pace and many devices require bulky recharging systems or batteries, which need to be surgically replaced when they run down.
Scientists have experimented with “near field” electromagnetic waves as an alternative power source, but they have been considered viable only for shallow implants such as hearing devices a centimetre beneath the skin’s surface.
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Health CIO expects 'strong views' on opt-out PCEHR

Outsourcing RFT due this month.

Federal health CIO Paul Madden expects some “strong and sharp” views from various interest groups this year, as the government consults on a proposal that would see its health records system made opt-out for users.
Earlier this week the report of an inquiry into the the Personally Controlled Electronic Health Records scheme was made public, including its recommendation that registration for the system become default.
“We worked with the privacy lobby in the lead up to passing legislation for the PCEHR, which became an opt-in system,” Madden said to the Trans-Tasman Business Circle in Canberra on Thursday.
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Mobile vision for telehealth

Cate Swannell
Monday, 19 May, 2014
MOBILE health technologies — mHealth — may be the catalyst that lifts the cost-effective and sustainable implementation of telemedicine, says a telehealth expert.
Professor Sven-Erik Bursell, professor of telehealth at the NHMRC Clinical Trials Centre at the University of Sydney, said mobile technologies and health applications were crucial in overcoming “barriers to implementation” of telemedicine highlighted in an article published in the MJA. (1)
The MJA authors, led by Dr Nigel Armfield from the Centre for Online Health at the University of Queensland, wrote that the evidence base for telemedicine was “very limited”, leading to “slow and patchy” implementation.
“There is little incentive to adopt telemedicine, particularly in the absence of clinical and economic evidence”, they wrote. “Analysis before implementation of telemedicine is sometimes insufficient or omitted entirely.”
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Written by Renai LeMay on Friday, May 23, 2014 17:50

Report savages NT Govt’s ICT performance

news The Northern Territory’s parliament has published a landmark report into the management of ICT projects by its departments and agencies, finding a similar list of disasters as have been suffered by other state jurisdictions in Australia and recommending the immediate appointment of a whole of government chief information officer to help rectify the systemic issues.
The report, entitled Management of ICT Projects by Government Agencies, is available online in PDF format and was produced by the Public Accounts Committee of the Territory’s Legislative Assembly. It examined three major ICT projects within the Territory — the Department of Corporate and Information Services’ Asset Management System, Power and Water Corporation’s Asset Management Capability Project, and the Department of Health’s Grants Management System. Issues were found with all three.
Of the three projects reviewed for the inquiry, the Department of Infrastructure’s Asset Management System (AMS) project constituted the most significant failure, according to the report.
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No co-payments at your online doctor, says Doctus

An Australian-based online medical company, launched last year, is claiming it can provide a way around the government’s proposed co-payment for a visit to the doctor by offering an online doctor’s consultation in the comfort of your home or workplace.
The company – Doctus –  is promoting its so-called ‘revolutionary’ service as offering a convenient, cost effective solution, but only for “simple, low-risk medical conditions.”
Doctus founder and PR graduate from Sydney’s University of Technology – Sarah  Beckwith – and her father and Doctus Medical Director, Dr Rodney Beckwith, say that with routine visits to the doctor now set to cost patients an extra $7 per visit, the cost of healthcare for “routine script renewals and simple medical conditions is set to skyrocket.”
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Wearable computer to improve brain health

Date May 18, 2014

Matthew Hall

A former refugee, Young Australian of the Year and a global innovator to watch has turned her talent to help the fight against Alzheimer’s disease and other neurological conditions.
Tan Le is poised to launch a wearable computer to help monitor a user’s brain activity and prompt behavioural changes for long-term benefits.
Named Young Australian of the Year in 1998, Ms Le moved to the United States in 2005 to work on her bioinformatics start-up. Nearly a decade later and her Emotiv Insight headset is set to hit the shelves after raising more than $US1.6 million ($1.7 million) through fund-raising website Kickstarter. Her initial call late last year was for just $100,000 in funding.
“We’re all living longer and we know that once you reach the age of 65 the chances of developing a neurological condition increases and accelerates,” she said. 
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Medical board bows to pressure on social media rules

20th May 2014
THE Medical Board of Australia has yielded to pressure from doctors over confusing advertising and social media rules, changing the wording of guidelines relating to unsolicited testimonials.
Two months after the Guidelines for advertising regulated health services were first released, they have been updated to clarify that doctors “are not responsible for removing, or trying to have removed, unsolicited testimonials published on a website or in social media over which they do not have control”. 
In a statement issued on Tuesday, the national boards said they had acted on feedback received about the guidelines, which were first released in March.
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Board's final word on social media reviews

23 May, 2014 Paul Smith comments
The labyrinthine saga over whether doctors should be attempting to remove unsolicited reviews of their clinical care on social media seems to have reached an end.
The Medical Board of Australia caused a storm earlier this year after its draft advertising guidelines seemed to suggest doctors would be in breach of the rules if they did not attempt to remove unsolicited posts by patients.
The argument was that these testimonials could be seen as a form of advertising for which doctors could be held responsible.
Those guidelines, after being rewritten and clarified, are now in force. The board said that the rules were not intended to stop the community or patients from discussing their experiences online.
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Update on  the 3rd Edition

May 18, 2014
Many people have been asking me about the progress with our re-write of the Guide. My goal is for the completed book to be delivered to the publisher around mid June 2014. So, very soon now. Hopefully you will see the 3rd edition available in electronic or paper formats towards the end of the year.
Notable changes to the book include major updates to most chapters, as well as many new chapters. New chapters will cover topics such as the safety of information technology, social networks and social media, personalised medicine, and consumer informatics. System implementation will be reflected in the text, and the last parts of the book which traditionally have focussed on decision support topics are largely re-written and expanded.
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Mind-reading machine takes images from brain

SCIENTISTS have created a mind-reading machine so powerful it can extract images from people’s brains and then display them on a screen for ­others to see. The system has been used to accurately reconstruct human faces based only on data from the brain scanner.
The researchers say the same approach could one day also allow them to reconstruct images from people’s dreams, memories and imagination. Another future application could be to generate images of criminals from the minds of witnesses.
“Our methods yield strikingly accurate neural reconstructions of faces,” said Alan Cowen, a neuroscientist at the University of California, Berkeley.
In the research, the scientists showed six volunteers 300 faces while they lay in an MRI scanner. This process showed how their brains responded to features ranging from blond hair and blue eyes to dark skin and beards.
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Qld’s payroll repair man takes over NSW Health IT


Walsh appointed to ‘super-CIO’ role.

The NSW Government has appointed Michael Walsh the inaugural chief executive of its brand new IT agency, eHealth NSW.
Health Minister Jillian Skinner launched the new agency in December last year, which will see IT oversight for the state’s health system split out of HealthShare NSW and installed into a dedicated group.
Walsh effectively takes over the responsibilities left behind by NSW Health’s last permanent CIO Greg Wells, but will work side-by-side with Secretary Mary Foley, reflecting the promotion of IT up the executive food chain in the department.
He now holds responsibility for IT running the country’s largest health system, which employs more than 100,000 staff and cares for 17,500 patients in hospital beds every night.
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Wristband aid to help manage Parkinson’s

A MELBOURNE firm is expanding its production of wearable technology designed to help ­Parkinson’s disease sufferers live a better quality of life.
The technology, a wristband called the Parkinson’s Kinetigraph, has a built-in accelerometer like the common one found in smartphones and wearable tech devices such as the Jawbone Up and Fitbit Flex.
The Kinetigraph collects raw movement data which shows the symptoms of Parkinson’s disease. Clinicians can use the data to finetune medication.
The Melbourne-based Global Kinetics Corporation managing director Andrew Maxwell said the firm had developed two software algorithms that turned the wristband data into information discernible to doctors.
Patients typically wore the ­device for 10 days. It measured the level of “bradykinesia” — the slowness of movement patients experienced at the onset of symptoms. Bradykinesia typically is treated with dopamine replacement therapy.
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Telemedicine — is the cart being put before the horse?

Nigel R Armfield, Sisira K Edirippulige, Natalie Bradford and Anthony C Smith
Med J Aust 2014; 200 (9): 530-533.
doi: 10.5694/mja13.11101

Summary

  • A large literature base on telemedicine exists, but the evidence base for telemedicine is very limited. There is little practical or useful information to guide clinicians and health policymakers.
  • Telemedicine is often implemented based on limited or no prior formal analysis of its appropriateness to the circumstances, and adoption of telemedicine by clinicians has been slow and patchy.
  • Formal analysis should be conducted before implementation of telemedicine to identify the patients, conditions and settings that it is likely to benefit.
  • Primary studies of telemedicine tend to be of insufficient quality to enable synthesis of formal evidence.
  • Methods typically used to assess effectiveness in medicine are often difficult, expensive or impractical to apply to telemedicine.
  • Formal studies of telemedicine should examine efficacy, effectiveness, economics and clinician preferences.
  • Successful adoption and sustainable integration of telemedicine into routine care could be improved by evidence-based implementation.
Telemedicine, the use of information and communication technology to deliver clinical services at a distance, although perceived as an innovation, has been discussed in peer-reviewed literature for over 40 years.1 While many articles describe the successes and failures of telemedicine, the evidence base for its use is weak. The common view is that it can benefit patients and clinicians, extending services into places where none previously existed. Here, we reflect on the shortcomings of telemedicine research and implementation, and suggest ways to strengthen the quality of evidence in relation to telemedicine.
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New online training helps health professionals deliver best-practice quitting advice

Monday 19 May, 2014
Helping health professionals to incorporate evidence-based brief advice to clients who smoke is the focus of a new online learning hub created by Quit Victoria.
The online training will guide health professionals through the best way to talk to clients across a broad range of settings about quitting. as well as the stages of change, the 5A’s framework and smoking behaviour.
Quit Victoria Cessation, Partnerships and Priority Settings Manager Luke Atkin said health professionals played a vital role in helping smokers to quit but the range of scenarios and attitudes to quitting they faced was broad.
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How BASIC opened up computers to all of us

  • Dan Rockmore
  • The Wall Street Journal
  • May 19, 2014 10:10AM
FIFTY years ago, at 4am on May 1, 1964, in the basement of College Hall at Dartmouth College, the world of computing changed forever.
Professor John Kemeny, then the chairman of the mathematics department at Dartmouth and later its president, and Mike Busch, a Dartmouth sophomore, typed “RUN” on a pair of computer terminals to execute two programs on a single industrial-sized General Electric “mainframe” computer.
The programs were written in BASIC (Beginner’s All-purpose Symbolic Instruction Code), a fledgling computer language designed for the everyman, by Prof. Kemeny, Professor Tom Kurtz and a team of eager students.
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Enjoy!
David.

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