Monday, September 01, 2014

Weekly Australian Health IT Links – 01st September, 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 review of the NBN and what will now apparently be delivered, as far as broadband is concerned, to a waiting populace. It is a compromise but seems as though it might just deliver some useful improvement reasonably quickly. As always it seems, time will tell!
Otherwise the consultation period on the PCEHR Review concludes today and now we wait to discover what we all think. Hopefully will only take a few weeks and then the outcomes can become public - in my dreams I fear!
Enjoy the browse.
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FTTP needed for teleHealth, say Labor MPs in open letter

Two Labor members of Parliament have written an open letter to Malcolm Turnbull asking him to reconsider his scrapping of the Coalition’s FTTP NBN plans.
They argue that the greater bandwidth of Labor’s fibre to the premises (FTTP) plan is necessary for the effective provision of teleHealth – using the Internet for remote diagnostics and monitoring and the like.
The letter some two days after the Vertigan panel on the NBN’s cost-effectiveness concluded that an FTTP network would be much less cost-effective than the Coalition’s ‘multi technology mix’ model.
The main criticism of Vertigan’s findings is that its conclusions are made on assumptions about the future value of broadband services, when we cannot put a value on applications we cannot know about. The Vertigan report assumes the Internet will be used much as it is now, while the open letter explores one specific class of new applications - teleHealth
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eHealth NSW gets busy on technology rollouts

CIO Michael Walsh and CCIO John Lambert give an update on the several e-health projects underway
Rebecca Merrett (CIO) on 29 August, 2014 09:00
eHealth NSW CIO, Michael Walsh, and newly appointed chief clinical information officer, John Lambert, have laid out some of the technology projects they are focusing on this year, as part of the state’s $400 million e-health strategy.
At an AIIA event in Sydney this week, Walsh and Lambert gave an update on clinical portal HealtheNet, an enterprise image repository, incident management system, StaffLink HR system , videoconferencing, and how the organisation is increasing bandwidth.
The HealtheNet portal is a Commonwealth funded project that links multiple hospital databases to give clinicians a single view of repositories. It also integrates with the national Personally Controlled Electronic Record (PCEHR).
Walsh said he is currently working with the federal government on integrating pathology reports into the PECHR so that clinicians using HealtheNet do not have to re-do recent reports.
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E-health needs information, not just data: CIO

By Natasha Egan on August 29, 2014 in Government, Technology
Data collected for e-health must be useful information to clinicians and system managers otherwise it is not worth collecting and providing, NSW Health’s chief information officer has told an information industry forum in Sydney this week.
Michael Walsh, who is also the newly-appointed CEO of the government’s two-month old e-health entity, was giving an update on the state’s 10-year $1.5 billion e-health strategy to the Australian Information Industry Association’s state healthcare forum on Wednesday.
Mr Walsh gave a glimpse of the thinking in eHealth NSW’s forthcoming draft strategic plan, which, while originally due in August, would be released later this year for public consultation, he said.
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Telstra says answer to healthcare lies in the cloud

Jessica Gardner
Healthcare companies hoping to tap into growing Asian markets should focus on innovative cost-saving measures that help governments reduce their exposure to ballooning medical care budgets, experts have said.
Telstra’s head of health Shane Solomon told an Asialink Business event in Melbourne that although countries in the region were spending to improve their healthcare offering, companies should not expect an easy windfall based on exporting systems in place in Western economies. “These [Asian] systems are not rich,” he said. “The real disrupter in Asia will be the low-cost solutions.”
Mr Solomon, who was poached from KPMG last year to lead Telstra’s foray into health technology, said countries like Indonesia, where there are 0.6 hospital beds per 1000 people, cannot simply respond by building expensive infrastructure. “[The government is] looking to understand how can the population benefit from the advances in the economy without having to build ­squillions of hospitals,” he said.
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Telstra plans to move into e-health before Asia push

Telstra executive Gordon Ballantyne says the telecommunications giant will use domestic markets as a proving ground for its burgeoning health business before pushing into growth markets in Asia.
Telstra has made a number of investments in start-ups such as pharmacy software provider Fred IT and doctor booking website HealthEngine after announcing, just over a year ago, that it would make a play in the health technology sector.
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J Am Med Inform Assoc doi:10.1136/amiajnl-2014-002804

The double-edged sword of electronic health records: implications for patient disclosure

  1. Celeste Campos-Castillo1,
  2. Denise L Anthony2

Abstract

Objective Electronic health record (EHR) systems are linked to improvements in quality of care, yet also privacy and security risks. Results from research studies are mixed about whether patients withhold personal information from their providers to protect against the perceived EHR privacy and security risks. This study seeks to reconcile the mixed findings by focusing on whether accounting for patients’ global ratings of care reveals a relationship between EHR provider-use and patient non-disclosure.
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EPtalk by Dr. Jayne

Recent research at the University of Michigan finds that patients with low literacy and low comprehension of numerical concepts are less able to understand online lab results. The Internet survey of 1,800 adult patients looked at simulated diabetes results and whether patients understood if labs were within or outside of reference ranges. Less literate patients were also less able to determine when they should call their doctor, based on the data.
Researcher Brian Zikmund-Fisher is quoted as saying, “We can spend all the money we want making sure that patients have access to their test results, but it won’t matter if they don’t know what to do with them.” At the other end of the spectrum, over three-quarters of patients with higher literacy skills could identify levels outside the reference range. He goes on to state the need for more research on the best ways to display lab data.
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New Online Forums to Support People Living with Mental Illness

Support for people living with mental illness and their family, friends and carers is the focus of two new online forums launched by the Minister for Health, Peter Dutton.
Page last updated: 27 August 2014
27 August 2014
Support for people living with mental illness and their family, friends and carers is the focus of two new online forums launched in Canberra today by the Minister for Health, Peter Dutton.
Minister Dutton said the SANE Australia Online Forums would help people by giving them trusted and anonymous access to reliable mental health information, advice and referrals.
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Taking care of each other online

| Aug 25, 2014 8:06AM | EMAIL | PRINT
One of the benefits of the Internet is its use as a tool to create communities among people who previously would have been isolated from each other.  Nowhere is this more apparent than in the growth of online forums for people with chronic illnesses and disabilities.  These are playing an increasingly important role in providing information, support and assistance to people with serious and chronic illnesses but they remain an under-researched area of the health system.   Susan Stewart Loane, a PhD Researcher at Macquarie University, is addressing this gap through her research and provides the following report of her findings. She writes:
No one had heard from Tracey[*] for a while, which was a concern because Tracey had Motor Neuron Disease (MND).  Members of Tracey’s social circle tried valiantly to contact her with no success.  Finally, someone decided to drive 250km to her house and check that she was ok.  She was.  She’d had a fall and was too dizzy to use the computer.  The friend got the message out and everyone was relieved.  But a week later Tracey still hadn’t got in touch and they started to worry again.  Someone who lived closer (but who barely knew Tracey) offered to drive to her house and check on her.  Again Tracey was found to be ok, but still recovering.
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Department of Human Services uses big data analytics to measure staff performance

DHS health and information deputy secretary Barry Sandison says call centre staff are measured on how quickly they answer the phone
Hamish Barwick (CIO) on 26 August, 2014 09:52
The Department of Human Services (DHS) is striving to improve its customer service through the use of big data analytics.
Speaking at the Teradata Summit in Sydney, DHS health and information deputy secretary Barry Sandison told delegates that it has a “gigantic database” of customer behaviour information.
“Every Australian is in the database and we divide our data sets into child support, Centrelink and Medicare. There are 23.5 million active records,” he said.
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Pharmacy project stops drug misuse

By ARYELLE SARGENT
Aug. 26, 2014, 3:33 p.m.
BEFORE a program called Project STOP, people could walk into a pharmacy off the street and purchase cold and flu tablets for the pseudoephedrine to make ice.
Pharmacy Guild of Australia state president and Coventry Pharmacy Latrobe pharmacist John Dowling said customers looking to make the drug would go to several pharmacies to buy enough tablets to avoid suspicion.
Project STOP has nipped this in the bud with a national database that records who buys cold and flu tablets containing pseudoephedrine.
This requires those buying the tablets to show a valid drivers’ licence.
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How Medibank embraced cloud, overcame shadow IT

Medibank enterprise security manager Mark Burns says it has embraced the cloud rather than trying to stop staff using services
Hamish Barwick (Computerworld) on 27 August, 2014 11:09
Medibank is allowing staff outside of the IT department to sign up to cloud services such as Amazon Web Services (AWS) to reduce website hosting costs, while at the same time including IT security in the process, according to Medibank enterprise security manager Mark Burns.
Speaking at the Gartner Security and Risk Management Summit in Sydney this week, Burns told delegates that IT security has received 20 separate requests over the past six months to use different cloud services such as online storage.
“One of the key challenges for my security team is dealing with the potential loss of visibility. Traditionally, we were able to force the business to engage with IT because they were relying on us to deploy the server, install the software or open up the firewall,” he said.
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DHS to roll out network ‘stress testing’ for agencies

Department of Human Service's data centre environment has become more complex following integration of other agencies in mid-2011
Byron Connolly (CIO) on 28 August, 2014 11:24
The Department of Human Services (DHS) has tendered for testing and network infrastructure to benchmark and validate changes to its data centre to support the integration of Centrelink, Medicare and CRS Australia.
These agencies were rolled into one DHS portfolio in mid-2011, which has increased the scale and complexity of its data centre environment.
In February last year, DHS told CIO it was hoping to cut the number of system outages across its environment by 5 per cent per quarter until early 2014. The agency experienced 137 system reliability outages in the 12 months between October 1, 2011 and September 30, 2012.
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The many tribes of informatics

August 29, 2014
My learned and senior informatics colleagues spend much time debating the different professional roles that together are needed to support the practice of informatics (e.g. informatician, informatasist). Over the years I have assembled a set of definitions for these professional roles, as well as allied concepts. I feel this list is unlikely to help the debate at all.
Informatocyst [In-for-mata-s-ist, n] (see also, legacy system). A collection or build up of information, walled off from the greater information system by a barrier of incompatible or aged interchange standards.
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Paging Dr. Watson, IBM's medical adviser for the future

IBM's Watson could help doctors by analyzing the masses of literature in the field
Joab Jackson (IDG News Service) on 29 August, 2014 07:39
IBM Watson can match possible treatments to genetic disorders
IBM continues to make the case for the nascent field of cognitive computing, showing off some Watson prototypes Thursday that could help speed scientific discovery in the medical field, by scanning large volumes of literature and data far more quickly then humans can, and suggesting possible leads.
The New York event was to promote an update to a cloud service, called Watson Discovery Advisor, that can help researchers find fresh connections within mass realms of data.
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Diagnostic software may detect cancer in X-rays

  • Elizabeth Dwoskin
  • The Wall Street Journal
  • August 26, 2014 12:00AM
WHAT if software akin to the program that recognises faces in Facebook photos could detect cancer in an X-ray?
That’s the idea behind Enlitic, a new US startup founded by Jeremy Howard, who is a heavy hitter in big data — he’s data strategist for Silicon Valley venture capital powerhouse Khosla Ventures and former president and chief scientist of Kaggle, which hosts big-brain predictive modeling competitions.
Enlitic aims to use advances in machine learning to make medical diagnoses.
The company says it has partnered with hospitals and medical imaging companies — Howard won’t say which ones — to mine a host of data sources, including X-rays, lab results, handwritten doctors notes, and claims records. The company is building software algorithms to identify otherwise invisible patterns in these data sources, making for sharper diagnoses.
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Thatcher reflects on ten years at Mater

Longstanding Mater Heath Services chief information officer, Mal Thatcher is set to move to the new strategically focused Chief Health Information Officer role at Queensland Health. The move, which involves a 12 month leave of absence from Mater, is set to commence next month.
While Thatcher was circumspect about what his placement will involve at Queensland Health – he said he was waiting until he hit the ground – he was willing to look back over his decade plus time at Mater.
“I have two roles at Mater,” he said. “I am chief information officer, and also executive director for information and infrastructure.”
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Australian startup snapshot: Vimcore

Connecting business employees to healthcare providers
Adam Bender (Techworld Australia) on 29 August, 2014 16:06
Vimcore is a Sydney B2B startup that connects its customers’ employees to local healthcare providers. When not running the business, the company’s co-founder, Jessica Evans, advocates women entrepreneurship in the largely male tech startup scene.

The pitch

Vimcore targets businesses that care about employee health and want to provide a simple way for their staff to access healthcare advice and find medical services.
Evans, a physiotherapist, has experience in the corporate world, including a previous job at Sanitarium. She said she has seen first-hand that large companies often struggle to provide good healthcare information and services to employees.
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CDA Validator v2.0 and Template Packages Available for Download

Created on Thursday, 28 August 2014
NEHTA has released the next major version of its CDA Validator tool for the automated validation of clinical documents. This new version helps implementers reduce development and test times by performing a wider range of checks for clinical documents.
Version 2.0 of the CDA Validator now covers validation of:
  • The CDA document itself;
  • The CDA package containing the CDA document, attachments and additional material;
  • Updated versions of clinical terminology.
The validation of CDA documents can now be performed against different versions of clinical document specifications. This is supported by the publication of all available template packages for these specification versions on the NEHTA website. CDA Validator v2.0 can perform CDA document validation against any of these template packages.
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Astounding finding - NBN benefit not worth cost

The long awaited Vertigan cost benefit analysis of the NBN has found that Labor’s version was a waste of money, while the Coalition’s offers much better value. Wow!
One of the main criticisms Malcolm Turnbull and the Coalition levelled against Labor’s FTTP (fibre to the premises) NBN was that no cost benefit analysis (CBA) was ever conducted.
Now, as part of the Government’s never ending NBN review process, we have such a CBA. It finds that Labor’s FTTP NBN provides much worse value for money than the Coalition’s ‘multi technology mix’ (MTM) NBN. The unsurprising finding is based on a number of assumptions that unfortunately do little to dispel the view that the report’s conclusions are tailor-made to suit the Coalition’s purposes.
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NBN cost-benefit analysis signals the end of an era

The long-awaited cost-benefit analysis of the National Broadband Network suggests the days of politicians shooting from the hip with taxpayer dollars are numbered.
The long-awaited cost-benefit analysis of the National Broadband Network suggests the days of politicians shooting from the hip with taxpayer dollars are numbered.
As Labor’s NBN unfolds amid reviews and revelations, it’s apparent the NBN was a political move based on romantic notions of policy-making ending in Labor’s electoral defeat in 2013.
In government, the Coalition called for a strategic review of the NBN, revealing a number of problems with the project’s implementation. Malcolm Turnbull also promised to deliver an independent cost-benefit analysis of the economic and social costs and benefits of the NBN.
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Cost benefit analysis shows Turnbull plan has $16b advantage

Date August 27, 2014 - 11:00AM

Matthew Knott, Peter Martin

The Abbott government's pared-back broadband plan is three times more cost effective than Labor's ambitious scheme and would leave Australians $16 billion better off, according to the first independent cost-benefit analysis of the national broadband network.
In a scathing verdict on the Rudd and Gillard governments' plan to introduce fibre directly to 93 per cent of premises, the cost benefit analysis finds the policy is so expensive it would barely leave the community any better off in net terms than if broadband investment remained frozen at present levels.
The much-anticipated report finds households and businesses will benefit from quicker downloads but the much-vaunted societal benefits of fast broadband – such as improvements to health and education services – will probably be extremely limited.
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Government low-balling us on second-rate NBN

Date August 29, 2014 - 11:52AM

Gadgets on the go

Adam Turner is an award-winning Australian freelance technology journalist with a passion for gadgets and the "digital lounge room".

Justifications for the multi-technology mix only add up when you ignore the inconvenient numbers.
This week's NBN review supports the government's decision to scrap the national fibre-to-the-premises rollout and instead take a patchwork multi-technology mix approach – hooking up a quarter of homes to fibre but relegating the rest to HFC cable, fibre-to-the-node or satellite. It's telling that Communications Minister, Malcolm Turnbull, was happy to sign off on this approach before the report was completed, after criticising Labor for favouring fibre-to-the-premises without first crunching the numbers.
If you're still not convinced that the NBN-lite is a bargain, Turnbull is happy to spell it out for you on a whiteboard – explaining why fibre-to-the-node is more cost-effective than fibre-to-the-premises. The always articulate Turnbull makes some valid points, but the numbers only stack up if you assume low growth in bandwidth demand, ignore the costs in maintaining legacy infrstructure and don't factor in the possibility of future fibre upgrades.
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High-speed broadband can quickly be delivered at a reasonable cost

Henry Ergas

THAT the release of the cost-benefit analysis of the National Broadband Network has generated as much heat as light is perhaps unsurprising. The debate about the NBN has always been drenched in politics. And the analysis itself is lengthy and complex, making its findings difficult to communicate and absorb.
But every voter needs to understand what is at stake in Australia’s biggest infrastructure project. So here is “an intelligent reader’s guide to the NBN CBA”.
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Explainer: Which NBN scheme is best for you?

Date August 31, 2014 - 9:00AM

Peter Martin

Economics Editor, The Age

It was going to be bigger than the Snowy Mountains Scheme and it was going to revolutionise our lives. Four years ago Labor began an audacious program of connecting every house and business in the country to the internet, all over again. It was to cost $43 billion and it commenced without a cost benefit analysis. This week the Coalition released the results of a cost benefit analysis into Labor's NBN, the first. It finds the benefits would never have approached the cost. Who's right, and who's offering the best plan now? Peter Martin runs the numbers.
WHAT WAS LABOR OFFERING?
Every address in every city and reasonable sized town was to be offered the chance to be wired up to an optical fibre cable. Remote locations were to be connected by satellite and wireless. As of June this year NBN Co had connected 210,000 locations and had millions to go. The promised speed for the fibre links was 100 megabits per second, with the whole system upgradable later to 1000 Mbps, each far faster anything that was available at the time.
WHAT COULD IT BE USED FOR?
The cost benefit study finds most uses don't require anything like 100 Mbps. Ultra high definition TV comes closest. The government's advertising stressed instead the unknowable nature of its uses saying the NBN would be used "in ways we only dream of".
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DIY blood pressure better than doctor, study finds

  • AP
  • August 27, 2014 7:27AM
 “DO-IT-YOURSELF” blood pressure measurements and medicine changes work better than usual doctor-office care in some patients, a study of older adults in England found.
Those who did their own readings at home and adjusted their medicine as needed had healthier blood pressure levels after a year than those who got standard doctors’ care.
Self-care patients weren’t completely on their own — any changes they made were part of a treatment plan previously OK’d by their doctors. But the patients didn’t need to consult their doctors every time they increased the dose if it was part of the original treatment plan.
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Enjoy!
David.

1 comment:

Anonymous said...

It's just a blatant lie that fibre to the premises (FTTP) plan is necessary for the effective provision of teleHealth. This was one of the only conclusive outcomes of the NBN funded tele health trials.