Monday, March 16, 2015

Weekly Australian Health IT Links – 16th March, 2015.

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

An interesting week with a fair bit happening in terms of Audits and the need to fund major system updates.
Well worth a browse through the headlines
Still no news on the PCEHR.

ADF health records IT system implementation 'deficient'

Summary: The planning and implementation of the Australian Defence Force's health records management system in 2009 has been found to have been 'deficient', resulting in a AU$110 million blowout of the project's original budget, according to the Australian National Audit Office.
By Leon Spencer | March 10, 2015 -- 06:16 GMT (17:16 AEDT)
Australian Auditor-General Ian McPhee has released a report concluding that the "deficient" planning and implementation of the Australian Defence Force's (ADF) Defence eHealth System (DeHS) in 2009 resulted in a five-fold increase in the project's overall budget by February 2014, to AU$133.3 million.
The initial June 2009 budget for the project was AU$23.3 million, according to the Australian National Audit Office's (ANAO) Report (PDF) into its review of the ADF's electronic health records management system for Defence personnel.
Defence initially planned to develop DeHS as a mature system by December 2011, but did not complete its rollout until December 2014.
The ANAO's report, released on Tuesday, said that it had identified significant weaknesses in the early stages of the project, relating to its planning and budgeting, project management, and implementation.

Audit blames Defence Department for e-health project bungle

Fran Foo

THE Department of Defence misinformed its minister in an e-health project that subsequently blew out by a whopping $110 million, a new audit report found.
The department was squarely to blame for the blowout in implementing the Defence e-health system, originally known as Jedhi or joint e-health data and information system.
The Auditor-General delivered a scathing report on Defence’s performance, describing the department’s planning, budgeting and risk management for the project as “deficient”.
Weak project governance meant the system went live in December 2014 -- three years after the initial deadline.

Bad governance behind Defence eHealth cost blowout

Minister in charge not properly informed, auditor finds.

A $110 million cost blowout to the Department of Defence's new eHealth system was a result of deficient planning, budgeting and risk management, the national audit office has found.
Auditor-General Ian McPhee today published his report [PDF] into the Defence eHealth System (DeHS), which was approved in 2009 with a budget of $23.3 million and was scheduled to go live by December 2011.
However, a series of scope changes and budgeting bungles lead to a massive cost overrun - to the tune of $110 million by 2014 - as well as a number of delays to the go-live, McPhee revealed.
He laid the blame for the cost blowout squarely on Defence.

Health websites ‘too difficult to read’

12 March, 2015 Bronwyn Walenkamp
Information on most consumer health websites is too complex for lay Australians to read and understand, according to their study published in the Australian and New Zealand Journal of Public Health.
The readability of government, not-for-profit, and commercial health websites was found to be above average Australian levels of reading, which for this study was set at year 8.
“Limited availability of easy to read health materials suggests many Australians may not be benefiting from the convenience of the internet,” say Matthew Dunn and Christina Cheng from Deakin University.

Co-dependent? New stoush between SAI Global, Standards Australia

Simon Evans
A new stoush has developed between the former $1.1 billion takeover target SAI Global and its one-time parent Standards Australia, which owns the 6900 standards and regulations that are the lifeblood of one of SAI's most profitable divisions.
Standards Australia chief executive Dr Bronwyn Evans says her organisation has many options available to it and is annoyed that SAI Global chief executive Peter Mullins referred to the two organisations as being "co-dependent" on each other when delivering his first-half earnings.
The relationship between the two entities is of vital importance to the future valuation of SAI and whether private equity firm Pacific Equity Partners may seek to revive a $1.1 billion buyout proposal that ultimately ended up not becoming binding when a formal sale process began. PEP and partner Kohlberg Kravis Roberts didn't lodge a binding offer after extensive due diligence, largely because of uncertainty surrounding the future of the lucrative publishing agreement held by SAI, which publishes 6900 standards and regulations on behalf of Standards Australia under a 15-year contract, which ends in late 2018.

Welfare systems face $1bn upgrade

Phillip Hudson

FEDERAL cabinet is considering a $1 billion plan to replace the 1980s-era Centrelink computer system amid warnings it has ­become an impediment to the sweeping welfare overhaul designed to ease pressure on the fastest-growing area of government spending.
With the simple task of changing a letter for social security payments taking 100 public servants six months and costing $500,000, Social Services Minister Scott Morrison and Human Services Minister Marise Payne are pushing for funding in the May budget to replace the system.
Senior public servants have backed the call and have prepared a business case, outlining a three-year plan that was formally handed to the government last month.
Centrelink’s Income Security Integrated System, which handles $100bn of payments a year, runs on a Model 204 mainframe that has been repeatedly patched up by successive governments but is now considered unable to cope with the overhaul of the payments system suggested by welfare reformer Patrick McClure.

Welfare systems face $1bn upgrade

Phillip Hudson

Joe Kelly

A new hope to welfare system

SOCIAL Services Minister Scott Morrison has declared there would be near-immediate savings and more effective service delivery arising from the replacement of an antediluvian 1980s era Centrelink computer that poses a new impediment to welfare reform.
Federal cabinet is currently considering replacing the system in a move estimated to cost about $1bn with The Australian revealing today that changing a letter for social security payments takes 100 public servants six months at a cost of $500,000.
Centrelink’s “Income Security Integrated System” which handles $100bn worth of payments each year runs on a Model 204 mainframe considered to be too cumbersome to cope with the overhaul of the payments system proposed by welfare reformer Patrick McClure.
Mr Morrison and Human Services Minister Marise Payne are pushing for funding in the May budget to replace the outdated system.

Records are your best defence

Most doctors are likely to receive one complaint or claim during their professional life. It is a ‘life event’, likely to be stressful and filled with uncertainty. None of us like our professionalism questioned or suggestions that we may have done wrong. 
Upon receipt of a complaint or a claim, you will of course immediately notify your medical indemnity insurer.
Your insurer is unlikely to say – “That’s terrible doctor.  Please come round and have a cup of tea and a biscuit so that we can discuss the matter with you.”  Your insurer is more likely to say – “That’s terrible doctor.  Can you please send us a copy of your medical records and file in relation to this claim, and then we will have you around for a cup of tea and a biscuit to discuss the matter with you.”

eHealth Integration Sample Code (eHISC) v2.0 March 2015 Release

Created on Thursday, 12 March 2015
NEHTA has released updated specifications for the eHealth Integration Sample Code (eHISC) comprising source code and associated documentation for the software.
It is available for download from the following location on the NEHTA website:
eHISC has had multiple enhancements, please download the Release Note v2.0 to view changes:
The eHISC provides implementers and software vendors with a sample implementation of a communications solution that enables patient administration systems and clinical information systems to interact with the Healthcare Identifiers Service and the personally controlled eHealth record system (PCEHR).

Establishing Interoperability by Legislative Fiat

Posted on March 10, 2015 by Grahame Grieve
h/t to Roger Maduro for the notification about the Rep Burgess Bill:
The office of Rep. Michael C. Burgess, MD (R-Texas) released a draft of the interoperability bill that they have been working for the past several months on Friday. Rep. Burgess, one of the few physicians in Congress, has been working very hard with his staff to come up with legislation that can fix the current Health IT “lock-in” crisis.
Well, I’m not sure that it’s a crisis. Perhaps it’s one politically, but maybe legislation can help. With that in mind, the centerpiece of the legislation, as far as I can see, is these 3 clauses:

Coroner's inquest to focus on electronic monitoring of meds

9 March, 2015 Christie Moffat
A coronial inquest into the deaths of three men from Western Australia will focus on the need for an electronic prescription monitoring system.
As reported by the ABC, the Coroner’s Court of Western Australia today commences its two-week inquest into the prescription drug-related deaths, and will examine the importance of doctors and pharmacists being able to access patient drug history in real time.
The inquest will hear from a range of expert witnesses, including a toxicologist, a specialist in pain medicine and representatives from the Pharmacy Guild of Australia and the Western Australia Alcohol and Drug Authority.

Centrelink IT system costing millions: Abbott

Centrelink's antiquated computer system is set to be scrapped at a cost of $1 billion because of concerns it won't cope with a planned overhaul of the welfare system.
AAP (Computerworld) on 09 March, 2015 13:52
Centrelink's antiquated computer system is set to be scrapped at a cost of $1 billion because of concerns it won't cope with a planned overhaul of the welfare system.
Social Services Minister Scott Morrison said when the system was introduced in the 1980s about two-and-a-half million people received payments.
Now there are about 10 million welfare recipients, with $400 million spent on 50 million transactions every day.

Electronic medication management outperforms paper system in cost and patient safety

By admin E-Health & Technology Mar 12, 2015
A recent study into the cost-effectiveness of using an electronic medication management system (eMMs) has shown that monetary savings from reduced adverse drug events can offset the cost of implementing the system, making it more cost effective when compared with paper-based prescribing.
Research led by Professor Johanna Westbrook of the Australian Institute for Health Innovation at Macquarie University, and clinical and IT staff from St Vincent’s Hospital in Sydney, found that the implementation of CSC’s MedChart system could provide savings of about $100,000 a year in a 30-bed ward.
“Before now, several studies had shown that health information technologies help to reduce medication errors, particularly prescribing errors among hospital patients. This is the first Australian study to look into the cost savings of these reductions,” said Westbrook.

Authority scripts to be automated?

12th Mar 2015
THE days of waiting up to 10 minutes on the phone for a clerk’s permission to prescribe certain PBS-listed drugs may be coming to an end.
The Department of Human Services is considering a plan to automate the PBS authority approvals process, in an overhaul that would give GPs online approval to prescribe many drugs. 
In a letter seen by MO, the DHS says it will consider two options to automate authority prescriptions — one built into prescriber software and one accessed through Medicare’s Health Professional Online Services (HPOS) portal. 
Authority approval processes for complex and restricted medications would remain the same for now, the letter says. 

ABC’s Active Memory brain training website wins AIMIA award

Active Memory, the ABC’s online brain training program, has won the Best Website or Online Services – Healthcare & Pharmaceuticals Award at last night’s AIMIA awards. Active Memory also was highly commended in the Best Website or Online Services in the Learning and Education category.
AIMIA and the digital industry celebrated the outstanding achievements and work produced over the past year by over 100 finalists across 30 categories. The recognition of Active Memory places the ABC brand alongside some of the best digital products in the country.

St Vincent's bans photography in hospitals amid privacy concerns

Date March 15, 2015 - 12:15AM

Harriet Alexander

St Vincent's Hospital has banned unauthorised photography on its campuses in a bid to protect the privacy of its patients.
Patients and their visitors will now have to seek permission from staff members before taking photographs in all wards except for the maternity ward at the Mater Hospital on the north shore, where celebrity babies such as the daughter of Erica and James Packer and the three sons of Cate Blanchett were born.
The policy follows several episodes where patient privacy has been compromised, including two occasions in which the victims of high-profile assaults were filmed – once by a member of the public – and broadcast on television.

What can Medicare data tell us about system design?

| Mar 13, 2015 11:35AM | EMAIL | PRINT
Recently, Adjunct Associate Professor at the Menzies Centre for Health Policy, University of Sydney, Lesley Russell published a paper on Scrbd that reminds us how underutilized the data available to us on medical services really areMedicare obstetrics services and costs: an analysis of publicly-available data 2003-04 to 2013-14, demonstrates that data aren’t t always just about answers but can sometimes be  useful pointers to the most pertinent questions. In particular Dr  Russell is keen to demonstrate what examining financial data can tell us about system design and utilization.
The introduction to Lesley’s study is provided below. The full text can be found here.
VAXXIN8 provides the healthcare sector and organisations that they be exposed to preventable infectious diseases with a centralised, real-time view of the vaccination compliance for each member within their organisation. VAXXIN8 removes the administrative burden to investigate, store and manage vaccination compliance across the workforce.
10 March 2015, 5.38am AEDT

Apple releases its watch and makes a surprise move into the area of medical research

David Glance
Apple’s event at San Francisco’s Yerba Buena Center was widely expected to focus on the release of the Apple Watch.


In a move that took everyone by surprise however, Apple also released a new software platform called ResearchKit. Like HealthKit, the platform enables medical researchers to create applications that specifically support the enrolment of subjects in medical trials and the continuous collection of data for research projects. Five sample applications supporting research into Parkinson’s Disease, Cardiovascular Disease and Breast Cancer, were built with partner universities in the US, UK and China for the launch of the kit. Unusually for Apple, the platform will be Open Sourced which means that others can contribute to the core platform.

Apple aims to help medical studies with ResearchKit software framework

Apple will not see any of the health data collected by apps developed with ResearchKit
Fred O'Connor (IDG News Service) on 10 March, 2015 05:56
Apple introduces ResearchKit, giving medical researchers the tools to revolutionize medical studies
Apple thinks its new software framework can solve some of the biggest challenges facing medical researchers, including recruiting people for studies and collecting health data more frequently.
Called ResearchKit, the framework will allow developers to create apps for medical research studies and turn a smartphone into a diagnostic tool, Apple said Monday during an event in San Francisco. ResearchKit will be released as open source next month and the first five apps are available today, said Jeff Williams, Apple's senior vice president of operations. Because it's releasing ResearchKit as open source, apps can be developed for mobile platforms other than iOS, such as Android.

Inside the Australian Institute for Healthcare Innovation

The move from the University of New South Wales to Macquarie University by the Australian Institute for Healthcare Innovation (AIHI) late last year caused a stir in industry circles. Many wondered why the Institute had moved from the environment it had been in since its founding in 1999 – was there bad blood? Was money involved? However the AIHI played things close to its chest.
Now Professor Enrico Coiera, a director at the AIHI, has spoken for the first time about the move, and what the Institute has been up to since its move in 2014.
“The idea behind the move was to help us grow,” said Prof. Coiera, in an interview with “It had nothing to do with us being unhappy at UNSW – far from it. In fact we’re still in contact with people there, and still do work with them.”

NBN Co to test hooking up more premises to HFC

Construction trials for NBN HFC in Queensland and NSW
NBN Co will undertake construction trials in NSW and Queensland to test hooking up to the NBN homes that sit within the footprint of Optus's and Telstra's Hybrid Fibre Coaxial networks.
The trials will include hooking up homes that are not currently connected to the telcos' HFC networks.
The government-owned company said that the construction trials would begin mid-year.
The initial release of HFC commercial services on the NBN is slated for Q1 2016, according to the January 2015 edition of NBN Co's product roadmap.
  • March 6, 2015, 11:53 AM ET

What Will Life Be Like in an AI Future?

  • By Irving Wladawsky-Berger

Guest Contributor

People have long argued about the future impact of technology. But, as AI is now seemingly everywhere, the concerns surrounding its long term impact may well be in a class by themselves. Like no other technology, AI forces us to explore the boundaries between machines and humans. What will life be like in such an AI future?
Not surprisingly, considerable speculation surrounds this question. At one end we find books and articles exploring AI’s impact on jobs and the economy. Will AI turn out like other major innovations, e.g., steam power, electricity, cars–highly disruptive in the near term, but ultimately beneficial to society? Or, as our smart machines are being increasingly applied to cognitive activities, will we see more radical economic and societal transformations? We don’t really know.
These concerns are not new. In a 1930 essay, for example, English economist John Maynard Keynes warned about the coming technological unemployment, a new societal disease whereby automation would outrun our ability to create new jobs.

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