Monday, May 18, 2015

Weekly Australian Health IT Links – 18th May, 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

There is really little news other than the e-Health Budget plan. A good range of commentary follows.
11 May 2015, 3.30pm AEST

New name and opt-out policy won’t save the personal health record

DDespite A$485 million of rescue funding, there is no guarantee health professionals will participate in the e-health scheme, nor that the information supplied will be complete.

Author David Glance

Director of UWA Centre for Software Practice at University of Western Australia
The federal government is set to spend A$485 million to rescue Australia’s failed personalised electronic health record project. All Australians will be set up with a record and can opt out, in contrast to the previous system where patients opted in.
The new system, called myHealth Records, will be revised according to the recommendations of a report commissioned by the former health minister Peter Dutton in 2013. The report had 38 recommendations to improve the existing Personally Controlled Electronic Health Record system (PCEHR). The very first was to change the name from the less-than-catchy PCEHR (pronounced “pecker”) to the only slightly more acceptable myHealth Record.

A modest e-health proposal to government

Enrico Coiera
May 12, 2015
Dear [insert country name] Government,
E-health is hard. I think we can all agree on that by now. You have spent [insert currency] [insert number] billion on e-health programs of one form or another over the last decade, and no one knows better than you how hard it is to demonstrate that you are making a difference to the quality, safety or efficiency of health care.
You also know that so much of e-health needs to happen in the public domain that, irrespective of your desire to privatise the problem, you will end up holding the can for much of what happens. E-health is your responsibility, and your citizens will, rightly or wrongly, hold you accountable.
It is so hard to get good strategic advice on e-health. You recently commissioned [insert large international consultancy firm] to prepare a new national e-health strategy, and it didn’t come cheap at [insert currency] [insert number] million. In the end it told you nothing you didn’t really already know, but at least you can say you tried.

New approach to e-health, but will it lead to more waste?

Tuesday, May 12, 2015
New approach to e-health, but will it lead to more waste?
The Australian Healthcare and Hospitals Association (AHHA) has cautiously welcomed the Government’s investment in e-health, newly rebadged as MyHealthRecord. Likewise Centrelink’s investment in IT systems, and the Department of Health’s investment in expanded analytical capability, have the potential to positively contribute to improved health data resources for Australia, particularly if health data linkage programs are supported.
“E-health records have the potential to be an effective tool supporting high quality healthcare, but a comprehensive approach which addresses the needs of both clinicians and consumers is required, and the wasteful approaches of the past must be brought to an end,” says AHHA Chief Executive, Alison Verhoeven.

$485m for e-health is ‘good money after bad’

11th May 2015
THE government’s $485 million budget commitment to the personally controlled electronic health record has been met with scepticism by clinicians who say their e-health concerns have historically been ignored.
The Consumers Health Forum was one of the first stakeholder groups to welcome the “rescue package”, along with news that the PCEHR will go from an opt-in to an opt-out system as per one recommendation of the PCEHR’s comprehensive review completed in 2013.
“A common plea we hear from consumers is the frustration they feel when they have to repeat key information about themselves, their medical history and current medications to multiple clinicians,” CHF CEO Leanne Wells said yesterday.

Why the Govt can't simply go opt-out for e-health

Security, privacy safeguards not up to scratch.
The Australian Government plans to revamp the troubled PCEHR e-health records scheme to change patient participation from the current opt-in model to opt-out.
In line with the 2013 Royle Review, patient data from hospitals, general practice, pathology and pharmacy will be added by default to a central longitudinal health record, unless patients take steps (yet to be specified) to disable sharing.
The main reason for switching the consent model is simply to increase the take-up rate. But it's a much bigger change than many seem to realise.
The Government is asking the community to trust it to hold essentially all medical records. Are the PCEHR's security and privacy safeguards up to scratch to take on this grave responsibility?

New ‘opt out’ e-health system

10:58pm, May 10, 2015
Sophie Scott
All Australians will now have an electronic health record as part of a new e-health system, and people will have to opt out if they do not want to take part.
The previous arrangement, commissioned in 2012, was an “opt in” system where patients could choose to join, but it was plagued with problems.
Federal Health Minister Sussan Ley said research showed the best way was to put everyone on the system by default.

Budget 2015: What Joe Hockey should be announcing tomorrow night

Date May 11, 2015 - 12:15AM

Amanda Vanstone

Former Howard government minister

One more sleep and we will all know the full shape of the budget. Understandably, some bits have already been announced. If changes in one area would dominate the coverage of the budget, it is sensible to pre-announce them and let the minister responsible deal with the media fanfare or flack. It gives other aspects of the budget a chance to get some limelight in the budget coverage. Indeed it helps ensure that the whole narrative is not drowned out on budget night and thereafter by one or two aspects alone.
The Howard government did this at my suggestion in 1996 when we had some very contentious education changes. The week following was a week from hell, but it ensured the first Howard budget coverage was not dominated by education issues.

Oz gummint to empty another money-truck into e-health records

Take $AU485 million and call me in the morning, says Doctor Ley

11 May 2015 at 01:14, Richard Chirgwin
Having failed to attract Australians to e-health records in any significant numbers, the cash-strapped federal government is going to pour nearly half a billion into “rebooting” the strategy.
Health minister Sussan Ley announced over the weekend that under this week's federal budget, Australia's Personally-Controlled Electronic Health Record (PCEHR) would be renamed MyHealth Record.
It's hoped that this, along with AU$485 million, will find a home for a puppy nobody really cares about.
With less than 10 per cent of Australians willing to subject their health records to government storage and access bothering to register for the opt-in PCEHR, Ley said the new record would be opt-out rather than the current opt-in arrangement.

Floundering PCEHR gets $485 million 'reboot'

11 May, 2015 Paul Smith
Patients will be automatically signed up to the PCEHR unless they opt out under trials being rolled out by the Federal Government.
The move is part of its $485 million attempt to “reboot” the PCEHR, which has been blighted by low uptake and a lack of doctor involvement.
Federal Health Minister Sussan Ley said: “Doctors have indicated they’re much more likely to use the system if all their patients have a record.
 “It’s important that all Australians are signed up to ensure we have a functioning system, and trialling an opt-out model means we can do it carefully, methodically and ensure the appropriate protections are in place to give patients peace of mind.”

Care plan rebate link to PCEHR mooted

12 May, 2015 Paul Smith
Access to care plan rebates could be dependent on doctors using the PCEHR system.
There have been long-running concerns about the low uptake of the PCEHR, particularly with GPs’ (lack of) involvement in creating and updating patients’ shared e-health summaries.
To improve clinical engagement, it is now expected the Federal Government’s review of funding for chronic disease care, due to report by the end of the year, will recommend that Medicare-funded care plans are linked to the PCEHR.
Dr Steve Hambleton (pictured), chair of the advisory panel carrying out the review, said: “The panel has not started its work but I would be surprised if there was not some recommendation that e-health records are linked to management plans for those patients with complex problems.”
He said e-health records were a crucial part of the care of patients with chronic illness, especially in reducing adverse medication event.  

Rebooting the PCEHR: Opt-out and a new name are not enough

Health Minister Sussan Ley has announced that “the Abbott Government will deliver a rebooted personalised myHealth Record system for patients and doctors that will trial an opt-out, rather than opt-in, option as part of a $485 million budget rescue package (…).”
I like the word ‘rebooted’, as it implies a fresh start and that is certainly what the Australian e-health records system needs. ‘MyHealth record’ sounds better than PCEHR too. But many questions remain, including the most important one: will clinicians use the renamed system once it’s opt-out instead of opt-in?

Budget Review 2015–16 Index

Dr Rhonda Jolly
E health makes use of developments in computer technology and telecommunications to deliver health information and services more effectively and efficiently. The e health funding provided in this Budget represents the Government’s response to recommendations made in a 2013 review into its predecessor’s Personally Controlled Electronic Health Record (PCEHR) system.[1]
Prior to Budget night, Health Minister Sussan Ley announced that the Government would provide $485 million over four years to restructure the current system.[2] The Minister suggested that this funding would deliver ‘a fully functioning national e-health system’ that could save taxpayers $2.5 billion per year within a decade, and an additional $1.6 billion in annual savings for the states and territories.[3]

Melbourne pneumonia-testing app could help save lives

Date May 10, 2015 - 12:15AM

Julie Milland

Health workers in Africa have started testing a low-cost mobile phone app, developed by Melbourne researchers, which could help save the lives of thousands of children by more easily detecting whether or not they have pneumonia.
The app, designed specifically for non-smart or "feature" phones, helps workers better diagnose the killer illness simply by counting the number of breaths being taken by sick children.
Pneumonia, a leading killer of young children for more than 30 years, causes fever and a faster breathing rate. The app allows health workers, particularly in remote areas, to accurately count breaths so they can distinguish between pneumonia and other illnesses less likely to increase breathing rates, such as malaria and colds.

Govt to make e-health records opt-out


Backs Royle recommendations, including NeHTA closure.

The federal government plans to create electronic health records for all Australians by default in the hope an opt-out model will counter the slow take up of the former PCEHR system, now known as myHealth Record.
Health Minister Sussan Ley today said less than ten percent of eligible Australians had signed up for a health record. She said the slow uptake was undermining the system's clinical usefulness.
In his report into the operation of the Personally Controlled Electronic Health Record (PCEHR) scheme (pdf), Dr Richard Royle pointed out that making e-health records opt-out in the UK led to records being set up for nearly 46 million people, with an opt-out rate of just 1.4 percent.

Govt aims to boost eHealth record uptake with opt-out model

Less than 10 per cent of Australians have enrolled in the PCEHR, which will be renamed myHealth Record.
The Personally Controlled Electronic Health Record (PCEHR) will be renamed 'myHealth Record' and shifted to an opt-out model, the government has announced.
Health minister Sussan Ley revealed that the government's budget, released tomorrow, will include $485 million for the eHealth record system.
Both headline changes to the system's rollout were included in a report commissioned by the government in 2013 .
The review was led by Richard Royle, executive director of the UnitingCare Health group in Queensland and vice-president of the Australian Private Hospitals Association.

E-health outcomes queried

Nicole MacKee
Monday, 11 May, 2015
A US study showing electronic health records failed to have any impact on outcomes for stroke patients highlights the pitfalls of simply mechanising paper-based processes, says the head of Australia’s e-health authority.
Dr Steve Hambleton, chair of the National E-Health Transition Authority (NEHTA), said e-health was unlikely to be effective if it was simply providing an electronic record of sub-standard care.
“Electronic health records (EHRs) alone — just making a computerised record of what used to be paper — isn’t helpful”, Dr Hambleton told MJA InSight. However, by interrogating the data and applying benchmarks, it’s possible to pinpoint unwanted clinical variation and improve health outcomes, he said.
“If you mechanise medical records by creating an EHR, there will be no change. But if you re-engineer what you do with that information, that’s when we should get some leverage.”

Australian government injects AU$485m into e-health records

Summary: The Australian government will force some patients to use electronic health records as part of a trial included in a AU$485 million 'rescue' package for the personally controlled e-health record system set up by the former Labor government.
By Josh Taylor | May 10, 2015 -- 23:33 GMT (09:33 AEST)
The Australian government has announced that it will inject AU$485 million into a "rebooted" personally controlled e-health record system (PCEHR), to be known as myHealth Record.
The funding, to be allocated in Tuesday's Budget, will see the rebranded myHealth Record system go through changes that the government has said are in response to feedback from clinicians. The government has not outlined specific changes, but rather stated that there will be a better alignment with clinical workflows in practices to ensure information including medications and adverse drug reactions can be easily identified by GPs.

Budget: Call for aged care to be part of opt-out e-health trials

By Natasha Egan on May 13, 2015 in Technology Review
Aged care should be a key participant in the health department’s trials of an opt-out e-health record system but further investment is still needed to ensure older Australians benefit from digital health, sector representatives have said following measures in the Federal Budget.
In a pre-Budget release, the government announced on Sunday it would provide $485 million over four years to “rescue” the under-subscribed eHealth system, including trialling an opt‑out model in two regions in 2016, renaming the Personally Controlled Electronic Health Record (PCEHR) to My Health Record and making the record system more user-friendly.
The Budget papers now show that figure falls over $200 million short of the $699.2 million provisioned for the redevelopment of the PCEHR in the 2014‑15 Budget, with savings to be redirected to fund other health policy priorities or reinvested into the Medical Research Future Fund.
Sunday 10 May, 2015

Online health records trial a big step forward

The trial of a more proactive approach to online personally controlled  health records should provide a significant advance to unlock the potential of electronic medical records to transform health care, the Consumers Health Forum, says.   
 “A common plea we hear from consumers is the frustration they feel when they have to repeat key information about themselves, their medical history, and current medications to multiple clinicians”.
“If we get the implementation right, the potential benefits of the national myHealth Record system announced by Minister Ley over the weekend are tremendous, offering a future of a safer, more efficient, less wasteful and more consumer-friendly health system.  The myHealth Record will provide a secure national system that enables health records to be shared between patients and their doctors and other designated health practitioners.

Google Australia engineers join Africa’s fight against Ebola

Mitchell Bingemann

Design and product engineers from Google Australia have helped develop a tablet device that allows Ebola medical workers in Africa to record patient information without spreading the deadly virus.
At the height of the West African Ebola in September last year donated a product team to Doctors Without Borders, which was hunting for technology companies to help improve the time-consuming methods it used to document and share vital patient information.
Poor infrastructure, intermittent power supply and no internet networks meant health workers in Sierra Leone were forced to shout patient notes across fences to avoid contamination.
15 May 2015, 6.01am AEST

New register shows importance of vaccination beyond childhood

TTucked away in the budget papers is an intitiative worthy of applause – the establishment of an adult immunisation register and the expansion of the childhood register to include adolescents.

Author Heath Kelly

Professor (Adjunct) in Infectious Diseases Epidemiology at Australian National University
Health was not one of the winners of Tuesday night’s big-spending federal budget, but one initiative tucked away in the budget papers is worthy of applause – the establishment of an adult immunisation register and the expansion of the childhood register to include adolescents.
The budget papers say immunisation data collection will be expanded to include school-based adolescent vaccinations and that an adult register will be established from September 1, 2016.
The move means that we will soon record all vaccinations delivered to adolescents and adults through the government-funded National Immunisation Program (NIP). The program covers the cost of vaccines, but not all the recommended shots are on the NIP.

Immigration CIO leaves to join Health

Paul Madden takes over e-health drive.

The Department of Immigration's chief information officer Matt Yannopoulos will leave the agency to take over as CIO at the federal Department of Health.
Yannopoulos will end an almost two-year stint as Immigration's top tech chief in July to take on a position held by former Health CIO Paul Madden, as first reported by Intermedium.
Madden was moved into a new special adviser role at Health - responsible for strategic health systems and information management - as the result of an internal restructure several months ago.
  • May 15 2015 at 2:33 PM

Do-it-yourself healthcare has arrived – but are we ready?

For 10 years we've been hearing about how technology and broadband internet are the future of medicine. Now, as the nation faces a $60 billion hole in its health budgets, the future is almost here, writes David Ramli.

As winter turns Melbourne a darker shade of grey, one-month-old Toby has a worrying gurgle in his chest. It's bad enough that his mother, Julianne, wants him seen by a doctor. But instead of taking her son out into the cold on an hour-long trip for a five-minute consultation, she plugs a small digital stethoscope into her iPhone's headphone jack and gets to work.
The device looks more like a silver yo-yo than a medical device but paired with the accompanying wireless, non-contact thermometer it has, in less than a minute, measured Toby's temperature, heart rate and made a 15-second recording of his breathing.
As he shuffles impatiently in his father's arms, a smartphone app analyses the data and gives a prognosis before sending it to a GP for confirmation. It's nothing more than a passing cold and Toby is soon back on the sofa with a spoonful of cough syrup – the whole process having taken seven minutes and 32 seconds in the warmth of his own home.

eHealth guidelines keep medical records cyber safe

Online health records are increasingly at risk but new guidelines set out how they should be secured.
Australian’s medical records are increasingly under threat from cyber criminals but landmark new guidelines will improve their security and protection according to ECU eHealth expert Associate Professor Trish Williams.
Medical identity theft is increasing around the world and the incorrect storage of medical records increases the risk of data breaches.
“If your information is not kept secure it may lead to misuse of your personal information,” said Professor Williams.

Backers start website in fight to reinstate Leeder

14th May 2015
EIGHT contributors to the Medical Journal of Australia have launched a campaign to have the board of AMPCo sacked and reinstate the journal’s editor-in-chief, Professor Stephen Leeder.
Of 80 responses already received, 79 have been "positive”, say the Friends of the MJA, who launched their website last night.
Aside from sacking the board, the group is seeking a reversal of the decision to outsource the MJA’s production and sub-editing to Elsevier, and want an independent external review of all matters.
The committee includes a former AMA chairman, a former Australian Chief Medical Officer, chair of the Alfred Hospital Ethics Committee and two former NHMRC committee chairs. They bring a combined total of around 300 years of experience contributing to the journal.
Orion Health launches Rhapsody Version 6.1
Orion Health, a population health management and healthcare integration company, has announced the release of Rhapsody Integration Engine Version 6.1, the first integration engine to implement the new HL7® Fast Healthcare Interoperability Resources (FHIR®) standard.

IBM's Watson aims to be jack of all trades

Date May 15, 2015
Watson already has won a major TV game show, is looking for a cure for cancer and has ambitious gastronomy ambitions including devising a recipe for chocolate-beef burritos.
The IBM supercomputer is becoming a jack of all trades for the US tech giant — including in its new role as a business consultant and analyst for various industries by using massive internet databases.
Watson, which gained fame in 2011 for defeating human opponents on the Jeopardy quiz show, has been reaching into its computing power since then for an array of other services.
IBM has developed a Watson Engagement Advisor application to counsel members of the military and their families how to smartly manage shifting to life after the service.

Mars' stunning blue sunset

Date May 12, 2015 - 5:48AM

Abby Ohlheiser

More than three years after Curiosity first began its mission on Mars, the NASA rover finally had some time to observe -- and photograph -- its first sunset.
And yes, a sunset on the Red Planet is blue. Why? In simple terms, it comes down to dust.
"The colours come from the fact that the very fine dust is the right size so that blue light penetrates the atmosphere slightly more efficiently," Curiosity team member Mark Lemmon of Texas A&M University said in a statement. "When the blue light scatters off the dust, it stays closer to the direction of the sun than light of other colors does. The rest of the sky is yellow to orange, as yellow and red light scatter all over the sky instead of being absorbed or staying close to the sun."

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