This blog is totally independent and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Monday, August 10, 2015
Weekly Australian Health IT Links – 10th August, 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.
A very interesting weekwith the Health Information Conference (HIC15) held last week with lots ov view expressed and issues raised.
Other than that we have seen e-prescribing reach a major milestone with a billion electronic scripts!
Enjoy browsing and congratulations to Grahame Grieve for his award at HIC15. Great to see someone from Australia adding continuing value to Global E-Health as some others have over the years!
Queensland's health department will bundle its strategic and operational IT functions into a new unit called eHealth Queensland.
State health minister Cameron Dick announced this week that the Health Services Information Agency and the Office of the Chief Health Information Officer would be combined into the new "single strong agency" that will operate under the leadership of inaugural chief health information officer Mal Thatcher.
“Having our strategic and operational information technology leadership in one agency will better enable us to achieve our eHealth goals," the minister said in a statement.
Over the next few months, Australian consumers will begin to see noticeable change in healthcare delivery. Greater targeting of at risk consumers, increased coordination between agencies, plus improved efficiency and effectiveness are just some of the outcomes anticipated as Medicare Local makes way for Primary Health Networks (PHNs). In addition, for consumers and the profession itself, the value and importance of e-health records will increase, as opt-in arrangements are replaced by the recently announced opt-out scheme.
The transition will be very quick, with July 1 the start date for the new PHNs. Faced with high expectations, the management and boards of Australia's PHNs will be under pressure to perform from day one, leaving little time for bedding down their new organisations.
Grahame Grieve is a principal with Health Intersections of Melbourne, Australia and was the architect-developer of HL7’s Fast Healthcare Interoperability Resources (FHIR, pronounced “fire”) specification that allows EHRs to exchange information.
Tell me about yourself and what you do.
I qualified as a bench scientist in a hospital, but got dragged into working for a lab systems vendor. I got more and more involved in interoperability. Eventually I cut loose and consulted in interoperability and system integration in healthcare. Then I got gradually more and more involved in leading the standards in the area. Mainly I consult with the national programs.
Programmers call FHIR public API for EHRs. How would you define FHIR to a clinician and explain to them why it’s important?
It’s a framework for finding and exchanging data between two different systems so that they can exchange data in the background to provide services in the foreground that make people’s ability to do medicine better. You have to sort out flows, data contents, and agreements about responsibilities. FHIR focuses on doing those through modern technology, the same kind of agreements that support the massive systems around Facebook, Google, Apple, and the current social web system.
Users of MyGov online have been reporting problems.
Software failures and a lack of capacity has caused mass lockouts from the MyGov online portal in recent weeks, according to users, with many clients staying blocked from the system for up to two weeks.
Users of the Commonwealth system are reporting lockouts from accounts and shutdowns of the system with some clients taking their complaints to the Parliament and Commonwealth Ombudsman.
But the Department of Human Services continues to insist there is nothing wrong with MyGov except some problems in early July caused by an easily fixed algorithm glitch.
The denials come despite call centre operators telling callers in late July that a software problem had locked large numbers of users out of their MyGov accounts and that clients would have to wait 12 hours before they could log back onto the system.
According to Graeme Osborne, director National Health IT Board and Information Group, National Health Board, Ministry of Health, New Zealand, it’s easy to mistake technology as a panacea when it comes to health, rather than simply a tool used to get to an end goal.
“Tech is simply an enabler, it’s not the end game,” he tells eEhealthspace.org in an interview. “The measure of well implemented IT is adoption and value.”
At the core of the national New Zealand health IT project is the notion of shared value. Osborne says the notion of shared value comes from an understanding of stake holders, how those stake holders work together, and how the hand-offs between each stake holder occur.
“It’s a matter of coming to a shared agreement on what success looks like,” he says. “Otherwise there’s very little point in spending money on health IT.”
The FDA and DHS cited research from independent cyber security expert Billy Rios, who found that remote attacks could be launched on patients by accessing a hospital's network.
Both the FDA and DHS said they know of no cases where such an attack has been launched, but the FDA said in its advisory that it strongly encouraged healthcare facilities to stop using the Symbiq infusion pump system and move to other devices.
Consistent with the Abbott Government’s commitment to reforming primary health care, the government today released an options discussion paper ‘Better outcomes for people living Chronic and Complex Health Conditions through Primary Health Care’.
Minister for Health Sussan Ley said the discussion paper considered possible reform options which would inform the government’s development of a healthier Medicare to support people with complex and chronic diseases and keep them out of hospital longer.
Ms Ley said options in the discussion paper included enrolling people to a single provider who would coordinate the multi-disciplinary care the patient received rather than the patient coordinating their care, set chronic disease payments for a defined package of care rather than individual services and international methods of best practice.
If anybody is still labouring under the mistaken belief that anything online can remain private and secure, this week should have seen them finally admit defeat. In the US, UCLA Health reported ) that 4.5 million health records had been compromised. UCLA Health runs four hospitals and 150 hospitals in Southern California, based at the University of California and Los Angeles. The security breech joins a long list of recent hacks of health insurance, and health services, companies, including that of health insurance company Anthem that had up to 80 million customer records illegally accessed earlier this year.
More poignantly, and also this week, international dating site Ashley Madison admitted that hackers had accessed their systems and stolen details of their 37 million customers. The particular twist in this hack is that the site encouraged people in existing relationships to “cheat” on their partners and have casual affairs. Amongst information stolen by the hackers were details of customers’ sexual fantasies which the hackers threatened to publish if demands to close down the site completely were not met.
To date, there is little information in the literature to guide the provision of supports for using the Personally Controlled Electronic Health Record (PCEHR) in populations with severe communication impairments associated with a range of disabilities. In this paper we will (a) outline the rationale for use of PCEHR in these populations by providing an overview of relevant research to date, and (b) present results of three integrated pilot studies aiming to investigate the barriers to and facilitators for PCEHR use by people with severe communication impairments and their service providers. Finally, we will present directions for future research on use of PCEHR by people with severe communication impairments.
It’s time for a national system for the Electronic Recording and Reporting of Controlled Drugs, says Pharmacy Guild executive director David Quilty.
Writing in this week’s edition of Guild newsletter Forefront, Quilty says doctors and pharmacists need to unite in demanding an ERRCD system.
“For too long, governments have dawdled and blame shifted, instead of putting this vital medication management tool in place,” he writes.
“Coroners in virtually every jurisdiction have consistently called for an ERRCD to no avail. It is a sad situation when the voice of the coroner is starting to sound repetitive.
“In Australia, drug overdose fatalities regularly exceed motor vehicle fatalities, with legal prescription medicines—rather than illicit substances—comprising the overwhelming majority of these fatalities.”
Australia has achieved a major milestone in patient safety, reaching one billion prescriptions dispensed electronically through eRx.
Electronic transfer of prescriptions improves patient safety by increasing confidence that the correct medications are being dispensed while also making dispensing faster.
Electronic prescribing brings important safety gains as a result of the fact that prescription information, including patient and medication data, can be shared safely and securely between GPs and pharmacists.
As a result, pharmacists no longer have to re-type medications or patient information, which makes dispensing faster whilst also increasing GP confidence that the correct medications are being dispensed.
IMMUNISATION coverage rates appear to have been significantly underestimated in the Australian Childhood Immunisation Register, according to a short report published in the MJA. The authors studied a cohort of children in south-eastern Sydney aged 12‒15 months in 2002. According to the Register, 81% of children in the region had received all vaccination doses scheduled for the first year of life. However, systematic follow up of one third of the children recorded as being overdue for one or more doses found the overall proportion who were up-to-date was at least 91%.
Ever wondered what all the acronyms on your medical documents actually mean? Well, it turns out your GP probably struggles with them too.
In a worrying finding that could explain some catastrophic errors for Australian patients, a survey of 240 GPs found they did not understand much of the shorthand used by hospital doctors in electronic handover notes.
After compiling a list of 321 abbreviations used in 200 discharge letters produced by a major Sydney hospital, researchers surveyed the GPs to see how many of those abbreviations they understood.
POWERHEALTH SOLUTIONS (PHS) is an international healthcare software company specialising in Costing & Revenue, Enterprise Billing and Patient Safety software for hospitals and other healthcare organisations. The company is developing a network of business and technology partners around the world to enrich products and reach more clients. PHS is internationally recognised and used across the UK, Ireland, Hong Kong, New Zealand, the Middle East and the United States. PHS has demonstrated expertise in delivery quality, large scale implementations through the use of developed project management and governance skills. www.powerhealthsolutions.com
Microsoft discontinued support for the popular Windows XP operating system in April 2014.
Australian federal government departments are paying Microsoft $14.4 million to continue to support their use of outdated Windows operating systems for another year because the software giant no longer officially provides security updates or support for them.
The Department of Finance recently signed off on two one-year contracts for ongoing "custom support" for Windows XP and Windows Server 2003 to service the departments of Defence, Human Services, Immigration and Border Protection, and the Australian Taxation Office. Technology news websites iTnews and Delimiter first reported the cost.
Windows 10, it seems, is proving a hit with both the public and the technology press after its release last week. After two days, it had been installed on 67 million PCs. Of course, sceptics may argue that this may have simply been a reflection of how much people disliked Windows 8 and the fact that the upgrade was free.
For others, though, it is the very fact that the upgrade is free that has them concerned that Microsoft has adopted a new, “freemium” model for making money from its operating system.
They argue that, while Apple can make its upgrades free because it makes its money from the hardware it sells, Microsoft will have to find some way to make money from doing the same with its software. Given that there are only a few ways of doing this, it seems that Microsoft has taken a shotgun approach and adopted them all.
Chris Capossela, Microsoft’s Chief Marketing Officer, has declared that Microsoft’s strategy is to “acquire, engage, enlist and monetise”. In other words, get people using the platform and then sell them other things like apps from the Microsoft App Store.