Monday, October 19, 2015

Weekly Australian Health IT Links – 19th October, 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

What an amazing week. To stay it is all happening would be an understatement. Sadly pretty much all that is happening is going backwards or sideways. Sad about that!
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GPs face massive fines over PCEHR privacy breaches

Paul Smith | 16 October, 2015 | 
GPs and practice staff face jail and fines of up to $108,000 for misuse of the PCEHR system under controversial new laws being pushed through the Federal Parliament.
There have been long-running fears across the medical profession about the scale of civil sanctions for unauthorised use or disclosure of information on the controversial system which was launched three years ago.
But under the new regime the Federal Government is pushing to introduce, civil penalties will increase five-fold. 
Any health practitioner who “recklessly” flouts the system's privacy provisions will be fined up to $108,000 for each offence.
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AMA blasts “half-baked” MyHealth medical records plan

Friday, October 16, 2015 - 10:21
Claiming that “forcing GPs to adopt half-baked e-health record [is] a dud idea,” the Australian Medical Association (AMA), has opposed government plans to link GP incentive payments to the adoption of the scheme.
The Government has proposed that Practice Incentive Program e-health payments be tied to doctor use of the MyHealth Record (MyHR) system being developed to replace the $A1 billion Personally Controlled Electronic Health Record scheme. The PCEHR has been dumped amid dismal take-up rates among patients, doctors and medical practices.
But AMA President Professor Brian Owler said the MyHR system was far from fully developed, so using PIP incentives to get doctors to sign up was ill-considered and premature.
“The MyHealth Record is not at a stage where it can be adopted by practices, so it should not be linked to the PIP scheme,” Professor Owler said. “There are fundamental issues with the design of the MyHR that are yet to be fully addressed.”
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'Misaligned and superficial': RACGP slams eHealth PIP proposals

14 October 2015
THE RACGP has issued a stinging rebuke of the government’s proposals to link PIP eHealth payments to the uploading of Shared Health Summaries (SHS), calling them “misaligned”, “ill-timed” and “superficial”.
It says the government must drop proposals, set out in a recent Department of Health discussion paper, that will not improve meaningful use and the care and safety of patients.
The discussion paper was released last month as part of the consultation process to revise the current PIP eHealth eligibility criteria. The aim is to encourage more active and meaningful use of My Health Record, formally known as the PCEHR.
The paper proposes that such use should be defined, in the first instance, by measuring SHS contributions.
But the RACGP says such an approach is too simplistic and fails to appreciate the crucial importance of GP autonomy in everyday practice.
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Mixed reaction to latest eHealth developments

13 October 2015
THE appointment of the eHealth implementation committee to set up the Personally Controlled eHealth Record (PCEHR) and My Health Record has been met by mixed reactions from the medical IT community.
While some hope progress will finally be made, critics fear a continuation of the same problems that have plagued it from the outset. 
The 11-person eHealth Implementation Taskforce Steering Committee will establish the Australian Commission for eHealth (ACeH). This follows a review of the National E-Health Transition Authority (NEHTA), which called for NEHTA to be dissolved.
Two members of the new committee — current NEHTA chairman Dr Steve Hambleton and UnitingCare Queensland executive director Richard Royle — were involved in the NEHTA review, which was ordered by then health minister Peter Dutton almost two years ago.
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Opt-out e-health records may violate privacy: MPs

Parliamentary committee investigates My Health Record bill.

By Allie Coyne
Oct 16 2015 9:24AM
A joint parliamentary committee has written to Health Minister Sussan Ley to express concerns about the "significant" effect the government's planned introduction of opt-out e-health records could have on an individual's privacy.
In September the government introduced a bill that would amend the existing personally controlled electronic health record (PCEHR) law to enable it to boost its stalled e-health records scheme by creating a record for every Australian by default.
Despite the bill achieving bipartisan support in the parliament, the committee - chaired by Liberal MP Phillip Ruddock - has raised a number of concerns about the implications of the reforms.
Currently, an individual must proactively register for a PCEHR account before their medical records are uploaded.
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8 reasons to avoid the latest e-health record system

15 October, 2015
It is unreasonable to expect GPs to use the proposed MyHealth Record (MyHR) system because it is not fit for purpose, says the AMA.
The organisation has rejected the Federal Government’s plan to link GP incentive payments to MyHR, describing the proposal as poorly thought out and premature.
AMA president, professor Brian Owler says there are fundamental issues with the design of MyHR that are yet to be fully addressed, and it is not at a stage where it can be adopted by practices.
The AMA says the model has eight flaws that must be fixed.
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'Significant privacy concerns' over myHealth Record system

Date October 15, 2015 - 6:49PM

Harriet Alexander

Health Reporter

New laws to give doctors and pharmacists instant access to medical records may pose a risk to human rights by violating privacy.
A parliamentary joint committee on human rights has called on Health Minister Sussan Ley to explain what safeguards are in place to protect Australians' privacy when their health records are uploaded onto a central electronic database, under the new myHealth Record system.
Currently, Australians' health records are only included on the database if they choose to register.
Longstanding Liberal MP Philip Ruddock, who chairs the committee, told Parliament the e-health bill raised "significant privacy concerns".
It was questionable whether the bill's objective - to drive increased use of the database by health professionals - justified the potential privacy breach, Mr Ruddock said.
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Human rights warning over PCEHR 'opt out' plan

Paul Smith | 15 October, 2015 | 
Automatically signing patients up to the personally controlled e-health records scheme risks breaching international human rights law, a top parliamentary committee is warning.
In an attempt to breathe life into the PCEHR system, the Federal Government is pushing through legislation to make it “opt-out” only, where patients must declare they do not want their medical records automatically uploaded onto the system.
This is a shift from the current process where patients 'opt-in' to the scheme.
But the Parliamentary Joint Committee on Human Rights has warned that this approach could fall foul of international law.
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RACGP urges Federal Government to dump proposed changes to PIP e-Health

14 October 2015
The Royal Australian College of General Practitioners (RACGP) strongly opposes proposed reforms to the PIP e-Health that would see payments linked to meeting targets for uploading shared health summaries (SHS).
This week the RACGP has responded to the Department of Health (DoH) Practice Incentives Program (PIP) e-Health Incentive discussion paper, which was released as part of the consultation process to revise the current PIP e-Health Incentive eligibility criteria to encourage ‘active and meaningful use’ of the My Health Record (formally PCEHR).
Increased uptake of My Health Record will be achieved by addressing the fundamental usability issues as raised by the profession, rather than implementing misaligned financial incentives.
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AMA Rejects MyHealth Record Link to PIP Payments

15 Oct 2015
In a submission to the Department of Health, the AMA has rejected a Government plan to link general practice Practice Incentive Program (PIP) e-Health Incentive payments to the adoption of the MyHealth Record (MyHR) by GPs.
AMA President, Professor Brian Owler, said today that the Government proposal was poorly thought out and premature.
“Until now, the PIP e-health incentive has focused on building the capacity of practices to embrace various e-Health technologies to enhance the efficiency of patient care,” Professor Owler said.
“The MyHealth Record is not at a stage where it can be adopted by practices, so it should not be linked to the PIP scheme.
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Govt's life support plan for e-health records slammed

Paul Smith | 14 October, 2015
The RACGP has slammed the push to save the beleaguered personally controlled e-health records system from oblivion by pressuring GPs to populate it with clinical information.
Last month, the Federal Government released a consultation paper suggesting future e-Practice Incentive Program payments should be linked to doctors’ “meaningful use” of the PCEHR.
A key suggestion is that doctors create a fixed number of shared health summaries — a list of diagnoses, medications and allergies — to upload onto patients' health records.
The paper also suggests that payments would become dependent on doctors creating and curating health summaries for patients claiming rebates for MBS care plans.
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Commission for eHealth taking shape


A Steering Committee has been set up to oversee the establishment of the new Australian Commission for eHealth and the personalised My Health Record system for patients and doctors.
Minister for Health, Sussan Ley announced the appointment of Robyn Kruk as the Independent Chair of the eHealth Implementation Taskforce Steering Committee responsible for the establishment of the Australian Commission for eHealth.
“It is essential Australia has a national digital health system and My Health Record makes up an important part of this system,” Ms Ley said.
“Ms Kruk has held several significant Public Service positions at the State and Federal Government level in health and environment, most recently as Chief Executive of the National Mental Health Commission.”
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MEDIA RELEASE
Monday, 12 October, 2015

My Health Record reboot must kick in with consumers

Consumers Health Forum welcomes the “rebooting” of the development of the My Health Record system and looks forward to active consumer involvement in its design.
“An effective eHealth system has the potential to transform health care in Australia, making it not only more safe and effective, but also enabling the development of more personally focused care,” the CEO of the Consumers Health Forum, Leanne Wells, said.
“We welcome the announcement by Health Minister Sussan Ley, of the eHealth Implementation Taskforce Steering Committee responsible for the establishment of the Australian Commission for eHealth. 
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Peaks angry aged care misses out on eHealth support

By Natasha Egan on October 12, 2015 in Technology Review
Aged care providers will not be offered any financial support by government to participate in the forthcoming trials of an opt-out eHealth system, Technology Review can confirm.
The revelation has drawn the ire of the aged care peaks, which have long been campaigning for the same kind of support other healthcare providers including GPs and private hospitals have received to connect to the eHealth system.
The government recently changed tack with the Personally Controlled Electronic Health Record (PCEHR) in response to a top-level review, allowing its $51 million trials to test opt-out arrangements for individuals, which would be rolled out nationally if successful.
The program also got a name change – to the My Health Record.
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Richard Royle named on My Health Record committee

October 12, 2015 | Posted in APHA News
Australian Private Hospitals Association (APHA) president Richard Royle has been named on the committee that will oversee the rebooted personalised My Health Record system for patients and doctors.
The My Health Record system is part of a $485 million package to strengthen and transform national digital health governance through an Australian Commission for eHealth.
“In this modern world where technology makes information sharing boundless, it is essential Australia has a national digital health system and My Health Record makes up an important part of this system,” Health Minister Sussan Ley said.
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Clinicians on FHIR

Posted on October 15, 2015 by Grahame Grieve
From very early in the FHIR project, we’ve been running Connectathons, where a group of people – mainly developers – gather to test one of a variety of exchange scenarios. The connectathons perform several key functions:
  • Build a community with practical experience using the specification
  • Accelerate the progress of specific functionality towards production
  • Provide detailed QA of the specification
However while these connectathons perform a thorough QA of parts of the specification, there’s others that they don’t check at all. Principally, this is whether the specification offers support for a broad – and realistic – set of clinical use cases. That’s because the developers involved in the technical connectathon pick simple data for the content that is not involved in their exchange concerns.
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Reducing the paperwork

14 October, 2015 Meg Pigram 
A majority of pharmacists see paper-optional prescriptions as key to preventing prescription fraud and misadventure, a new survey reveals.
More than half (62%) of respondents to the 2015 Pharmacy eHealth Survey saw e-scripts as a positive step for reducing crime and misuse, the survey revealed.
The survey, which was run on behalf of eRx Script Exchange, also found that 89% of respondents said that outside repeats and new patients are easier with e-scripts, while 87% said that dispensing is now faster and more accurate.
Just under half (46%) said dispensing efficiency and patient safety were major motivations for adopting the technology.
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Saluda spinal implant for pain relief heralded as 'breakthrough'

Date October 14, 2015 - 8:44PM

Harriet Alexander

Every minute of the night and day, for decades, Jaswir Grewal was in pain.
The constant ache in his back forced him to leave his jobs as a mechanic and banana grower. The pain troubled his sleep, made him irritable with his wife, depressed about his prospects and rarely left his thoughts. At times, he said, it felt like more than he could bear.
"It was like a bad toothache and a migraine all mixed in together. But those things are temporary and this was 24/7," he said.
"They put me on painkillers to stop the idea of depression or, dare I say, suicide, because something like that will push people to that point and I've been near there. It has been like that."
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Sonic buys stake in telehealth company

Serkan Ozturk | 14 October, 2015 |
Diagnostic and corporate giant Sonic Healthcare has taken a 12.5% stake in GP2U, the company that facilitates GP and other specialist consultations via Skype.
GP2U’s founder, Dr James Freeman, who now owns 40% of the business, said the move would allow a possible expansion of the business into services provided by Sonic in aged care and palliative care. 
“A lot of palliative care can be done by video without a doctor needing to be there for a physical home visit,” said Dr Freeman, a GP in Hobart.
“We could also have GPs who could check on residents of aged care homes via video and save on costs associated with transporting people to EDs when not required.”
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Carers struggle with technology demands, low incomes: survey

October 12, 2015
A carers' support group has warned against relying too heavily on technology to deliver aged care, disability and mental health services.
Carers SA said a range of changes at both state and federal levels could be making it harder rather than easier for people to get the support services they needed.
Carers chief executive officer Rosemary Warmington said the demand for carers was higher than ever but extra layers of complexity, such as a planned national carers digital gateway, might be unnecessary hurdles in what could already be a complex and stressful system to navigate.
"Carers have indicated that they want to access services from people and providers they trust and are familiar with," she said.
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Brand new eHealth strategy doomed to fail

I had an interesting experience recently. I participated in a webinar organised by the Department of Health. It was supposed to be a consultation of GPs about the uptake of eHealth.
It went something like this: “We want to gain feedback from GPs about how we can get you to use the eHealth. This is how we’re going to do it; we’ve already organised training and we’re kicking off after the Christmas break. But before we start this session you must know that we cannot consider other options or timeframes.”
I was speechless. Literally – as I was not allowed to speak. I could only send little text messages via the closed online question platform. I was unable to see the feedback from other online participants.

Meaningful use?

For years health providers have repeated the same message over and over: if you want to make eHealth successful please take us with you.
The government is talking about new incentive payments to practices, ‘refreshed’ training programs and opt-out instead of opt-in, but there is little mention about improvements that make health providers want to use the PCEHR (now called ‘My Health Record’).
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Parker Magin: Human factor

Parker Magin
Monday, 12 October, 2015
SEEKING answers to clinical questions which arise directly from patient care is an important element of clinical practice.
Framing the most appropriate answer to these questions is a vital factor in individual patient care — it is a basic component of evidence-based medicine. It is also an ideal opportunity for the clinician to expand their knowledge and skills base.
Some questions that arise in a consultation can be followed up and answered post-consultation but many need to be answered in “real time” within the consultation. Obtaining the right answers to clinical questions is singularly important for generalists, as GPs generally will have questions about treatments and diagnoses than specialists.
GP vocational trainees (registrars) have particular information needs given their relative inexperience of the wide breadth of primary care medicine. Registrars function, in many respects, as independent practitioners in regard to ordering tests, prescribing medication, referrals, etc, but also have recourse to assistance and advice from experienced GP supervisors within an apprenticeship-style model.
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Is medicine really having an Uber moment?

There has been a lot of interest in telehealth recently. In July, Telstra launched its ReadyCare scheme, which allows patients to have “treatment from a GP wherever you are and when you need it”.
And earlier this month saw the launch of another new service called Teleconsult, set up by an Australian respiratory physician. It allows doctors and patients to register online and communicate securely. These services join others that have existed over time, such as OzDocs Online.
They all work on the premise that there is significant scope for patients to interact with doctors in a myriad of ways other than by simply walking through the front door of the surgery.
‘Telehealth’ seems to involve a broad church of methods, from full-blown teleconferencing, through to email and the use of POTS: the Plain Old Telephone System.
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Pharmacists weigh the benefits of eRx Script Exchange

eRx Script Exchange today launched the results of its 2015 Pharmacy eHealth Survey identifying the business impact of ETP (electronic transfer of prescriptions) on community pharmacy since eRx’s launch in 2009.

A total of 740 pharmacies, representing 14% of Australia’s community pharmacy sector, took part in the survey, which ran in the first half of this year.
The survey honed in on four key areas of dispensing and workflow, patient outcomes, challenges and priorities, and innovations for the future.
Of the pharmacies that took part, 75% said that they find eRx valuable or extremely valuable, highlighting these key areas of benefit:
  • 89% said that outside repeats and new patients are now easier;
  • 87% said that dispensing is now faster and more accurate; and
  • 46% said that dispensing efficiency was the major motivation for using eRx, followed by patient safety.
Pharmacies also identified four distinct ETP priorities needed to further advance health and safety outcomes for Australian patients over the short and longer term.
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DHS CIO appeals to tech grads with a social conscience

Pilot recruitment drive to lure high performers into public service.

By Paris Cowan
Oct 12 2015 5:09PM
Department of Human Services CIO Gary Sterrenberg is attempting to lure 150 of the country’s best tech graduates into a career in the public service.
As part of a new pilot grad program, the CIO group is taking applications from grads until October 23, for positions within the DHS' Adelaide, Brisbane and Canberra ICT hubs.
Sterrenberg today called on in-demand science, technology, engineering and maths (STEM) grads to consider the national importance of the DHS when weighing up their career options.
“Not many people realise how big the department’s ICT operations are – our in-house technology workforce plays a crucial part in delivering over $100 billion in welfare payments to 7.3 million Australians each year,” he said.
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House of Reps approves release of de-identified welfare data

Anonymous payments records could be made public.

By Paris Cowan
Oct 13 2015 10:05AM
The House of Representatives yesterday passed a bill that could see vast troves of de-identified data on Australia’s welfare recipients released to the public.
After a number of unsuccessful attempts, the lower house finally ushered through the government's autumn red-tape reduction omnibus, designed to strip redundant legislation and unnecessary bureaucracy out of Australia’s laws.
Should it clear the Senate, schedule five of the omnibus bill will change welfare legislation in a way that allow for the release of “de-identified, aggregated data” for the purpose of policy, research and public transparency.
The data due to be released is collected under the acts governing family tax benefits, paid parental leave, social security and student allowances.
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Telstra’s muted AGM reflects investor contentment

Tim Boreham

Maybe it was the tempting odour of savoury morsels wafting from the lobby area into the auditorium.
Or perhaps it was Telstra’s pre-emptive effort to dull protests about the remuneration report with a lengthy explanatory oration from “rem” committee head John Mullen.
(But not enough to prevent a stiff 11 per cent protest vote on proxies, compared with 2 per cent last year).
Or maybe it was the goodwill towards the board’s CEO transition process that saw a proposal to grant new CEO Andy Penn up to $4.2 million of long-term incentive rights passed with only token protest.
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Enjoy!
David.

3 comments:

Anonymous said...

GPs and practice staff face jail and fines of up to $108,000 for misuse of the PCEHR system .....

The likelihood of an 'accidental or 'inadvertent' misuse of the PCEHR by a medical practitioner, a staff member, or a hospital employee is 100% - no less.

Why am I so confident that it's 100% and not a lesser number.
1. Health IT is a bewildering mess.
2. The PCEHR system is incomplete, untried, unproven and full of inaccuracies.
3. The PCEHR is immature and unstable.
4. The PCEHR is not user friendly, is confusing to use and difficult to navigate.
5. An inadvertent act in using the PCEHR can easily be construed as 'misuse'.

When the claim of misuse is made against a medical practitioner, mischievous or otherwise, it will be extraordinarily difficult to defend oneself and horrifically costly. There is only one way to avoid such an occurrence and this will be obvious to most doctors and their Medical Defense Unions.

Bernard Robertson-Dunn said...

It looks as though they are trying to make up for the abysmal access controls by having huge fines for "misuse".

The unintended consequence is that, in order to manage the risk, it is very likely that GPs etc won't use it.

Anonymous said...

I had an interesting experience recently. I participated in a webinar organised by the Department of Health. It was supposed to be a consultation of GPs about the uptake of eHealth.
It went something like this: “We want to gain feedback from GPs about how we can get you to use the eHealth. This is how we’re going to do it; we’ve already organised training and we’re kicking off after the Christmas break. But before we start this session you must know that we cannot consider other options or timeframes.”
I was speechless. Literally – as I was not allowed to speak. I could only send little text messages via the closed online question platform. I was unable to see the feedback from other online participants.

That pretty much sums up the complete ignorance and indifference of those pulling the PCEHR strings, anyone who thinks that engagement and consultation are a one off exercise and should take second stage to meeting some pre defined made up delivery date should go back to Installing office networks.