Monday, October 24, 2016

Weekly Australian Health IT Links – 24th October, 2016.

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 biggest news this week was the huge cyber-attack against the Internet last Friday. As we get the facts about this I am sure there will be lessons that e-Health can take about securing both devices and software.
Lots of other headlines to browse as well..
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After massive cyberattack, shoddy smart device security comes back to haunt

Almost everyone affected by the cyberattack had a part to play — from shipping shoddy devices to a consumer apathy towards security.
By Zack Whittaker for Zero Day | October 22, 2016 -- 18:49 GMT (05:49 AEDT) | Topic: Security
Friday morning saw the largest internet blackout in US history. Almost every corner of the web was affected in some way -- streaming services like Spotify, social sites like Twitter and Reddit, and news sites like Wired and Vox appeared offline to vast swathes of the eastern seaboard.
After suffering three separate distributed denial-of-service (DDoS) attacks, Dyn, the domain name system provider for hundreds of major websites, recovered and the web started to spring back to life.
The flooding attack was designed to overload systems and prevent people from accessing the sites they want on a scale never seen before this.
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Government pushes ahead with Medicare payment system overhaul

Seeks solution “based on existing commercial technology”
Rohan Pearce (Computerworld) 19 October, 2016 09:19
The government has confirmed that it will overhaul the aging health and aged care payments system.
The current system is three decades old.
A statement from health minister Sussan Ley and human services minister Alan Tudge said the government "has commenced today to identify solutions for this new payments system, which will be based on existing commercial technology".
A consultation on the design of the new system is expected to be finalised in January next year.
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10:15am October 19, 2016

Outside help 'needed' for Medicare update

By AAP
The federal health department admits it will need outside help to update the Medicare payments system but is adamant it will continue to be operated by the federal government.
Department secretary Martin Bowles on Wednesday denied there was ever a plan to privatise the system, as claimed by Labor in the lead-up to the July 2 election.
The 30-year-old payments system was in "urgent" need of updating and the department began looking for solutions in 2014, with outsourcing just one option.
Mr Bowles says the system will continue to be owned and operated by the federal government as promised by Prime Minister Malcolm Turnbull during the election campaign.
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Health surges toward Medicare payments system tender

By Paris Cowan on Oct 19, 2016 11:26AM

Govt commits to replacing legacy tech itself.

The Department of Health hopes to have a tender to market for its controversial Medicare payments gateway by early next year after it completes a four-month co-design process to nut out the core requirements of a modern infrastructure.
Having previously toyed with the idea of outsourcing the operation of the payments engine to a private sector provider, the Turnbull government was forced to backtrack on the proposal in the lead-up to the July election after the plan was attacked as a threat to the Medicare safety net.
The prime minister has since promised that any replacement to the 30-year-old legacy system, which crunches rebate payments according to the Medicare and pharmaceutical benefits system, will be fully owned and operated by the government.
It has been described as an IT project on a scale comparable to the $1.5 billion Centrelink payments system replacement also currently underway, albeit slightly less complex.
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Sector welcomes replacement of troubled aged care payments system

By Natasha Egan on October 21, 2016 in Government, Industry
Aged care sector representatives have welcomed the government’s move to replace the outdated system for aged care payments, which continues to cause major challenges for providers.
Minister for Aged Care Sussan Ley and Minister for Human Services Alan Tudge announced on Wednesday that the Federal Government would replace the 30-year-old system with a new platform to deliver health, aged care and veterans’ payments.
Aged care systems for online claiming, payments and income and asset testing have been causing major problems for aged care providers on an ongoing basis for more than two years resulting in lengthy delays for payments, inaccuracies along with demands for compensation and apologies.
Ms Ley confirmed the new system would be government owned and operated and said that the process to find a solution based on existing commercial technology had begun.
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Digital payments IT system replacement

The Australian Government will replace the IT system to deliver reliable and accurate health, aged care and veterans’ payments.
Page last updated: 19 October 2016

Joint Media Release

The Hon Sussan Ley MP
Minister for Health and Aged Care
Minister for Sport

The Hon Alan Tudge MP
Minister for Human Services

19 October 2016
The Australian Government will replace the IT system to deliver reliable and accurate health, aged care and veterans’ payments.
Australia’s existing health and aged care payments system is 30-years-old and is now obsolete.
The new system will support the Australian Government continuing to own, operate and deliver Medicare, PBS, aged care and related veterans payments into the future.
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17 October, 2016

Where to now for the MyHR?

Posted by julie lambert
The government has dodged a major embarrassment by dropping its threat to punish general practices for not meeting initial upload targets for the My Health Record system.
After a series of backflips and retreats on health policy, from the failed GP co-payments scheme to the damaging pre-election brawls over bulk-billing incentives, the Coalition is desperate to avoid another humiliation, and the MyHR system is ripe for attack.
For now, Health Minister Sussan Ley has agreed only to shift the deadline for GPs to upload 0.5% of their patients’ health summaries to the MHR system to January 31, after a large proportion missed the August cut-off for the first quarter despite the threat of financial pain.
Speaking at the RACGP’s annual conference on September 29, Minister Ley said the move was evidence of the government’s flexible approach to general practice and its willingness to listen.
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Whole-of-life immunisation register cranks up ahead of shingles vax roll-out

18 October 2016
GPs are being urged to ensure practice software updates are installed to obtain new vaccine codes and facilitate lodging adult vaccinations in the new Australian Immunisation Register (AIR).
The former Australian Childhood Immunisation Register became a whole-of-life vaccination record this month ahead of the 1 November roll-out of the national shingles vaccination program.
According to the Department of Human Services, 13,759 immunisations have been recorded for adults aged 20 and older recorded since 30 September.
“GPs should be checking for updates from their general practice software provider [which] enable transmission of the data from their general practice to the register,” says immunisation specialist Associate Professor Kristine Macartney.
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19 October, 2016

Doctors still smarter than the average machine

Posted by Felicity Nelson
Many patients use apps and websites to arrive at their own diagnosis before stepping foot in a GP clinic. But, as GPs may have suspected, the diagnostic skills of doctors far surpass those of computers – and a recent study proves it.
Research published in JAMA Internal Medicine showed doctors were more than twice as accurate as web-based systems when it came to diagnosis.
Websites and apps (known as “symptom checkers”) picked the correct diagnosis in a dismal 34% of cases, whereas physicians got it right 72% of the time.
“In what we believe to be the first direct comparison of diagnostic accuracy, physicians vastly outperformed computer algorithms,” the authors said.
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Govt's data breach notification bill enters parliament

By Ry Crozier on Oct 19, 2016 12:48PM

Expands on actions that could reduce need to notify.

The federal government has introduced mandatory data breach notification laws into parliament after missing a self-imposed deadline to have a scheme up and running before the end of last year.
The substance of the proposed laws – and the process for declaring a breach – is largely unchanged from an exposure draft published by the Attorney-General last December. The government spent until March this year consulting with industry on the proposed changes.
However, the government has heeded calls from industry to edit the language of the bill to remove the requirement for notification if an organisation "ought to have been aware" a breach had occurred.
Under the bill, organisations that determine they have been breached or have lost data will need to report the incident, and notify customers that are directly impacted or “at risk”. Those that don’t face a range of penalties, including fines of $360,000 for individuals and $1.8 million for organisations.
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RACGP, IBM Watson, Health& collaborate on health data initiative

The Royal Australian College of General Practitioners (RACGP) is collaborating with Health&, a new Web portal, and IBM Watson, to provide all Australian general practitioners and their patients access to the latest health and data technologies.
The Health& online proactive health management tool, supported by the RACGP, offers a secure place for individuals and their families to store their health data plus an easy-to- use library of health information approved by the Health& Medical Advisory Board, and made “easy to understand” with IBM Watson.
“Providing easy access to health information is the key to good health for all Australians,” said David Yip, Health Industry technical director, IBM Australia.
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Doctors’ union warns Queen Elizabeth Hospital patients ‘at risk’ from EPAS electronic health record system

Brad Crouch, Medical Reporter, The Advertiser
October 21, 2016 10:30pm
CRITICALLY ill patients are being placed in “dangerous environments” and there is a “high risk” clinicians are missing vital medical information following introduction of the controversial electronic health record system at the Queen Elizabeth Hospital, doctors warn.
In a letter to SA Health interim chief executive Vickie Kaminski, obtained by The Advertiser, the SA Salaried Medical Officers Association warned workloads had risen since the Enterprise Patient Administration System was rolled out in June and registrars were taking double the time to do ward rounds.
However, Mrs Kaminski said the rollout had “significantly improved patient safety” with a marked reduction in medication errors thanks to the automatic safety net built into the EPAS.
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Stroke victims to be treated with electric shocks

Stroke patients could recover the use of their hands with a device that triggers their nerves through a series of clicks and electric shocks.
  • Oliver Moody
  • The Times
  • 12:00AM October 20, 2016
Stroke patients could recover the use of their hands with a device that triggers their nerves through a series of clicks and electric shocks.
Each year millions of people around the world suffer strokes, in which part of the brain is damaged because its blood supply is cut off.
About half of those who survive the attacks are left with a disability, which often takes the form of a persistently clenched fist.
Scientists from Britain’s University of Newcastle believe they can teach patients how to loosen their hands by changing the wiring through which the brain sends messages to limbs.
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Digital Health Space blog: Leading voices in health and care

Created on Monday, 17 October 2016
The Australian Digital Health Agency has launched the Digital Health Space, a blog where stories across Australian health and care are told and shared. Leading voices across peak bodies, healthcare advocates, along with emerging and established health and technology professionals will share their stories on the future of digital health and care.
CEO Tim Kelsey tells his story on his visits to the Northern Territory, where he spoke to pharmacists and patients on the transformative power of digital services and the crucial role people play in realising its potential. Recently, Mr Kelsey also visited Perth, Western Australia where the extraordinary story of Fiona and her husband Peter showed how important easier access to health information is in order to help patient care and improve patient outcomes.
The latest blog post by Vanessa Halter, senior privacy specialist at the Australian Digital Health Agency, highlights the crucial role of privacy in building confidence in digital health and driving its adoption across a range of health and care providers.
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Privacy – enabling trust and confidence in digital health

Monday, 17 October 2016
What’s the collective noun for a group of healthcare providers? A horde? A congregation? Certainly not a gaggle. I think it should be an orchestra – just as an orchestra is made up of distinctive yet harmonious sections, so too is the healthcare industry.
Recently, at the Sydney North PHN workshop, an orchestra of healthcare providers watched expectantly, waiting for me to pick up my baton, set the tempo and begin:
“The vast majority of people in this room did not get into the healthcare industry to work with computers. Your priority is your patient. Am I right?”
The pharmacists nod their heads, the general practitioners give a bit of a chuckle, and the practice nurses smile. Good, we’re in agreement.
I’ve been a privacy advisor for digital health for five years, and no presentation I make is ever the same. Yet, there is one consistent element with every audience: privacy is a priority. I see that as one of the reasons why some providers have not dived head first into adopting digital health. Those providers want to be absolutely sure that the trust their patients already have in them to uphold privacy is not eroded.
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My Health Record Clinical Engagement: Medicines Integration

The Australian Digital Health Agency wants to improve access to medicines, allergies and adverse reactions information in the My Health Record system, to better support medicines reconciliation processes and reduce adverse events.  To do this, the agency will be undertaking a research study in October and November of 2016, engaging with a range of healthcare providers to understand how the design of medicines information in My Health Record system could be optimised for use.
The research will seek to deepen understanding how the Agency should evolve the design of medicines related data in the My Health Record system, sensitive to this complex context, and so improve how users interact with, consume and contribute to consumer medicines related data.
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6 wearable technologies doctors need to know about

John Kron | 14 October, 2016 |  
The explosion in wearable technology in recent years may be a commercial fad but many believe it will benefit doctors in treating patients. Australian Doctor takes a look.
Basic is probably the word that best describes the technology used in most pedometers back in the 1990s.
The device attached to your belt. A sensor counted up the steps and, well, that was about it.
Now, compare this with the Samsung belt launched in January.
Yes, it counts steps, but the sensors also measure distance travelled, activity and sedentary time, calories burned, waistline size based on belt tension. Then it sends the data to a smart phone app that suggests how best to manage your weight.
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Can big data research lead to useful medical insights?

Antony Scholefield | 18 October, 2016 
Many doctors have heard the phrase ‘big data’.
In fact, some might be tired of it already. There’s no perfect definition, but it usually describes huge datasets that reveal patterns of behaviour.
The Federal Department of Health has started to focus on using big data for medical research, and recently released a dataset based on anonymised Medicare data from 10% of patients.
It’s also working on a framework for secondary uses of MyHealth Record data, which will probably include using it for research.
But some UK and US researchers argue that big data will not lead to useful medical insights.
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Top scientist wants to bring big data analysis to healthcare

A day after winning the Prime Minister's Innovation Prize, Mike Aitken, was busy pressuring federal and state governments, health funds, hospitals and doctors to begin a mammoth big data exercise in healthcare.
Aitken, who is chief executive of the Capital Markets Co-operative Research Centre, says there is an opportunity to save up to $20 billion a year from leveraging the power of personal health data.
His urgent call for action is timed to coincide with the publication of the first of three reports by CMCRC on the multiple silos of data in the health system.
The first report is called Flying Blind – Australian consumers and digital health.
Aitken says it "chronicles the opportunity loss to Australia from a failure to integrate more than 50 sources of health data in Australia".
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Bacchus Marsh baby deaths: Australia should learn from the UK and publish clinician performance data

20 October 2016
The United Kingdom has been where the Victorian government is now. After a review confirmed 11 newborn and stillborn deaths at Victoria’s Bacchus Marsh hospital were potentially avoidable, the state is set to overhaul its health services.
It also took the deaths or serious injury of babies and children to change things in England. The General Medical Council’s 1998 inquiry into the deaths of 29 babies undergoing heart surgery in the 1980s and early 1990s at the Bristol Royal Infirmary concluded that there had been serious professional misconduct by three doctors. In response, the UK government decided to publish hospital death statistics.
The Victorian government’s review was chaired by Stephen Duckett, director of the health program at Grattan Institute. Its report into the safety of care in Victorian hospitals, released last week, concluded that the potentially avoidable deaths were the result of a series of catastrophic clinical and governance failures.
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Telstra-run national cancer register voted in

Paul Smith and AAP | 14 October, 2016 | 
The ALP has failed in its initial attempts to stop Telstra running the new national cancer screening register, amid concerns that sensitive medical information would be handed to the private sector.
From 1 May, the national register will hold patient data on the revamped cervical cancer screening program, along with the bowel cancer screening program.
Despite Opposition claims the government was treating the register like a guinea pig by giving sensitive patient data to Telstra, the bill to establish the register passed the House of Representatives and the Senate last week.
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Can an app identify autism as well as a doctor?

By Ry Crozier on Oct 21, 2016 6:42AM

La Trobe to test app coded for free by Salesforce.

Autism researchers from La Trobe University are about to test whether a smartphone app can identify potential signs of autism as accurately as healthcare professionals.
Salesforce earlier this year contributed a team of its engineers, developers and designers to researchers from the Olga Tennison Autism Research Centre (OTARC) to convert their work into code.
The result was ASDetect, an app available for iOS and Android. It has garnered 10,000 downloads in the first six months of availability, 75 percent from Australia. The researchers used Salesforce’s Dreamforce conference this month to officially launch the app in markets outside of Australia.
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http://www.healthlink.net/en_NZ/

HealthLink is 50% of the way to Meeting its Australian SmartForms Platform Establishment Target

Implementation of HealthLink’s SmartForms’ service is dependent upon establishment of the Aduro Interface, a standards based interface that enables a GP or Specialist’s electronic medical record (EMR) system to communicate with a centrally hosted forms server.  It is the Aduro Interface that automatically pulls information out of the EMR in order to populate the eReferral or service order form prior to its being sent. 
As of 1 October HealthLink was 50% of the way to implementing the Aduro interface across Australia’s main EMR systems.  With 4,300 sites now installed, HealthLink expects to reach the full 8,000 target sites by the end of 2016, with use of SmartForms applications ready to commence on a production basis early in 2017.  More than 95% of New Zealand General Practice sites have been installed and development by Incisive Software, New Zealand’s largest specialist EMR company is now underway.
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The natural side of artificial intelligence

  • Ginni Rometty
  • The Wall Street Journal
  • 2:23PM October 19, 2016
The rise of artificial intelligence has inspired both fascination and fear of the world to come. Some tech prophets envision a “singularity,” in which advances in AI trigger drastic technological growth, while others imagine that autonomous machines will someday turn on their creators and destroy us.
But when you’re engaged in the science of machine intelligence, you understand that this is a false set of choices shaped by a misleading phrase.
The term “artificial intelligence” was coined in 1955 to convey the concept of general intelligence: the notion that all human cognition stems from one or more underlying algorithms, and that by programming computers to think in the same way, we could create autonomous systems modelled on the human brain.
At the same time, other researchers were taking a different approach. Their method — which worked bottom up to find patterns in growing volumes of data — was called IA, short for “intelligence augmentation.”
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Microsoft cracks the code on speech recognition – as good as humans

Microsoft has “cracked the code” achieving computer speech recognition on parity with humans for conversational speech.
This has long been the goal – a computer than can recognise conversational language with human accuracy. It is defined as Word Error Rate and humans generally get about 5.9% wrong. Microsoft says it is the lowest recorded against the industry standard Switchboard speech recognition task.
Suffice to say the researchers at Microsoft AI are chuffed and have published the paper in the Cornell University Library.
The abstract says, “The key to our system's performance is the systematic use of convolutional and LSTM neural networks, combined with a novel spatial smoothing method and lattice-free MMI acoustic training.” 
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Enjoy!
David.

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