Monday, January 16, 2017

Weekly Australian Health IT Links – 16th January, 2017.

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 message of the break seems to have been how bad IT can really ruin your holidays and have you spending hours on the phone trying to sort things out…..what a fiasco!
Other interesting stuff also happened so do browse on!
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Screw-up nation: Why the tech we count on keeps letting us down

January 8, 20177:23am
THE Centrelink debacle that’s slugged thousands of Aussies with unfair debt is the latest in a string of disasters in which technology has let us down - with devastating consequences.
We have become a nation where screw-ups are the new normal.
Almost exactly a year ago, Centrelink was in the middle of another storm, when it was forced to apologise for a New Year’s computer glitch that incorrectly told 73,000 families they were in debt.
When Family Tax Benefits claimants checked their accounts online, they were wrongly shown to owe money, with one mother mistakenly charged more than $700.
The Australian Bureau of Statistics then paid IBM $9.6 million to run the bungled 2016 Census because its own systems were antiquated and unreliable. The national survey was a massive failure, with the website going down for 40 hours and a Senate Committee inquiry finding “significant and obvious oversights” in its delivery.

Centrelink crisis 'cataclysmic' says PM's former head of digital transformation

Paul Shetler, appointed to transform the government’s digital approach, says Centrelink’s error rate would put a private firm out of business
The man handpicked by Malcolm Turnbull to head the government’s digital transformation has said the error rate in Centrelink’s data-matching process is so unfathomably high that it would send a commercial enterprise out of business.
Paul Shetler, the former digital transformation office head, criticised the government’s response to its latest IT crisis, telling Guardian Australia it was symptomatic of a culture of blame aversion within the bureaucracy.
“It is literally blame aversion, it is not risk aversion,” Shetler said. “They’re trying to avoid the blame, and they’re trying to cast it wide.
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Trial to give pharmacists more power over scripts

Antony Scholefield | 12 January, 2017 | 21 comments Read Later
Pharmacists will be free to change medication doses, issue repeat scripts and perform point-of-care tests for patients with chronic diseases under a trial starting this year.
Running for 18 months, the Victorian trial is a way of freeing up GP time to deal with complex clinical issues, according to the state government.
Supporters argue the trial will not fragment care and GPs will retain control over what happens to patients.
The GPs taking part will write shared care plans that will guide pharmacists in monitoring and refining the medication regimen of patients with asthma, hypertension and hypercholesterolaemia, and those on anticoagulation medications.
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Better broadband needed in the bush

BETTER BROADBAND NEEDED IN THE BUSH
AMA Position Statement on Better Access to High Speed Broadband for Rural and Remote Health Care
The AMA has warned that health services in rural, regional, and remote Australia could fall even further behind city services, without urgent Government action to ensure all Australians have access to affordable and reliable high speed broadband.
The AMA today released its Position Statement on Better Access to High Speed Broadband for Rural and Remote Health Care, which calls on the Government to improve internet access across the nation.
AMA Vice President, Dr Tony Bartone, said that rapid improvements in technology have the potential to deliver better health outcomes at lower cost outside major cities and towns through telemedicine and eHealth.
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Doctors underwhelmed by NBN for e-health

By Ry Crozier on Jan 10, 2017 5:12PM

Peak medical body calls for fibre and wireless expansion.

Australian GPs have delivered a lukewarm assessment of the NBN as an enabler of e-health services in regional, rural and remote Australia, just days after the network builder publicly talked up its credentials in the space.
The Australian Medical Association (AMA) unveiled a position statement Tuesday calling on the government to take “urgent action” on bush broadband to ensure regional Australia could access “the same standard of healthcare … as those living in the major cities”.
It warned that without access to telemedicine and e-health services, those in regional, rural and remote Australia “could fall even further behind” in terms of access to quality health services.
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Ehealth: AMA call for bush broadband boost

NBN fixed line and fixed wireless footprint should be extended wherever possible, says the Australian Medical Association
Rohan Pearce (Computerworld) 11 January, 2017 10:27
The Australian Medical Association has called on the government to tackle barriers to the use of ehealth and telemedicine in rural and regional Australia.
In a position paper released this week the AMA argued that “the utilisation of telehealth and telemedicine in rural and remote Australia remains patchy and is not used to full potential, because of no, or inadequate internet access”.
Internet connections in rural areas are often expensive, slow and have relatively small download allowances, the AMA said.
The AMA called for “measures to prioritise or optimise the broadband capacity available by satellite for hospitals and medical practices, such as exempting or allocating higher data allowance quotas, or providing a separate data allowance”.
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Health starts briefing vendors on new Medicare IT

By Paris Cowan on Jan 9, 2017 3:15PM

Meetings begin this week.

Officials from the Department of Health are set to meet with IT industry representatives in Sydney and Melbourne this week, as they prepare to take bids for the right to build Australia’s new Medicare payments engine.
The agency will partner with a third party systems integrator to build the new IT system, after plans to fully outsource the end-to-end process of calculating and paying health rebates to a bank, telco or other organisation were officially canned during the 2015 election campaign.
The Turnbull government was forced to turn its back on a proposal to privatise the rebate processing work after a major public backlash threatened to derail its re-election prospects in July.
It had been tentatively taking market proposals from potential outsourcers, including Australia Post, since August 2014.
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Reform the PBS, consumer group demands

Chris Brooker 11/01/2017

Government should scrap co-pay increases and move to electronic recording, CHF says

The Federal Government should reform the PBS safety net so consumers with high usage of PBS medicines have “smoothed out annual co-payments”, the Consumers Health Forum believes.
In its 2017-18 Budget Submission, released last week, the CHF calls for reforms to PBS administration and payments to better aid consumers, with these proposals winning support from the Pharmacy Guild of Australia.
The CHF endorsed pharmacy as a “key element in the strong and sustainable primary healthcare system that Australia needs”, while calling for its integration into ongoing health structural reforms.
“CHF supports the strengthening of this crucial sector through: the removal of the PBS co-payment increase, the development of a new health payment system and through the reform of the PBS safety net”, the submission states.
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Personal health records now available online

12 Jan 2017, 10:25 a.m.
Following a Federal Government trial in Western Sydney, local hospitals are now uploading around 570 discharge summaries to My Health Record each month.
What this means is that GPs can easily access information about their patients after a stay in hospital and our clinicians can access important health information about patients that their GPs have uploaded.
As a resident of the Nepean Blue Mountains regions, which also includes Hawkesbury residents, can access their personal health record online and even set access restrictions and add information about allergies, medication and other important health information.
“In the event of a medical emergency, residents will know that their health information is stored safely and securely and can be accessed immediately by emergency doctors if required,” a spokesperson said.
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How the Turnbull government killed off its big website dream

Noel Towell
Published: January 12, 2017 - 11:48AM
The Turnbull government has quietly killed off one of its biggest plans for "digital transformation": the hugely ambitious GOV.AU website project.
Fairfax understands that Minister for Digital Innovation Angus Taylor pulled the pin on the program, at the urging of the powerful Finance Department, just minutes before plans for its next phase were due to go to cabinet in August 2016.
Mr Taylor's office insists that a rebadged version of the plan will go ahead and that it is a "priority project".
The dramatic dropping of the much-hyped centrepiece of Malcolm Turnbull's "agile and innovative government agenda" came after a Canberra turf war that had raged for months between Finance and the Prime Minister's pet public service project, the Digital Transformation Office.  
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Three simple ways to avoid more IT failures like Centrelink and the census

Centrelink’s debt recovery system is just the latest IT failure by government. It needs to fix labour hire practices if it wants better software
Centrelink’s software problems, like those of Queensland Health, the Census and Victoria Police before them, arise from pathologies created by the powerful labour hire and outsourcing industries.
Centrelink’s software invents second employers and additional income. Queensland Health bungled the pay of nurses and doctors and also sent them nasty legal letters. Queensland lost a staggering $1bn through that disaster. The census website system fell over.
These would be extraordinary mistakes even for a small business, and yet they’re being made by government departments with hundreds of millions of dollars to spend. How does this happen? 
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Commonwealth Ombudsman launches Centrelink investigation

Tom McIlroy
Published: January 9, 2017 - 4:19PM
Pressure is growing on the Turnbull government over the Centrelink debt-recovery controversy, after the Commonwealth Ombudsman launched a wide-ranging investigation amid calls for the system to be shut down.
The ombudsman moved to initiate an investigation this month over significant concerns about automated data-matching processes being used to check welfare recipients' eligibility for some Centrelink payments, leading to outcry over the Christmas period as about 170,000 debt notices were issued.
Independent MP Andrew Wilkie and South Australian senator Nick Xenophon both referred the matter to the Ombudsman in December, but the investigation was already under way within the office.
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Centrelink debt recovery drive has caused summer from hell, Bill Shorten says

Matthew Knott
Published: January 9, 2017 - 12:15AM
Opposition Leader Bill Shorten has called on the Turnbull government to immediately suspend Centrelink's controversial automated debt recovery program, describing it as a "toxic mix of incompetence and cruelty" that has ruined Christmas for vulnerable Australians.
Mr Shorten, who is on summer holidays until the end of the week, has not previously commented on the project, which the government estimates will add an extra $4.5 billion to the budget. The automated system has been accused of miscalculating bills and sending debt notices to people who do not owe.
Stories have mounted in recent weeks of Australians – including asylum seekers and people with disabilities – who say they have been sent inaccurate debt notices.
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Centrelink's debt debacle: It's going to get worse, says union

Noel Towell
Published: January 10, 2017 - 12:15AM
Beleaguered Centrelink staff are bracing for a "perfect storm" of customer service problems in the coming weeks, heaping more misery on the welfare agency's millions of clients, according to the main workplace union.
The ongoing debt recovery debacle already has public servants at Centrelink stretched to breaking point, the CPSU is warning, and the agency's workers will soon have to cope with hundreds of thousands of student benefit applications and pensioners trying to make sense of changes to their payments.
But the department says customer demand is normal for this time of year.
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New digital health chief to get $522,000 a year to fix troubled My Health Record system

Daniel Burdon
Published: January 11, 2017 - 11:08AM
The head of the Turnbull government's six-month-old Australian Digital Health Agency will be paid a tidy $522,000 annual salary package after beating more than 100 other applicants to take the role fixing the plagued My Health Record system.
The chief executive's pay comes with the difficult task of overseeing the $156 million agency and its remit to digitise the nation's health systems, including fixing the delayed national roll-out of My Health Record.
Despite a number of teething problems, about 4.4 million Australians have signed up so far, as the government moves towards an "opt-out" system rather than the previous "opt-in" system.
The government's creation of an agency dedicated to improving digital health systems was been widely supported, although some stakeholders have been sceptical of how much the agency will achieve given past problems.
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Australian Medical Association appoints new group CIO

Chartered Accountants ANZ’s former ICT strategy chief joins AMA
Rohan Pearce (Computerworld) 12 January, 2017 08:06
The Australian Medical Association has appointed a new group chief information officer to replace Colin O'Sullivan, who left the AMA last year to return to Ireland for family reasons.
An AMA spokesperson told Computerworld Australia that the organisation had recruited Phil Barton to take charge of IT.
Barton joins the doctors organisation from UGL Unipart – a joint venture between Australia’s UGL and the UK’s Unipart Rail that provides heavy maintenance and supply chain services for Sydney’s rail fleet.
At UGL Unipart Barton was head of program, which included developing the consortium’s ICT roadmap and strategy and leading its project management team. Barton joined the company in April 2015.
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National Digital Health Strategy consultation: What have we learned so far?

Created on Friday, 13 January 2017
How should Australia take advantage of the opportunities that new technologies offer to improve health and care? What do Australians want and expect from a modern healthcare system?
Over 600 online submissions have been received and more than 2,500 people have attended meetings, forums, workshops, webcasts and town halls across Australia – watch the video below to see what the Australian community has been saying!

Survey and written submissions

Our survey provides you or your organisation the opportunity to have your say about the future of digital health in Australia.
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Child Immunisation and Digital Health

Monday, 09 January 2017
The week before Christmas 2016, with temperatures peaking at 43 degrees, I travelled with our CEO, Tim Kelsey and Chief Medical Adviser, Clinical Professor Meredith Makeham to Perth, Bunbury and Busselton in Western Australia.
The trip was part of our national conversation with the Australian people about digital health; how we can best shape it around Australia's needs, wants and aspirations. This conversation is part of a larger consultation activity as we work towards co-producing a National Digital Health Strategy for the Australian Government.
All up, we talked to around 100 people across the WA health sector. Many subjects were raised and discussed, including the important subject of child immunisation.
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12 January 2017

Smartwatches know you’re getting a cold days before you feel ill

By Alice Klein
Once we had palm-reading, now we have smartwatches. Wearable tech can now detect when you’re about to fall ill, simply by tracking your vital signs.
Michael Snyder at Stanford University in California experienced this first-hand last year. For over a year he had been wearing seven sensors to test their reliability, when suddenly they began to show abnormal readings. Even though he felt fine, the sensors showed that his heart was beating faster than normal, his skin temperature had risen, and the level of oxygen in his blood had dropped.
“That’s what first alerted me that something wasn’t quite right,” says Snyder. He wondered whether he might have caught Lyme disease from a tick during a recent trip to rural Massachusetts.
A mild fever soon followed, and Snyder asked a doctor for the antibiotic doxycycline, which can be used to treat Lyme disease. His symptoms cleared within a day. Subsequent tests confirmed his self-diagnosis.
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Engineering technology resilience through informatics safety science

Enrico Coiera, Farah Magrabi, Jan Talmon
DOI: http://dx.doi.org/10.1093/jamia/ocw162   First published online: 31 December 2016
With every year that passes, our relationship to information technology becomes more complex, and our dependence deeper. Technology is our great ally, promising greater efficiency and productivity. It also promises greater safety for our patients. However, this relationship with technology can sometimes be a brittle one. We can quickly cross a safety gap from a comfortable place where everything works well, to one where the limits of technology introduce new risks. Whether it is through a computer network failure, applying a system software patch, or a user accidentally clicking on the wrong patient name, it is surprisingly easy to move from safe to unsafe. As the footprint of technology across our health services has grown, so to by extrapolation, has the associated risk of technology harms to patients.1 It is the potential abruptness of this transition to increased risk of harm, this lack of graceful degradation in performance, and the silence accompanying degradation, that remain unsolved challenges to the effective use of information technology in healthcare.
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Problems with health information technology and their effects on care delivery and patient outcomes: a systematic review

Restricted access
Mi Ok Kim, Enrico Coiera, Farah Magrabi
DOI: http://dx.doi.org/10.1093/jamia/ocw154 First published online: 23 December 2016

Abstract

Objective: To systematically review studies reporting problems with information technology (IT) in health care and their effects on care delivery and patient outcomes.
Materials and methods: We searched bibliographic databases including Scopus, PubMed, and Science Citation Index Expanded from January 2004 to December 2015 for studies reporting problems with IT and their effects. A framework called the information value chain, which connects technology use to final outcome, was used to assess how IT problems affect user interaction, information receipt, decision-making, care processes, and patient outcomes. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
Results: Of the 34 studies identified, the majority (n = 14, 41%) were analyses of incidents reported from 6 countries. There were 7 descriptive studies, 9 ethnographic studies, and 4 case reports. The types of IT problems were similar to those described in earlier classifications of safety problems associated with health IT. The frequency, scale, and severity of IT problems were not adequately captured within these studies. Use errors and poor user interfaces interfered with the receipt of information and led to errors of commission when making decisions. Clinical errors involving medications were well characterized. Issues with system functionality, including poor user interfaces and fragmented displays, delayed care delivery. Issues with system access, system configuration, and software updates also delayed care. In 18 studies (53%), IT problems were linked to patient harm and death. Near-miss events were reported in 10 studies (29%).
Discussion and conclusion: The research evidence describing problems with health IT remains largely qualitative, and many opportunities remain to systematically study and quantify risks and benefits with regard to patient safety. The information value chain, when used in conjunction with existing classifications for health IT safety problems, can enhance measurement and should facilitate identification of the most significant risks to patient safety.
  • health information technology
  • patient safety
  • adverse events
  • systematic review
  • unintended consequences
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Downside of fitness trackers and health apps is loss of privacy

December 23, 2016 6.08am AEDT
Do you know how the data from your running app is being used?

Author

  1. Victoria J Palmer
Postdoctoral Researcher Applied Ethics, University of Melbourne
At the touch of an app, Emma tracks her diabetes. She enters food, exercise, weight and blood sugar levels, then sets up medication reminders.
Suzanne uses the latest wearable device to track her running route and distances walked. As she has not slept too well in the past month, she also records her sleep patterns.
Richard takes his tablet for schizophrenia. The tablet contains a sensor that communicates with central health databases to tell health professionals if he has taken his medication.

The participatory health revolution

This is the participatory health revolution, where people use apps and wearable devices, and swallow sensors, to keep track of their health and well-being, to take control in the name of empowerment.
Latest figures indicate two in three Australians have a social media account and most spend almost the equivalent of one day a week online. In 2017, 90% of Australians will be online and by 2019 most households will have an average of 24 home devices (like alarms, phones, cars and computers) connected online.
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Enjoy!
David.

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