Monday, January 30, 2017

Weekly Australian Health IT Links – 30th 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

With a week broken up by Australia Day we don’t seem to have had much going on other than yet another amazingly messy Government IT debacle with Ultranet!
At the same time we still have the Centrelink data mining and letter generation system under more than considerable fire.
Enjoy the browse.
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When it comes to privacy, patients trust e-health more than faxes

23 January 2017
ANALYSIS
Stories about digital health data being compromised, hacked or accidentally leaked seemed to be a theme last year. 
In October, more than 500,000 blood donors had sensitive data, including sexual health details, posted online after a mistake at Australian Red Cross. In the same month, the Federal Department of Health released one million lines of MBS claims data online, not realising it could potentially identify individual doctors.
Concerns have also grown in recent months that the government’s prized MyHealth Record system could suffer a breach. 
However, a new US study says despite the fact digital health data breaches are attracting more and more media attention, patients are not spooked by this.
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25 January, 2017

One step forward then two back for digital health?

Posted by Jeremy Knibbs
Spare a thought for Tim Kelsey and his new, and, so far, tightly knit, team at the Australian Digital Health Agency (ADHA).
Faced with an almost impossible task of re-igniting a spark under our digital health agenda, his group had, by year’s end, done an amazing job of re-enlisting large numbers of a mostly disenfranchised and cynical healthcare community into a rebooted crusade for digital change.
Since assuming the top job at the ADHA in mid-August, Kelsey travelled much of Australia, listening to patients, clinicians and regulators at the coalface, and quickly decided on a new team. This team included selected ex NEHTA staff who could provide valuable corporate memory and experience, and had done much of the key initial work required to deliver a cohesive, workable and believable new digital healthcare strategy.
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New ePIP deadline looms for practices

Antony Scholefield | 25 January, 2017 | 
GP practices have until 31 January to meet Federal Government targets for uploading shared health summaries to the MyHealth Record system.
Under the e-health Practice Incentives Program, clinics will have to ask their GPs to upload the summaries for at least 0.5% of the clinic’s patient list or face losing an average of $25,000.
The original deadline for the uploads was 31 July 2016, but it emerged in August that about 1500 practices had not met the target and would have to repay the ePIP cash.
In response, the original deadline was pushed back six months to January.
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Slick, misleading YouTube clips pose health threat

24 January, 2017 Rachel Worsley 
Parents should be advised to avoid YouTube for medical information because it is packed with slickly produced but ultimately misleading video clips, child health researchers warn.
UK paediatricians who reviewed 400 patient-uploaded clips of children with croup or dehydration found just 15 provided good clinical examples.
Worryingly, misleading clips were often more technically accomplished than reputable ones.
Even paediatricians find it laborious to track down good-quality child health videos on YouTube, the authors say, and it is likely even harder for parents to separate the helpful from the harmful.
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Senior citizen walkers drawn to fitness tracking devices

Seniors and baby boomers have joined the younger, healthy set in using fitness tracking devices, according to new research which shows that the older brigade in Australia are emerging as a major market for fitness tracking devices as they take up health technology and devices as rapidly as young people.
The survey of 1000 Australians by data insights and programmatic media company Pureprofile reveals that walkers over the age of 60 make up the largest number of users of fitness devices, such as smartphone apps and wrist bands.
According to Pureprofile, walking is by far the most popular activity, with an average of 53% of survey respondents claiming it is their main fitness activity, followed by gym/workouts (17%), running (9%) and swimming (5%).
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My Health Record

My Health Record is the name of the National digital health record system. Having a My Health Record means your important health information like allergies, medical conditions and treatments, medicine/prescription details, blood test results and scans as well as hospital discharges can be shared.
You control what goes into it, and who is allowed to access it. Your eHealth record allows you and your doctors, hospitals and other healthcare providers to view and share your health information from anywhere they need to, like in an accident or emergency.
After you create your Electronic Health Record ask your GP at Hornsby Fountain Medical Centre to upload your medical file. You can go through with the GP and see/choose what you would like shared or not.
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Advance notice: Plan to call for Expressions of Interest for secure messaging proof of concept projects

Created on Tuesday, 24 January 2017
The Australian Digital Health Agency (Agency) is providing advance notice to jurisdictions, industry and the healthcare sector that it plans to call for Expressions of Interest as part of its secure messaging program.
Proposals will be sought from industry secure messaging suppliers, clinical information system/applications suppliers and end users to collaborate on implementation projects to prove the concept and demonstrate a working model going forward for three key use cases to support the adoption of secure messaging capabilities across the health sector:
  1. General Practice referral to Specialist
  2. Allied Health message to General Practice or Specialist
  3. Hospital Discharge Summary to General Practice and/or other Provider
The EOI will seek consortiums of suppliers and users (possibly organised through a healthcare organisation or group such as a PHN or LHD)  to respond with written fixed-price proposals from supplier/s who can collaborate with other suppliers, and end user sites who demonstrate the ability to implement secure messaging capabilities.
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FHIR Product Roadmap January 2017

R3 plans
The FHIR project is presently finalising “STU3” (Standard for Trial Use, release 3). This 3rd major milestone is currently close to completion. We’ve been meeting in San Antonio this week to finalise ballot reconciliation, perform testing and quality activities, and we are now focusing on preparing the final publication package. Following our publication plan we expect to be publishing release 3 on or about Mar 20.
R4 plans
Once R3 is published, we will start working on release 4. The various committees that manage the different parts of Release 4 have been discussing their scope of work for R4, and planning their engagement and implementation activities to support that this week.
Some of the major things under consideration for Release 4:
  • Improvements across all domains
  • Cds-hooks integrated in FHIR Specification
  • Query language framework
  • Support for integrating research and clinical practice
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Initial foundations for clinical workflow

Posted on by wolandscat
Over the last 6 months or so I have been working on two projects, but one theme: implementing computable clinical workflow. For as long as I can remember, ‘workflow’ and ‘process’ are the main words that excite most clinical professionals in health informatics. They get mildly enthused about data, modelling tools, and applications, but what they really want is for the IT layer to help them work with other clinicians and the patient through time. From my point of view, they’ve always been right, but I’ve also thought we needed to get something working in the data layer to even have a chance at solving process.
Today I think we have enough going in terms of a semantic health data platform in openEHR, and some of the smarter EMR systems, such as at Intermountain, Kaiser etc to consider the next layer. Serendipitously, I’ve recently had the chance to concentrate on the process question.
Making workplace processes computable is a huge challenge, and it would be difficult to over-estimate the effort that has gone into it over some decades. There are dozens of process languages and workflow tools, and endless reams of research to cover. In some industries, notably manufacturing, there have been successes, but creating similar solutions for healthcare seems endlessly elusive. Intuitively, it’s not hard to understand why. Most workflow solutions are based on the idea of modelling deterministic processes that can then be performed by agents, i.e. humans, robots, or other devices. This can work well in e.g. car manufacturing, where there are very few unknowns (the amount of time for specialist human welders to finish a weld will vary somewhat for example).
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IBAC finds disastrous Ultranet project for schools was a 'corrupt' shambles

Henrietta Cook, Benjamin Preiss, Timna Jacks
Published: January 27, 2017 - 5:10PM
Education Department officials wasted up to $240 million of taxpayers' money during a corrupt tender process for a school IT project, Victoria's anti-corruption watchdog has concluded.
The officials could now faces criminal charges over the "appalling waste" following a lengthy investigation by the Independent Broad-Based Anti-Corruption Commission.
The Ultranet project promised to deliver an online platform that connected teachers, parents and students, but was plagued by technical issues and rarely used after its rollout by the former state Labor government in 2010.
In a long-awaited report tabled in state parliament on Friday, IBAC found that department officials purchased shares in CSG – the company awarded the Ultranet project – influenced the tender process and accepted inappropriate gifts from suppliers including flights and lavish dinners.
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Corruption claims over failed $240m Ultranet project

Inquiry finds evidence of process corruption, improper diversion of funds, conflict of interest and mismanagement
George Nott (Computerworld) 27 January, 2017 15:00
The launch was extravagant. Dancers and singers were hired to perform a specially choreographed musical number. A bespoke stage was constructed to look like a giant laptop. Kindles and iPads were given away as spot prizes.
A branded bus ferried then Victorian education minister Browyn Pike and special guests to the ‘Big Day Out’ event at Melbourne Convention and Exhibition Centre. Today, they would launch Ultranet, a virtual learning portal that promised to ‘revolutionise learning’ for every Victorian school pupil.
Poised at their computers in schools across the state, teachers readied themselves to log-on to the system as it went live. It crashed. The million-dollar event was a damp squib. And so was Ultranet.
Three years later, in 2013, plagued by limited functionality and declining student take-up from an already pitiful base of 10 per cent, the Ultranet project was abandoned. Although the exact cost is unknown, estimates go as high as $240 million.
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Director Enterprise Patient Administration System (EPAS) Clinical Delivery

  • Central Adelaide Local Health Network, Royal Adelaide Hospital
  • Temp F/T (up to 1/3/2019) – SAES Level 1
You will be accountable to the Chief Executive Officer, Central Adelaide Local Health Network (CALHN), through the Executive Director new Royal Adelaide Hospital (RAH) Activation, for managing the delivery of the Enterprise Patient Administration System (EPAS) across CALHN to achieve successful and sustainable implementation. Working with the CALHN Executive and EPAS Leadership, you will provide authoritative advice, leadership, oversight and management for the coordination of the operational outcomes for the EPAS Program implementation. This will include planning, leading, coordinating, controlling and managing timely, high quality and cost effective projects and providing expert advice and consultancy services. Overseeing operational changes required across all EPAS-live sites in CALHN, you will deliver recommendations regarding resource allocation and changes to key workflows and business processes. You will also act as the overall site lead during EPAS activation at the new RAH, providing direction, coordination leadership and single point of liaison with the EPAS Team during this period.
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Complex algorithms can use a little of that human touch

  • Anthony Wong
  • The Australian
  • 12:00AM January 24, 2017
Recent publicity over Centrelink’s automated debt recovery program has reignited the debate on how algorithms and data matching are used to inform decisions, in both the public and private sectors, and the need to ensure that human judgment continues to play a role.
The use of complex algorithms to automate processes might reduce costs, but ICT professionals need to ensure that appropriate checks are in place to achieve the desired result. No one would argue the government’s right and indeed responsibility to protect public moneys by ensuring that welfare recipients receive their exact entitlements and no more.
The government has clarified its approach, while making adjustments to soften the impact and ensure that recipients under the debt recovery program understand what steps are available to them and how to exercise their rights.
Labor is pushing ahead with calls for a Senate inquiry and demanding that Centrelink’s data matching system be suspended until a comprehensive review has taken place. The Commonwealth Ombudsman is conducting his own investigation after receiving a series of complaints.
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Centrelink staff speak out against DHS over data matching bungle

By Allie Coyne on Jan 25, 2017 11:11AM

Claim the department ignored warnings.

Unionised Centrelink staff have banded together to speak out against the Department of Human Services' botched data matching system, claiming the agency refused to listen to warnings that it was problematic.
The Community and Public Sector Union - representing "thousands" of unionised departmental staff - today published an open letter to Centrelink customers acknowledging the 'unfairness' of the automated debt notice system.
"We need to tell you that we see your pain and acknowledge your fear. We know you are angry and we are too. We know that the people of Australia deserve better," the open letter states.
"We know that the automated debt notices are unfair, unjust and callous. We acknowledge that in a great many cases, they are not your debts.
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Using genomics to predict heart risk

Authored by Charlotte Mitchell
THE clinical application of genomic risk scores for coronary heart disease (CHD) has been debated by experts, after new research finds that genetic variants can be more predictive of disease than traditional clinical risk scores.
Lead authors of the research from the University of Melbourne, Dr Gad Abraham and Associate Professor Mike Inouye, told MJA InSight that current clinical approaches for detecting increased heart disease risk were “severely” limited because they depended on elevated levels of known risk factors, while ignoring the substantial genetic component of the disease.
“Consequently, a large number of individuals who will experience myocardial infarction cannot be detected ahead of time.
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1stGroup rebrands health portal as MyHealth1st

Australian online heath portal group 1st Group has rebranded its health portal to MyHealth1st from 1stAvailable.
1st Group managing director Klaus Bartosch said the new brand made it clear that the company is a “consumer-centric health portal which brings a more accessible, less intimidating way for people to connect with their preferred healthcare providers”.
He said the new name conveyed that the portal and related apps delivered a “simple connection to better health and wellbeing”.
Bartosch said the portal had transitioned from being a free online appointment booking platform for healthcare appointments to a platform with significantly expanded scope and functionality. “The MyHealth1st portal today enables access to a much broader range of products that leverage the booking platform, supporting an expanded range of healthcare services.”
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Pioneering medical research institute seeking CIO

Garvan Institute of Medical Research looking for experienced IT chief
George Nott (Computerworld) 20 January, 2017 15:46
The Garvan Institute of Medical Research – home of Australia’s first clinical whole-genome sequencing service – is seeking a new CIO.
A major focus of the role will be “bringing business discipline to the way IT is used within the organisation”, a job listing noted.
The successful candidate would be “commercially astute” and have experience in driving transformation change.
The CIO will lead the institute's IT department and report to Chief Operating Officer Philip Knox, formerly CFO of broadcaster Austrar.
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Federal Court erred in Grubb metadata ruling

The Australian judicial system has usually proved itself to be one that applies the common sense principle when confronted by technological cases. But in the case of the recent ruling on what is, and what is not, personal information, the Federal Court has erred and badly too.
Over the years, the court system has handled the Kazaa case, the Sony case, the iiNet case, the Dallas Buyers Club copyright case and more recently the copyright case involving Foxtel and Village Roadshow.
In every case, the judges have shown that despite fears to the contrary, they have a more than adequate understanding of technological detail to make an informed judgment.
Over and above this, they have always shown that they are worldly-wise and aware of the extent to which some entities try to use scare tactics to frighten members of the public.
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Future shocks: beyond drones, driverless cars and 3-D printing

Sophisticated artificial intelligence could ultimately decide it can run things better than humans.
  • The Australian
  • 12:00AM January 28, 2017

Graham Lloyd

It is fitting the future has come first to fashion. Buying shoes will never be the same again. Customers can simply scan their feet with a smartphone and use the digital file to 3-D print a bespoke, perfect pair. It is a future that has already arrived.
Soon, customers will be able to instruct a personal robot to summon a battery-powered driverless transportation pod. This will be when the “internet of things” (when everything is connected) gets really interesting.
Driverless vehicles will all but eliminate car ownership — and accidents. Roads will be freed up, cutting insurance rates to shreds.
Alternatively, a drone can whiz the new shoes to the buyer’s hands using enhanced geo-satellite tracking that has mapped the physical world to the square millimetre.
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Enjoy!
David.

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