It Seems Major Government Health IT Projects Can Do Little But Disappoint.

This time we have a Canadian story.

There are many reports on this issue:

First we have:

After $8B spent, e-health records initiative still not complete

Auditor General annual report critical of program to switch to electronic health records

December 1, 2016 by: Sudbury.com Staff

Ontario’s health-care sector spent more than $8 billion between 2002/03 and 2015/16 on various electronic health records projects and related initiatives, but significant components are still not operational, Ontario Auditor General Bonnie Lysyk said in her 2016 Annual Report.

The government had committed in 2008 to providing an electronic health records for every Ontarian by 2015.

“The initiative has certainly advanced since our last audit in 2009,” Lysyk said Wednesday after tabling her report in the Legislature. “However, it is still not possible to say if it is on budget because the government never set an overall budget for it. In effect, we cannot say if $8 billion is a reasonable figure.”

Although an overall strategy or budget is lacking, the province did create a formal $1.06-billion budget in 2010 (which also covered prior periods) for completion of some electronic health records projects under the responsibility of eHealth Ontario. This budget excluded eHealth Ontario’s annual corporate administration expenses.

An electronic health record is a digital lifetime record of an individual’s health and health-care history, updated in real-time and securely available to authorized health-care professionals. 

More here:

https://www.sudbury.com/local-news/after-8b-spent-e-health-records-initiative-still-not-complete-478440

There is also coverage here:

$8 billion and 14 years later, eHealth has yet to finish the job

By Shawn Jeffords, Political Bureau Chief

First posted: Wednesday, November 30, 2016 01:11 PM EST | Updated: Wednesday, November 30, 2016 01:17 PM EST

More than $8 billion and 14 years later and Ontario still doesn’t have a working electronic health records system.

That according to Ontario’s Auditor General who tabled her annual report Wednesday. In it, she notes that “significant components” of the system are still not working in 2016 after a government pledge seven years ago to have electronic health records for every Ontarian by 2015.

“The initiative has certainly advanced since our last audit in 2009,” Lysyk said in a news release. “However, it is still not possible to say if it is on budget because the government never set an overall budget for it. In effect, we cannot say if the $8 billion is a reasonable figure.”

More here:

http://www.torontosun.com/2016/11/30/8-billion-and-14-years-later-ehealth-has-yet-to-finish-the-job

Last we have broader coverage here:

Ontario auditor general exposes litany of government snafus in annual report

Examples include cracked highways, overspending on eHealth records, shoddy Metrolinx oversight of contractors, and a climate change plan that will do more in California than Ontario.

By Robert BenzieQueen's Park Bureau Chief

Wed., Nov. 30, 2016

Crumbling highways, shoddy transit contractors, $8 billion spent on still-incomplete eHealth electronic medical records, and a climate change plan that will do more in California than Ontario.

Those are some of a litany of government snafus exposed by auditor general Bonnie Lysyk in her annual two-volume, 1,063-page report to the legislature on Wednesday.

The independent watchdog said a common theme throughout her 13 value-for-money audits was government contractors and suppliers screwing up yet still being rewarded with additional business.

“They probably receive more chances than you and I would give them if they were renovating our house,” said Lysyk.

Her audit of eHealth Ontario found the controversial agency’s work remained unfinished some 14 years after the computerized health records program was formally launched.

“The initiative has certainly advanced since our last audit in 2009. However it is still not possible to say if it is on budget because the government never set an overall budget,” she said.

“In effect, we cannot say if $8 billion is a reasonable figure.”

That amount includes $3 billion spent by eHealth, $1 billion by the Ministry of Health and agencies like Cancer Care Ontario, and $4 billion by hospitals, community care access centres and other clinics across the province.

As first disclosed by the Star on Oct. 13, the government was so worried about Lysyk’s audit that it scrambled former TD Bank CEO Ed Clark, Premier Kathleen Wynne’s business guru, to recommend improvements.

In a 48-page report last week, Clark said while eHealth provides‎ $900 million in annual health-care benefits to Ontarians, its mandate should be sharpened so it has “an explicit focus on technology service delivery and to ensure the agency is held to account for delivery” of those services.

The agency has been dogged by problems, including an expense account scandal when private consultants earning $3,000 a day billed taxpayers for $3.99 Choco Bite cookies and $1.65 Tim Hortons tea.

Lysyk found the seven main eHealth projects that former premier Dalton McGuinty’s government deemed priorities in 2010 were only about 80 per cent done — despite a 2015 deadline for completion. Those are now expected to be finished by March.

Health Minister Eric Hoskins said he will soon unveil “the next steps of our digital health strategy that will continue modernizing our system, further improving patient access, connectivity and experience.”

Lots more here:

Here is the link to the relevant section of the report:

http://www.auditor.on.ca/en/content/annualreports/arreports/en16/v1_303en16.pdf

Reading the detailed report (which I have to say makes riveting reading) what struck me is that we all really need this Ontario Auditor General to spend three months or so to audit our national e-Health Program.

I think her views would be very useful!

David.

Digital Health Seems To Still Have Some Work To Do To Prove Its Value. Why Is It Taking So Long I Wonder?

This appeared last week:

Digital utopia or dystopian distraction?

Antony Scholefield | 1 December, 2016   

Some GPs aren’t sure whether new digital technology is going to live up to the hype. Apparently they’re not alone.

UK health think-tank Nuffield Trust recently looked at the evidence for seven types of digital technology for primary care patients to work out whether the world is headed towards “a digital utopia” or “dystopian distraction”.

They examined the research for wearable technology, online triage, online health information, online appointment booking, telehealth, e-records and apps.

They concluded that there’s not enough evidence to show that patient technology actually improves health outcomes. There’s some evidence that some technology boosts patient engagement and their experience. But that’s about it.

For example, regarding telehealth, the trust’s report says: “Remote consultations have variously been found to increase workload, increase workload temporarily and decrease workload”. It’s hardly scientific consensus.

The evidence for online triage is “mixed”, with limited evidence suggesting that it reduces demand by keeping patients away from inappropriate healthcare channels.

Similarly, the evidence for online bookings is “inconclusive”. Some GPs might think online bookings would enable practices to run more efficiently, but the report says there’s “no concrete evidence” for this.

More here:

http://www.australiandoctor.com.au/news/latest-news/digital-utopia-or-dystopian-distraction

Here is a link to the report:

More information:

Nuffield Trust. The Digital Patient.

The Executive Summary provides some more detail.

Key points

Digital technology is transforming our lives, but its use in the NHS is still limited. There is a growing gap between the digital experience we have as consumers and as patients in the NHS. This gap is all the more pronounced given the rapid growth of commercially available health-related products – there are over 165,000 health apps on the market.

In the future, digital tools could transform our experience of care and facilitate improved self-management. It is hoped that this enhanced capacity for self-care will reduce demand on stretched services. But the impact of this new digital capability is far from certain; we are lacking evidence in a wide range of areas. Not only this, but NHS professionals could shy away from patient technology for fear of an increased workload or patients receiving inaccurate advice. Or a host of new private providers offering advanced digital services could disrupt the primary care landscape and threaten joined-up  care.

Despite this significant uncertainty, health care organisations and policy-makers will need to make decisions based on the best available evidence. This report explores that evidence. We looked at seven types of patient-facing technologies, collating what the evidence tells us to date with experiences of those using the technology on the front line. From this we suggest lessons for success. Our key findings for each area are as follows.

Monitoring and wearable technology. We found some evidence that monitoring can improve people’s diet, exercise and medication adherence, but sustained engagement can prove challenging and not all of the studies were positive in their findings. Virtually all of the evidence comes from the use of monitoring equipment that has been professionally recommended, which is known to increase adherence and engagement. Professional monitoring interventions for chronic conditions, whereby data is sent to the health care team, have had very positive results on health outcomes and resource use.

Online triage. Support for self-triage (such as service directories and interactive symptom checkers) and professionally led online triage (using emails or web consults) have the potential to reduce demand, although evidence of this is weak to date. At present, interactive symptom checkers are risk averse and may drive unnecessary demand to the health care system. These are already used at scale, and advancements in artificial intelligence among other things mean there are opportunities to make them much more accurate. But there are concerns that the use of these tools removes the opportunity for holistic clinical assessment and people do not always follow advice – particularly when self-management has been advised. We need more research on how patients engage with these tools alongside rigorous testing and evaluation of the technology itself.

Online sources of health information, targeted interventions and peer support. Online information can help patients manage their condition and have more productive conversations with their health care team. Where patients belong to a patient network, they often feel better socially supported and have improved behavioural and clinical outcomes. If there are also positive results from targeted web-based interventions, particularly for mental and sexual health, but they must be effectively targeted to the appropriate audience to be successful.

Online appointment booking and other transactional services. Booking appointments and ordering repeat prescriptions online can improve patient experience. Many assume online booking will also result in administrative efficiencies, but there is little evidence of this to date; in most places uptake is too low to have any discernible impact.

Remote consultations. Evidence suggests email consultations improve communication with professionals, save patients time and increase overall satisfaction. Video consultations are also generally well received by those that use them, but they tend to appeal to those who struggle to access their health care team in person. This may change if video consultations are offered on demand or when a face-to-face option is not possible (for example out of hours). There is mixed evidence on their impact on demand – with various results showing they increase workload permanently or temporarily, or decrease workload. Much depends on the context and the type of patient. Focusing on those most likely to benefit, such as patients with access difficulties, may help.

Online access to records.        This is one of the most effective ways to engage patients, often leading to improved communication, adherence to lifestyle advice and shared decision-making. It also tends to be highly valued by patients. Evidence about the impact on demand is generally inconclusive,    but it has the potential to increase GP visits, telephone encounters, A&E   visits and hospitalisations and we do not have robust evidence on its impact  on health outcomes. There are also a number of governance concerns around granting record access to vulnerable patients and the potential for others    to exploit their data. If full record access is granted, some worry about the extent to which third-party information is shared. There are several strategies to mitigate against these risks, including restricting access or redacting records where necessary. But this takes considerable resource and a new business model is required.

Apps.  There is a wide variety of apps on the market available for all of the functions set out above. But there are also a number of apps to help patients manage their condition or stay well. There is an emerging body of evidence suggesting that apps can have a positive impact on diet monitoring; physical activity; adherence to medication and chronic condition management, particularly for multiple sclerosis, Parkinson’s disease and cardiovascular disease. Apps that use ‘gamification’ and established behaviour-change techniques such as prompting goal setting, review and feedback on performance to encourage engagement may prove increasingly important in helping to sustain behaviour change. But many apps are inaccurate and the efficacy of the majority of them is unknown. We need more robust evidence on what works and in which  contexts.

So, there are a range of positive impacts to date. But the uptake of digital services offered by the NHS is low and the health system is not currently making the  most of beneficial consumer devices or apps:

·     Increased uptake will require significant changes in the ways professionals work: they will need new skills and expertise.

·     If patients are to self-manage using apps or wearable devices, the largest gains are likely to come from professionals recommending innovations, using the data for diagnostic and treatment decisions where appropriate and actively encouraging sustained engagement with support from others in community or general practice settings.

·     Benefits from online access to records are likely to be maximised by professionals moving to a model of shared decision-making and    showing patients how the information in the record can support self-care. Even online appointment booking is likely to be improved by demonstrations of how it works and what the benefits are in order to improve uptake, which has been slow to develop.

·     Uptake is also likely to improve with technology that is intuitive and easy to use for everyone – including those with low literacy levels and cognitive impairments. This should be part of broader efforts to reduce the risk of digital exclusion. Of course, traditional channels should also remain available.

·     All of this requires resources and it is a mistake to think that the use of patient- facing technology to support healthier lifestyles and self-care will be an easy or free option. It will require funding and support at all levels of the system, at least in the short term. We make a number of recommendations about where this might be most helpful.

·     This agenda needs to be considered in light of an entire health system. The potential for transformational change comes from patients using digital tools on every step of their health journey. Sustainability and Transformation Plans alongside Local Digital Roadmaps present a valuable opportunity to take a place-based approach to promoting the uptake of digital tools, rather than focusing on particular sectors or services.

·     Finally, there is still so much we do not know about how this will play out. As uptake and awareness increases, it will be important to have local and national evaluations, which help to highlight best practice and avoid common  pitfalls.

A concluding summary says it all:

A summary

Perhaps the most positive evidence to date on health-related digital technology comes from the impact it has on patient engagement and patient experience.    In both cases, online access to records plays a fundamental role, simultaneously supporting self-management and improving convenience. However, concerns remain about ensuring patient privacy, developing a business model to support the additional time and resource that granting record access requires and  the potential to inflate demand. Online patient networks have also had very positive results and can result in improved behavioural and clinical  outcomes.

There is emerging evidence that apps are increasingly encouraging patient engagement with diet, exercise, medication adherence and chronic disease management. However, we need more evidence on the quality and efficacy of the majority of apps. In addition, some evidence suggests that monitoring devices can improve physical activity and diet – but most of this comes from short, professional interventions. This is an area that needs further research.

The overall impact of health-related digital technology on demand and health outcomes is not clear. In terms of demand, while there are some quick wins – such as improving appointment attendance through text-message reminders – there is also the potential to increase demand via remote consultations, risk-averse triage and access to records. We need a better understanding of how  demand is affected and why. And we still do not know how the majority of these tools impact on health outcomes.

But new (and not so new) technologies can support patients along the entire patient pathway – transforming how they stay well, find the care they need, interact with the health care system and manage a condition (see ‘Technology and the health care journey’ graphic on p. 2). And apps are increasingly the vehicle that brings these new capabilities together, providing neatly packaged, user-friendly solutions to patients and consumers through the touch of a button. Patients now have a whole suite of new ways to manage their health and health care in their pocket, via their  smartphone.

This has to be a good thing. The challenge for the NHS is making the best use of digital services for those who stand to benefit the most.

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All in all this is a useful report which shows just how vague the evidence is for the value of many digital health initiatives.

Care with the public purse is definitely warranted!

David.

Weekly Australian Health IT Links – 5th December, 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

Were it not for the ongoing concern regarding ePAS this would go down as a very quiet week, perhaps reflecting that the ‘silly season’ is coming upon us a little early.

Otherwise, again we see lots of private sector activity in the space this week.

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http://www.smh.com.au/technology/consumer-security/from-cybercrime-to-cyber-warfare-australia-woefully-unprepared-20161130-gt0o5r.html

From cybercrime to cyber warfare: Australia woefully unprepared

Nassim Khadem
Published: December 3, 2016 - 12:15AM

If there was one event in 2016 that characterised Australia's total lack of preparedness against cyber attacks, it was the epic failure of the Census on August 9.

The Australian Federal Police is still investigating who was responsible for the attack on the nation's first e-Census.

Alastair MacGibbon, special adviser to the Prime Minister on cyber security, in his review of the events surrounding the e-Census debacle, hints it may never be clear: "Attribution of malicious actors online is difficult and denial of service incidents are hard to trace."

MacGibbon's 91-page report explains in detail how one of the government's once most-respected agencies, the Australian Bureau of Statistics, together with technology giant IBM, failed miserably on Census night.

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http://www.australiandoctor.com.au/news/latest-news/digital-utopia-or-dystopian-distraction

Digital utopia or dystopian distraction?

Antony Scholefield | 1 December, 2016 | 

Some GPs aren’t sure whether new digital technology is going to live up to the hype. Apparently they’re not alone.

UK health think-tank Nuffield Trust recently looked at the evidence for seven types of digital technology for primary care patients to work out whether the world is headed towards “a digital utopia” or “dystopian distraction”.

They examined the research for wearable technology, online triage, online health information, online appointment booking, telehealth, e-records and apps.

They concluded that there’s not enough evidence to show that patient technology actually improves health outcomes. There’s some evidence that some technology boosts patient engagement and their experience. But that’s about it.

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https://wolandscat.net/2016/11/29/future-of-the-ehr-adaptive-clinical-workflow-support/

Future of the EHR: adaptive clinical workflow support

Posted on 29/11/2016 by wolandscat

In the time since I left Ocean Informatics (the company I started with Dr Sam Heard and others in the late 1990s), I have been working with Intermountain Healthcare as well as various other openEHR vendor companies, notably DIPS (Norway) and Marand (central/south-east Europe). With both groups I am working on what could be described as the next layer of the open EHR: process.

For the whole time I have worked in health informatics (24 years and counting), clinical professionals have wanted two things: decision support, and workflow support. Both of these things properly belong to the world of clinical process. It’s taken many years to get a sufficiently good architecture of healthcare data and basic semantics in place to seriously attack process, but we’re ready to go there now. What we need now is a conceptual model of collaborative healthcare delivery during a whole care episode, extending into ongoing care and monitoring, leading to a new architecture for implementing process support.

We know a couple of crucial things at the outset: clinical process is an emergent phenomenon, not a deterministic one; and, any credible solution must be inherently adaptive, i.e. allow changes and exceptions to the clinical workflow during its execution.

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http://www.itnews.com.au/news/sa-healths-epas-system-auto-deleting-follow-up-appointments-442995

SA Health's EPAS system auto-deleting follow-up appointments

By Allie Coyne on Nov 30, 2016 8:31AM

Auditor finds problematic workflow.

Follow-up appointments for discharged Adelaide patients are being automatically deleted on a daily basis due to configuration issues with South Australia's EPAS system, the state's auditor general has revealed.

The maligned $422 million EPAS platform has long been a challenge for the state due to cost overruns, usability issues, and delays. Earlier this month it suffered a nine-hour outage across three major Adelaide hospitals.

In its annual report into the state health department's IT systems tabled yesterday, the SA audit office revealed user error with the system had resulted in follow-up appointments for 258 discharged patients being cancelled between June and August this year.

EPAS handles appointments for things like medical imaging, pathology, medications, general care and diet.

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http://www.abc.net.au/news/2016-11-30/epas-deletes-258-patients-treatment-orders/8076926

EPAS medical records software deletes 258 treatment orders for Adelaide patients

By Nicola Gage

November 30, 2016

South Australia's troubled electronic patient records system is under fire again after it deleted treatment appointments for 258 discharged patients.

A report from the Auditor-General's Department shows 258 EPAS treatment orders were cancelled between the end of June and mid-August after the patients had been discharged from hospital.

The orders relate to follow-up appointments such as X-ray services.

South Australia's Salaried Medical Officers Association (SASMOA) president David Pope said it was a serious mishap.

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http://www.adelaidenow.com.au/news/south-australia/state-government-deliberately-delaying-new-rah-to-cover-up-epas-medical-records-failings-builder-claims-in-800-million-lawsuit/news-story/d2fe19a6a61004e4149a332c0c63e549

State Government deliberately delaying new RAH to ‘cover up’ EPAS medical records failings, builder claims in $800 million lawsuit

Exclusive — State Political Editor Daniel Wills, The Advertiser

November 30, 2016 9:09am

CLAIMS the State Government has deliberately delayed opening the new Royal Adelaide Hospital to “cover up” failings in a troubled-plagued computer system crucial to its operation are the basis of an $800 million-plus lawsuit its builder is preparing.

The Advertiser last week revealed the consortium that oversees delivery of the new RAH is gearing up for a $4 billion countersuit against the Government if its contract is torn up, and has now obtained new documents showing the builders are compiling a separate case.

The SA Health Partnership group delivering the $2.1 billion project comprises several companies, including the Hansen Yuncken Leighton Contractors Joint Venture, which is responsible for building the biggest infrastructure project in SA’s history.

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http://www.theaustralian.com.au/national-affairs/state-politics/builders-claim-royal-adelaide-hospital-delayed-by-records-fault/news-story/97fb3853b95efdeb685fbb3a9985071f

Builders claim Royal Adelaide Hospital delayed by records fault

• The Australian
• 12:00AM November 30, 2016

Meredith Booth

Builders of the troubled $2.3 billion Royal Adelaide Hospital twice requested extra time to complete the project because of problems with the government’s electronic patient record system, parliament has been told.

However, South Australian Health Minister Jack Snelling yesterday insisted the flawed records system had not contributed to delays, but conceded it would not be ready to be fully rolled out in the new hospital.

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http://www.digitalhealth.gov.au/news-and-events/news/1210-chief-medical-adviser-associate-professor-meredith-makeham-talks-to-australian-doctor

Chief Medical Adviser Associate Professor Meredith Makeham talks to Australian Doctor

Created on Wednesday, 30 November 2016

Associate Professor Meredith Makeham, the newly appointed Chief Medical Adviser for the Australian Digital Health Agency, recently spoke to GPs attending Australian Doctor's Smart Practice Live event in Sydney.

She urged GPs to explore available tools and resources that can enhance primary care and also have a say in the development of Australia’s digital health future.

To listen, visit the Australian Doctor website or watch the video below.

This video was produced by Australian Doctor as part of their Australian Doctor Education Seminars and was first published Why it’s time for GPs to speak out about tech and patient care on 30 November 2016.

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http://www.afr.com/technology/productivity-commission-chairman-wants-longterm-reform-to-get-value-from-data-20161124-gswsam

• Updated Nov 28 2016 at 11:00 PM

Productivity Commission chairman wants long-term reform to get value from data

by Paul Smith

Productivity Commission chairman Peter Harris has warned against rushing to implement technology-based laws to regulate customer data sharing across industries, saying the government must enact broad new standards that set the scene for long term, future-proof open access to a wealth of valuable data.

Mr Harris was speaking to The Australian Financial Review after the parliamentary inquiry into the banks imposed aggressive timelines for the creation of an open access regime for customer data through the use of application programming interfaces (APIs,) in an approach that differed to a recent landmark Productivity Commission report urging greater citizen control over their data. 

While supportive of the principals behind the parliamentary inquiry findings – that consumers and emerging businesses benefit by banks opening up access to customer data – Mr Harris said he hoped a new era of innovation and productivity gains could be ushered in by broader legislation that enshrined standards and principles of openness, rather than legislating based on current technology options, which could quickly become outdated.

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http://www.australianageingagenda.com.au/2016/11/30/baptistcare-tops-aged-care-it-awards-with-platform-facilitating-consumer-control/

BaptistCare tops aged care IT awards with platform facilitating consumer control

By staff writers on November 30, 2016 in Awards, Technology

An aged care provider’s website that enables clients to customise their home care package has taken out top honours at the sector’s annual technology awards last night.

BaptistCare won both the best consumer-friendly product award and the overall winner award at the Information Technology in Aged Care (ITAC) 2016 awards in Melbourne.

The provider’s YouChoose website allows customers to design their own home care package online by tailoring their services to meet their financial and personal needs.

Launched in response to the introduction of consumer directed care, the website allows consumers to take full control of the services they receive across four areas – health, home, community and independence.

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http://www.itwire.com/health/76001-apple-plans-parkinson-s-app,-cardiac-devices.html

Apple plans Parkinson's app, cardiac devices

• 01 December 2016
• Written by  Sam Varghese

Apple has plans to build an app to diagnose Parkinson's disease and two separate but related cardiac devices, the website MobiHealthNews has reported, based on emails exchanged between the company and the US Food and Drug Administration.

The emails were obtained by the website through a Freedom of Information request.

The correspondence showed that the FDA and Apple had discussed the way apps are reviewed before they are put up on the App Store, the software framework ResearchKit, diagnostic apps and working with the FDA in an "unregulated" way.

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http://www.afr.com/technology/web/security/hidden-challenges-emerge-as-data-breach-notification-laws-finally-hit-australia-20161125-gsxnri

• Updated Nov 28 2016 at 3:00 PM

Hidden challenges emerge as data breach notification laws finally hit Australia

by Leonard Kleinman

Australia's new mandatory data breach disclosure law is attracting a lot of attention, and a lot of criticism. But it will also have some interesting – and perhaps unintended – consequences.

Most commentary has been about the fact that it will give Australia some of the strictest disclosure rules in the world. That is a good thing to some people and a bad thing to others.

Some critics, such as the recently formed group Data Governance Australia, are still trying to stop the law.

The chief executive of Data Governance Australia, Graeme Samuels, former head of the ACCC, says the legislation is "heavy-handed" and wants instead an industry voluntary code of conduct.

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http://www.zdnet.com/article/another-australian-parliamentary-year-ends-without-data-breach-notification-laws/

Another Australian parliamentary year ends without data breach notification laws

Labor lashes out at Coalition for failing to pass a bill that it failed to pass in 2013.

By Chris Duckett for Null Pointer | December 2, 2016 -- 01:08 GMT (12:08 AEDT) | Topic: Security

With Australian Parliament risen for 2016 and members headed towards their summer breaks, Australia appears set to be without a working data breach notification scheme until sometime in 2018.

If it feels like Australia has been through this before, you'd be right.

Parliament is currently undertaking its third attempt to pass data breach notification laws, following previous attempts being stranded in the Senate by both Labor and Coalition governments.

Due to commencement provisions in the legislation, unless otherwise proclaimed, any laws passed would take effect 12 months after gaining Royal Assent, which is likely to rule out 2017 for a working notification scheme.

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http://www.doctorportal.com.au/mjainsight/2016/46/interactive-atlas-puts-data-at-fingertips/

Interactive atlas puts data at fingertips

Authored by  Anne Duggan

Issue 46 / 28 November 2016

ASKED what tools they have to improve the care they offer patients, few doctors or other health professionals would think of data. Better drugs, devices and tests tend to get the credit, perhaps with a nod to better work practices and clinical evidence.

But data are no longer the preserve of the statistician or academic researcher. Around the world, data are being re-imagined and democratised, and that revolution is transforming our understanding of health care in ways that we are only starting to explore. This has implications for a range of medical specialties and even individual clinicians.

Earlier  this month (November 2016), the Australian Commission on Safety and Quality in Health Care published the interactive version of the Australian Atlas of Healthcare Variation, which presents a clear picture of substantial variation in health care use across 36 clinical activities, including dispensing of specific medicines, such as ADHD drugs; diagnostic and surgical procedures, such as cataract surgery and lower-back computed tomography scans; and treatments for chronic diseases, such as diabetes and asthma.

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http://www.itnews.com.au/news/telstra-failing-to-plug-earnings-hole-with-new-investments-442829

Telstra failing to plug earnings hole with new investments

By Staff Writer on Nov 28, 2016 1:54PM

Expansions yet to pay off.

Telstra's ability to offset the fall in its traditional revenue streams by diversifying into a range of technology and other businesses is in doubt.

So far, Telstra's funding of 44 start-ups since 2013, the $235 million spent acquiring 18 health-related companies, the purchase of more than 30 companies by its venture-capital division, and its financing of a mining technology arm, have come to little.

Lumped together with the company's underperforming media department, the entire gamut of these operations – which include a range of technology businesses from cloud computing to app delivery specialists - contributed just $908 million, or 3.4 percent of Telstra's income, in the fiscal year ended in June.

In particular, high hopes for a $330 million investment in tech start-up Ooyala, a video platform, have all but faded, with Telstra mostly writing off in August what it called "a rapidly growing business" six months earlier. Ooyala was the biggest single investment by Telstra’s venture capital arm.

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http://www.itwire.com/cloud/75955-silver-chain-goes-real-time-%E2%80%9Chealth-as-a-service%E2%80%9D.html

Silver Chain goes real-time 'Health as a Service'

• 29 November 2016
• Written by  Ray Shaw

Australia-wide, not-for-profit, community health and aged care provider Silver Chain has deployed a Microsoft Dynamics 365 cloud solution to implement a more mobile workforce that could rely on real-time patient care information.

Silver Chain needed to better support its mobile workforce and ensure governance and transparency for hospitals and GPs. The day-to-day running of Silver Chain is more than a business imperative: it is a matter of life and death for many of its patients.

The answer was to configure a Microsoft Dynamics 365 solution hosted securely in an Australian Azure data centre to allow equal, real-time access by all its users.

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http://www.itnews.com.au/news/monash-health-to-overhaul-antiquated-clinical-comms-442849

Monash Health to overhaul antiquated clinical comms

By Andrew Sadauskas on Nov 29, 2016 3:05PM

Will replace pagers with task management system.

Monash Health is preparing to overhaul its “inadequate” unidirectional paging infrastructure with a modern clinical task management solution to remove the risk of delayed treatment for patients.

In tender documents the public health service said its current system requires clinicians to manually respond to new tasks with a telephone call, a process that interrupts patient care.

Because the requests can be sent from multiple areas within each hospital, clinical staff can in some cases receive multiple requests for the same task. This can lead to unnecessary stress, as well as some tasks potentially being overlooked, Monash Health said.

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http://rustreport.com.au/issues/latestissue/whos-how-of-aussie-ict/

Who’s who of Aussie ICT

November 28, 2016

CLINICLOUD’s goal is to be at the centre of patient lead care by delivering thoughtfully designed tools, services and access to leading physicians through telemedicine partners. CliniCloud connects parents and patients with doctors. The CliniCloud Medical Kits allows for the closely monitoring of every fever, chill, cough, wheeze or cold. The kit contains a non-contact thermometer, digital stethoscope and Smartphone app. The company is currently expanding the availability of CliniCoud with new partnerships with Amazon Launchpad and a retailer with stores in the United States. www.clinicloud.com

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http://www.itwire.com/listed-tech/75937-orion-pushes-ahead-with-global-growth-in-healthcare-market.html

Orion pushes ahead with global growth in healthcare market

• 28 November 2016
• Written by  Peter Dinham

New Zealand-based healthcare tech solutions provider Orion Health is claiming 110 million patient health records under its management worldwide as the company pursues further global expansion.

The dual Australian, New Zealand-listed Orion (NZX/ASX:OHE) has reported its interim results for the six months to the end of September this year, with operating revenues of $104 million, including a rise in recurring revenue of $46 million.

The operating loss for the six months was $17 million, a $10 million improvement from the first half of 2016, which the company says reflects a big step up in performance in North America, a levelling off of investment in research and development at $32 million, while at the same time managing overheads.

Orion chief executive Ian McCrae says the number of patient health records managed by Orion Health software is estimated to now be more than 110 million – an important metric which, he says, evidences Orion Health’s steady progress towards its goal of being the ”custodian of the world’s health records”.

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http://rustreport.com.au/issues/latestissue/all-the-bottom-line-action-270/

ProVision selects 1stAvailable for optical stores

1st Available Limited (‘1stAvailable’) (ASX: 1ST), the Australian online health portal, has announced that the largest independent network of 440 optometrists in Australia, ProVision, has selected 1stAvailable as its partner to manage online optical appointment bookings. ProVision provides independent optometrists with comprehensive business support, enabling them to benefit from its collective resources and buying power. Following a highly successful pilot of 1stAvailable’s platform for 20 optical practices, which began in August 2016 and was completed in November 2016, ProVision has begun active promotion of 1stAvailable’s platform to its members. More than 80 ProVision practices have already signed on to use 1stAvailable’s services. These includes many businesses also using 1stAvailable’s easyRECALL value-added product. This product replaces labour intensive costly phone calls, letters and basic SMS messages used by practices today, with an automated digital service that improves patient re-booking enabling them to book an appointment online with just three clicks.

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Enjoy!

David.