Wednesday, August 16, 2017

A Conversation Article Raises The Interesting Issue Of The Fate Of Your Health Information When You Move On.

This appeared last week:

Our healthcare records outlive us. It’s time to decide what happens to the data once we’re gone.

August 7, 2017 6.12am AEST

Author: Jon Cornwall

Senior Lecturer, Faculty of Health, Victoria University of Wellington
Death is inevitable. The creation of healthcare records about every complaint and ailment we seek treatment for is also a near-certainty.
Data about patients is a vital cog in the provision of efficient health services.
Our study explores what happens to those healthcare records after you die. We focus on New Zealand’s legal situation and practices, but the issue is truly a global one.
Previously, healthcare records were held in paper form and stored in an archive. Next came the advent of digital storage in on-site databases. In both of these cases, when you died your records were either shredded or erased, depending on the technology.
But it is now increasingly common for healthcare records to be digitised and held in a central repository. They can potentially be held for an indefinite period after someone dies, depending on the jurisdiction.
Should we be worried?

A question of value

Large, population-based healthcare data sets have immense value.
This is particularly true of records that include genomic information alongside other healthcare data – a phenomenon that will only increase as information about a person’s genes is more widely used in clinical treatment.
These posthumous healthcare data sets, which will grow in size and detail over the coming decades, could tell us a great deal about diseases and heritability. Data sets from generations of families and communities may well be available for research, and able to be analysed.
Information on this scale is worth a lot, especially for data storage companies and those with a financial interest in these data sets, such as pharmaceutical companies. Imagine, for instance, if a company could quickly analyse millions of genomes to isolate a disease that could be cured by an engineered pharmaceutical, and the commercial value this would create.
So how will this affect the individual whose data is held and their surviving family? Many people would be willing to donate medical records if the downstream result was beneficial for their community and country.
Yet the lines become easily blurred.
Would it be acceptable if data sets were sent to foreign companies? What if they provided a cure free of charge to the families of citizens whose data they used?
How about if the cure was half price, or full price, but the other option was having no cure at all? Would it be all right for companies to make millions of dollars out of this information? There is no easy answer.

What’s the legal situation?

It’s impossible to talk about the long term fate of healthcare data without considering privacy and consent.
As part of medical research, for example, participants are required to provide informed consent and often the gathered data are anonymised. Access to posthumous medical records, on the other hand, is not highly regulated or protected in most countries, and the laws surrounding access are incredibly unclear.
In New Zealand, a deceased person has no privacy rights under the Privacy Act. And while healthcare data has to be held for a minimum of 10 years after death, the regulatory body which is then custodian of that data may decide - broadly - what purposes it may be used for.
Given that the custodian can be anyone from a health board or local doctor to a commercial institution that stores health records, the situation is exceedingly vague.
It is often argued that use of anonymous data sets do not require consent from an individual – in our case, a deceased person cannot provide this anyway. However the lines of true “anonymity” are becoming more blurred, particularly thanks to genomics.
Your own genome is partly that of your family and relatives. They may also have an emotional stake, and possibly a legal stake, in any action or research where the genome of a deceased family member is involved.
The medical profession has not always dealt well with consent and ethics issues. In one infamous case, the cancer cells of Henrietta Lacks – a 31-year-old American woman who died of cervical cancer in 1951 – have been used thousands of times in research projects.
She unwittingly made an invaluable contribution to global health, yet she never consented and her family was not consulted.
Then there is the fact that if large data bases are readily available, the possibility of data linkage increases – matching data sets that may belong to the same person – potentially undermining the ability to maintain true anonymity for the individual and their family.

What happens now?

The New Zealand and Australian governments have signalled that healthcare data are a widely underused resource. Commercialisation of such data is a possibility.
At some point, large posthumous healthcare data sets from these countries could potentially be accessed by researchers and private institutions around the world.
It is time for the public to decide what they think is reasonable. If the use of posthumous healthcare data is not aligned with the wishes of society, especially its desire for anonymity, the trust between our healthcare providers and patients may become compromised.
Healthcare data sets have immense value, but the public must be consulted about their use. Only then can the potential of posthumous healthcare data sets be properly realised.
You can view the original article here:
This article raises a series of fascinating issues – especially about the protection of your data after you die when the information may be of concern to or embarrassing to your relatives or progeny.
The fate of the information in your myHR when you go would be interesting to have spelt out.
Well worth a browse.
David.

Somehow South Australia Seems To Have Got Itself Back Into The News In Health IT Systems.

There have been two different bits of news last week.
First we had this.

Near half-billion-dollar South Australian hospital records system failing: AMA

The AMA has said a new electronic records system being rolled out in South Australian hospitals is not fit for purpose.
By Chris Duckett | August 9, 2017 -- 07:39 GMT (17:39 AEST) | Topic: Innovation
A new electronic records system being rolled out across South Australia's public hospitals is possibly not fit for purpose, according to the Australian Medical Association (AMA).
The AMA said it sent a questionnaire to almost 250 staff members, including doctors and nurses, asking for their views on the AU$422 million enterprise patient administration system (EPAS).
It says almost 40 percent reported that their opinion of EPAS was poor, 30 percent believed patients are not clinically safer, and 20 percent found it responsible for adverse patient outcomes.
"The AMA has consistently supported the concept of electronic medical records," president William Tam said on Wednesday.
"Yet our members are telling us that EPAS has failed to meet their hopes and expectations and is contributing to errors.
"You might expect some teething problems, but quite honestly, after four years we would expect most problems to be fixed."
However, Health Minister Jack Snelling said the government believes those who responded to the AMA survey were not representative of the wider medical workforce.
Snelling told state parliament that the AMA is a "serial whinger".
Lots more here:
Secondly a Coroner’s Enquiry that involved the ePAS System reported last week:

Death of ex-Socceroo Stephen Herczeg, 72, at Queen Elizabeth Hospital preventable, coroner rules

Andrew Hough, The Advertiser
August 9, 2017 6:53pm
A FORMER Socceroo’s “horrific” and “macabre” death at a major Adelaide hospital was entirely preventable, the State Coroner has ruled.
An urgent inquest was told his bladder ruptured and his lungs collapsed after oxygen was mistakenly attached to a catheter tube meant to drain urine.
In his findings handed down on Thursday, State Coroner Mark Johns ruled Mr Herczeg’s death was “entirely preventable” and said the level of observation on him in the hours before his death was “inadequate”.
There is a great deal more here:
Of most interest were the recommendations:
Here they are:
"Mr Johns made five recommendations to Health Minister Jack Snelling:
THAT EPAS modifications for CO2 retaining chronic obstructive pulmonary disease patients have both upper and lower limits on oxygen saturation levels;
THAT a password be entered into EPAS when observations are recorded;
THAT the practice of one person taking observations and another person entering data onto the EPAS system cease;
THAT if respiratory patients are not admitted to a respiratory ward, the admitting doctor provides detailed instructions to staff leaving no room for error;
THAT patients exhibiting confusion undergo a risk assessment prior to their admission to the ward."
-----
Clearly there is a need for a little re-training and behavior modification for staff using this system.
This is the first time I can recall when an EHR system has been found, in a Court, to not have been implemented to a standard that was maximally safe and useful!
David.

Tuesday, August 15, 2017

It Seems Victoria Is Being Sensible In Getting Going On The Prescription Monitoring System.

This appeared last week:
7 August 2017

Victoria goes it alone on real-time monitoring

Posted by Julie Lambert
The Victorian government’s decision to go it alone with a mandatory real-time prescription monitoring for high-risk medicines has exposed some disarray in the plans for a national scheme.
Victoria’s Health Minister, Jill Hennessy, recently announced a $29.5 million plan to roll out the surveillance program to crack down on the misuse of dangerous prescription drugs within the next year, including $1 million to train doctors and pharmacists.
“In an Australian first, and following worldwide best practice, using the system will be mandatory for doctors and pharmacists before prescribing or supplying a high-risk medicine,” the state minister said in a statement.
As well as Schedule 8 drugs such as morphine and oxycodone, the new rules will apply to benzodiazepines, “Z-class” medicines taken for insomnia, and the anti-psychotic, quetiapine. Codeine will be added to the watch list at a later date.
The Victorian announcement on July 28 came the same day federal Health Minister Greg Hunt made a $16 million commitment to activate a national monitoring scheme, to begin next year, covering S8 drugs.
To date, real-time prescription monitoring operates only in Tasmania. However, that system, launched in 2012 as the forerunner of the commonwealth’s Electronic Recording and Reporting Controlled Drugs (ERRCD) system, is voluntary and confined to S8s.
Doctors have commended Victoria’s step, but they are in the dark as to how the state will manage the burden of a real-time mandatory system, including S4 medications.
Melbourne addiction medicine specialist, Dr Benny Monheit, said the tougher Victorian rules signalled a “new frontier” for Australia and the mandatory nature of the proposed system could present an enormous technology challenge.
The slowness of many other States is discussed further on in the article:
There is also coverage here:

State set to make real-time monitoring mandatory

8 August, 2017
It will soon be illegal for pharmacists in Victoria to dispense controlled medications without checking a prescription monitoring system.
This will follow the introduction of the state’s $29.5 million real-time-monitoring system in 2018.
And the state government is tabling legislation that makes it mandatory for pharmacists to check a patient’s prescription history before they dispense a high-risk medicine.
Prescriptions for schedule 8 medicines and all other high-risk medications, including benzodiazepines, ‘Z’ class medicines used for insomnia and quetiapine will be monitored by the system.
Codeine will also be monitored, but will be included after the 2018 upscheduling.
Health minister Jill Hennessy says Victoria will have the most comprehensive real-time prescription monitoring system in Australia.
“We know it will save lives. Through our legislation, we will be able to monitor new medicines that emerge and prevent them causing harm in the community.”
More here:
And also here:

Victoria moves on real-time monitoring

The state government has rejected the federal EERCD system, this week introducing legislation to deliver its own real-time prescription monitoring system

The Drugs, Poisons and Controlled Substances Amendment (Real-time Prescription Monitoring) Bill 2017 establishes the legislative framework that will underpin Victoria’s real-time prescription monitoring system.
The move comes after Health Minister Greg Hunt’s 28 July announcement that the government would be moving “immediately” towards implementing a national real-time monitoring system for dangerous prescription drugs.
Victoria’s Bill will provide doctors, nurse practitioners and pharmacists with access to a system to review prescription histories of patients, monitor use of S8 medicines and monitor other high-risk medicines, including benzodiazepines.
It will also make it mandatory for prescribers and pharmacists to check the system before writing or dispensing a prescription for a high-risk medicine, with some exceptions in certain circumstances.
“Due to the limitations of the existing Commonwealth software, specific fit-for-purpose software will be built for Victorian clinicians,” says the Victorian Department of Health.
“Our legislation will allow Victoria to implement the most comprehensive real-time prescription monitoring system in Australia. We know it will save lives,” says Victorian Minister for Health Jill Hennessy.
More here:
Given that the other States seem to be moving rather more slowly the Victorians can act as a useful pilot for the rest of the country.
I hope the system delivers the benefits expected.
David.

Monday, August 14, 2017

Weekly Australian Health IT Links – 14th August, 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

Has been a big week with lots of reaction to the new Digital Health Strategy.
Lots of other stuff as well – enjoy!
-----

Australia's digital health strategy gets the nod without data interoperability controls

The Council of Australian Governments Health Council has given the federal government the green light to automatically sign citizens up to an electronic health record, with a public consultation on draft interoperability standards to come by the end of next year.
By Asha McLean | August 7, 2017 -- 01:26 GMT (11:26 AEST) | Topic: Security
My Health Record, the Australian government's e-health record system, has been officially given the green light from the Council of Australian Governments Health Council to automatically sign citizens up to the service, allowing them to opt-out if they choose.
By 2018, all Australians will have a My Health Record and by 2022, all healthcare providers will be able to contribute to and use health information in My Health Record on behalf of their patients. They will also be able to communicate with other healthcare providers on the clinical status of joint patients via the digital platform.
According to the strategy, Safe, seamless, and secure: Evolving health and care to meet the needs of modern Australia, the interoperability of clinical data is essential to high-quality, sustainable healthcare, with My Health Record allowing the collection of citizen's data to share in real-time between providers. However, there is currently no overarching standard in place to govern the sharing of data, with a public consultation on draft interoperability standards to determine an agreed vision and roadmap for implementation of interoperability slated to occur "by the end of 2018".
-----

Australia's inside-out digital health strategy

If patients are to be 'put at the centre of their healthcare', they need to be put at the centre of their health data.
By Stilgherrian for The Full Tilt | August 7, 2017 -- 07:21 GMT (17:21 AEST) | Topic: Security
The thing to remember about strategy documents is that they're merely aspirational. They set out a proposed pathway to achieving a set of defined goals, but they're no guarantee that those goals will even be achieved.
Australia's digital health strategy, released on Monday, is no exception.
As the old BBC TV series Yes Minister taught us, when it comes to writing government reports, "the tricky bit should be disposed of in the title". This strategy [PDF] does exactly that: Safe, seamless, and secure.
That dealt with, let's look at some of the details that worry me.
-----

Critics voice concerns about a national digital health strategy lacking details

Lynne Minion | 08 Aug 2017
Australia's new digital health strategy has been labelled “incomplete”, with critics claiming it is short on detail about how sensitive medical records will be secured.
 Australia’s state and territory health ministers approved the Federal Government’s Safe, seamless, and secure: Evolving health and care to meet the needs of modern Australia at a COAG meeting on Friday, giving the green light to automatically sign up citizens to My Health Record by 2018, with an opt-out function. By 2022, all of the nation’s healthcare providers will be connected to the digital platform.
 But some, including managing director of IT consultancy PivotNine, Justin Warren, have raised concerns about a lack of detail.
-----
8 August 2017

ADHA outlines digital future for doctors

Posted by Julie Lambert
The Australian Digital Health Agency says it will smooth a five-year transition to the digital future for doctors by having technology vendors adopt secure interoperable platforms across the health system.
The agency’s blueprint for change is spelled out in a five-year strategy, approved last week by all state and territories, that will begin in earnest with the creation of opt-out My Health Records for all Australians in 2018.
“By 2022 all healthcare providers will be able to contribute to and use health information in My Health Record on behalf of their patients…” the strategy says.
-----

Digital health record custodian establishes cyber security centre

Health ministers back national eHealth strategy
Rohan Pearce (Computerworld) 07 August, 2017 09:50
The Australian Digital Health Agency (ADHA) has revealed it has established a cyber security centre to help safeguard the My Health Record system.
The new Digital Health Cyber Security Centre will “ensure Australian healthcare is at the cutting edge of international data security,” according to the agency.
“Its primary purpose is to protect the national digital health systems and personal health information of Australians from the cyber threat, and to raise the security posture of the Australian health sector,” states an ADHA developed national eHealth strategy document.
-----

How would you like all your medical and mental health records leaked online? You might find out soon.

Asher Wolf
Freelance JournalistThe government is planning to give every Australian a digital health record by the end of 2018. With that goal in mind, the Council of Australian Governments (COAG) Health Council has approved Australia’s National Digital Health Strategy, drafted by the Australian Digital Health Agency (ADHA.) So how much data will a digital health record — known officially as a My Health Record (MHR) — contain?
Lots.
The MHR was previously known as the Personally Controlled E-Health Record (PCEHR.) But after patients and healthcare providers avoided signing up to the PCEHR in droves, ADHA renamed the project and changed patients’ sign-up option from opt-in, to opt-out only. Yes, that’s right: you all get an MHR, whether you like it or not. Want to opt-out? Too bad.
The government won’t delete your e-health record: people who opt-out will still have a shadow-file — a shell account the ADHA will retain, void of healthcare data from the date patients opt-out. And how well do opt-outs work anyway? Well, before the UK scrapped its equivalent digital health data project — known as care.data — it was discovered the National Health Service was disregarding patient requests and still populating patient files with information, even after patients opted-out.
-----
7 August 2017

Victoria goes it alone on real-time monitoring

Posted by Julie Lambert
The Victorian government’s decision to go it alone with a mandatory real-time prescription monitoring for high-risk medicines has exposed some disarray in the plans for a national scheme.
Victoria’s Health Minister, Jill Hennessy, recently announced a $29.5 million plan to roll out the surveillance program to crack down on the misuse of dangerous prescription drugs within the next year, including $1 million to train doctors and pharmacists.
“In an Australian first, and following worldwide best practice, using the system will be mandatory for doctors and pharmacists before prescribing or supplying a high-risk medicine,” the state minister said in a statement.
-----

State set to make real-time monitoring mandatory

8 August, 2017 Heather Saxena 0 comments
It will soon be illegal for pharmacists in Victoria to dispense controlled medications without checking a prescription monitoring system.
This will follow the introduction of the state’s $29.5 million real-time-monitoring system in 2018.
And the state government is tabling legislation that makes it mandatory for pharmacists to check a patient’s prescription history before they dispense a high-risk medicine.
-----

Federal govt commits to real-time monitoring of prescriptions

By Australian Hospital + Healthcare Bulletin Staff
Thursday, 03 August, 2017
The federal government is investing $16 million to ensure the national rollout of real-time prescription monitoring for medicines to prevent their misuse and needless loss of life.
The Real Time Prescription Monitoring system will give pharmacists and doctors an instant alert if patients have received multiple supplies of prescription-only medicines, providing an up-to-the-minute medication supply history of certain high-risk medicines at the point of consultation. This information will enable doctors and pharmacists to make more informed decisions about the safety of supply of medication to that patient, assisting them to identify patients who are at risk of harm due to dependency, misuse or abuse of controlled medicines, as well as patients who are diverting these medicines for other purposes. 
This can happen if a patient has developed a dependency on controlled medicines or is selling these medicines to others, including for the purposes of manufacturing other illegal drugs. Controlled medicines include morphine, oxycodone, dexamphetamine and alprazolam.
-----

Is it time to tear up your prescription pad?

11 August 2017

TECH TALK

The so-called King Review of pharmacy has generated fierce debate among pharmacists, or at least among their representative groups.
Most GPs will be happy to ignore this debate. There is one suggestion, however, that may have a big effect on GPs — the endorsement of paperless prescriptions.
For GPs already linked to electronic script exchanges, it may seem like an obvious step. For those who don’t know what an ‘e-script exchange’ is, it may seem a bit like sci-fi.
-----

Patients might prefer results by text message — but who foots the bill?

9 August 2017

COMMENT

For now, texting as a free service remains a dream writ only on the pages of surveys.
What patients want and what they get are often very different things.
When offered the choice of how to receive pathology results, patients prefer text messaging.
A survey published this week indicates three-quarters of patients aged under 60 years would prefer texts for normal results, although only 7% would prefer texts to deliver news of an abnormal result. For abnormal results, they far prefer a phone conversation (73%) to having to attend the doctor (14%).
-----

Tim Kelsey - HIC17 Presentation 'Digital Health: A Human Imperative'

Tim Kelsey, CEO of the Australian Digital Health Agency, presented at the Health Informatics Conference (HIC) on 9 August 2017 about our work program, My Health Record and COAG's (Council of Australia's Governments) approval of Australia’s National Digital Health strategy.

Australian Digital Health Agency - My Health Record Expansion Program

What is the My Health Record, why is it important, and how can it help? This short (2:36) introductory video answers these questions from a variety of perspectives: the patient, the carer, and Australian Digital Health Agency staff members.
-----

Blood Cross escapes penalties in data breach investigation

By Allie Coyne on Aug 7, 2017 11:51AM

Contractor given harsher rebuke.

The Australian Red Cross Blood Service and its website contractor have escaped penalties from the country's privacy watchdog over a 2016 data breach that exposed the data of 550,000 donors.
In late October last year the Blood Service revealed its website partner Precedent had inadvertently exposed a 1.74GB database backup containing 1.28 million records entered by donors as part of the appointment booking process.
A Precedent employee tasked with enhancing a feature on the Blood Service's Donate Blood site accidently saved a backup of the site's user acceptance testing (UAT) database to a publicly accessible portion of the web server that hosted the UAT environment. 
-----

Privacy commissioner commends Blood Service for handling of data breach

Report on database dump commends quick response by Australian Red Cross Blood Service
Rohan Pearce (Computerworld) 07 August, 2017 12:51
A data breach that involved a backup of a prospetive donor database maintained by the Australian Red Cross Blood Service being placed on a public web server was the result of a “one-off human error,” according to a report from the Office of the Australian Information Commissioner.
Australian Information Commissioner Timothy Pilgrim launched an investigation in October last year after the the privacy breach was revealed. The OAIC today released a pair of reports on the incident: One on the Blood Service and one on Precedent Communications Pty Ltd, which managed the donateblood.com.au website.
-----

New report proposes radical reforms for rare cancer regulation

Kate Aubusson
Published: August 9 2017 - 12:15AM
The first Lauren Poole had heard of epithelioid sarcoma was the day she was told her thumb had to be amputated to save her life.
The tiny lump on the tip of her thumb had been innocuous enough. But her instincts told her to have it removed and tested.
She was diagnosed with the rare soft tissue cancer, and 17 hours later a surgeon was severing her thumb at the main knuckle.
-----

What can social movements teach digital health change agents?

Melissa Sweet Author: Helen Bevan on: In: e-health, health reform
Australia now has a National Digital Health Strategy, which proposes that by 2022, health information will be available whenever and wherever it is needed, and that its exchange will be secure.
The Strategy was endorsed by federal, state and territory health ministers meeting in Brisbane last Friday.
(See other items on their agenda here – including Indigenous health, Andrew Forrest and a global Eliminate Cancer Initiative, a national primary care training package regarding family violence, the Fifth National Mental Health and Suicide Prevention Plan 2017-2022, and plans to provide support for people with severe mental resulting in psychosocial disability who are not eligible for the NDIS).
-----

Keith McNeil resigns from the NHS to return to Queensland Health in new digital leadership role

Lynne Minion | 11 Aug 2017
Queensland Health has announced internationally recognised transplant specialist and digital hospital evangelist Professor Keith McNeil is decamping from his role with the NHS and returning to Brisbane to help drive the digital transformation of the state’s hospitals.
 Due to take up the newly created position of Assistant Deputy Director General and Chief Medical Information Officer in December, McNeil will bring considerable clinical insight and technical competency to Queensland’s eHealth program.
 McNeil has resigned as the UK’s first national Chief Clinical Information Officer for Health and Care after 13 months in the job for what he says are personal and family reasons.
-----

SA health records system failing: AMA

Published: 5:13 pm, Wednesday, 9 August 2017
A new electronic records system being rolled out across South Australia's public hospitals is possibly not fit for purpose, the Australian Medical Association says.
The AMA says it sent a questionnaire to almost 250 staff, including doctors and nurses, asking for their views on the $422 million Enterprise Patient Administration System.
It says almost 40 per cent reported their opinion of EPAS was poor, 30 per cent believed patients were not clinically safer and 20 per cent found it responsible for adverse patient outcomes.
-----

newsCO.com.au –Near half-billion-dollar South Australian hospital records system failing: AMA

August 9, 2017
A new electronic records system being rolled out across South Australia’s public hospitals is possibly not fit for purpose, according to the Australian Medical Association (AMA).
The AMA said it sent a questionnaire to almost 250 staff members, including doctors and nurses, asking for their views on the AU$422 million enterprise patient administration system (EPAS).
It says almost 40 percent reported that their opinion of EPAS was poor, 30 percent believed patients are not clinically safer, and 20 percent found it responsible for adverse patient outcomes.
“The AMA has consistently supported the concept of electronic medical records,” president William Tam said on Wednesday.
-----

Death of ex-Socceroo Stephen Herczeg, 72, at Queen Elizabeth Hospital preventable, coroner rules

Andrew Hough, The Advertiser
August 9, 2017 6:53pm
A FORMER Socceroo’s “horrific” and “macabre” death at a major Adelaide hospital was entirely preventable, the State Coroner has ruled.
An urgent inquest was told his bladder ruptured and his lungs collapsed after oxygen was mistakenly attached to a catheter tube meant to drain urine.
-----

South Australian patient records system EPAS ‘dangerous’, ‘unfit for purpose’, new survey of medical staff reveals

KATRINA STOKES, HEALTH REPORTER, The Advertiser
August 9, 2017 11:03am
A DAMNING new survey by the state’s peak medical association has revealed the highly controversial Enterprise Patient Administration System is a total dud, it’s “dangerous” and questions whether it should be used at the new Royal Adelaide Hospital.
Results from an Australian Medical Association (SA) questionnaire of 248 staff, including doctors and nurses, reveals the system is “unfit for purpose” and “dangerous”.
AMA (SA) president Dr William Tam has questioned whether it should be rolled out at the nRAH.
-----

Near half-billion-dollar South Australian hospital records system failing: AMA

The AMA has said a new electronic records system being rolled out in South Australian hospitals is not fit for purpose.
By Chris Duckett | August 9, 2017 -- 07:39 GMT (17:39 AEST) | Topic: Innovation
A new electronic records system being rolled out across South Australia's public hospitals is possibly not fit for purpose, according to the Australian Medical Association (AMA).
The AMA said it sent a questionnaire to almost 250 staff members, including doctors and nurses, asking for their views on the AU$422 million enterprise patient administration system (EPAS).
It says almost 40 percent reported that their opinion of EPAS was poor, 30 percent believed patients are not clinically safer, and 20 percent found it responsible for adverse patient outcomes.
-----

Health Minister Jack Snelling faces claim that State Government computer system caused hospital building delay, in $185m suit

Daniel Wills, State Political Editor, The Advertiser
August 10, 2017 11:22pm
BUILDERS of the new Royal Adelaide Hospital have claimed that delays with the State Government’s troubled new electronic patient records system made it “impossible” for the project to be completed on time, as they launch a $185 million suit in the Federal Court.
The Advertiser yesterday revealed a new legal battle had broken out over the $2.3 billion project, set to open on September 5, and has now obtained documents detailing the claim.
The case has been brought by two building firms that combined in a joint venture to construct the new RAH — CPB Contractors and Hansen Yuncken — against the private consortium overseeing the project, Health Minister Jack Snelling and the state of SA.
-----

Data-driven nurses ask for a voice in Australia's digital health strategy

The group representing nurses well-versed in informatics is appealing for heavy involvement in the delivery of Australia's digital health strategy.
By Asha McLean | August 9, 2017 -- 23:48 GMT (09:48 AEST) | Topic: Big Data Analytics
A consortium of organisations representing nurses in Australia is advocating for their role in digitally transforming the country's healthcare, arguing that it makes sense for nurses to lead in decision-making and act as knowledge brokers to transform services and empower patients.
The Nursing Informatics Position statement, developed by the Health Informatics Society of Australia, Nursing Informatics Australia, and the Australian College of Nursing, touts the role of nurses in the widespread implementation and adoption of digital health technologies as pivotal for the primary purpose of improving safety and quality of patient care.
"While the Australian healthcare system is the envy of many countries, in recent years, levels of improvement in health system performance have remained static and it may be argued, have plateaued," the report [PDF] explains.
-----

The elephant at the IT industry lunch: DTA chief silent on privacy, security

By Stephen Easton

10.08.2017
In his first speech, the new DTA chief Gavin Slater talked up the value of digital technologies that cause the biggest privacy fears — digital identity verification, facial recognition and electronic health records — but ignored the p-word entirely.
There was one rather large elephant in the room when Gavin Slater gave his first speech as CEO of the Digital Transformation Agency to an IT industry audience last week: privacy.
Slater did not touch the subject, even when talking up the value of the government digital initiatives that generate the biggest privacy fears: the use of facial recognition, electronic health records, and the DTA’s nascent national digital identity verification system, GovPass.
Slater lauded e-health and the use of facial recognition to speed up immigration processing at airports, along with myGov and myTax, as examples showing the federal government had already created significant value in recent years through digital transformation. “I don’t think we do a good enough job in government of talking about the progress that is actually being made,” he added.
-----

Industry take-up of My Health Record

Six additional community pharmacy software vendors have agreed to connect up to the My Health Record system

The Australian Digital Health Agency has entered into agreements with Dispense Works, Minfos, Mountaintop Dispense, RxOne, ScriptPro Dispense, and Z Dispense, the agency announced on Wednesday.
These are in addition to Fred Dispense and Aquarius Dispense, which already connect to the My Health Record system.
And negotiations are ongoing with a number of other pharmacy dispensing software vendors; the agency says it is confident that agreements will be in place with almost all vendors in the next few months.
-----

More pharmacy software vendors to link to eHealth record system

Australian Digital Health Agency enters into agreements with more software vendors
Rohan Pearce (Computerworld) 09 August, 2017 17:06
The Australian Digital Health Agency has struck agreements with half a dozen community pharmacy software vendors to connect to the federal My Health Record system.
The ADHA revealed that Dispense Works, Minfos, Mountaintop Dispense, RxOne, ScriptPro Dispense and Z Dispense will integrate support for the eHealth record system.
Fred Dispense and Aquarius Dispense already support My Health Record, and the agency said that it was confident that agreements will be in place with “almost all vendors in the next few months”.
-----

Transforming Australia’s digital health services

Monday 7 August 2017 5:30PM (view full episode)
Transforming Australia’s digital health services will benefit Australians in a number of ways; from reducing hospital admissions, and adverse events, to improving patients’ care and treatment options.
The Council of Australian Governments (COAG) Health Council recently approved Australia’s National Digital Health Strategy.
Currently, 5 million Australians have a My Health record – the strategy aims, amongst other things, to expand this offer to all Australians by 2018 (unless they opt to not have one).
Guest
Tim Kelsey
CEO, Australian Digital Health Agency
Presenter
Dr Norman Swan
Producer
Joel Werner
-----

ACT Health turns to analytics to cure performance woes

By Justin Hendry on Aug 7, 2017 4:39PM

Amid ongoing review.

ACT Health has set about introducing a real-time data analytics platform to address its troublesome performance reporting, while a system-wide review of the territory's health data management processes continues.
The review was ordered by Health Minister Meegan Fitzharris earlier this year after ACT Health failed to provide the Productivity Commission with emergency department figures for benchmarking with other jurisdictions, because of concerns with data accuracy.
Once the cause of the health directorate's ongoing data issues are understood, revised governance arrangements for data management and a framework for essential data reports willl be introduced, and the territoy's data warehouse will be rebuilt.
-----

ID card back on agenda in national security overhaul

SHARRI MARKSON, The Daily Telegraph
August 7, 2017 12:00am
A NATIONAL identification card for every Australian is back on the agenda, while cargo from the Middle-East will now undergo exhaustive security checks.
It comes as the Turnbull government­ examines new ways to strengthen security at airports. Security flaws at regional airports, where passengers and cargo do not undergo any screening, is also being immediately reviewed.
Immigration Minister Peter Dutton, Infrastructure and Transport Minister Darren Chester and Justice Minister Michael­ Keenan will present a range of measures to the National­ Security Committee of Cabinet soon — possibly within the week. Requiring passengers to show ID before boarding domestic flights will be considered, with sources suggesting there could be renewed discussion about a national ID card.
-----

Duty to disclose performance data: sooner than later

Authored by Nicole MacKee
INCREASED health care data collection and broader expectations of transparency may lead to a legal duty to disclose performance data as part of informed consent, says an expert in the MJA this week.
Dr Rebekah McWhirter, from the Menzies Institute for Medical Research and the University of Tasmania’s Centre for Law and Genetics, wrote in an MJA Perspective that there was currently no general duty to disclose performance data, but “a duty may arise in future as the health care system evolves”.
She noted that there had been moves towards greater transparency in Australia with the publication of surgical mortality reports and initiatives such as the health care directory Whitecoat.
-----

Why does crucial patient information reside in so many different places?

7 August 2017

IMPROVING PRACTICE SOFTWARE

THE ISSUE

Each type of information about a patient’s health problems is stored in a different place in the electronic clinical record.
This partly reflects the history of the development of clinical software used in Australian general practice, some of which started as systems only to improve the ease and quality of prescribing, with other functions being added gradually.
The patient’s long-term health conditions appear in one screen or place, while investigations relevant to all of their problems appear together in a separate screen or place, as do correspondence, current medicines, and other treatments.
-----

Global Health wins contract to deploy cloud system at Sydney hospital

11:32 08 Aug 2017
The 5-year contract will see MasterCare PAS hosted on Global Health’s Altitude Cloud Service.
It is the core system for a number of other rehabilitation hospitals across Australia
Global Health (ASX:GLH) has secured a contract to deploy its MasterCare Patient Administration System (PAS) at the Arcadia Pittwater rehabilitation hospital in the Northern Beaches of Sydney.
Launching in early 2018, the 5-year contract will see MasterCare PAS hosted on Global Health’s Altitude Cloud Service.
-----

NZ’s Orion Health secures 5-year Victorian contract

New Zealand healthcare provider Orion Health has inked a five-year contract with the Department of Health and Human Services in Victoria to deploy its flagship interoperability solution, Rhapsody Integration Engine, across the DHHS and 15 public health agencies.
Under the contract, Orion will partner with MKM Health, an Australasian IT technology company with extensive knowledge of the Victorian healthcare sector, to supply additional architecture, solution support and professional services capability.
The Victorian DHHS delivers programmes and services that support and enhance the health, well-being and safety of 6.2 million people.
-----

Our healthcare records outlive us. It’s time to decide what happens to the data once we’re gone.

August 7, 2017 6.12am AEST

Author: Jon Cornwall

Senior Lecturer, Faculty of Health, Victoria University of Wellington
Death is inevitable. The creation of healthcare records about every complaint and ailment we seek treatment for is also a near-certainty.
Data about patients is a vital cog in the provision of efficient health services.
Our study explores what happens to those healthcare records after you die. We focus on New Zealand’s legal situation and practices, but the issue is truly a global one.
-----

Australia ranks 55th in broadband download speed tests

A test of broadband speeds across 189 countries has found that Australia ranks 55th, well behind New Zealand (30th) and miles behind table-topper Singapore.
The table was compiled by British broadband advice site Cable.co.uk from more than 63 million broadband speed tests.
The data collection was done across 12 months ending on 10 May, by M-Lab, a partnership between New America's Open Technology Institute, Google Open Source Research, Princeton University's PlanetLab, and other partners.
-----

NBN woes: govt must carry the can, says Paul Budde

A veteran independent telecommunications commentator claims that government policy, not the NBN Co or retail service providers, is to blame for the fiasco that the national broadband network rollout has become.
Paul Budde said at its core, the problem was one created by politicians, going all the way back to the original NBN policy which was drafted by the Labor Party.
"The only solution for the government is to realise that their government-led rollout is not simply a commercial exercise. If it was based on commercial principles, the rollout would first start in markets where they can charge a premium price," he pointed out. "The government must realise that they can’t burden the NBN Co with an unrealistic return on investment." 
-----
  • Updated Aug 7 2017 at 11:00 AM

How I learned to stop worrying and love my broadband, despite the NBN

Is the NBN getting you down?
Are you awaking irritable and still tired each morning, afraid that Malcolm Turnbull's version of the National Broadband Network has condemned you, your children and possibly your children's children to broadband speeds that are marginal at best right now, but that will lag far behind the rest of the world in years to come?
Lord knows the NBN has been getting me down, and I don't even have it yet.
Ever since the NBN appeared in my suburb, my already very sketchy broadband speed has sunk to a 10-year low, especially for uploads. Many of the smart home gadgets in my house, ranging from Google Home to security cameras, now refuse to work, not all of the time, but all too often.
NBN Co insists it's not its fault, and that my ISP must be to blame. My ISP, which sent out a technician who couldn't find anything wrong with my connection, suggested that it may not be a coincidence that the connection went dodgy soon after the NBN took over the local backbone.
-----
Enjoy!
David.