Again, in the last week, I have come across a few reports and news items which are worth passing on.
These include first:
How important is Mirth?
Fred Trotter recently decided to turn his regular talks on open source health computing into a series of blog posts. They are well worth looking at.
His review calls Mirth the most important interoperability project out there. This despite what he acknowledges are weaknesses in the underlying HL7 standard.
Mirth is a great effort. There are implementations for Windows, Linux, the Mac OS, even JBOSS middleware. The most recent version is 1.7.1, released on April 30, and dozens of bug reports and improvement suggestions have already been posted.
More here:
http://healthcare.zdnet.com/?p=994
The answer to the question I believe is very important. This software is a key enabler of interoperation between different systems and to have it open source and available freely is really a good thing.
The web site for the project is well worth a careful review.
Second we have:
GPs reject web-based ‘Healthbook’ record
Andrew Bracey - Friday, 30 May 2008
GPs have roundly dismissed proposals for a Facebook-like system of personal electronic health records, pointing to issues of reliability and patient privacy as major stumbling blocks.
A recent national survey of 151 GPs by Cegedim Strategic Data for Medical Observer revealed just 13% of GPs were convinced the concept would work.
The proposal – dubbed Healthbook – emerged from the recent 2020 Summit and involves the establishment of individual health profiles controlled by each patient.
The Internet-based system would allow patients to store medical data and share it with health professionals.
GPs were cynical about the proposal. Just over 28% said they did not believe such a system would ever be realised.
Patient privacy, security and incomplete record-keeping were cited as key barriers to safe implementation.
More here (if access available):
I find this level of negativity quite interesting – I wonder how well the proposal was explained to the respondents before their views were sought.
Third we have:
Vic IT projects in crisis: Auditor
Fran Foo | May 28, 2008
PEOPLE with tunnel vision are running some of Victoria's most complex ICT projects, and the ramifications are hurting the state's bottom line.
Victoria's Auditor-General Des Pearson today said such projects, often involving myriad government agencies, were increasingly late and over budget.
Mr Pearson made the comments as he released an audit report on Project Rosetta, saying the whole-of-government enterprise directory project was a prime example of the deepening malaise.
"The time and cost overruns experienced in Rosetta are becoming commonplace when reviewing multi-agency ICT implementations ," he said in a statement.
"While not at the same scale as those experienced in other projects recently audited, such as HealthSMART, these recurring features indicate that lessons need to be learned."
In April, Mr Pearson said the $320 million HealthSMART project is two years overdue.
Meanwhile, Rosetta incurred additional costs of more than $10 million, and was delivered seven months past its deadline. The directory was nearly four years in the making, with work commencing in August 2002.
More here:
http://www.australianit.news.com.au/story/0,24897,23773298-15306,00.html
It seems that major projects in the public sector are virtually always very problematic. This lesson should not be lost on those in NEHTA proposing a Shared EHR (or whatever it is called today). A decentralised locally driven process would seem to me to be much more sensible.
Fourthly we have:
Data breach reporting a scramble
Karen Dearne | May 27, 2008
BANKS say they are well placed to adopt new data breach notification rules, but other businesses may struggle to get protections and policies in place.
The Rudd Government is considering making reporting of data breaches mandatory as part of a review of the Privacy Act.
In the meantime, federal privacy commissioner Karen Curtis is seeking public comment on an interim voluntary scheme.
ANZ Bank privacy compliance manager David Templeton said it had had an incident reporting system in place for a number of years. "Any privacy incidents are recorded in a database, which reports issues in real time to a central compliance area for review," he said.
"We then consult with the relevant business area to decide what action is appropriate."
Symantec Pacific vice-president Craig Scroggie anticipates a windfall for security vendors arising from new legislation. His firm recently acquired Vontu, a leader in data loss prevention tools.
"Data loss is clearly a big issue because of the federal privacy commissioner's draft guidelines for voluntary notification, and the forthcoming Australian Law Reform Commission recommendations on a mandatary scheme," he said.
"Data loss is not just an IT issue, it's a significant business issue, as information is a prime company asset. Data loss and leakage are hot topics right now, but they're not new."
More here:
http://www.australianit.news.com.au/story/0,24897,23762990-5013040,00.html
What I am not clear on as yet is just what the implications of this are for the health sector. It would seem to me that everyone who holds computerised (or even paper based) health information needs to keep an eye as to what is going on here.
Fifth we have:
One-stop shop for Centrelink, Medicare
Patricia Karvelas, Political correspondent | May 28, 2008
SOME Centrelink and Medicare outlets will be combined into "one-stop government shops" under a Labor plan to improve access for customers.
The overhaul of Centrelink, to be unveiled today, will also involve the introduction of digital forms to reduce processing times and allow for quicker decisions.
While a national rollout of the one-stop shop concept remains a long-term plan, Human Services Minister Joe Ludwig said that in areas where the viability of the local Centrelink office might be in question, the all-in-one option would enable towns to keep their branch open. Uniting offices would be trialled in one-off locations under a $10million plan.
Senator Ludwig said some of the service improvements, to be announced today, were aimed at introducing new technology to Centrelink agencies, including digital scanning of documents.
Online "smart forms" would allow questions about customers' circumstances to be asked in one hit for a range of benefits.
"Similarly, better use of available technology could mean that, for students, requests for information from Centrelink can be sent via SMS," Senator Ludwig said.
More here:
http://www.theaustralian.news.com.au/story/0,25197,23769877-23289,00.html
While at first blush this may seem like a good idea I wonder just how people would feel talking to the same customer service officer about both their Centrelink payments and their health claims. The possibility for all sorts of privacy breeches and possibly some forms of abuse of privilege seem higher in this environment. The officers would potentially have access to a huge amount of private information on a client to be able to manage all these programs from a single visit – and that may not be uniformly a good thing.
This article may also be relevant.
Medicare IT outsourcing deal delayed
Karen Dearne | May 29, 2008
THE planned retendering of Medicare's key ICT outsourcing services contract has once again been postponed while the Human Services Department awaits direction from the Gershon Review of federal government agencies' use and management of IT systems.
Human Services Minister Joe Ludwig says the plan to take a "more universal" approach to ICT requirements will affect the timing of approaches to the market by agencies.
"We have a number of major contracts - including the Medicare Australia ICT services contract - which are due to expire over the next 12 to 24 months," Senator Ludwig said in a statement.
"A key element of the department's service delivery reform strategy involves strategic portfolio approach. Our agencies, including Centrelink, Medicare and Child Support, are collectively among the biggest users of ICT within Australia."
More here:
http://www.australianit.news.com.au/story/0,24897,23777892-15306,00.html
Sixth we have:
Rollout of NHS e-record software faces more delays
22 May 2008 09:15
Connecting for Health and CSC may be preparing a new contract extending the schedule for implementation of the Lorenzo software until 2016
Further delays have beset the implementation of a key feature of the NHS National Programme for IT.
According to a paper released online by the North West Strategic Health Authority, NHS Connecting for Health and local service provider CSC are preparing a new schedule, extending to 2016, for installation of the Lorenzo software within health service trusts. Lorenzo will provide the core clinical information system for hospitals in the north and east of England and the Midlands.
This is at odds with a National Audit Office report released on 16 May, which said the implementation of electronic care records, the core of the national programme, had been delayed to 2014-15, making it four years late.
Continue reading here:
http://news.zdnet.co.uk/itmanagement/0,1000000308,39422253,00.htm
This is a little worrying. One really hopes some of this ground can be made up over the next few years.
Last we have:
Call for e-health to ‘permeate’ rural Scotland
27 May 2008
E-health should permeate thinking about every aspect of remote and rural healthcare, according to a newly-published report on healthcare in remote areas of Scotland.
Scotland’s Remote and Rural Steering Group, 'Delivering for Remote and Rural Healthcare: what it means for you', sets out a framework to develop a sustainable care system in remote Scotland. Its findings have been accepted by the Scottish government.
The report calls for Scotland’s eHealth Strategy Board to ensure that the level and quality of connectivity is the same across Scotland and says that remote and rural communities should be supported by a “first class IT infrastructure”.
The steering group said that the principles underpinning a technological approach should be that specialist advice could be provided from a distance using videoconference, telephone or e-mail, that videoconferencing could avoid the need for traveling to a central point and that digital data such as blood tests and ECGs could be transferred from remote sites to other points, enhancing diagnosis.
More here:
It seems that some of the ideas for remote Scotland might be worthwhile considering for remote Australia given our plans to improve the network connectivity all over Australia with the new Broadband investments.
More next week.
David.
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