Again, in the last week, I have come across a few reports and news items which are worth passing on.
These include first:
AMA wants patient views on audit plan
Adam Cresswell, Health editor | September 13, 2008
THE peak doctors' group is considering surveying patients for their views of a Medicare Australia plan for a huge expansion of auditing activities, which could for the first time allow non-medically qualified officials to inspect material from patients' medical records.
The Australian Medical Association claims the proposals -- which it strongly opposes -- could make some patients reluctant to discuss sensitive issues with their doctor for fear the details might later be read without their consent by Medicare auditors.
The long-running compliance program, which is designed to sniff out instances of inadvertently incorrect Medicare claiming as well as outright fraud, is about to quadruple in size following a near $80 million cash injection by the federal Government.
Last week Medicare Australia embarked on a publicity campaign to build public support for the changes, which will see the number of health professionals subjected to compliance audits rise from 500 to 2500.
But there could be a tussle for public support. AMA president doctor Rosanna Capolingua says patients "would very much want to know" if there was a risk of their records being accessed by a third party, and a survey option would be considered.
More here:
http://www.theaustralian.news.com.au/story/0,25197,24331476-23289,00.html
It is vital that we have proper compliance with Medicare rules, however proper regulation and control of indentified health records is absolutely vital. The AMA is right to demand that such safeguards for patient privacy are in place but wrong to try and weaken the Medicare compliance regime.
Second we have:
Security worries see GPs drop shared lab tests
4:00AM Tuesday September 09, 2008
The aim of TestSafe is to make lab results instantly and widely available.
A health group with 150,000 patients has pulled out of a system that shares lab test results among doctors because of fears over inadequate informed consent.
The withdrawal of North Shore-based Harbour Health and most of its GPs is a blow to the Auckland region's TestSafe system of sharing lab results among district health board clinicians and participating GPs.
TestSafe was started without fanfare by the region's three boards in 2006 as a way to reduce duplication of lab tests done or funded by the DHBs and to improve patient safety by making the latest results instantly and widely available.
Patients can opt out test by test. In the first nine months, just 18 did so, out of more than 560,000 tested.
Yesterday, however, the Herald learned that all but three of the 147 GPs in the Harbour Health primary health organisation told TestSafe in July not to list their patients' results.
Chief executive Susan Turner said they had done so because of legal advice that it was impossible for GPs to obtain informed consent from patients to have their results put on to the TestSafe database.
More here:
http://www.nzherald.co.nz/topic/story.cfm?c_id=255&objectid=10531160
It interesting that what is obviously a useful system has operated for over two years is suddenly brought low by consent issues not being properly addressed. There are a number of data-bases of results in Australia that may have similar issues. One especially wonders about the pathology database underlying OACIS in South Australia.
The SA privacy policy of their systems is clearly purely an “opt-out” approach which is recognised around the world as being a good deal less than best practice.
See here:
http://www.careconnect.sa.gov.au/Default.aspx?tabid=189
Third we have:
E-prescribing project delayed
Michael Woodhead
A pharmacy-driven electronic prescribing project announced with much fanfare earlier this year has hit a setback with one partner, prescribing software company Medical Director, going cold on the project.
In March the Pharmacy Guild announced a ScriptX project to start in October which would allow GPs to create electronic prescriptions on a central encrypted hub that any participating pharmacy could access and dispense.
More here:
http://www.6minutes.com.au/dirplus/images/6minutes/newsletter/8_09_2008.pdf
Looks like all the fanfare about this was a trifle overdone. My view is that provision of hubing services for e-prescribing is, recognising the way our health system operates, is something that should be delivered and controlled by the federal government and not any private entity.
Fourth we have:
All eyes on case against Medicare
Monday, 08 September 2008
The Australian Financial Review|
Julian Bajkowski
The Federal Court has ordered Medicare Australia to file its defence to a landmark legal action, opening the door for a determination on the extent government can participate in the private transactions market.
The action was brought against Medicare by Thelma, a subsidiary of the listed health technology company ICSGlobal.
Thelma has alleged Medicare illegally used its market power by offering free electronic private health transaction services that copied the company's own, in an effort to eliminate or substantially damage competition in its market.
More here:
This is an interesting development and should be watched closely by all those who hope we might have fully interoperable secure messaging in the health sector some time soon. It can be argued that such services should be a Government monopoly to ensure full interoperation but can be equally be argued that only competition will optimise the quality of service provided and the cost of that service.
Fifth we have:
Collider probes universe's mysteries at the speed of light
Worldwide computer grid helps scientists make sense of data coming from collider experiments
Sharon Gaudin 10/09/2008 08:56:00
With the world's biggest physics experiment ready to fire up today, scientists from around the world are hoping to find answers to a question that has haunted mankind for centuries -- how was the universe created?
The Large Hadron Collider (LHC), which has been under construction for 20 years, will shoot its first beam of protons around a 17-mile, vacuum-sealed loop at a facility that sits astride the Franco-Swiss border. The test run of what is the largest, most powerful particle accelerator in the world, is a forebear to the coming time when scientists will accelerate two particle beams toward each other at 99.9 percent of the speed of light.
Smashing the beams together will create showers of new particles that should recreate conditions in the universe just moments after its conception.
Wednesday's test run is a critical milestone in getting to that ultimate test. And a worldwide grid of servers and desktops will help the scientific team make sense of the information that they expect will come pouring in.
More here:
http://www.computerworld.com.au/index.php?id=977114375&eid=-6787
The mother of all physics experiments with the potential to transform our view of the way the Universe works. I for one delight that in this troubled world such things can still be made to happen. We need value what this signals about what a co-operative world can achieve
More also here:
http://www.smh.com.au/news/science/atomsmasher-may-prove-god-particle/2008/09/08/1220857456604.html
Atom-smasher may prove 'God particle'
Last we have the slightly more technical article for the week:
Opening Search to Semantic Upstarts
Yahoo's new open-search platform is giving semantic search a helping hand.
By Kate Greene
Even if you have a great idea for a new search engine, it's far from easy to get it off the ground. For one thing, the best engineering talent resides at big-name companies. Even more significantly, according to some estimates, it costs hundreds of millions of dollars to buy and maintain the servers needed to index the Web in its entirety.
However, Yahoo recently released a resource that may offer hope to search innovators and entrepreneurs. Called Build Your Own Search Service (BOSS), it allows programmers to make use of Yahoo's index of the Web--billions of pages that are continually updated--thereby removing perhaps the biggest barrier to search innovation. By opening its index to thousands of independent programmers and entrepreneurs, Yahoo hopes that BOSS will kick-start projects that it lacks the time, money, and resources to invent itself. Prabhakar Raghavan, head of Yahoo Research and a consulting professor at Stanford University, says this might include better ways of searching videos or images, tools that use social networks to rank search results, or a semantic search engine that tries to understand the contents of Web pages, rather than just a collection of keywords and links.
"We're trying to break down the barriers to innovation," says Raghavan, although he admits that BOSS is far from an altruistic venture. If a new search-engine tool built using Yahoo's index becomes popular and potentially profitable, Yahoo reserves the right to place ads next to its results.
More here:
http://www.technologyreview.com/Infotech/21342/?nlid=1322&a=f
This is an interesting approach to fostering innovation in an area where the barriers to entry are very high – and as ‘cloud computing’ evolves seem likely to go higher. For an excellent take on the cloud and where it is heading the ABC’s Background Briefing has just broadcast an excellent program. Available for download free for the next month.
See here:
http://www.abc.net.au/rn/backgroundbriefing/stories/2008/2359128.htm
Great set of links as well for further information.
More next week.
David.
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