Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Sunday, November 09, 2008

Useful and Interesting Health IT Links from the Last Week – 09/11/2008

Again, in the last week, I have come across a few reports and news items which are worth passing on.

These include first:

Healthlinks in US software deal

Karen Dearne | November 04, 2008

THE Pharmacy Guild continues its push into primary healthcare with tailored management plans for patients suffering from chronic illnesses.

A guild subsidiary, Healthlinks.net, has signed a deal with US pharmacy-based patient system provider Mirixa to bring its web-based software, MirixaPro, to Australia.

Guild national president Kos Sclavos said Mirixa technology was a platform that let community pharmacies run care management programs for illnesses ranging from diabetes to HIV.

"As people have been trying to get health services out of the hospitals and into the community, US pharmacies are getting back some of the traditional markets they had lost, such as HIV drug delivery," he said.

"Mirixa software helps with medication compliance and better health outcomes by making sure that people on chronic therapy medicines stick to their treatment regimen."

Mr Sclavos said no decisions had yet been made on which programs would be brought across. "Any system that comes here has to be Australianised, and we've previously announced that we'll be in a position to discuss our plans by April next year," he said.

More here:


This is an interesting initiative. Having a care management system that assists patient compliance can only be a good thing. Additionally having closer post marketing surveillance may also be useful. The worry with all this will be how the information flow between prescribers and the pharmacists can be optimised and consist of a information set beyond the simple prescription. Without proper clinical communication between GPs, Specialists and Pharmacists any additional roles and responsibilities being taken on by pharmacists could have some un-intended and negative consequences.

Second we have:

Tailwinds for Web-Based Medical Systems

Over the past couple of years, we’ve noticed a marked change in medical office’s views on the web-based, or Software as a Service (SaaS), model of using EMR and practice management systems. Among practices looking for new software, we’ve observed:

· ~30% are asking specifically for a SaaS system;

· ~45% are aware of SaaS and considering the model; and,

· ~25% remain adamant about managing software “on premise.”

These numbers are substantially different from what we might have seen a few years ago from buyers of electronic medical records and practice management software. Why is that?

The short answer is that SaaS has gone mainstream. It’s not a nascent technology concept any more. People get it, and they use it – to bank, to shop, to email…

In addition to the familiarity users have gained through using web-based applications in other areas of their life, we see three macro drivers that are making SaaS work.

More here:


I was sent this URL by a provider of advisory services to clinicians among some other groups. The comments on more web based provision make sense and are worth being aware of.

Third we have:

Primary health care needs shake-up: govt

October 30, 2008 - 5:22PM

Australia's primary health care system will continue to favour the rich and could break down if Medicare is not overhauled, Health Minister Nicola Roxon says.

The minister spoke of the need for a shake-up of the nation's health landscape on Thursday, as she launched the inaugural discussion paper on primary-care reform from a government reference group.

The paper paints a dim picture of primary care in Australia, where patients have to wait weeks to see their GP if they are fortunate enough to live in an area with a doctor at all.

A greater emphasis on nurses and other allied health professionals and new funding arrangements to boost access to health care for people in remote and disadvantaged areas are the group's key suggestions.

A greater focus on prevention and advancing e-health were also discussed in the report.

More here:


It is good to see e-Health gets a mention in the new proposed primary care strategy. GPs have for too long not been given a sensible level of government support in this area – not so much as far as money is concerned – but more in terms of leadership, objective setting and co-ordination.

Fourth we have:

Department's e-health spin not even close to reality, say critics

Karen Dearne | November 04, 2008

INDUSTRY observers are taking the positive spin on e-health achievements in the Health Department's annual report with a large dose of salt.

The federal agency has underspent its e-health budget by $11.2 million. It spent only $42.6 million out of $53.8 million allocated for 2007-08.

This followed a disastrous year for health IT funding in 2006-07, when $41.5 million was left unspent out of $79 million allocated to national projects, including the failed HealthConnect.

AushealthIT blogger David More said it was unclear how the department could claim "so many successes and performance indicators being met".

According to the report, more than 300 million clinical communications, including specialist referrals, hospital discharge summaries, prescriptions, pathology reports and diagnostic imaging took place during the year.

More here:


It is nice your faithful blogger gets the odd mention in the mainstream press. It seems to me one of the few ways that might get Government off their backsides is a little criticism in the media – recognising just how media driven the present government is.

It should be noted that the Rudd Government has deferred the COAG Meeting planned for November 17 – because of PM travels to the US regarding the financial crisis. The chance of new e-health spending at this meeting – given the budgetary situation – must be pretty low.

The risk is much increased by the unravelling of COAG with election of the Liberal Government

Fifth we have:

Windows 7 returns control to the user

Tim Anderson and Jack Schofield

November 3, 2008

The next version of Windows seems to be on the right track as Microsoft learns from its Vista experience, write Tim Anderson and Jack Schofield.

An early "pre-beta" build of Windows 7, the successor to Vista, is now in the hands of thousands of software developers after it was previewed at last week's Microsoft Professional Developers Conference in Los Angeles.

Major hardware manufacturers already have copies but many more will get them at WinHEC, the Windows Hardware Engineering Conference, which opens in Los Angeles on Wednesday.

Microsoft is keen to avoid a repeat of Vista's shambolic launch. Corporate vice-president Mike Nash spoke at the press briefing about learning from the Vista experience. The man in charge of Windows engineering, Steven Sinofsky, emphasised the rigour and discipline of the Windows 7 development process.

It appears to be working. Even in the preview handed out to the media, Windows 7 feels more polished and less annoying than its predecessor. The changes are not dramatic but that is a good thing. Microsoft has left the core architecture untouched, so software and devices that worked on Vista should still work.

Microsoft is also making Windows "quieter", in other words, reducing the number of prompts that interrupt your work. For example, too many applications now install themselves in the Windows system tray and pop up frequent notifications. Windows 7 returns control to the user by letting you hide them or turn off their messages. You can also fine-tune User Account Control, the security feature that in Vista flashes the screen and shows a dialogue box whenever you change a system setting.

Vastly more here:


Can I say this all sounds like very good news. The stability of Vista without all the annoyances would be a very good thing indeed!

Last we have the slightly more technical article for the week:

SOA growth projections shrinking

Gartner finds for the first time in five years of surveying that fewer companies have plans to move forward with SOA.

Paul Krill (InfoWorld) 04/11/2008 13:17:00

SOA adoption has hit a bump in the road, according to survey detailed by Gartner on Monday.

The number of organizations planning to adopt SOA for the first time decreased to 25 percent; it had been 53 percent in last year's survey. Also, the number of organizations with no plans to adopt SOA doubled from 7 percent in 2007 to 16 percent in 2008. This dramatic falloff has been happening since the beginning of 2008, Gartner said.

Gartner has been doing the survey for five years, and this is the first time the numbers dropped, said analyst Dan Sholler, research vice president at Gartner. "What we're seeing is that there are a bunch of organizations [that] for a variety of reasons don't expect to be doing anything specific about SOA next year," Sholler said.

This year's survey saw a decline in the growth rate for SOA, he stressed. Overall, organizations expect to be doing fewer projects next year, with the economy contributing to that to a degree, Sholler said. Organizations also may be doing fewer things for which SOA applies, he said.

More discussion here:


It is interesting that the trend towards Services Orientated Architecture (SOA) adoption appears to be slowing. The health sector in a number of countries is relying on implementations of SOA working well – so any issues need to be understood and resolved as quickly as possible.

Also we have more details in MS Azure – which intersects with SOA based approaches.


The inside view of Microsoft's cloud strategy

The project lead explains why the hypervisor is not Hyper-V, how multitenant apps are supported, and why Azure is not like Amazon's EC2

Paul Krill and Eric Knorr (InfoWorld) 03/11/2008 08:32:00

More next week.



Anonymous said...

This deal is positioned as being between the Guild subsidiary, Healthlinks.net, and the US-based company Mirixa.

The Guild’s lead partner in the pharmacy software space (PCA NU Systems which is half-owned by the Guild) seems to have been well and truly relegated to the sidelines!! They, PCA NU, have been ominously quiet about the announcement.

Anonymous said...

If that is the case it would not be surprising if the big American campany convinced the smart people who run the Guild that Mirixa will do it ‘all or nothin’ - step aside buddy and leave it to us, we're experts and this is our market, we'll show you how to do it our way.

Anonymous said...

I doubt that would be the case because the Guild, is a major shareholder in PCA NU Systems, and therefore a substantial beneficiary of PCAs subsidiaries - PharmX Pty Ltd, ScriptX Pty Ltd and ERX Script Exchange Pty Ltd.

Consequently it would be very surprising if the Guild had gone out on its own without involving PCA in the Guild’s strategy every step of the way.

The only way that it could happen would be if Mirixa insisted it must be be the lead boss cocky as your previous commentator suggested might be the case.

Anonymous said...

I think it quite probable the Guild decided to exclude PCA from its deal-making with Mirixa. Remember the Guild owns Healthlinks.net and PCA has no part in it. As there is a lot of money at stake the Guild would prefer to share with as few parties as possible.

Anonymous said...

Re Monday, November 10, 2008 10:19:00 AM "PCA NU, have been ominously quiet about the announcement."

Maybe PCA NU Systems didn't know it was in the offing!!! ???.

The market, which includes PCA's customers and the PSA, should be informed about PCA's involvement or otherwise, and more importantly so should the Government-DoHA.

The best way to do that is for PCA NU Systems to clarify its position and appropriately distance itself from the Guild if it is not involved in the Mirixa deal.

Anonymous said...

Yep it would be in everyone's interest to get it all out in the open. I think the whole deal looks very smelly. I bet the Government does too.

I'm fed up with these big American companies coming into Australia to muddle around in the health market when they can't even get their own health system in order.

I mean, hey, look at it this way, we are light years ahead of the US with clinical desktop computing. Sonic in pathology is now the largest in the world. IBA Health is also one of the world's largest health software houses originating in Australia (IBA and iSoft both began in Australia).

If we can do that down here why the hell do we need Mirixa to stomp their way round our patch. Hey, look how the American magicians have stuffed up the world's financial system.

Does the Guild have any idea what it is doing? Why would it? No one at the top of the Guild has any idea about IT applications - shopkeepers they may be - but IT - forget it.

Anonymous said...

The best person to ask would be Patrick Reid, recently appointed as the Guild's Director of IT.

Anonymous said...

I'll wager a pound to a gooseberry the PSA knew nothing about Mirixa and have been kept well sidelined throughout. They have been deathly silent on the subject.

Anonymous said...

Surely the PSA was involved in the decision to roll Mirixa out in Australia! This has major ramifications for standards, quality control, and clinical management, not to mention the future of pharmacy. I don't think I have seen any comment by PSA about this as yet.

Anonymous said...

PSA haven't commented because they knew nothing about it. The Guild is riding rough-shod once again.

Anonymous said...

You raise a very valid concern when you say "Without proper clinical communication between GPs, Specialists and Pharmacists any additional roles and responsibilities being taken on by pharmacists could have some un-intended and negative consequences."

Un-intended and negative consequences indeed. That is primarily why any introduction of such an all pervasive system needs to be approached with the involvement of consumers and government. The Government is a serious stakeholder because it basically funds the health system. The first thing that needs to be done is to have the system thoroughly evaluated and gap analysed - and pharmacy specialists outside of the Guild should be closely involved in the evaluation.

Anonymous said...

Would you expect anything less from the Guild? Ride rough shod aptly describes their approach. Remember what happened when they applied for a patent around the MediConnect IP. At least the Department had the guts to take the Guild on at its own game and forced them to put the IP into the Government’s hands. Most of us can’t fathom why the Government keeps pushing millions of dollars at the Guild year after year instead of building a stronger relationship with the vast majority of pharmacists(via the Pharmaceutical Society of Australia - the PSA) who are excluded from being Guild members.

Anonymous said...

Who has written the MedsIndex software for the compliance monitoring and support service?

The Guild said it would use MedsIndex to build a web-based medication compliance program, HygeiaRx. Where does the money come from to pay for these developments?

Anonymous said...

It's hard to tell where the money comes from but probably from grants made available under the Guild-Government Community Health Agreement. As to who develops the software is anyone's guess - but it can't be the Guild itself because the would have difficulty designing a dunny door.