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, December 07, 2008

Useful and Interesting Health IT Links from the Last Week – 07/12/2008

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

These include first:

E-health privacy threat for small towns

Elizabeth McIntosh - Friday, 28 November 2008

THE federal government’s plans to roll out patient e-health records could cause serious problems for those in small communities if strict privacy protocols are not in place, the Consumers’ Health Forum has warned.

In a submission to the National E-Health Transition Authority (NEHTA), the forum raised questions around the levels of access health professionals would have to patient records.

In particular, it expressed concern that if health professionals were given unfettered access to health records containing highly sensitive information, patients in small towns with specific conditions may find themselves stigmatised.

“If more people know information, or people have access to irrelevant information, it could lead to leaks and in a small town, that leaked information could have an awful impact,” the submission stated.

More here:

http://www.medicalobserver.com.au/medical-observer/news/Article.aspx/E-health-privacy-threat-for-small-towns

I find this an interesting perspective that has not been widely aired. In small communities there is no doubt very great care will need to be taken with information relating to diseases that may stigmatise people.

Second we have:

Hospital data 'rorts' face audit

  • Julia Medew
  • December 4, 2008

CLAIMS of "virtual wards" and data manipulation in Victorian hospitals to meet Government targets for bonus payments are being investigated by the Auditor-General.

A spokeswoman for Des Pearson yesterday confirmed the audit of hospital performance data despite Health Minister Daniel Andrews' insistence that there is no evidence to warrant an inquiry.

The investigation comes six months after the Australasian College for Emergency Medicine said overcrowded hospitals were changing patient data, admitting patients to fictitious wards and inconsistently measuring waiting times to qualify for bonus payments.

A survey of 19 emergency department directors by the college found almost 40 per cent of their hospitals had "admitted" patients when they were still in waiting rooms, corridors or on trolleys.

The doctors said the "virtual wards" were used purely for "creative accounting" to receive funding and avoid "performance watch".

More here:

http://www.theage.com.au/national/hospital-data-rorts-face-audit-20081203-6qo0.html

First we have NSW bureaucrats faking ED information and now we find Victoria up to the same tricks. The auditors nationwide need to really now conduct a comprehensive review of Health System data quality and reliability – especially as the Health Minister is planning to make so much more use of performance data.

Third we have:

Sydney hospitals switch TVs for MFDs

Liam Tung, ZDNet.com.au

03 December 2008 09:32 AM

Days after NSW's Health's technology was slammed as archaic, the Sydney West Area Health Service has gone to market for over 2,000 high-capacity bedside touch-screen computers for patient entertainment and clinician access to core health systems.

The proposed bedside "multifunctional devices" which Sydney West Area Health Service (SWAHS) released request for tender documents yesterday, are planned to be powered by 40 gigabyte hard drives, with 1Ghz Intel CPUs, and garnished with a 17 inch touch-screen.

SWAHS has asked for the units to be supplied with infrared keyboards, a web camera for video conferencing, and a magnetic swipe card reader and biometric scanner for secure access.

.....

Auburn's 185 hospital beds are the first planned to be equipped with the devices, followed by 400 beds at Blacktown Hospital, 116 at Blue Mountains District Anzac Memorial Hospital, 40 at Lithgow, 180 at Mt Druitt, 480 at Nepean, 32 at Springwood and 900 Westmead — in total, 2333 devices.

Tender responses are due by Wednesday 17 December.

More here:

http://www.zdnet.com.au/news/hardware/soa/Sydney-hospitals-switch-TVs-for-MFDs/0,130061702,339293601,00.htm

This is an interesting tender and show some forward thinking about the need to provide a more interesting environment for patient’s stuck in bed as well as for clinicians to access core clinical systems.

I must say, however, that the devices seem rather underpowered, and I wonder why the tender was not State-wide to help reduce costs.

Fourth we have:

Microsoft change hits aged care

Karen Dearne | December 02, 2008

MICROSOFT Australia has accused aged-care services providers of illegitimately buying software through a discount licensing program.

Aged-care providers were shocked in October by the software giant's decision to revoke their not-for-profit status and charge full commercial rates for using Microsoft's Office, Sharepoint and SQL Server products.

The move will hike annual licensing fees by about 400 per cent. Despite representations from the Aged Care Industry IT Council, Microsoft has not changed its mind.

An independent review by Connecting Up Australia found that a number of customers across a range of industries had been illegitimately buying software through a discounted licence program, called Academic Open, for which they did not qualify, a Microsoft spokeswoman said.

Most customers were unaware they were buying an illegitimate licence, but a small number were deliberately abusing the system to access discounted software.

In the past, customers and partners had self-qualified their use of this licence, with no independent vetting.

Microsoft said lack of oversight had contributed to the issue of licence misuse and isolated cases of abuse.

The Aged Care IT Council estimated full licences for installed software would cost the industry $70 million over the next 18 months, swallowing half of the sector's annual technology budget at a time when it was being urged to improve uptake of technology systems.

.....

Federal Minister for Ageing Justine Elliot and federal Finance Minister Lindsay Tanner both said they were monitoring the issue.

Ms Elliot has launched a free, plain-English guide, called the Aged Care IT Implementation Kit, developed at a cost of $212,000 to promote the use of technology to reduce administrative burdens.

.....

More here:

http://www.australianit.news.com.au/story/0,24897,24734620-15306,00.html

Two points

First, aged care providers do have options (especially Open Source options) to reduce the cost of software.

Second the guide developed by the Department is quite a worthwhile document for all those starting up the technology curve. It can be found here:

http://www.health.gov.au/internet/main/publishing.nsf/Content/7C8F0E64280BF568CA2574AC00183992/$File/ITAC%20Guide.pdf

Fifth we have:

iSOFT signs $14 million pharmacy contract with WA Department of Health

02 Dec 2008

Sydney – 1 December 2008 – IBA Health Group Limited (ASX: IBA) Australia's largest listed specialist health information technology company, today announced that its iSOFT Health division has signed a contract with the Western Australian Department of Health (WA Health) for a pharmacy management solution and support services in a deal worth up to $14 million.

In up to a ten year contract, which includes license revenue and support, the centrally-managed solution from iSOFT will streamline pharmacy services at 21 public hospitals across Western Australia. The iPharmacy solution will provide consistency in managing medications and offers clinical decision support to assist with the prevention of medication errors at the point of dispensing.

i.Pharmacy will assist WA Health in implementing a series of pharmaceutical reforms, including on-line PBS processing. i.Pharmacy is already installed at 250 sites throughout Australia making iSOFT the country’s market-leader in hospital pharmacy systems.

Gary Cohen, Executive Chairman & CEO of the IBA Health Group, said: “WA Health is one of iSOFT’s major customers in Australia. We are pleased WA Health has chosen our hospital pharmacy and medication management solution to improve pharmacy, clinician and medication management in the state’s hospitals. The selection of i.Pharmacy by WA Health follows on the heels of the recent wins in South Australia and Tasmania and demonstrates that iSOFT meets the needs of collaborating health professionals operating in an integrated healthcare environment across Australia.”

More here:

http://www.ibahealth.com/html/isoft_signs_14_million_pharmacy_contract_with_wa_department_of_health.cfm

This is good to see as it means there is a process of upgrading the clinical software infrastructure of WA public hospitals actually really underway. Not before time after various problems and changes of senior management. (Usual disclaimer that I have a few IBA shares)

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

Would InternetWatch Actually WORK?

Network engineer Geordie Guy explains the technical limitations of the Government's clean feed proposal

The Australian Government's plans to introduce mandatory ISP filtering have caused something of a media frenzy.

Most of the debate has been conducted on either side of an imaginary line between advocates of free speech and critics of censorship on the one side, and organisations which seek to protect children and adults from indecency and harm on the other. This debate has at times descended into a shouting match over statistics and objectives, confusing Australians who are unsure how they feel about the issue.

Supporters argue that the clean feed proposal would merely bring the internet into line with existing regulation on traditional media such as print publications, television and radio. Meanwhile, opposition to the plan is based on a number of concerns, and of these, possibly the most confusing for many people is the claim that the filter simply won't work.

So what are the technical problems that the opponents are claiming? Are they necessarily deal breakers which make the filtering plan unworkable, or are these arguments just what filter supporters claim they are: an excuse to try and maintain the free availability of pornography?

Nobody knows precisely what screening method would be used if the filter were to go ahead. The Government trials considered several commercial products, referred to by code names, and each of them could use any one of several methods, or a set of the available methods in combination.

Much more here:

http://newmatilda.com/2008/12/04/would-internetwatch-actually-work

I found this a clear, lucid, technical explanation of why Minister Conroy is dead wrong on this internet filtering nonsense. It would do more harm than it is worth. We would be better off insisting parents take an active interest in what their young ones are doing on the Internet (and elsewhere)!

More next week.

David.

1 comment:

Anonymous said...

David, thanks for putting up the issue of stigmatisation in small communities. Although some may have missed it in the past, it has been an issue on the 'concerns' list with regard to holus-bolus record access in the analysis of the privacy community for many years now.

I can't recall specifically which NEHTA submission included it, but I know it has been on my list of issues for quite a long time. However, if those submissions are never aired [as you've suggested in later posts], it's hard to know what the consumer sector objections/concerns are.

Sorry again for the late comment, but I just found your blog today!

Jan Whitaker
Australian Privacy Foundation