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, February 08, 2009

Useful and Interesting Health IT Links from the Last Week – 08/02/2009.

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

First we have:

Flying docs pilot first national e-health database

Regional sites united after 80 years

Darren Pauli 03/02/2009 20:40:00

The Royal Flying Doctor Service (RFDS) is deploying what may be the first national e-health records management system to unify disparate medical databases across its four regional sites.

The RFDS was established in 1928 as the Area Medical Service and provides not-for-profit aero-medical and primary healthcare to regional and remote Australia. It consists of four independent divisions, with 25 sites and 776 staff, and services all but the upper region of the Northern Territory.

Speaking at an e-health summit in Sydney today, RFDS national and sectional ICT manager Gary Oldman said the $2.9 million government-funded e-health records system will replace siloed databases and manual processes throughout the organisation.

“Electronic records are being deployed to other regions [following] the success of the first roll out in our South East [division],” Oldman said, adding it will be the first time the RFDS sites have cooperated in 80 years.

“[Other regions] have separate databases in their laptops without central storage… There are problems with remote access and retrieving patient data after-hours.

“We want to end-up with a single national medical identifier, but [RFDS] is split into legally separate entities. We will use separate identifiers for now.”

The national deployment, dubbed E-Health for Remote Australia (EHRA), will mirror the initial e-health system deployment which centralised nine isolated databases.

It is expected that the Medical Doctor content management database will be installed on all RFDS laptops to facilitate central storage of medical data using Telstra’s Next G mobile network. A replication feature allows data uploads to be delayed during coverage black spots in remote areas.

Oldman said the transition to EHRA will be a “huge challenge” for some RFDS sites, but is confident of meeting the February 2010 completion date thanks to the recruitment of a dedicated project manager, extensive system testing and scheduled staff training.

More here:

http://www.computerworld.com.au/article/275281/flying_docs_pilot_first_national_e-health_database?eid=-255

The amazing thing about all this is just how long it has taken and is planned to take to get a shared Medical Director (I assume) database operational on a wider scale – given the software already does this in large group practices.

As can be see the announcement of this project was made in 2007

Rural health wins $23 million in broadband subsidies

Round two of Clever Network initiatives announced

Darren Pauli 31/08/2007 10:27:11

.....

The Royal Flying Doctor Service will receive a new $2.7 million e-health medical record system to improve its health care service for its 750,000 remote patients across New South Wales, South Australia, Queensland and Western Australia.

.....

More here:

http://www.computerworld.com.au/article/192192/rural_health_wins_23_million_broadband_subsidies

I look forward to the evaluation of the system. I wonder does an evaluation report of the first phase of this exist or has it just been suppressed as seems usual!

Second we have:

ACS, AIIA disappointed at Rudd stimulus package

IT industry representative bodies welcome the overall economic stimulus package but express frustration at the lack of big ICT infrastructure spending

Trevor Clarke (ARN) 04/02/2009 14:30:00

Australian ICT industry representative bodies have panned the exclusion of ICT infrastructure spending from the Rudd Government’s economic stimulus package. In response to the grim global economic climate and bleak forecasts of the International Monetary Fund (IMF), the Rudd Government unveiled a far-reaching $42 billion stimulus package that included, among other incentives, a 30 per cent tax break for small businesses on items worth more than $1000 purchased before June 30.

Australian Information Industry Association CEO, Ian Birks, said while the package would bring a welcome boost to technology spending by organisations, it failed to look at the big picture for ICT.

“I think we would say the package has insufficient focus on the digital economy, on new technologies, and really feels like the Government may be missing the point somewhat about the transformational impact ICT can have,” Birks said.

More here:

http://www.computerworld.com.au/article/275410/acs_aiia_disappointed_rudd_stimulus_package?eid=-255

Looks like the Health Sector are not the only ones feeling left out. I have to say that comparison with the Obama package in the US, with a real emphasis on both low and high tech infrastructure, does not fill me with any joy about what we are seeing here. There could have been a good deal more of the package devoted to infrastructure with real returns – which I find hard to see is being optimised by building assembly halls! I guess we will all see!

At the very least – as suggested by Brian Toohey – the cuts to the CSIRO, ABS and the Bureau of Meteorology should be reversed. Trivial and important, and hardly large in the context of $42 Billion! You can be sure that would save some jobs.

Third we have:

HealthSmart gets new head

Suzanne Tindal, ZDNet.com.au

03 February 2009 05:36 PM

The Victorian Department of Human Services has appointed a new CIO of health services who will also lead up the state's HealthSmart electronic health initiative.

Dr Andrew Howard, not the same Andrew Howard who holds the CIO position for the whole department and had previously been acting National E-Health Transition Authority CEO, will start next week.

A spokesperson for the Department of Human Services was sure there would be ample confusion caused by the two like-named CIOs.

The incoming CIO's role will include taking responsibility of HealthSmart, filling the shoes of Fiona Wilson who left last September.

More here:

http://www.zdnet.com.au/news/software/soa/HealthSmart-gets-new-head/0,130061733,339294729,00.htm

We can all wish Dr Howard luck and hope some of the more ‘problematic’ aspects of the project can now be addressed successfully. The Victorian Hospital system really needs this to work and deliver the benefits we all know can be achieved.

Fourth we have:

Training lags for nurses

5-Feb-2009

COMPUTERS Practice nurses must be trained to use clinical software to keep medical records accurate and up to date. By Mr Noel Stewart

THE rapid increase in the number of nurses employed in general practice has created a few problems in information management.

The major problems have been caused by a lack of a suitable orientation and training in practice information systems.

There have been cases where a new practice nurse has been told to prepare a GP management plan and health assessment. Just imagine the difficulty for a new nurse, who may have previously worked in the emergency department of a hospital. He or she is confronted by a strange world of item numbers, unfamiliar clinical soft ware and a group of GPs who are so time-poor they have no time to supply training.

The result of this lack of training in the practice computer systems is poor clinical practices. Examples include:

* Measurements such as BP, height/weight and family/ social histories entered directly into health assess ments or care plans where they are ‘buried’ and not part of the clinical record.

* The same measurements entered directly into the progress notes with the same result.

* Reasons for contact or diagnoses not coded correctly.

More here (for those with access):

http://www.australiandoctor.com.au/articles/af/0c05caaf.asp

The point Mr Stewart makes is actually a more general one in my view. In all clinical situations the use of computers should be supported by appropriate educational support for both new and old users. One day we will have a court case where someone will be blamed for permitting the untrained to use a clinical computer system and causing clinical harm

Fifth we have:

Debate over GP clinical software ads intensifies

Elizabeth McIntosh - Friday, 6 February 2009

THE company that created Medical Director, the most widely used patient management and prescribing software, has rejected calls to strip pharmaceutical advertising from its products, claiming such a move would result in GPs paying more for the software.

In a submission to the Medicines Australia Code of Conduct Review, the AMA called for an end to advertising in prescribing software.

“The AMA is opposed to the use of [this] material in prescribing software because of its potential to interfere with the doctor-patient relationship during consultations,” said Associate Professor John Gullotta, chair of the AMA Therapeutics Committee. The RACGP and the National Prescribing Service also called for the removal of such advertisements.

However, John Frost, CEO of Health Communication Network – which produces Medical Director – said targeting this revenue source would raise the price of software.

“Our customers have preferred a cheaper product that contains ads, than more expensive ad-free software,” he said.

More here (for subscribers):

http://www.medicalobserver.com.au/News/0,1734,3945,06200902.aspx

Can I just say your humble blogger thinks advertising in clinical software is an abomination and should be outlawed.

Sixth we have (from the Courier Mail a blog posting:

Another IT chief vacancy at Queensland Health

Craig Johnstone

Tuesday, December 09, 2008 at 11:14am

Regular readers might remember the sudden departure of former cop Paul Summergreene as Chief Information Officer for Queensland Health. I wondered at the time what that meant for the continued stability of what is one of the most crucial divisions of the most politically sensitive of govenment departments. Now someone has passed on an internal email sent around last week from Queensland Health director-general Mick Reid:

Changes to the CIO

I would like to congratulate Dr Richard Ashby on his appointment to the position of Executive Director and Director of Medical Services, Princess Alexandra Hospital.

Dr Ashby has been in the Chief Information Officer role since July this year and will continue in this role to the end of his 6 months secondment on 23rd January 2009.

.....

I would like to take this opportunity to congratulate Richard on his appointment and sincerely thank him for his time and contribution to Information Division and the valuable knowledge transfer that he has provided to the Senior Staff of the Division.

Michael Reid

Director-General

How goes the department’s E-health policy?

All the comments follow this head posting:

http://blogs.news.com.au/couriermail/pineapplepolitics/index.php/couriermail/comments/another_it_chief_vacancy_at_queensland_health/

The comments are well worth a browse..seems there are some insiders contributing! It does not sound good I must say – but, as always, it may be that the happy campers are not contributing.

Last a slightly more technical article:

Skype 4.0 adds better video, Linux update unclear

Linux release is still under development

Rodney Gedda 03/02/2009 16:27:00

Internet telephony software company Skype is pushing ahead with videoconferencing in a bigger way with the release of version 4.0 for Windows, but the company is yet to standardise its releases for Linux and Mac OS X.

Previous versions of Skype did include videoconferencing, but the latest release integrates “one touch” video calls into the application and sports new codecs to improve sound and video quality.

Skype's Asia Pacific vice president and general manager Dan Neary said 4.0 is not an “incremental” upgrade, but the most significant release of the product since it started.

“We have incorporated feedback from users and designed wizards for microphones and Web cams to make it truly plug-and-play,” Neary said.

“Video is becoming increasingly important for communication and with 4.0 it is easy to launch a Skype call with video on one click.”

In addition, there is now more screen real estate dedicated to video and a full-screen mode.

Skype spent three years developing its new audio codec for version 4.0, which Neary said is better quality, more efficient and requires less processing power than the codec shipped with previous versions.

More here:

http://www.computerworld.com.au/article/275270/skype_4_0_adds_better_video_linux_update_unclear?eid=-255

This is good news – with Skype being progressively enhanced and refined. If you have a broadband connection Skype can provide essentially free video-conferencing and contact with friends interstate and overseas. Well worth exploring if you are not already a user.

More next week.

David.

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