Again, in the last week, I have come across a few news items which are worth passing on.
First we have:
E-health projects sick without govt aid
But experts say electronic records on track in NSW, VIC.
Darren Pauli 12/02/2009 14:31:00
Health professionals have slammed Australian governments for a lacklustre investment in e-health, claiming the nation has slipped behind many countries in the field because of weak funding and unresponsive departments.
Experts said a $218 million national fund allocation to the National E-Health Transition Authority (NEHTA) over three years to June 2012 should be increased to bolster what they say is an ailing e-health industry. The grants will be used for the SNOMED Clinical Terminology project, a national e-health identification system for individuals and providers, and to develop a user-authentication scheme for the health care sector.
Speaking at an e-health summit in Sydney last week, University of NSW Professor Branko Cellar said government health departments have ignored workable e-health technologies in favour of existing solutions to mitigate risk and accountability.
“A recent premier came to visit and was impressed by [telehealth] technology but even though [he] may want it, no one in the health department was incentivised to take it on because their seats are more carefully retained if they do more of the same — they see disruptive technology as too risky,” Cellar said.
“Australia was a world leader but now we need to start catching up with the rest of the world… There is no policy for [telehealth] in Australia and the government has never ran a clear trial of the technology.”
Cellar, a long term advocate of remote care and head of the Biomedical Systems Laboratory at the university, said the potential for telehealth to reduce time spent in areas like chronic disease management, which itself occupies more than 75 percent of clinicians time, is “manna from heaven”.
More here:
http://www.computerworld.com.au/article/276474/e-health_projects_sick_without_govt_aid?eid=-6787
These paragraphs especially caught my eye.
“Ascribe Asia Pacific chief executive Bryn Evans took a different perspective and played down concerns over Australia’s e-health policy and direction.
He told Computerworld Australia has solid investments in e-health, found in NSW Health’s electronic Medical Record (eMR) and Victoria’s HealthSmart projects, but conceded the industry needs more government funding.
“The two largest states in Australia, NSW Health with its eMR Project and Victoria with its HealthSmart Program, are absolutely doing the right thing, and are developing and implementing a standard electronic medical record on a state-wide basis. It will mean that wherever a patient is treated in the state, their patient details, medical history, test results, treatment notes etc will be fully up to date and instantly available to any clinician attending to that patient,” Evans said.”
I wonder does Mr Evans know something the rest of us don’t to be sure NSW and Victoria are going so well. Sure there have been some successes but it has taken over 10 years in NSW to get to even this stage of partial implementation. Hardly impressive in my view. He is certainly right that this work is underfunded. I would also contend it has been badly managed - as Mr Garling pointed out – along with many other aspects of NSW Health.
I am sure Prof Cellar would be happy about this!
http://www.cabinet.qld.gov.au/mms/StatementDisplaySingle.aspx?id=62555
Minister for Health
The Honourable Stephen Robertson
Wednesday, February 04, 2009
Telehealth project boosts home-based care for Ipswich patients
Ipswich patients are benefiting from specialist appointments and consultations in their own homes under a new Telehealth program launched today by Health Minister Stephen Robertson.
Mr Robertson launched the Tunstall Telehealth Lifestyle Coordination (TLC) Project with State Member for Ipswich West Wayne Wendt and State Member for Ipswich Rachel Nolan.
“World-wide environmental factors, including an ageing population and staff shortages, are placing enormous pressure on health systems to deliver more for less,” Mr Robertson said.
“This project shows how health service providers and the community are using innovative approaches to rise to these challenges.
“The Tunstall TLC Project is a home monitoring Telehealth system which allows the patient to capture their vital signs and have the data monitored by the appropriate specialist.
“The benefit of Telehealth services lies in removing physical and social distances between health professionals and patients without affecting the quality of care provided.”
Second we have:
ID demand: Centrelink apology
Sid Maher | February 13, 2009
CENTRELINK will be forced to apologise to more than 1500 Victorian bushfire and north Queensland flood victims after letters demanding they provide identification were automatically mailed out by computer.
Kevin Rudd on Wednesday promised Victorian bushfire victims they would receive emergency Centrelink payments even if they had lost all their identification in the inferno.
But it was discovered yesterday that some victims of the Victorian bushfires and the north Queensland floods who had obtained payments had been sent a letter demanding proof of identity as part of an automatic letter dispatch generated by a computer.
Human Services Minister Joe Ludwig yesterday ordered the letters to be halted and Centrelink to individually apologise to bushfire victims who had received the letters and tell them to disregard its demand for proof of identity.
There were 1778 letters printed for the fire and flood victims, but 239 of these generated yesterday were stopped. However, 648 were sent out on Monday, 551 were sent on Tuesday and a further 340 were sent on Wednesday.
Senator Ludwig described the sending out of the letter as "highly insensitive" and said "it should not have been done".
He urged victims to "throw this letter in the bin when they receive it".
More here:
http://www.australianit.news.com.au/story/0,24897,25048433-15306,00.html
This sort of disaster reminds us just how important it will be to plan properly for disaster with systems like the NEHTA Health Identifier – to make sure individuals information is accessible when it may be most needed. (Hurricane Katrina and the response provide some useful lessons on what can be done.)
See here:
http://govhealthit.com/Articles/2005/09/Leavitt-Katrina-demonstrates-need-for-ehealth-records.aspx
and here:
http://www.okjolt.org/pdf/2007okjoltrev38.pdf
and here:
http://www.computerworld.com/action/article.do?command=viewArticleBasic&articleId=9063839
“Mayer said in October, when Google first began laying out its plan for online records, that the company became interested in entering the personal health records (PHR) business when Hurricane Katrina hit the Gulf Coast and countless paper-based medical records were lost in the aftermath of the storm.”
Third we have:
http://www.nehta.gov.au/nehta-news/474-release-ensures-patients-get-exactly-what-the-doctor-ordered
Release ensures patients get exactly what the doctor ordered
February 9, 2009. The National E-Health Transition Authority (NEHTA) has released documentation and reference sets for dosage terminology which will underpin a future electronic prescribing service.
Electronic prescribing will ensure patients receive a prescribed medicine in the right dose, at the right time, on each occasion they fill a prescription.
“Handwritten prescriptions can be misinterpreted and patients’ safety can be put at risk if abbreviations or dosage instructions are not clearly understood by a nurse or pharmacist. Dosage Terminology will ensure consistency in understanding the dosage term,” said Peter Fleming, NEHTA Chief Executive.
In the future, prescriptions will be sent electronically, removing the need for the pharmacist to interpret difficult to read handwriting or confusing abbreviations. The prescription data will also be incorporated with SNOMED CT, the internationally pre-eminent clinical terminology that has been identified by NEHTA as the preferred terminology for Australia.
The document for release details NEHTA’s approach to dosage terminology. The Dosage Approach document also describes the Dosage Terminology reference sets and the guiding principles used in the creation and development of the Dosage Reference Sets.
More here:
This is good news – as it seems we are slowly getting some progress in this area. Pity it has taken so long!
Fourth we have:
Patient safety compromised by severe IT outages
10 February 2009 03:00PM
A third of healthcare and IT professionals say patient safety was compromised by a severe outage of administration or clinical systems in the past year, a survey found.
The survey of 83 professionals at the Health Informatics Conference in Melbourne also found the average length of a severe outage was 4.1 hours, although most lasted less than an hour.
Most of those surveyed reported performance issues, including lack of availability, on the day their organisations deployed their most recent healthcare application.
iSoft/IBA was the most common healthcare information system deployed by respondents.
"Healthcare information systems are expected to play a central role in improving healthcare outcomes and reducing costs, yet many Australian healthcare organisations lack the basic tools to ensure their major IT applications can be relied upon to deliver 24 hours a day, 365 days a year," said Craig Little, vice-president of sales operations for APJ at Compuware.
More here:
http://www.itnews.com.au/News/96032,patient-safety-compromised-by-severe-it-outages.aspx
While you can be sure the commissioners of the survey are trying to see something – like continuity services – the message is a reasonable one. I have to say, however, the degree and timing of outages is hardly surprise. I am pretty sure most new deployments cause some disruption till they are bedded down!
Fifth we have:
Parkinson's suffers embracing Wii
Danny Rose, Medical Writer
February 11, 2009 - 7:59AM
Parkinson's disease sufferers who play computer games have "fun", says an Australian professor who now wants to see whether they can also improve how sure they are on their feet.
A group of seven older people with and without the degenerative condition took part in a NSW pilot project, and they were put through an almost daily regime of playing the Nintendo Wii.
The home entertainment device is controlled through arm movements, while a Wii Fit "board" was also added requiring the seated users to interact with on-screen objects using their feet.
Southern Cross University Associate Professor Rick van der Zwan said the initial findings were positive, as it showed the older people were prepared to embrace an unfamiliar technology.
"Lots of older people when you talk to them about computer games they think about shooting up spaceships ... they're not so interested," Dr van der Zwan says.
More here:
http://news.smh.com.au/breaking-news-national/parkinsons-suffers-embracing-wii-20090211-83t9.html
Good to see the Nintendo is really making a difference!
Sixth we have:
Thieves take doctor's laptop and research
10.02.2009
by Simon Wood
A Wanganui surgeon is willing to post a $500 reward for the return of his laptop computer, which contains vital patient data he has been accumulating over recent months.
Alan Hearn is a general surgeon at Wanganui Hospital, and he and his family are renting a home in Longbeach Dr, Castecliff.
At some time during the night of February 5-6, their home was burgled and Mr Hearn's black Toshiba laptop and a red Western digital external hard drive were stolen.
"I know it's a long shot, but the computer is a bit distinctive. It's a high-gloss black with no silver markings and has Harman Kardon speakers built in," he said.
Also missing is a UK power lead.
Sadly, not all that data was backed up, and that means if Mr Hearn doesn't get the laptop back, a study he planned to publish will come to nothing and he will have to start again.
Mr Hearn specialises in colo-rectal surgery, and his study focused on patients he had been dealing with.
It looked at whether or not pre-operative radiotherapy before bowel cancer surgery was benefiting them in the long term.
"There's a lot of stuff on the laptop, including some family photos as well as that patient data.
"But if I don't get it back, I've lost all that data on local patients.
"It means we can't publish those outcomes."
"The back-up I had was a portable hard drive, and that was on the desk. That went as well," he said.
More here:
Oh dear, oh dear. At the very least it makes one keen to have an offsite backup of critical data. Keeping the portable hard disk backup separate from the laptop – and preferably hidden – would make good sense – after the event!
Last a slightly more technical article:
Debate IT: What role can technology play in times of natural disasters?
Can technology be more effectively utilised to help prevent loss during times of extreme circumstances like bushfires and floods.
Computerworld Staff 13/02/2009 14:40:00
Australia's emergency communication systems have been called into question following the devastating bushfires that tore through much of Victoria last week, killing at least 181 people.
Thousands of Victorian customers were cut-off from telephone and Internet services after the blazes melted tens of millions of dollars worth of Telstra telecommunication infrastructure.
The telco lost some 2800 fixed phone lines, 2100 ADSL Internet connections and 47 ISDN phone lines, while eight Next G network and six GSM mobile towers were knocked offline.
Red Cross State Inquiry Centres were overrun by distressed callers seeking information on friends and family, prompting one outsourcer to donate a 40-seat call centre to handle overflow.
Firefighters have laid some blame on stalled upgrades to the nation's emergency communications system, which they say has remained dormant for years.
On the back of pledges to improve national emergency communications by Australia's political leaders, including PM Kevin Rudd, Computerworld asks its readers, what role should technology play to avert future natural disasters? What are some of the ideas brewing in your mind that could come in handy during a natural disaster and which can help save lives, wildlife and property?
More here:
In the context of the fires in Victoria and floods in Qld this seems like a useful discussion. Follow on the site. Condolences to all who have suffered in this awful period.
More next week.
David.
Professor Cellar says in regards to Telehealth that "the government has never ran a clear trial of the technology".
ReplyDeleteI guess the DICITA funded trail of Telehealth in Tasmania started in 1996 does not count. Was that because it wasn't based in NSW or Victoria, or because it wasn't run by acedemics?
It's hard not to be cynical when you see good work like the Tasmanian trial ignored in such an off-hand manner such as that.