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

Sunday, March 01, 2009

Useful and Interesting Health IT Links from the Last Week – 01/03/2009.

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

First we have:

NSW a silent success in e-health

NSW is leading the country in e-health with both doctors and patients benefiting from new technology, but why wont Health Minister John Della Bosca tell us about it, writes Bryn Evans.

Bryn Evans 25/02/2009 10:38:00

When will some really good health news get some coverage? While the media has recently been fixated by the world financial crisis, political backstabbing, or the misdeeds of the latest rogue doctor, real progress has occurred in NSW e-health that will bring far-reaching benefits to everyone in the state.

On 1 October last year, St George Hospital implemented an electronic medical record system (eMR) for some 2300 clinicians across its emergency department, all wards including pathology and radiology, nine operating theatres and more than 300 outpatients clinics, and allows electronic discharge forms to be sent to general practitioners. The project has been hugely successful, and is the start of a state-wide program by NSW Health to introduce the eMR to every hospital in the state.

The eMR system was first deployed at the St George Hospital in the South Eastern Sydney & Illawarra Area Health Service (SESIAHS), followed by Calvary and Sutherland hospitals, and will be rolled-out to each hospital in the Area Health Service for some 1.3 million people.

All hospitals in the Illawarra region will go live in the next two months, followed by the Northern Coast Area Health Service which is in the middle of its eMR roll out.

In time eMR will spread state-wide.

Some Area Health Services with earlier, less comprehensive eMRs, are planning upgrades.

So why does NSW Health Minister John Della Bosca not tell us about it?

The eMR rollouts mean that patients treated in SESIAHS will have their patient details, medical history, test results and treatment notes updated and instantly available to any clinician attending to them.

No more tedious and inefficient questions such as “Which hospital and doctor did you last see?”, “What did your last test results state?”, “What medication are you on?”, or “Do you have your ultrasound scan with you?” that drive every patient to distraction.

More here:

http://www.computerworld.com.au/article/277923/nsw_silent_success_e-health?eid=-6787

I wonder what this means. Does it mean that the Cerner clinical implementations are going well in NSW and all is OK in NSW Hospitals or is something more limited – like implementation of an Emergency Room System – of the sort sold by Mr Evan’s company – going well. It sounds like the former and if that is indeed the case it is very good news indeed.

It is odd that the Garling Enquiry of just 2 and a half months ago did not point out these reported successes. It seems things are still a little patchy or that very, very rapid progress has been made – I wonder which it is?

I certainly agree that if major success has been achieved there should be substantial publicity of same!

Second we have:

Hospital staff can't wear contamination suits forever: union

The Health Services Union says it is unacceptable to expect staff to wear full contamination suits for months on end, while a mould problem is addressed at Newcastle's John Hunter Hospital.

The Industrial Relations Commission yesterday held another hearing, after staff in the clinical information centre complained that mouldy medical records were making them sick.

The union's Bob Hull says it will take several months to get rid of the mould and it is crucial staff are moved quickly to an empty space that is available in the hospital.

He says staff are going to extreme lengths to protect themselves.

"Part of that process includes staff wearing protective equipment and they include operation theatre scrubs, gloves and or masks and or respirators ... they look like people from outer space," he said.

Hunter Health's director of acute operations, Michael Di Rienzo, says a remediation plan has been finalised and contingencies are in place to protect staff.

More here:

http://www.abc.net.au/news/stories/2009/02/23/2498453.htm

This is a great story about the danger of paper records...you can get problems with your lungs from the mould they accumulate. I would never of thought of that reason to go to electronic health records!

Third we have:

Videoconferencing to slash govt airfare bill

Mitchell Bingemann | February 27, 2009

THE federal Government will deploy Cisco videoconferencing systems across 20 government sites in an effort to drastically reduce its $280 million domestic airfare bill.

The contract, which will run for four years at a cost of $13.8 million, will be managed by Telstra and will run on its Next IP network.

Mr Tanner said the deployment will help the Government reduce the cost of travel, improve productivity and lower the impact of carbon emissions.

It is unclear how much the Government will save with the Cisco TelePresence system but Finance Minister Lindsay Tanner has in the past indicated that he wants to slash at least $15 million from the bill.

“From a finance minister point of view the most important issue is saving money. We currently spend about $280 million a year on domestic airfares across government,” Mr Tanner said.

“The savings we make on airfares alone will pay for this system.”

Mr Tanner is also hoping the roll-out will help retain staff.

More here:

http://www.australianit.news.com.au/story/0,24897,25114178-15306,00.html

Seems this could form a useful pilot for some other teleconferencing initiatives – including maybe some tele-health projects. We can hope there might be a dollar or two left in the budget from the savings!

Fourth we have:

No complaints: Queensland Health can't handle them

Daniel Hurst | February 27, 2009 - 5:11AM

Queensland Health employees are finding a computer system designed to log complaints about poor patient care in public hospitals too difficult to use.

An external review into clinical incident reports at Bundaberg Hospital, released yesterday, has identified significant problems with the PRIME incident reporting system used in public hospitals.

The system allows doctors, nurses and other staff to raise the alarm over clinical incidents and "near misses". Hospital managers can provide comments and record the results of their investigations and actions in a central database.

In his review, Prince Charles Hospital's executive director of medical services, Stephen Ayre, noted the system was plagued by problems since its introduction at Bundaberg Hospital in 2005.

Staff members making complaints in the early days were frequently logged out of the system in the middle of recording a new incident, the report said.

"This has led to a perception that the system is problematic, difficult and clunky," Dr Ayre wrote.

"Staff have had difficulty in saving incomplete reports and cannot follow progress of their own incident report in the system."

More here:

http://www.brisbanetimes.com.au/news/queensland/complaints-system-too-difficult/2009/02/26/1235237823135.html

Oh dear, oh dear. It seems that the next report may have more than a grain of truth to it!

Fifth we have:

Irate IT staff a bitter pill for QLD Health

Department says IT in top health while employees gripe on management, policy

Darren Pauli 23/02/2009 08:38:00

Queensland Health (QH) became a target for an outburst of mudslinging when people either close to, or inside the organisation, dished the dirt on its IT department and revolving door CIOs.

Heated criticism claiming the department is in disarray and lacks leadership erupted following an innocuous e-mail leaked on a Courier Mail blog that cited the appointment of Ray Brown as interim CIO in early December. Brown, who was previously QH’s information division executive director, replaced acting CIO Dr Richard Ashby in late January, and is now the department’s CIO 4.0 in just two years.

A string of failed projects aired on the public record over the last six years has set a shaky history for QH, which includes the axing of its last permanent CIO Paul Summergreene on alleged misconduct charges less than 12 months after he took the job.

Plans to fast-track the adoption of electronic patient records across the state collapsed in 2006, while in 2007 QH's technology partner EDS withdrew from the eHealth Alliance that is designed to buttress a now defunct clinical information systems project.

A QH spokesperson told Computerworld EDS withdrew from the alliance due to a “conflict of interest” arising from its acquisition by Hewlett Packard in August last year. The spokesperson said EDS is providing “some contract resources” to its IT department under arrangements.

After posting the internal e-mail on his Pineapple Politics blog, Craig Johnstone asked: “How goes the department’s E-health policy?” There was no paucity of opinion, with comments running hot and heavy claiming QH's IT department “is currently experiencing its worst period of operation with a distinct lack of leadership”. Other purported staff said employees had a lack of confidence in Dr Ashby.

More here:

http://www.computerworld.com.au/article/277406/irate_it_staff_bitter_pill_qld_health?eid=-255

This all seems to be settling down now..has there been a permanent appointment yet does anyone know?

Last a slightly more political article:

Xenophon speaks out against Internet content filtering

South Australian independent senator raises concerns and says there are better ways to spend the money

Trevor Clarke (ARN) 27/02/2009 13:11:00

Independent South Australian senator, Nick Xenophon, has spoken out against the Government’s Internet content filtering plan saying “there are better ways to deal with the problem”.

Xenophon told ARN he had serious concerns about the ability of the Government’s proposed filter – currently in trial by six ISPs – to block harmful content.

“My concern has always been about online gambling, but it is not access to the content that causes harm, it is the access to your credit card details,” he said.

“From what I have seen so far, I have some serious concerns that it is not going to stop what the Government is hoping. It won’t stop peer-to-peer pedophile networks. There is a strong argument the money could be better spent in tracking down those. I also think parents should supervise computers.”

The national clean feed Internet scheme, part of the government's $128 million Plan for Cyber Safety, will impose national content filtering for all Internet connections and will block Web pages detailed in a blacklist operated by the Australian Communications and Media Authority (ACMA).

The senator was unwilling to say whether or not he would support content filtering if the Government’s trial produced workable results but said he would be monitoring the outcome.

“I think the Government’s intentions are good but I don’t think it will achieve what it was meant to achieve.

More here:

http://www.computerworld.com.au/article/278285/xenophon_speaks_against_internet_content_filtering?fp=16&fpid=1&pf=1

This has the look of announcing the end of this doomed idea with the Opposition, Greens and now Sen. Xenophon suggesting he is less than impressed. Time to move to strategies to protect children that might work while stopping attempting to ‘nanny’ adults.

More detail is provided here:

http://www.smh.com.au/news/technology/biztech/web-censorship-plan-heads-towards-a-dead-end/2009/02/26/1235237810486.html?page=fullpage#contentSwap1

Web censorship plan heads towards a dead end

More next week.

David.

5 comments:

Anonymous said...

One would reasonably expect it to mean the Cerner implementation at that site in NSW has gone well. Although, if that is the case why is the man from Ascribe telling us and not the man from Cerner.

Anonymous said...

As you rightly say “It is odd that the Garling Enquiry of just 2 and a half months ago did not point out these (St George Hospital eMR implementation) reported successes.” It’s more than just ‘odd’, it’s extremely odd indeed.

It is sobering to read the claim once more: “On 1 October last year, St George Hospital implemented an electronic medical record system (eMR) for some 2300 clinicians across its emergency department, all wards including pathology and radiology, nine operating theatres and more than 300 outpatients clinics, and allows electronic discharge forms to be sent to general practitioners.”

Why is it that after spending well over $1 million with Deloitte to deliver national eHealth Strategy, and goodness know how much with Booz & Co, that there is no mention, absolutely NO MENTION, of this grand achievement by Deloitte, or Booz, or even on NEHTA’s web site which I note is promoting one NSW and one QLD system not far removed from the St George Hospital story.

Surely these big consultant firms that were paid so much money were aware of the St George eMR!!!

Anonymous said...

The QLD Health CIO saga's just don't seem to want to go away. With such a turbulent and troubled environment in QLD Health is it within the realms of possibilities that Cerner might be able to sort out QLD Health - based on their experiences as preferred Clinicals s/w supplier for VICs HealthSmart and also for NSW Health !!!

Anonymous said...

Bryn Evan's story is quite humorous. Not taking away from the good work the team has done in SESIAHS, highlighting NSW as a silent sucess in eHealth is absurd. The project discussed is the Cerner implementation in St.George - great stuff but it cost something like $80 million or so and is not the all-singing, all-dancing success Mr Evans claims it to be. Just ask the nurses.

Strange that Mr Evans also failed to note that he was the former CIO of South East Sydney Illawarra Area Health Service until 2006 when he joined Ascribe, and I believe is married to the current CIO, Jean Evans.

Maybe I'm just a sceptic but Mr Evans would know just how disingenuous he's being by claiming "NSW as a silent success".

Considering he wrote this article and the editor just published it, I would suggest the editor and get a more interesting interview from Garling - see if he considers NSW to be a 'silent success', or maybe the State Coroner who's investigated numerous cases of adverse events - see if he thinks NSW is a silent success. Or read the NSW HealtheLink report (which albeit is incredibly sanitised) that stated only between 3% and 5% of all EHR records created were ever accessed again! What a stunning silent success, not!

I agree with you David, that if significant successes are being made, they should be publicised. But not in this way to serve vendor and individual interests.

At the very least, the author should have declared his interest!

Anonymous said...

Well I worked in this program until just recently and I can tell you it is going pretty much OK in implementing Cerner in South East AND North Coast although not with all the functionality some of us would have liked to see but still it’s more than just ED. I'm sure there's happy and unhappy docs and nurses out there and NSW Health are probably more scared of the unhappy ones if they publicise anything. Major factors in the success I reckon now are that various careers are on the line if this falls over (eg CIO), plus also they brought in a guy about 6 months ago who seems to know how to run a big project, plus Cerner want to sell in QLD so also are working hard, so it’s all coming together finally after ? years.