Again, in the last week, I have come across a few news items which are worth passing on.
First we have:
Practices face $50,000 loss under PIP changes
Elizabeth McIntosh - Friday, 27 March 2009
PRACTICES could fall victim to bureaucratic mismanagement and risk losing future payments of up to $50,000 per year under new requirements for a key Practice Incentive Payment (PIP).
New guidelines for the PIP for e-health released last week by the Department of Health and Ageing revealed practices must have a secure messaging service provided by an “eligible supplier” if they are to continue to qualify for as much as $12,500 in quarterly payments.
However, the Government has not delivered a list of eligible suppliers, which last week sparked widespread anxiety among GPs and a flurry of phone calls to software vendors.
The National E-Health Transition Authority (NEHTA) is responsible for compiling the list, and to be included, software vendors must agree to take part in negotiations with the authority to develop secure messaging service standards.
Secure messaging services are used to send and receive pathology and specialist reports.
While the standards are under development, the Health Department has agreed practices can continue to qualify for the payment by producing a “letter of commitment” from their software vendor stating its intent to take part in the process.
More here:
Seems the specialist clinical press is getting to understand just what a mess a rather disorganised DoHA have kicked off! Talk about not being able to organise a ‘p...-up in a brewery’!
Second we have:
Keeping it simple
25-Mar-2009 
COMPUTERS: New software helps keep clinical records accurate and up-to-date. By Noel Stewart
A NEW software program, written by Melbourne GP Dr Anton Knieriemen, has a pop-up at the bottom of the clinical software screen to alert GPs to preventive care items that need to be addressed.
The program, called the Doctor’s Control Panel, has colour-coded ‘tablets’ that alert you if nothing is recorded (red), it needs updating (orange) or is up-to-date (green) for the clinical, medication, measurement and required tests of preventive care in each patient file.
These items are also linked to the relevant section of the RACGP Red Book.
There is a version of the program for Medical Director that links to Pracsoft so item number use is monitored.
Dr Knieriemen says if GPs like the program they can buy it by making a donation to UNICEF or a charity of choice.
Dr Knieriemen is passion ate about preventive care and change principles. He began writing the control panel software in April 2008 because of the limitations of preventive care prompts in the clinical soft ware used by GPs. The presentation of the prompts reflects in the way he practises medicine. So far, more than 500 GPs have taken on the program.
Dr Knieriemen says most GPs want an uncomplicated software program. The design of the Doctor’s Control Panel is guided by this notion. The interface simply requires a left click on a ‘tablet’ to see what needs to be done and why. The colour coding allows the GP to instantly see if there are gaps in the clinical recording and immediately do something about it.
A right click on the relevant clinical guidelines, including the Red Book and the Immunisation Handbook, provides access via the Internet and take a few seconds to appear on the screen.
Improvements in the clinical record can be made quickly in three areas:
• Prompting to record measurements electronically and accurately.
• Improved compliance with clinical guidelines.
• Improved billing and workflow.
More here (if you have access):
http://www.australiandoctor.com.au/articles/4c/0c05f54c.asp
Anything that can improve guideline compliance and data quality in GP has to be a good thing I believe. Well done Dr Knieriemen!
Third we have:
Medicare Easyclaim off the critical list
26 March 2009 6:55am
When the Medicare Easyclaim system was introduced in 2006 it was set a target of handling 60 per cent of payments at doctors’ surgeries by June 2008. It got to one per cent.
Minister of Human Services Joe Ludwig said yesterday that the system involved too much duplication and manual keying to be useful
Ludwig said: “Easyclaim has copped a flogging and it’s mostly justified. When we came to office take-up had flatlined.”
More here:
http://www.thesheet.com/nl05_news_selected.php?act=2&stream=1&selkey=8052&hlc=2&hlw=
Really this in one of the most inglorious episodes in e-Health in Australia. If you are going to introduce technology to busy and already quite efficient practices you really need to get the workflow and usability issues right. They didn’t and that was the consequence.
I think a fundamental rethink – not a community awareness campaign – is what is needed here!
Fourth we have:
iSOFT wins two new projects in Latin America
26 Mar 2009
Sydney – Thursday, 26 March – IBA Health Group Limited (ASX: IBA) – Australia's largest listed health information technology company today announced an important step in its strategy for growth in Latin America with a fourth contract for iSOFT in Mexico and its first in Honduras.
In a contract with the Honduras government, iSOFT will develop and implement a system that will provide a central register of information for government departments to manage health services and improve preventative measures.
iSOFT is working with a consortium of three local companies, Techassist, Lain Entralgo and ASI Consulting, to complete the project within nine months. The contract includes support and maintenance for an additional 12 months. The deal is part of a development project by the United Nations, which is providing additional funding.
More here:
http://www.ibahealth.com/html/isoft_wins_two_new_projects_in_latin_america.cfm
They seem to be popping up everywhere. Good to see some work in the really just developing world! (Usual disclaimer about having a few shares in IBA)
Fifth we have:
New e-health tool take-up by Australian hospitals
by Peter Dinham
Tuesday, 24 March 2009
Milliman Care Guidelines, a US provider of e-health tools for hospitals and health systems, is introducing its web-based and interactive clinical care guidelines into Australian hospitals.
Milliman says the hand-held and interactive device has proven very successful in the United States and in limited Australian trials in reducing important factors such as the length of patient stay.
The CareWebIQ software is designed to offer clinicians easy access to evidence-based best practice guidelines, real-time clinical data and real-time management reporting, and Milliman says a number of Australian hospital operators are already using the software with some ‘significant results’
More here:
http://www.itwire.com/content/view/24024/598/
Interesting this report gets the name of the product a little wrong. It is CareWebQI not IQ.
The site for the product mentioned is here:
http://www.careguidelines.com/software/carewebqi.shtml
I must say that the product description makes it seem very US centric. It will be interesting to see how it goes here:
Sixth we have:
$12M Vic virtual care unit opens
City docs train regional colleagues over video
Darren Pauli 23/03/2009 15:26:00
The $12 million Virtual Trauma and Critical Care Unit (VTCCu) has today officially opened and will connect some 260 regional Victorians a year to superior metropolitan medical services.
Melbourne clinicians monitor patient vital signs, clinical test results and x-rays through a live bedside video conferencing screen, and provide further medical advice and patient referrals.
The project builds on an existing telephone link between doctors in Melbourne and Bendigo to those in regional areas, and has been a some operational capacity since late last year in areas including Mildura.
It is funded by the federal government's Clever Networks Initiative, Multimedia Victoria, participating hospitals, and a consortium of suppliers including Telstra, Cerner Corporation and KPMG.
Bendigo Health director of emergency Dr Salomon Zalstein said the project saves time by linking into the state's Adult Retrieval Service which coordinates availability for critically ill patients.
“Anything that results in improved care and treatment for patients is always very welcomed,” Zalstein said in a statement.
More here:
http://www.computerworld.com.au/article/296455/12m_vic_virtual_care_unit_opens
This is clearly a useful step forward. A lot more is found here as well.
http://www.australianit.news.com.au/story/0,24897,25231164-15306,00.html?referrer=email
Broadband brings medical specialists to the bush
Andrew Colley | March 24, 2009
IF you're ever a patient in a regional hospital and facing a tricky medical dilemma it's becoming increasingly likely your doctor will be beamed to your bedside by high-speed broadband.
The federal Government has endorsed a telemedicine trial by Victorian health authorities, using videoconferencing technology that has already been used successfully in NSW.
Seventh we have:
Bleak outlook hits bionic eye research
Andrew Colley | March 24, 2009
EFFORTS to get Australia into the race to develop a bionic eye have stalled, while a cyber-eye consortium waits for the federal Government to respond to a request for about $40 million in funding.
Funding for the research project, enthusiastically endorsed by Prime Minister Kevin Rudd at the 2020 Summit held in April last year, had dried up, slowing research efforts, project research director Professor Tony Burkitt said.
"We just don't have the resources to do it at the level we would really like to," Professor Burkitt said.
"We do have the activity being supported mainly through the Bionic Ear Institute and National ICT Australia that enables research to proceed, even though it's at a very reduced level," he said.
NICTA and the BEI are part of the bionic eye consortium, known as Bionic Vision Australia, alongside the Centre for Eye Research Australia, the University of Melbourne and the University of NSW.
More here:
http://www.australianit.news.com.au/story/0,24897,25231335-15306,00.html
I guess the CGF is changing the game in all sorts of unexpected ways. Very sad.
Lastly a very serious article:
Patients' medical records leaked online by pathology lab Sullivan Nicolaides
The Courier-Mail
March 28, 2009 12:00am
- Pathology lab published patient's details
- Names, numbers and more available online
- Lab blames it on processing error
AN alarming privacy breach by one of Queensland's biggest pathology labs has released patient medical histories on the internet.
The names, contact numbers and private details of at least 100 patients, and potentially hundreds more, were plastered on the website of Brisbane-based Sullivan Nicolaides.
The breach has cast serious doubt on the safety of electronic patient record systems, and angry patients were last night demanding answers.
The Courier-Mail yesterday viewed 102 patients' details before it alerted the lab to the security breach, which has been blamed on a processing error.
Much more here:
http://www.news.com.au/technology/story/0,28348,25253036-5014239,00.html
A few points. One it is clear Sullivan Nicolaides should have been more careful with patient data. That is obvious and I hope they have carefully reviewed policies and practices to make a repeat very, very unlikely. Mistakes can happen but they must not be repeated! Second it is clear the Courier Mail (CM) behaved very badly. Having discovered they could view records they should have stopped and notified the problem to Sullivan Nicolaides. But no, the hyperventilating, and very tabloid, CM tries to maximise concern and unhappiness. Hardly decent or helpful. Third this sort of leak – and the CM behaviour – should be a lesson to all information custodians as it hurts the prospects of e-Health into the future and can certainly cause significant organisation pain, if not cost.
More next week.
David.
2 comments:
Minister Joe Ludwig goes to the top of the class. Why? Because he had the nous to understand the system as it stood was stuffed and the techos had failed to deliver a system that its customers would use and benefit from doing so.
That Medicare should have persisted trying to drive such an inadequate system into the market is of real concern for ehealth in all its dimensions. Why can’t the techos understand what needs to be done to make a system swing sweetly in the breeze eliciting plaudits from all and sundry who are beholden to using it day in and day out?
It is reasonable to conclude that Minister Ludwig asked the same question. He got a crap answer and he took some basic common sense action to have the problem addressed. He can’t himself fix the problem - he can only make sure that someone does and he can also make sure that until it is proven to be fixed he doesn’t let a half-baked inadequately tested system get rolled out nationally. That's leadership.
Nous is all it takes, so go to the top of the class Joe Ludwig and stay there. Well done Minister.
Why couldn’t Medicare Australia use HICAPS or THELMA? Some modifications might be required but hey - surely that’s not too big a job, is it?
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