Again, in the last week, I have come across a few news items which are worth passing on.
First we have:
Standards development lags e-health plans
Karen Dearne | April 14, 2009
A HAM-FISTED federal Health Department incentive will result in GPs being paid to use "vapourware" -- essentially something that doesn't exist.
The Practice Incentives Program e-health secure messaging requirement will enable general practices to earn up to $50,000 a year by using approved software that complies with specifications not yet developed.
Doctors will be paid simply on the basis that their software provider "has agreed" to take part in work on standards development led by the National E-Health Transition Authority.
Vendors are not required to comply with existing standards, such as Health Level 7 for electronic messaging of health information adopted by NEHTA more than two years ago.
Over the past 10 years, GPs have received generous subsidies to put computers on their desks and to connect to the internet, but due to a lack of national e-health infrastructure, patient information remains largely locked in local doctors' PCs.
Although the federal Government is trying to hasten work on standards for next-generation web services systems that will in future be adopted by hospitals, the field is still in its infancy worldwide.
The announcement of the revised PIP regime caught most by surprise, and appeared to overlook the fact that Standards Australia's IT-014 committee is responsible for national health IT standards under its government charter.
Much more here:
http://www.australianit.news.com.au/story/0,24897,25329474-15306,00.html
It is important to read between the lines here. What actually happened was that the Health Department dreamed up this plan and gave all those who would have to action it essentially no notice at all. They had no clue how to actually do what they were demanding and have revealed themselves to be totally lacking any form of implementation ‘common sense’. I really wonder how any progress can be made with turkeys like this at the centre of power.
Second we have:
Floods force GPs to go back to basics
Elizabeth McIntosh - Friday, 17 April 2009
GPs along NSW’s mid-north coast have been forced to do without the comforts of modern technology and resort to pen and paper for patient records, after recent flood waters destroyed practice computers.
The North Bellingen Medical Centre closed for two days after floods destroyed computers, furnishings and medical equipment, including a vaccine fridge.
“It was pouring with rain, and within half an hour the water just hit us,” said practice manager Brenda Mitchell.
Ms Mitchell said no patient records were lost in the knee-deep waters, but the doctors now face ongoing disruption as they return to paper-based files, which will later need entering into practice software.
Mid North Coast Division of General Practice medical director Dr Helena Johnston said around six practices were affected by water damage.
More here (subscription required):
http://www.medicalobserver.com.au/News/0,1734,4351,17200904.aspx
A timely reminder to all of the importance of IT disaster planning.
Third we have:
Coles realises loss on sale of online medicines outfit
Ari Sharp
April 16, 2009
COLES owner Wesfarmers has taken a step backwards in its attempt to sell pharmaceuticals in its supermarkets, selling its online medicines business Pharmacy Direct at a large loss.
The deal will also end a three-year legal battle brought on by the Pharmacy Guild of Australia against Coles on the basis that the company was in breach of rules surrounding pharmacy ownership. The guild won the case, but an appeal by Coles was to have been heard in the NSW Supreme Court in June.
Coles bought the business for $48 million in 2006, before the supermarket chain was acquired by Perth-based Wesfarmers, in an effort to ready itself for regulatory change allowing supermarkets to sell pharmaceuticals. It is believed the business was sold for less than $20 million.
The next five-year pharmacy agreement between government and the industry, which covers the period until 2015, is not considering allowing supermarkets to sell prescription drugs, leading to the realisation that any regulatory change is still some time away.
Guild president Kos Sclavos said Coles' sale of the business "vindicates our position" on supermarkets being prevented from selling prescription medicines.
More here:
This is a bit of a pity. I for one would like to see the convenience of obtaining prescriptions anywhere there is a registered pharmacist to provide the service and would like to see the community pharmacy monopoly opened to rather more competition that exists at present. At the very least one should be able to pick up repeat prescriptions in the supermarket!
More information here:
http://www.theaustralian.news.com.au/story/0,25197,25339746-5018014,00.html
Terry White scores $20m Direct hit
Teresa Ooi | April 16, 2009
Article from: The Australian
WESFARMERS has sold its online Pharmacy Direct business to RX Direct -- a company owned by Terry White Chemists Advisory Board -- for under $20million.
Fourth we have:
Medical notes found blowing in the wind
BY ALICIA BOWIE
15/04/2009 4:00:00 AM
PEOPLE'S medical records were scattered on Cowpasture Bridge for the world to see last week.
Liberal politician Charlie Lynn was out for a run when he came across the medical imaging requests that appear to have come from Campbelltown Hospital.
Each request had the person's name, date of birth, address and what radiological scans or ultrasounds were needed.
Some of the records, for people in areas such as Camden, Campbelltown and Wollondilly, contained results of those scans.
The Sydney South West Area Health Service, which is responsible for Campbelltown and Camden hospitals, apologised for any distress caused.
``Sydney South West Area Health Service treats the privacy of our patients very seriously,'' a spokeswoman said.
``The area health service has strict processes in place for the disposal of patient records including locked bins and sealed trucks for transportation.
``A contractor is responsible for the disposal of records in line with privacy regulations.
More here:
Seems controlling that paper is even harder than controlling those pesky electronic records
Fifth we have:
Cancer find could end biopsies
Sam Lister | April 14, 2009
Article from: The Australian
A DROP of blood or speck of tissue no bigger than a full stop could soon be all that is required to diagnose cancers and assess their response to treatment, research suggests.
New technology that allows cancer proteins to be analysed in tiny samples could spell the end of surgical biopsies, which involve removing lumps of tissue, often under general anaesthetic.
Researchers at Stanford University, California, have developed a machine that separates cancer-associated proteins by means of their electric charge, which varies according to modifications on the protein's surface.
Antibodies, immune system agents that bind to specific molecules, are then used to identify the relative amounts and positions of different proteins.
The technique was able to detect varying levels of activity of common cancer genes in human lymphoma samples and even distinguish between different lymphoma types.
The researchers said the same system could be used to monitor cancer treatment more quickly and easily. Although the study focused on blood cancers, scientists also hope to apply the technique to solid tumours and are currently testing the technique on head and neck tumours.
More here:
http://www.theaustralian.news.com.au/story/0,25197,25330038-23289,00.html
This is a very encouraging technical find. I hope it turns out to be practical and realistic.
Sixth we have:
10 ideas for Australian ICT policy
25 March 2009 06:08 PM
"We'll all be rooned," said Hanrahan
In accents most forlorn
Online and twittering round the globe
One frosty Sunday morn.
(apologies to PJ Hartigan)
analysis There is currently a great deal of gloom and doom about the state of the Australian ICT sector.
Some of it is linked, validly, to the global financial crisis and the traditional place of ICT spending in business priorities; that is, one of the first things to be cut. But there is also a view that governments in Australia do not understand the sector and fail to give any strategic policy leadership. For good measure, some think the industry itself is inwards looking, too conservative and poorly led.
Certainly there are plenty of negative signs if you care to look for them: The tough economic climate, apparently falling disproportionately on the ICT sector, is a legitimate reason for firms to be a little distracted; There is fear and loathing (perhaps unwarranted but still there) about the impact of the Gershon Report on how Australian Government agencies manage ICT projects and budgets; and opportunities identified for ICT in the Review of the National Innovation System have vanished into "consideration in the budget context".
....
10 ideas for moving ahead
Here are some ideas for taking the ICT sector ahead, and which can be done without a summit, a Minister for ICT or the hiring of any new government employees. Some of them will require government action, some are a matter for industry and the research community. They are, in no particular order:
- Commit to an e-health strategy and follow it through: This has been an area of significant failure in national standards, interoperability, acceptance by health professionals and Commonwealth-State cooperation. The potential gains in terms of better services and lower costs make it worth pursuing. A strategy document has been agreed by commonwealth and state Ministers but there does not appear to be any implementation schedule.
.....
Tom Dale was a senior executive with the Department of Broadband, Communications and the Digital Economy until May 2008. He has 34 years' experience in the Australian Public Service and 12 years in the Senior Executive Service. He is a partner in BartonDale Partners. This article first appeared on the company's site and is published on ZDNet.com.au with his permission.
More here:
Good to see once public servants leave Government they suddenly see what is needed! Pity a few on the inside were not making a bit more internal noise about this issue.
Seventh we have:
IBA buys Hatrix to drive medication management
17 Apr 2009
Sydney – Friday, 17 April 2009 – IBA Health Group Limited (ASX: IBA) –Australia's largest listed health information technology company today announced it has agreed to acquire Australian-based Hatrix Pty Ltd. in a deal worth up to $15 million. Hatrix develops electronic medication management solutions for acute care, aged care and community health care providers in Australia and New Zealand. Formal completion of the deal will occur in the next few days.
IBA will pay Hatrix shareholders an initial consideration of $2 million. A further earn-out, capped at $13 million, may be paid over three years and payable in cash or shares at IBA’s election.
More here:
http://www.ibahealth.com/html/iba_buys_hatrix_to_drive_medication_management.cfm
Looks like the inevitable consolidation that is being provoked by the Financial Crisis – with the larger companies taking advantage of the situation they find themselves in. Seems to me to be a very useful add on acquisition. (Usual disclaimer about having a few IBA shares)
Eighth we have:
$96m medical IT system useless: whistleblowers
Nick Miller
April 17, 2009
A NEW $96 million computer system for Victorian hospitals that promised to cut down on dangerous medication errors will be almost useless when it goes "live" this year, insiders say.
Other new computer systems that handle finance and manage patient records are plagued with serious problems that take days, even weeks, to fix.
And in a further embarrassment for the years-overdue $360 million HealthSMART program, a hospital chosen by the Government to be a flagship "lead agency" — Ballarat Health System — has quit the project because it could not justify the expense.
An anonymous letter from "health-sector employees" sent to The Age says the Cerner clinical systems, intended to cut down on mistakes in doses or combinations of medicines, is being rushed into hospitals — with none of the medication functions working — so the Government will not be embarrassed before next year's election.
More here:
One is always slightly suspicious of anonymous letters – but the fact someone is clearly sufficiently unhappy to want to write to a newspaper must signal there are some issues to be addressed. Those running the program would do well to take the issues raised seriously.
Ninth we have:
HOCA has instant access to cancer patient files
Jennifer Foreshew | April 14, 2009
HAVING instant access to the patient management system is critical for consulting staff treating people with cancer at all sites of the Haematology and Oncology Clinics of Australasia.
"We needed to be able to provide large images across the network so staff could access things like medical reports and X-ray images," says HOCA's Douw Van der Walt
The Queensland organisation provides day hospital services for those with cancer, haematological illnesses and related disorders.
It has four branches as well as a head office site.
HOCA, which has 200 workers including nursing staff, sought a resilient and robust ethernet network to meet its growing voice and data requirements while providing the scalability to support expansion of the network.
More here:
http://www.australianit.news.com.au/story/0,24897,25329249-24169,00.html
Good to see progress in this small arena.
Lastly the final conclusion of a fiasco:
Qld Health buries TrakHealth suit
14 April 2009 10:44 AM
in brief Queensland Health has settled its long-running lawsuit with e-health vendor TrakHealth and its parent InterSystems.
TrakHealth dragged Queensland Health into the state's Supreme Court in December 2005 after the department terminated a contract with the vendor for the implementation of the department's Clinical Information System project and related software. The e-health vendor claimed it was owed damages.
More here:
Good to hear that has finally been closed.
More next week.
David.
Karen Dearne’s 14 April article “Standards development lags e-health plans” brings to the fore some fundamental issues in respect of the Department of Health & Ageing’s approach to ehealth.
ReplyDeleteYou succinctly summarised the heart of the problem as to why ehealth in Australia is in such a diabolical mess when you said “They had no clue how to actually do what they were demanding and have revealed themselves to be totally lacking any form of implementation ‘common sense’. I really wonder how any progress can be made with turkeys like this at the centre of power”.
In a nutshell - the cuckoo-land environment in which the bureaucrats exist is counter-productive to development of eHealth in Australia.
Let’s start by fixing some of the problems. For example - first problem - Standards.
ReplyDeleteRigidly mandating health IT standards, which by their very nature, steadily evolve, is not the right approach. Standards should be allowed to evolve in line with market forces and uptake by health application vendors.
A little more flexibility and creative thinking will help such as supporting an environment focused on accelerating the ‘development’ of standards. This does not mean delegating to NEHTA - they are not set up to develop standards.
What is required is that government needs to provide some funds to enable those who participate on the various standards bodies (which are already in place) to be, at least in part, remunerated for their work. We should not have to rely entirely on the goodwill of volunteers.
What a monumental battle win for the Pharmacy Guild. Taking on Wesfarmers and forcing them to sell the business for less than $20 million after Coles paid $48 million for it a few years earlier. This win truly demonstrates the absolute power of this extraordinarily powerful lobby group, and you know what they say about 'absolute power ...........' .
ReplyDeleteThe Consumer’s Association is not happy and bleat they may, but they can do nothing to counter the guild. And the government is impotent too, for it fears the power wielded by the guild over consumers through its members, the community pharmacy owners.
David, you might like to see “the community pharmacy monopoly opened to rather more competition than exists at present.” But face reality, the guild will never let that happen - they control the politicians through their skills at political lobbying and their ability to exercise fear in every politician.
ReplyDeleteIt’s all very well to suggest that at the very least one should be able to pick up repeat prescriptions in the supermarket! But hey - you can’t build a business on that - either pharmacy’s are allowed in supermarkets or they’re not. There is no half way option.
However, the increased competition in pharmacy will come from online services. The pharmacy guild knows that which is why it is under siege fighting on every front.
Terry White indicated that online will be a big part of the market in the future and that 120 pharmacy franchisees would be offered a stake in Pharmacy Direct. Put that up against the guild President’s stance, “Coles' sale of the business ‘vindicates our position’ on supermarkets being prevented from selling prescription medicines".
It’s a funny old world. The guild wants to dominate the online prescription space. It can only do this by making sure its eRx ScriptExchange gets well established and receives preferred government support ahead of any other alternatives. If it can marry that up in some way with ‘online pharmacies’ like Terry White’s PharmacyDirect it probably reckons it's home and hosed with all hatches battened down. Only then will it believe it can confidently go into battle over “the next five-year pharmacy agreement between government and the industry, which covers the period until 2015” and in doing so secure maximum government support for its eRx Exchange.
But with the RACGP now entering the fray with its own online alternative for an online prescription transfer exchange service - MediSecure - the guild’s plans may well be getting a little brittle.
The guild may be a powerful lobby group but at the moment pharmacists don’t write prescriptions - doctors do and they may just hold the key to the future direction of online prescriptions.
IBA’s Gary Cohen timed his acquisition of Hatrix perfectly. Electronic medication management solutions for acute care, aged care and community health care are the hottest areas of ehealth in Australia today.
ReplyDeleteIn the Acute Care sector most hospital vendors’ solutions are deficient in prescribing and medication management including, Cerner and until last week, IBA (iSoft).
In the Aged Care and Acute Care sectors Hatrix had established an enviable reputation and was well in the lead. In Community Care, although the jury is well and truly out, the situation is resolving fast as the pharmacy guild and the RACG fight for dominance over the transfer of consumers’ prescriptions between doctors and pharmacists and the compilation of the consumers’ medication record for all authorised parties to access. Government, by comparison, appears to have almost retired from the battle ground probably with a pragmatic realisation that its past failed and costly attempts at controlling this space will be tolerated no longer.
Whether IBA utilises Hatrix wisely remains to be seen. One thing is certain, this acquisition has played IBA into the heart of the medication management game and if Nick Miller’s Whistleblower article in the Age last Friday on Victoria’s HealthSmart project is any indication IBA has a challenging opportunity ahead of it.
In reply to the coment posted by Anonymous on Monday April 20th 1:33:00 PM re Garry Cohen's Hatrix acquisition...
ReplyDeleteThe The Age article was critical of IBA/iSOFT as well – they were just not specifically named. There is a few sentences about the PCMS (Patient Client Management System). This section of the article is talking about a IBA/iSOFT delivery, though IBA were lucky that the vendor name and actual product name wasn’t mentioned – the PCMS = iPM (iSOFT Patient Manager).
“Leaked reports show other new HealthSmart systems are highly unreliable. In the last quarter of 2008, the reports showed serious problems with the "PCMS" system, which tracks patient records, books operating theatres and warns doctors of a patient's particular allergies or chronic health problems. As of December, the system was used at five health services, including Northern, Frankston and Royal Women's hospitals”.