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, June 14, 2009

Useful and Interesting Health IT News from the Last Week – 14/06/2009.

First we have:

WA hospitals pay highest administration bills

Article from WA Sunday Times

Anthony Deceglie

June 13, 2009 06:00pm

WA hospitals spend more money on pen pushers and folder holders than any other state or territory.

The Sunday Times can reveal that for every patient treated in a WA hospital, $338 must be spent paying administration staff.

This compares with $265 in Victoria and Adelaide, $258 in Queensland and $234 in Tasmania.

WA spends well above the national average of $277 on administration staff for each patient treated.

About $223 million is spent on administration staff in WA hospitals every year.

Health Department boss Peter Flett told The Sunday Times he was alarmed by the figures.

``It is a concern and we are always looking for ways to make our hospitals more efficient while continuing to provide a high standard of health care to West Australians,'' Dr Flett said. ``We will soon be embarking on a benchmarking exercise with interstate health services to help identify where savings could be made.''

Dr Flett said it was possible the figures showed that the WA health system provided a better ratio of support for clinical staff.

Lots more here:

http://www.news.com.au/perthnow/story/0,21598,25630859-5017008,00.html

I also note the following:

10 June 2009

iSOFT upgrades i.PM with Western Australia Health

iSOFT Group Limited (ASX: ISF) – Australia's largest listed health information technology company – today announced it agreed on a licensing contract with the Western Australian Department of Health for its latest iSOFT Patient Manager (i.PM) hospital information system.

iSOFT will receive a A$1.5 million license fee as WA Health seeks to upgrade its older TOPAS solution to i.PM as part of the state’s eHealth reform programme. The company has also agreed, subject to final approval, to implementation and support services totaling A$15.4 million over five years.

Western Australia is set to become the nation’s first state to run iSOFT’s entire iSeries suite of solutions to provide a flexible, fully integrated patient health record across multiple hospitals. There is potential for an additional A$3.5 million in services should WA Health elect to roll out i.PM across as many as 68 rural sites.

More here:

http://www.isoftplc.com/corporate/home/nm_latest_3409.asp

The link here is obvious. WA has been very slow to improve its use of Health IT and that is reflected, to at least some degree, in the need for more staff to operate manual systems. TOPAS and the other systems have been in place for a very, very long time! (Usual disclaimer of having a few shares).

Second we have others noticing that e-Health in Australia is a mess.

National e-health system confused, critics say

Article posted on Saturday 13 June 2009

Confusion surrounds federal, state and public authority proposals for a national e-health system in Australia, critics say. As competing bodies propose varied systems, no-one is consulting with privacy and civil liberties groups to ensure people's health records are appropriately safeguarded and kept secure.

Privacy group criticises PR 'spin' over e-health

The Australian Privacy Foundation wants to work on positive developments for national electronic health system, instead of being forced to react to various poorly thought-through initiatives, the chair of the APF's health sub-committee, Dr Juanita Fernando, said in June.

"Where is our national, widely consulted and accepted, patient-controlled, e-health records system, with an inbuilt privacy and personal health information security framework?" she said.

"Australians have spent billions of dollars on e-health yet we remain caught up in the realm of reactive detail, government press releases, information control and secrecy rather than in determining the principle decisions which can be used to found a good discussion of e-health proposals.

"The APF's health sub-committee has written to Health Minister Nicola Roxon on the issue, and we patiently await a response," Dr Fernando said.

More here:

http://www.cla.asn.au/0805/index.php/articles/2009/national-e-health-system-confused-critics-say

The comments on the strategic mess which we find ourselves in are very telling indeed!

Third we have:

Keeping guard

9-Jun-2009

RISK MANAGEMENT: It is up to GPs to ensure staff protect patients' privacy. By Mr Andrew Took

ONE of the most common reasons members call Avant is for advice on issues of privacy. Medical practitioners in all states and territories must comply with the federal Privacy Act, which contains the National Privacy Principles. Victoria, NSW and the ACT also have their own legislation governing privacy obligations with which medical practitioners in those states and territories must also comply.

Parents generally have the right to access health information on their child until the child reaches a level of sufficient maturity and cognitive ability to provide their own consent to a particular treatment. At this point the child should generally have a right of confidentiality in respect of that treatment.

In family disputes, if one parent asserts that the other is not to have access to their child's health information this should be verified with a copy of the relevant court order.

All practice staff must respect patient privacy. It is your responsibility to ensure staff are aware of privacy obligations. It is recommended you regularly review the manner in which staff interact with patients to ensure they meet the obligations of privacy.

More here (registration required):

http://www.australiandoctor.com.au/articles/61/0c061761.asp

A point that cannot be made too often.

Fourth we have:

Govt 'obsession' killed national access card

Back-end efficiencies still attainable

Darren Pauli 11 June, 2009 09:55

Tags: medicare, joe hockey, access card

A former head of Australia's failed $1.1 billion Access Card said the project crashed because of the then Howard government “obsession” with delivering a mandatory single identity card, rather than back-end efficiency.

The Access Card was introduced by then human services minister Joe Hockey and born from a Medicare ID card project both directed by former smartcard technologies taskforce chair James Kelaher.

The project was scrapped after 10 years of research and more than $130 million in government expenditure, according to Kelaher.

He said more than $3 million was spent on aligning back-end systems and some $50 million on failed procurement processes.

Full article here:

http://www.computerworld.com.au/article/307075/govt_obsession_killed_national_access_card?eid=-255

An interesting perspective on what killed the access card – which as we have all noticed seems to have raised its head again.

Fifth we have:

Online CBT effective in depression

Friday, 12 June 2009

INTERNET-BASED cognitive behavioural therapy offers significant clinical benefits for patients with depression.

An Australian study of 45 patients randomised to a waitlist control group or to the Internet-based, clinician-assisted Sadness program found those in the intervention group had significantly reduced symptoms of depression.

The Sadness program consists of six online lessons, weekly homework assignments, weekly email contact from a clinical psychologist and participation in a moderated online discussion forum with other participants.

More here (registration required):

http://www.medicalobserver.com.au/News/0%2C1734%2C4670%2C09200906.aspx

More supporting evidence for the place of tele-psychiatry.

Sixth we have:

E-security policy in pipeline

Mahesh Sharma | June 09, 2009

THE federal government will release a policy framework in the next three months to tie together a raft of e-security initiatives.

There have been several announcements about different security initiatives over the past couple of months, including work slated under the defence white paper as well as the recently created national security resilience policy division.

An e-security policy framework is in the final approval stages, according to the head of the national security resilience policy division, Attorney-General's assistant secretary Mike Rothery.

"What we're now looking at doing is putting out a document to the public that describes how that fits together and the capabilities we're seeking to deliver in government to be able to achieve the outcome," Mr Rothery said.

The national security resilience policy division was established in March as part of the Attorney-General's Department. It is responsible for responsible for policy, legislation, advice and programs related to developing national resilience to the full range of natural and human made hazards including e-security, critical infrastructure protection, identity protection and also emergency management policy.

More here:

http://www.australianit.news.com.au/story/0,24897,25606831-5013040,00.html

Keeping an eye on where this heads is important for all those in e-Health as in due course it will be part of the critical national infrastructure – if it is not already.

Seventh we have:

FTTH networks are no sure bet

In recent months, national governments in Singapore, Australia, and New Zealand have announced significant policy interventions designed to promote fibre-to-the-home (FTTH) investment. In each case this has involved large commitments of taxpayer funding. Singapore is leading the charge, but Australia and New Zealand are following.

David Kennedy, research director at Ovum, said the cost of a national FTTH network is prohibitive outside city-states like Singapore, and even there a substantial public subsidy was required. "As a result, commercial returns to public investment in FTTH networks will not be possible. If they were, private capital would already be building this network."

"In summary, there is real uncertainty about the viability of national-scale FTTH networks in environments such as Australia and New Zealand. In neither country has a detailed business case been worked out, and it remains to be seen whether these networks can be delivered as currently proposed."

A basic policy model seems to be emerging in these three countries:

  • A preference for FTTH technology, with a recognition that this cannot be extended to 100 percent of the population.
  • A wholesale-only operator for the fibre access network. All three countries are aware of the danger of recreating a vertically integrated monopoly.
  • In both New Zealand and Singapore, the importance of access to raw dark fibre is also clear.

This is consistent with experience in other Asian markets such as Japan.

More here:

http://tc106.metawerx.com.au/Rustreport/rustreport_jun12_09.pdf

This is a very interesting discussion and makes one wonder just how viable the Rudd ambition of FTTH is in these rather difficult times.

Eighth we have:

Telstra split-up key: Optus

Mitchell Bingemann | June 08, 2009

THE federal Government's $43 billion national broadband network will be economically unviable unless Telstra is structurally separated, arch-rival Optus says.

Speaking at the Trans Tasman Business Circle in Sydney last week, Optus chief executive Paul O'Sullivan said a monthly wholesale access price of $50 could be expected if NBN penetration levels hit 60 per cent.

A $50 per month wholesale access charge would equate to a retail price average of about $106 per month for a broadband and telephony bundle today, an Optus spokeswoman said.

"We think this is a realistic price level -- and will allow for retail prices which are not out of line with those paid today," Mr O'Sullivan said.

An NBN penetration level of 60 per cent would be sufficient to ensure a viable commercial return, but Mr O'Sullivan said this could only be achieved if Telstra was structurally separated and its access network used as the building blocks for the Government's fibre-to-the-premises broadband project.

"First of all, we think the NBN can be economically viable," Mr O'Sullivan said.

"Secondly, to achieve this outcome the NBN must be the only network delivering high-speed broadband services to Australians.

"Thirdly, the essential way to ensure that is to structurally separate Telstra, so that its network becomes the foundation for the NBN into which the Government invests.

"But if there are two competing networks around the country, Telstra's and the NBN, then we think the NBN business case becomes a very challenging one."

More here:

http://www.australianit.news.com.au/story/0,24897,25602994-15306,00.html

Having privatised Telstra one really does wonder just what scale of compensation might be demanded to hand over its key network assets. There are a lot of shareholders out there who could be rather annoyed about that particular fate for their investment without some consideration. (Usual disclaimer of having a few shares).

This point is made here:

http://www.computerworld.com.au/article/307303/fttn_jettisoned_dodge_telstra_compensation?eid=-6787

FttN jettisoned to dodge Telstra compensation

Govt regulatory review highlights inadequate bids

Darren Pauli 12 June, 2009 14:37

I think all this may have a way to run yet given the timescale (8 years) being contemplated. Of course we have yet to see a business case for the NBN to understand just where the health sector and e-Health fits in. I fear that will be another document that never actually sees the light of day.

Second last we have:

SA takes $40 million from health IT

Suzanne Tindal, ZDNet.com.au
09 June 2009 04:39 PM

The South Australian State Government has cut back on new e-health projects in its budget delivered last week, slashing new initiatives worth $42 million over four years.

Despite spending over $4 billion in total on health, the state decided to cut back on new IT for the sector. The budget papers noted a reduction in an "ICT infrastructure program", which would save $9.2 million in the 2009/2010 years and $10.9 million, $11.3 million and $10.6 million in the three years after that.

A spokesperson for the state's health department could not give any information on the cancelled project, although they confirmed the money had been pulled out. The state's budget ran into deficit, and the government said it had needed to make some hard calls to bring it back into surplus in the future.

"When I first began to frame this budget we faced the prospect of an operating deficit well in excess of $500 million and significant deficits in each of the following years. Mr Speaker, this would not be sustainable, and as a result the government has made some tough decisions which I will detail later in order to place this state on a path to surplus," SA Treasurer Kevin Foley said in his budget speech.

More here:

http://www.zdnet.com.au/news/software/soa/SA-takes-40-million-from-health-IT/0,130061733,339296834,00.htm

This seems like a very bad an outcome indeed.

Lastly the slightly more technically orientated article for the week:

Firefox 3.5 features new Javascript engine, built-in video

The upcoming release will give people next-generation tools to interact with the modern Web, Mozilla said

Elizabeth Montalbano (IDG News Service) 11 June, 2009 04:16

The next version of Firefox will include next-generation features Mozilla hopes will help the browser stand apart from competitors.

Firefox 3.5, which is due out in final release at the end of the month, will allow people to edit digital images from within the browser without need for a third-party application, thanks to a new Javascript engine Mozilla has built for the browser, said Mike Beltzner, director of Firefox at Mozilla, during an interview in New York.

The software also will include the ability to run videos directly in the browser without the need for a third-party viewer or player, and will allow other elements of a Web page to interact with that video content, he said.

As an open-source company, Mozilla aims to give people technologies based on open standards that help them leverage the Web as both a content-delivery engine and platform for developing applications, Beltzner said.

"The more people we see using Firefox as their modern, standards-compliant browser, the better it is for the Web as an ecosystem," he said.

The new Javascript engine, called TraceMonkey, is twice as fast as the one in Firefox 3.0, and allows for image editing from within the browser without need for software such as Adobe Photoshop, Beltzner said. Javascript is a standard scripting language for Web applications.

"We can do this just as well with an online Web application as well as you could on a local application," he said, thanks to TraceMonkey. "Especially for those complex, power-hungry Web applications, people will find Firefox 3.5 a lot faster."

Similarly, the new video capability is based on the open-source video codec called Ogg, maintained by the Xiph.Org Foundation, so it is built on technology freely available for both Web users and developers.

More here:

http://www.computerworld.com.au/article/307047/firefox_3_5_features_new_javascript_engine_built-_video?eid=-219

I am using the last beta (Beta 99) of Version 3.5 and it is pretty quick and reliable so far. Certainly worth a try if you are not happy with IE or Chrome when the release version arrives.

More next week.

David.

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