Useful and Interesting Health IT News from the Last Week – 02/08/2009.

The Australian E-Health Press provided a good serve this week. It included these:

First we have:

E-health boost for local developers

Karen Dearne | July 28, 2009

THE e-health plan endorsed by the National Health and Hospitals Reform Commission gives local IT developers and medical professionals scope to build new products on top of the proposed Australian platform.

The NHHRC has backed the National E-Health Strategy, developed by Deloitte, as the best means of leveraging existing assets and programs to achieve results in the near future.

By 2012, the reform commission wants every Australian to have a personal health record, as well as a broad capability to send medical information to healthcare providers across both public and private sectors, as well as across state borders.

To achieve that, it recommends a "middle-out approach" and has charged the federal government with responsibility for "creating a common set of technical goals and underpinning standards that can sit between them", rather than a top-down, "big procurement" approach.

"With some core public interest exceptions, especially around safety, privacy and consent legislation, the pact that government makes with local institutions is that - beyond a commitment to common goals and standards - it will not try to shape what is done locally," the NHHRC says in its final report.

"However, standards development and, where necessary, support for their implementation, still requires a considerable financial commitment from government.

"Our recommended reforms build upon the National E-Health Strategy agreed by Australia's health ministers, but we urge the Commonwealth government to take responsibility for accelerating and adequately resourcing the plan."

Despite this support, the e-health strategy has not been released for public discussion.

But a copy obtained by The Australian shows Deloitte's preference for a “guided market” approach that attempts to avoid the opposite extremes of an industry free-for-all and bureaucracy's dead hand.

More here (subscription required):

http://www.australianit.news.com.au/story/0,24897,25847307-15319,00.html

If you have read nothing else about the NHHRC report this article gives the key. Essentially the NHHRC says we are to get on with, and fund the Deloittes developed e-Health Strategy while evolving an approach to patient controlled personal records. A good outcome I believe.

The point is firmly made here:

E-health shock for Roxon

Karen Dearne | July 29, 2009

THE final report of the long-running National Health and Hospitals Reform Commission must have come as a complete shock to federal Health Minister Nicola Roxon and her state counterparts.

Heaven knows why the health ministers buried Deloitte's strategy under a tonne of concrete after agreeing to adopt it as official policy.

After an embarrassing e-health blindspot in the commission's interim report, and a rushed paper suggesting patients could make their own arrangements for online records, someone flicked them a full copy of Deloitte's considered, and modest, National E-Health Strategy.

Fortunately, it's a very useful lifeline, and the reformers are wise to embrace it.

Heaven knows why the health ministers buried Deloitte's strategy so deep in the filing cabinet after agreeing to adopt it as official policy but clearly it's now time to put the whole document into the public domain.

Even the commission had to rely on the slim executive summary before a truck dropped a copy on its doorstop.

In a nutshell, the NHHRC wants every Australian to have a personal e-health record by 2012, and medical provider capabilities for accessing, sharing and transmitting medical information.

More here:

http://www.australianit.news.com.au/story/0,24897,25852322-15302,00.html

Second we have:

Medical e-card on board by 2012

Mark Dodd | July 28, 2009

Article from: The Australian

IF Canberra gets its way, by 2012 every Australian will be issued a personal electronic health card containing an archive of their health history.

If the National Health and Hospital Reform Commission recommendation is adopted, the e-card will reduce administrative red tape and allow card-holders personal access to their health records.

The NHHRC estimates in its report, A Healthier Future for All Australians, that the e-card would cost between $1.2billion and $1.9bn. Privacy and confidentiality concerns would be protected by special commonwealth legislation.

The Australian Medical Association gave the e-health card its strong backing, saying it welcomed the NHHRC's focus on and the Prime Minister's clear commitment to electronic health records.

"This will improve efficiency and help save lives," said AMA federal president Andrew Pesce.

In feedback sought by the NHHRC, the authors of the report heard that an electronic medical record would enhance patient diagnosis.

"As we live longer, often with health conditions, the nature of information needed to support care is changing from episodic care delivered by individual providers to chronic disease management with multiple providers," the report says.

More here:

http://www.theaustralian.news.com.au/story/0,25197,25844701-26040,00.html

Did anyone else spot the material on the e-Health Card in the report. I certainly missed it. I wonder how this actually got out? Is there a secret plan none of the rest of us know about?

There is much clearer coverage here:

http://www.itnews.com.au/News/151290,report-urges-electronic-health-records-by-2012.aspx

Report urges electronic health records by 2012

Brett Winterford | Jul 27, 2009 5:45 PM

Government blueprint advocates ICT transformation of the healthcare sector.

Third we have:

Sunday, 26 July 2009

E-Health Allows New Health Vision

Premier David Bartlett today outlined the Government’s vision to make the Tasmanian health system the most technologically advanced, patient-focussed system in the country.

At the ALP State Conference in Hobart, Mr Bartlett said the National Broadband Network would allow revolutionary E-Health capabilities, building on high tech initiatives already being developed across Tasmania.

“The health reforms detailed in Tasmania’s Health Plan are already well underway,” Mr Bartlett said.

“Now we want to use modern technology to shift health to the next level.

“This is about ensuring that no matter where they live, Tasmanians get the best clinical and patient care possible – whether in an acute care hospital, a regional health centre, or even in their own homes.

“Our vision is to provide patient centred clinical and information systems that support the delivery of care.

“Digital linkages across hospitals and health centres will improve the safety and timeliness of health care across the State.

“And clinicians will be able to digitally monitor and advise patients in their own homes.

“New technologies are the key to better patient care and the better utilisation of the skills and experience of our clinicians, nurses, and other health professionals,” Mr Bartlett said.

Ms Giddings said a wide range of e-health initiatives were already being rolled out across Tasmania and the potential for further health benefits was enormous.

“The health care of the future is already beginning to arrive in hospitals and health centres across Tasmania, Ms Giddings said.

“In this year’s State Budget we are investing a further $12.9 million over the next three years for better health IT systems.

“This funding will allow better medical imaging and on-line transfer of clinical data between hospitals to assist diagnosis and treatment, building on a wide range of high-tech innovative projects that already underway.

“At the LGH, for example, the Electronic Discharge Summary is providing advanced electronic methods to transmit vital clinical information between the hospital and a patient’s GP to improve care for a patient once they’ve left hospital.

“At the RHH patient records are being digitised so clinicians can access and update them online from anywhere in the hospital.

“In the Southern Highlands new mobile phone towers are being installed by Telstra to improve telehealth facilities and allow community nurses access to records and clinical advice while caring for patients in remote areas.

“In the North West clinicians at the NWRH in Burnie are already providing bedside advice to the Mersey’s High Dependency Unit via video link.

“And digital medical imaging is allowing us to take x-rays in areas like Queenstown, Rosebery and Smithton with immediate online support from radiographers anywhere in Tasmania or across Australia.

“Labor is determined to ensure Tasmanian patients benefit from the great advances in health care that modern technology can provide,” Ms Giddings said.

Full release here:

http://www.media.tas.gov.au/release.php?id=27413

It is good to see Tassie is pushing ahead. One wonders just how far and average of $4.3 million per year will go. We shall see I guess. This spend does need to be seen in the context of, to quote “Despite tough financial times, the State Budget includes a record funding allocation of more than $1.2 billion for health services in 2009-10 to help meet increasing demand.” The capital budget is said to $75 million so if that is all new money it is not too bad I!.

Fourth we have:

Real-time alert tool should be compulsory: Pharmacy Guild

Karen Dearne | July 29, 2009

AN online alert tool used to detect and prevent sales of pseudoephedrine should be made mandatory nationwide, and extended to other medications that may be abused, Pharmacy Guild president Kos Sclavos says.

The tool, Project Stop, is used by pharmacists to identify people suspected of diverting pseudoephedrine purchases to the illegal drug trade.

Earlier this month, the Queensland Government mandated real-time electronic reporting of all sales of products containing pseudoephedrine, commonly bought in bulk by criminals as a precursor ingredient in the backyard manufacture of illegal drugs.

Mr Sclavos said pharmacists participating in the program had denied sales on tens of thousands of occasions since Project Stop was released in Queensland in November 2005.

The program has been running on a voluntary basis nationally for the past two years.

"Project Stop is a decision support tool that allows the pharmacist to check whether it is appropriate to hand over the product," he told the National Press Club in Canberra.

Full article here:

http://www.australianit.news.com.au/story/0,24897,25853029-15306,00.html

I am not sure we really want pharmacists second guessing the content of valid prescriptions. The unintended outcomes of this sort of thing could be a real worry. If you want to prevent ‘doctor shopping’ you do it at the level of the doctor not the pharmacist in my view.

More here:

http://www.theaustralian.news.com.au/story/0,25197,25855522-23289,00.html

Pharmacy cure for doctor shopping

Siobhain Ryan | July 30, 2009

Article from: The Australian

Fifth we have:

Pharmacists push for e-script subsidies

Elizabeth McIntosh - Friday, 31 July 2009

PHARMACISTS are seeking payments from the Federal Government for signing up to electronic prescription systems that have been widely touted as a significant step forward in reducing medication errors.

The payment request is expected to be thrashed out when pharmacists face off with the Government over the Fifth Community Pharmacy Agreement in coming months.

Two electronic prescribing systems – which enable GPs to send electronic scripts directly to pharmacists – have emerged this year. While doctors can sign up to either system for free, pharmacists will be charged 25 cents for each electronic prescription that they access and dispense.

More here (subscription required):

http://www.medicalobserver.com.au/News/0,1734,4954,31200907.aspx

The profit motive on the part of the Guild is quite explicit here.

Sixth we have:

Healthways, HCF and Macquarie Hosting partner to support Australian health system

July 28, 2009 – (HOSTSEARCH.COM) – Macquarie Hosting, a division of Macquarie Telecom, has announced it has signed a three year $1 million deal with Healthways Australia Pty Ltd, part of Healthways Inc, a leading international provider of population health support services, including wellness, prevention and chronic disease management services.

Under the deal Macquarie Hosting will host Healthways Australia’s internet-based suite of health and wellness resources designed to help Australians measure their current health, assess risks and prevent future health problems.

Macquarie Hosting was awarded the contract following a competitive tender.

For Macquarie Hosting, the deal reflects its strategic approach to partner with health organisations with a strong eHealth focus. This is a sector the business expects will be a significant growth area for the next 12 to 18 months as the Government invests substantial funds in overhauling and improving the national health system.

Macquarie Hosting also provides hosting and data services for some of the countries leading health organisations including the National E-Health Transition Authority (NEHTA), Smart Health, Map of Medicine, OZDoc’s Online, NHMRC Clinical Trials Centre Sydney University, Medicines Australia, Alphapharm, Novartis, Merk Sharp and Dome, ResMed, and Catholic Health Care.

The Healthways service will focus on prevention, education and support for common health needs, providing Australians with access to the information they need to proactively manage their health and improve their quality of life.

More here:

http://hostsearch.com/news/macquarie_hosting_news_8916.asp

This is a trend we are likely to see more of from the private health insurance sector.

There is more here:

http://www.australianit.news.com.au/story/0,24897,25842571-24169,00.html

HCF puts lifestyle on the line

Karen Dearne | July 28, 2009

Seventh we have:

Commentary

12:35 PM, 31 Jul 2009

Tony Boyd

The myth of NBN profits

Questioning the economic viability of the National Broadband Network is a dangerous game judging from the reaction to comments made by AAPT chief executive Paul Broad.

Reliable sources say that Broad's trenchant criticism of the NBN, including its lack of a business case, has prompted a third party claiming to speak on behalf of the government to tell him to shut up.

The word out of AAPT is that Broad won't be silenced even if it affects the few federal government contracts on the AAPT books.

There are very few who have raised doubts about the economic viability of the NBN apart from Opposition spokesman Nick Minchin and Business Spectator's Stephen Bartholomeusz.

Southern Cross Equities analyst Daniel Blair this month told the Senate Committee NBN inquiry that an NBN earning a 10 per cent return and winning 50 per cent of available customers would need to charge a wholesale access of $110 a month and set a retail price of $200 to $220 a month.

Blair's scenario analysis assumes that both wholesale and retail broadband suppliers would maintain the profit margins that they are earning at the moment on the copper network.

Much more here:

http://www.businessspectator.com.au/bs.nsf/Article/The-myth-of-NBN-profits-pd20090731-UG4FD?OpenDocument&src=sph

I fear the present plan to fund the NBN may need some extra thought!

Lastly the slightly more technical article for the week:

Legal spat pushes Ebay to develop new base for Skype

eBay warns Skype could be shutdown if it loses in court and no alternative is available

Martyn Williams (IDG News Service) 31 July, 2009 12:53

Online auction giant eBay has begun developing an alternative to the P2P technology used by Skype as a licensing dispute drags on and threatens to close the popular IP telephony service.

eBbay bought Skype in 2005 for about $US2.6 billion but that deal didn't include the peer-to-peer networking technology on which it runs. That technology is owned by a company called Joltid and licensed to Skype but the two sides have fallen out over the licensing agreement.

Earlier this year Skype asked England's High Court to resolve the dispute, according to Ebay. After that Joltid "purported" to terminate the license agreement, it said.

"In particular, Joltid has alleged that Skype should not possess, use or modify certain software source code and that, by doing so, and by disclosing such code in certain US patent cases pursuant to orders from US courts, Skype has breached the license agreement," eBay said in the 10Q filing.

A counterclaim to Skype followed, pushing Skype to ask the English court to find that it was not in breach of the license and that Joltid's termination is invalid. The legal mess is set to be heard by the court in June 2010.

In the meantime, eBay said it has begun developing an alternative to the technology at the center of the dispute with Joltid.

More here:

http://www.computerworld.com.au/article/313365/legal_spat_pushes_ebay_develop_new_base_skype?fp=16&fpid=1

Now this is a serious worry. Skype is a wonderful boon for essentially free interstate and overseas phone calls!

More here:

http://www.smh.com.au/technology/biz-tech/shock-threat-to-shut-skype-20090731-e3qe.html

Shock threat to shut Skype

Asher Moses

July 31, 2009 - 1:38PM

eBay says it may have to shut down Skype due to a licensing dispute with the founders of the internet telephony service.

The surprise admission puts a cloud over the 40 million active daily users around the world who use Skype for business or to keep in touch with friends and far-flung relatives.

A recent study by market researcher TeleGeography found Skype carried about 8 per cent of all international voice traffic, making it the world’s largest provider of cross-border voice communications.

More next week.

David.