Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Monday, November 30, 2009

Weekly Australian Health IT Links - 30-11-2009

Here are a few I have come across this week.


Patient records Bill stymied


CONTROVERSIAL legislation giving Medicare the ability to seize patient records has been stopped in its tracks by the ongoing debacle over cataract rebates.

Yesterday, the Federal Government was forced to halt debate on the Health Insurance Amendment (Compliance) Bill 2009 until next year, because both sides of Parliament could not agree on amendments.



Health department accused of censorship


November 28, 2009

THE University of Sydney removed from its website an extremely critical essay about a new multimillion-dollar emergency department IT system after pressure from the NSW Health Department. .

Doctors, nurses and administrators at four area health services heavily criticised the system - which tracks patients - as posing an ''unacceptably high risk'' to patient safety because it was so slow, cumbersome and inefficient.



Academic claims NSW Health censorship

By Suzanne Tindal, ZDNet.com.au
27 November 2009 02:26 PM

A professor at the University of Sydney who wrote a scathing essay about NSW Health's implementation of a Cerner system within emergency departments has accused the government of pressuring his institution to take the essay down, which it did, if only temporarily.



Adobe outlines NBN vision

e-Health providers may resell superfast broadband connectivity with their health services

Tim Lohman 27 November, 2009 11:59

Adobe has released its vision for the services it believes will be delivered over the NBN in a new whitepaper, The National Broadband Network: Unleashing Australia’s Digital Potential.

The paper seeks to provides a simple, practical overview of how superfast broadband access will address areas such communication, education, entertainment, high definition video and photography, social networking and business efficiency.



iSOFT Group Limited (ASX:ISF) Boosts Patient Safety Solution Offering Through Acquisition Of PSI

Sydney, Nov 26, 2009 (ABN Newswire) - iSOFT Group Limited (ASX:ISF) Australia's largest listed health information technology company today announced it acquired Patient Safety International Pty Ltd. (PSI) in a deal worth up to A$5 million as part of the company's strategy of boosting its portfolio of innovative solutions through bolt-on acquisitions.

The acquisition provides iSOFT with state-of-the-art patient safety software that enables healthcare organizations to record, monitor and take relevant management action to minimize future adverse medical events. South Australia based PSI's AIMS solution uses an ontology that comprises a comprehensive set of some 25,000 terms developed by the Australian Patient Safety Foundation.



Victorian Auditor-General slams public sector privacy

Information security policy, standards and guidance for the sector are incomplete and too "narrowly focused" on ICT security

Tim Lohman 26 November, 2009 13:26

The confidentiality of personal information collected and used by the public sector can be, and has been, easily compromised, a Victorian Auditor-General report has found.

The Maintaining the Integrity and Confidentiality of Personal Information report, which examined information security in three Victorian government departments, found that the ability to penetrate databases, the consistency of its findings and the lack of effective oversight and coordination of information security practices strongly indicate that this phenomenon is widespread.



AG slams Vic data security

  • Melissa Jenkins
  • From: AAP
  • November 25, 2009 8:00PM

THE Victorian government is failing to put safeguards in place to prevent public servants snooping on our personal details.

Auditor-General Des Pearson is scathing in a report over the lack of effective and co-ordinated measures to protect personal information used by the public service.

He has particularly directed criticism at Premier John Brumby's own department and Treasury, but says his findings suggest lax information security throughout the entire public service.



Study to look at 'near miss' dispensing errors

25 November 2009

The Pharmacy Guild has urged pharmacy staff to take part in a study that will aim to discover the reasons behind 'near miss' dispensing errors.

Researchers from Monash University, University of Sydney and University of South Australia have teamed up to identify the nature of and reasons behind 'near misses' – dispensing errors that are detected before they reach the patient.



Health in second place as Wii Fit goes for games

  • Mahesh Sharma
  • From: Australian IT
  • November 10, 2009 10:10AM

NINTENDO'S exercise game controller has caught its second wind with Wii Fit Plus's launch.

The Wii Fit balance board, released last year, was designed to get gamers off the couch and on to their feet.



Medicare's new powers curbed

by Jared Reed

New privacy safeguards have been agreed to in the Senate in the contentious draft legislation which gives Medicare the right to seize patient documents when questioning payments.

The amendments mean that Medicare will not be able to “develop a reasonable concern” as to the clinical relevance of a service under investigation.



Improved medical message system improves patient safety

QUEENSLAND'S Mater Health Services is running electronic medical records for 1.4 million patients across its seven hospitals, off the back of InterSystems' Ensemble integration engine that links more than 95 separate clinical systems.

Mater chief information officer Malcolm Thatcher says the e-patient record (EPR) system now holds more than 10 million pathology results and 12.5 million events, as well as demographic information.



BCA calls for national e-health strategy

November 23, 2009 - 2:29PM


A national e-health strategy would bring benefits of nearly $28 billion in its first eight years, a leading business lobby group says.

In a letter sent to Prime Minister Kevin Rudd last month and released on Monday, the Business Council of Australia (BCA) says using communication technology to improve the flow of health information is key to a more efficient health system.



Open source no panacea for e-health

Leading CIO says open source should not be seen as a panacea for addressing the interoperability challenges in healthcare

Kathryn Edwards 23 November, 2009 16:56

Open source software could provide a model for better e-health collaboration, but should not be seen as a panacea for addressing the interoperability challenges in healthcare, according to a leading healthcare industry CIO.

Malcolm Thatcher, CIO of Queensland-based Mater Hospital, said there are two issues to consider around the need for interoperability amongst Australian healthcare providers.



Easyclaim too hard for doctors

20 November 2009 6:45am

There were 76 million patient-claimed Medicare rebates in the year ending June 30, representing the total potential market for the reverse Eftpos Easyclaim system.

However, most of these rebates are still being paid in cash at Medicare offices while a slowly growing number are being paid online.

As at October 2009, Medicare says 2763 practices had signed up to EasyClaim, while 4795 had signed up to Medicare Online.



iSOFT Business Solutions (ASX:ISF) Wins New Deals Worth A$10 Million

Sydney, Nov 23, 2009 (ABN Newswire) - iSOFT Business Solutions (ASX:ISF) Australia's largest listed health information technology company today announced that iSOFT Business Solutions won new business totalling about A$10 million in October. The new deals include two contracts worth GBP2 million each (A$7.2 million).



NSW Health to review privacy policy for insurers' lawyers


November 25, 2009

THE NSW Health department is likely to review its privacy policies after a number of complaints about solicitors for insurers seeking irrelevant medical records from claimants, a source familiar with the department's privacy policy said.

A review of the department's privacy manual will address the issue amid fears that the forms can lead to the incorrect provision of information by doctors, the source said.



Crash victim says insurer adds insult to injury


November 23, 2009

A RANDWICK woman knocked off her bicycle and thrown across a roundabout by a car has spent five years fighting a big insurance company that wants access to all her medical records, including ''irrelevant'' ones, before it will assess her claim.

The woman, who has asked to remain anonymous, says the catch-all request could capture highly personal information such as psychologists' notes about a previous sexual assault.



Swift treatment for heart attack victims

ACT paramedics treating heart attack victims will be able to send vital patient information to doctors at the Canberra hospital whilst enroute. (ABC News)

The vital signs of heart attack patients can now be sent electronically to the Canberra Hospital before the ambulance even arrives.

A picture of the electrocardiogram [E.C.G.] can be emailed to specialists at the Hospital via a blackberry while the patient is enroute.



Tech tools of the trade

November 17, 2009

It pays to know how your business can benefit from the latest technical advances, writes Julia Talevski.

Still using old software and back-up tapes in your company? As new technologies become available in the market, it can be hard to determine what they do and how they can benefit your business. Here is a list of technologies to help you grasp the latest on the market.



Telstra's dismemberment may be put on hold

THE legislative dismemberment of Telstra could be delayed indefinitely unless the Senate can speed through debates on the party-dividing emissions trading scheme that comes before parliament this week.

The historic telecommunication regulatory reforms, which are aimed at providing a level playing field ahead of construction of the government's $43 billion national broadband network (NBN), are due to be debated this week.



A CIO's Guide to the NBN

Australia's $43 billion National Broadband Network will usher in a new era of connectivity and business innovation. Here’s what CIOs need to know. . .

Darren Horrigan 19 November, 2009 07:51:00

Forests have been felled and new server rooms built to carry the torrent of words written about broadband Internet access in Australia. Some of the country’s most brilliant technical, business and social minds have joined what has become at times little more than a cacophony of claims, counter-claims and lies.



NBN Senate Select Committee report reveals massive split

Report recommends cost-benefit analysis, interim implementation study report by end of year

Trevor Clarke 26 November, 2009 21:05

The Senate Select Committee into the National Broadband Network (NBN) has called for a rigorous cost-benefit analysis, an interim implementation study report, a skills audit and that legislation be brought forward to provide the funding and governance framework for NBN Co.

In its third report, the coalition-heavy committee's call for a cost-benefit analysis follows a similar call from the OECD, which said the Federal Government should conduct a more rigorous and systematic analysis of planned infrastructure projects, including the NBN.




Sunday, November 29, 2009

NSW Health, Cerner and Professor Patrick. Where To From Here?

It is now clear that there is an issue with the implementation of Cerner FirstNet in at least some NSW Hospitals and that at least some of those using the system are pretty unhappy with the present state of play.

The following article rehearses the present state of play.

Health department accused of censorship


November 28, 2009

THE University of Sydney removed from its website an extremely critical essay about a new multimillion-dollar emergency department IT system after pressure from the NSW Health Department. .

Doctors, nurses and administrators at four area health services heavily criticised the system - which tracks patients - as posing an ''unacceptably high risk'' to patient safety because it was so slow, cumbersome and inefficient.

Some hospitals have boycotted Cerner FirstNet and reverted to paper to record clinical notes because it is too difficult and too time-consuming to retrieve critical patient information from the system, the essay said.

''In a number of cases we know senior clinicians have shut down the use of FirstNet within a few days of it coming online,'' it said.

This flies in the face of the recommendation last year from Peter Garling's inquiry into public hospitals for full electronic medical records to improve efficiency and patient safety.

The essay, by a medical IT professor, Jon Patrick, said several hospitals also reported it ''doubled the delay'' before emergency patients were first seen by a clinician.

He also said the Cerner contract proposal suggested it was giving a ''cheap price'' on the proviso of a ''speedy finalisation of the contract'' which left NSW Health with such an ''incredibly tight schedule'' it stymied proper clinical consultation.

The essay was published late last month but NSW Health asked that it be removed, Professor Patrick said on his website. The university then published it again two weeks later.

More here:


There is also very comprehensive in depth coverage of the issue here:

Academic claims NSW Health censorship

By Suzanne Tindal, ZDNet.com.au
27 November 2009 02:26 PM

A professor at the University of Sydney who wrote a scathing essay about NSW Health's implementation of a Cerner system within emergency departments has accused the government of pressuring his institution to take the essay down, which it did, if only temporarily.

“One would have thought that Cerner was aware of the failure of the contract to specify the necessary reporting module and so it appears to be a form of gazumping.”

Professor Jon Patrick

"Version 4 of this essay was temporarily withdrawn on Friday, 23rd October by the university following a complaint from NSW Health," Professor Jon Patrick said on the Health Information Technologies Research Laboratory website. He believed the university was correct to investigate the complaint and didn't consider it at the time as an act of censorship.

Much more here:


The most recent version of the paper / essay on the issue (all 23 pages of it) is found liked from here:


To me the issue around all this is not what has gone on to – date, but what must be done to now ‘pull the fat from the fire’.

First a few disclaimers:

1. I have known Jon Patrick for a number of years, have had many discussions with him on informatics matters and have no reason to believe he has anything other the most principled and honest reasons for raising this issue – despite one or two rather nasty assertions made in the comments sections on the blog (Anonymously not surprisingly!)

2. I have known the Cerner Corporation and many people who work for it (up to and including the CEO Neal Patterson) for a period that now extends over 20 years. I have also (not recently) done paid work for Cerner in Australia and reviewed Cerner implementations many years for NSW Health many years ago.

3. I have done paid work for some Cerner competitors over the years.

4. I worked in NSW Health for almost 20 years as a clinician and so on.

A few basic facts are:

1. Cerner is a highly successful global provider of Health Information Software company who – as their web site says:

“Working together with more than 8,000 clients worldwide, Cerner is solving healthcare's many challenges by making sure the right people have the right information at the right time. Building on our clinical expertise, we are finding new and innovative ways to deliver value to our clients.”

The basic facts are here:


2. Cerner seems to have met difficulties at least in NSW, Victoria and the UK when instances of their software have been customised for a large number of organisations. This has not as often been the case when they have worked with single organisations both in Qld and the UK and of course in the US.

3. The possibilities for the cause of the present set of complaints are legion (could be NSW Health issues, Cerner issues, internationalisation of software issues, local workflow or cultural issues, technology provisioning issues and a range of other possibilities - or a bit of each!)

The only thing that is crystal clear to me is that there is much more darkness than light both about how things are going, what the root causes of any issues are and how they can be addressed.

Looking as an outsider it seems to me what is needed is the input of a genuinely dis-interested expert in Hospital Information Systems (preferably with a good knowledge of a variety of HIS implementation from around the globe) to review (with no options ruled out) the NSW process and plans and consult with all stakeholders to define a way forward and have NSW Health implement what is recommended.

Sadly NSW Health does not have a great track record of undertaking such introspection and then actioning what is needed but we can all hope.

There are a lot of reputations on the line here – as well as the credibility of the NSW Health eMR agenda, and indeed the national e-Health Agenda, to get this right – and it needs to be done properly, transparently and openly. All involved could learn from what might be discovered.

We are well beyond the time when ED staff should need to bring their own laptops to work to manage data entry because the systems provided are so bad!

I wonder will anyone listen?


Saturday, November 28, 2009

Would You Pay $US 1000 for This Report?

The following little advertisement for a research study on Australian Health IT appeared a day or so ago.

Healthcare Industry In Australia - IT Market Assessment - New Report Published

New report provides detailed analysis of the Information Technology market

Published on November 26, 2009

by Press Office


The Healthcare IT sector of Australia, being one of the developed markets, has seen a positive growth owing to the introduction of advanced IT products and services. Australian Healthcare IT sector comprises healthcare organizations (hospitals, nursing homes, diagnostic centers, dental hospitals, clinics, etc.), persons (doctors, dentists, nurses, and other caregivers), and health insurance providers. The Australian Healthcare IT market has been shifting from being a hospital focused market to a patient focused market. IT solutions such as enterprise software solutions, hospital management, and clinical management systems have been implemented successfully, and are now accepted by the Australian healthcare providers. Further, Australia being one of the progressive nations in the eHealth sector, has provided efficient avenues for storage, retrieval, and management of healthcare information. Also, owing to rising of aging population, remote healthcare services such as patient monitoring devices and telemedicine have been deployed to a large extent.

The report forecasts the IT spending of the Australian Healthcare Industry for the period 2008-2012. It discusses the segmentation of this Industry based on technology, and also highlights the market trends and challenges that characterize the industry. Further, it discusses the key growth drivers and barriers of the Healthcare Industry in Australia, and profiles some of the key vendors operating in the Healthcare Industry in Australia.

This information is found here:


Table of Contents:


2. IT Spending and Forecast

3. Market Trends

3.3. Telemedicine Industry

4. Market Segmentation by Technology Type

5. Growth Drivers

5.1 Collaboration and Integration of Healthcare Information

5.2 Enhancing Mobility of Information

5.3 Reducing Operational Costs

5.4 Empowered Customers

6. Growth Barriers

6.1 Skill Workforce Shortage

6.2 Distribution problems

6.3 Privacy and Security of Data

6.4 Limited Budgets

7. Key Vendors

7.1 Baxter International Inc.

7.2 Health Communication Network

7.3 IBA Health Group Limited

7.4 Philips Healthcare

7.5 Toumaz Technology Limited

Other Reports in This Series

List of Exhibits

Exhibit 2.1: Australian Healthcare IT Spending and Forecast 2008-2012 (In million)
Exhibit 4.1: IT Market Segmentation by Technology Type for Australian Healthcare Industry – 2008
Exhibit 4.2: IT Market Segmentation by Technology Type for Australian Healthcare Industry – 2012

For those with lots of money you can have the report from this link.

Healthcare Industry in Australia - IT Market Assessment: http://www.companiesandmarkets.com/r.ashx?id=KD2RFK3Q583953

And the price for all this information $1000. Number of pages 18. (About $A60 per page!)

I leave it for the readers to decide on the value for money proposition! The introduction does not lead me to think the insights offered would be all that valuable. Clueless might be closer!


Friday, November 27, 2009

Trying Out a Reader Views Poll System

Dear Readers,

Just to highlight the blog user poll and to ask for votes so I can assess how I and the blog are doing, and what views readers have on important matters related to the overall blog topic.

I plan to have a weekly question and to try and get views on all the matters that are of interest to readers.

Suggestions for polls that are balanced and allow readers to express their view clearly welcome!

As always any other suggestions are also keenly received!



Thursday, November 26, 2009

Talk About a Non Document from NEHTA. The Introduction to National e-Health Services Document is Really a Joke.

Regular readers will know that I have been complaining that I could not seem to find a document which was referenced in the HI Services Documentation.

I was kindly given a link earlier today. I also had an e-mail from NEHTA letting me know of the link six days after I asked by e-mail (20/11/2009 3pm). I hope the support for the HI Service is going to be a trifle better than this!

The document was published on the 24th November. The link is here:


Despite the grand title:

NEHTA, Introduction to National e-Health Services, version 1.0, November 1 2009

The document turns out the be a riveting 13 page read explaining how someone with an apparently clinically fractured wrist can be passed between GP, Radiologist, Surgeon, (not Hospital but having surgery anyway – where who knows?) and back to GP followed and guided by securely sent and signed documentation all laden with patient and provider IDs courtesy of NEHTA.

The whole scenario is really clinically quite odd – and I leave it as an exercise for the reader to point out where. Oddities include

1. The unreality of the details provided (tip do GPs really decide on surgery and does all the surgery happen absent a hospital and a discharge summary etc?)

2. The number of IHI look ups and encrypted messages – does not look like we are actually adding a great deal efficiency here – who do you imagine made the decision not to have a way of having the verified IHI consumer who wants to have a personalised something with their IHI on it so look ups can be avoided? Most regular health system users I am sure would be keen on that!

There are other little issues – like the assumption of all this non NEHTA software all using the HI Service. That might take a while.

NEHTA really should provide an implementation plan of how we are going to reach this nirvana and maybe refine their plans and scenarios a little for reality.


Weekly Overseas Health IT Links 24-11-2009

Here are a few I have come across this week.


Medicare Extends PHR Pilot — Big Mistake!

Posted by Vince Kuraitis on

Medicare announced today that it is extending its Personal Health Record (PHR) pilot project for residents of Utah and Arizona.

This is a waste of time and taxpayer dollars. Those of you who read my blog know that I’m a big fan of PHRs, but you have to know when you’re backing the wrong approach.



Current security standards too complex, expert says

By Joseph Conn / HITS staff writer

Posted: November 20, 2009 - 5:59 am EDT

A federal health information technology advisory panel heard a whole day of testimony on the state of data security, and, not surprisingly, the testimony reflected the findings in a recent spate of public reports: Data security breaches are on the rise and healthcare organizations are ill-prepared to deal with them.



Eight Tips to Polish Your Hospital's Patient Breach Response

Dom Nicastro, for HealthLeaders Media, November 18, 2009

Editor's note: This is the third in a three-part series about breach notifications. Part one focused on how to prevent breaches. Part two tackled how to handle breaches. This installment offers some final tips if a breach occurs. focused on how to prevent breaches.



Conn. health insurer acknowledges missing data

By Associated Press

Posted: November 19, 2009 - 10:45 am EDT

Connecticut Attorney General Richard Blumenthal said that health insurer Health Net lost financial, health and personal information of nearly 450,000 state residents and failed to inform consumers for six months.



Meaningful use rule ‘on target’ for end of year

By Brian Robinson

Thursday, November 19, 2009

The Centers for Medicare and Medicaid Services is still on target to publish by the end of the year a proposed rule on the meaningful use of electronic health records, despite growing fears from industry about the possible impact of the regulation.



ECRI picks top 7 health plan IT trends to watch

November 16, 2009 | Diana Manos, Senior Editor

PLYMOUTH MEETING, PA – Genetic testing and electronic medical records are top of the ECRI Institute's 2010 technology watch list for health plans.

ECRI officials said the list represents important technologies and technology-related issues that private and public payers should pay close attention to in 2010.


The white paper on the watch list can be downloaded free at https://www.ecri.org/Forms/Pages/Top_Technologies_Health_Plans.aspx.



Study: RTLS technology can save hospitals time and money, boost care

November 17, 2009 | Eric Wicklund, Managing Editor

LUMBERTON, NC – A study of the use of a real-time location system (RTLS) at Southeastern Regional Medical Center indicates the technology can save hospitals hundreds of thousands of dollars a year, improve clinical outcomes and boost staff morale.



Healthcare Affiliates Unprepared For Data Breaches

Patient privacy is at risk from the companies that healthcare providers do business with, study says.

By Mitch Wagner

Companies that do business with healthcare providers, including accounting firms and offshore transcription vendors, are unprepared to meet data breach obligations included in new federal regulation, according to a survey released Tuesday.

The survey by Healthcare Information and Management Systems Society (HIMSS) Analytics, commissioned by security vendor ID Experts, looked at preparedness for healthcare providers business partners, such as billing, credit bureaus, benefits management, legal services, claims processing, insurance brokers, data processing firms, pharmacy chains, and temporary office personnel providers.



Nova Scotia Paramedics Gain In-ambulance Access to Patient Records

November 18, 2009 (Halifax, NS) - The first system in Canada to provide paramedics with instant access to MedicAlert health records has been successfully launched in Nova Scotia. Within hours of the system going live, a paramedic in Halifax accessed potentially life-saving information en route to the hospital with a patient.



Why Kenya needs to implement e-health

By HARRY HARE (email the author)

Posted Thursday, November 19 2009 at 00:00

In Summary

  • A basic health information management system can improve the ability to collect store and analyse data
  • Integrating e-health into healthcare practice can help increase data accuracy and improve the tracking of health trends
  • E-health can help improve the level of efficiency in medical facilities
  • With information on hand, healthcare practitioners can work more professionally and make better, more accurate decisions.
  • E-health can improve the tracking of health health trends which can lead to better healthcare planning



Kingston to go-live on 30 November

18 Nov 2009

Kingston Hospital NHS Trust plans to go live with Cerner Millennium on 30 November, in what has become a critical milestone for the £12.7 billion NHS IT programme.

If successful, the South West London NHS trust will become the first in the capital to go live with the US system in 18-months.



Rx Systems accredited for EPS R2

12 Nov 2009

Pharmacy software supplier Rx Systems has become the second pharmacy supplier to achieve technical accreditation for Release 2 of the Electronic Prescription Service.

The company’s ProScript dispensary management system will now be tested with TPP’s SystmOne - the only GP system to be accredited for R2 - at Burrows and Close Pharmacy in Kimberley, Nottingham.



London SCR roll out announced

16 Nov 2009

The Department of Health has announced that the Summary Care Record is to be rolled out across London from this week.

The Princess Street Group Practice in Southwark will be the first GP practice in the capital to upload SCRs, with this scheduled to happen on 19 November.



Posted on: November 18, 2009

Semantic Technology: The Next Step for Health Care IT

Web 3.0 technology is making its way to the mainstream, and savvy health care providers are adopting it to address data challenges.

By Michael Cataldo

Over the past few decades, the nature of the Internet has transformed from static, individual Web pages and basic e-mail (Web 1.0) to the current Web (Web 2.0), where a host of new capabilities such as social networking, wikis and instant messaging have transformed the way individuals and enterprises use the Web.

Today, Web 3.0 technologies, also known as "the Semantic Web," are beginning to gain traction on both sides of the firewall and are making their way to the mainstream. Semantic technologies are backed by a set of standards that have been developed by the World Wide Web Consortium (W3C) and promise to enable a whole new level of data collaboration. So dramatic, in fact, that Sir Tim Berners-Lee himself -- the inventor of the Web -- has identified semantics as the key technology for the next generation of the Internet, and leading companies from health care and biopharmaceuticals to finance, oil, gas and retail have begun to adopt it.



Hundreds of records breached in Hull

16 Nov 2009

More than 350 patients in Hull have had their electronic medical records accessed by a member of NHS Hull's staff who should not have had access to them.

A primary care trust employee, who was authorised to use collated and anonymous patient data for research, but not permitted to access individual patient records, accessed a total of 358 across 20 GP practices.



West Coast ‘code-a-thon’ set for Connect software

By Joseph Conn / HITS staff writer

Posted: November 17, 2009 - 11:00 am EDT

So far, about 180 federal officials and representatives from a host of private organizations have registered to convene on the campus of Portland State University later this week for a two-day Code-A-Thon to enhance the code base of Connect, the open source gateway to the proposed national health information network.



IT effect on patients, providers most vital: Blumenthal

By Rebecca Vesely / HITS staff writer

Posted: November 17, 2009 - 11:00 am EDT

Proposed rules on the meaningful use of electronic health records will be made public by the end of the year or perhaps sooner, said David Blumenthal, national coordinator for health information technology at HHS.

In a speech before the American Medical Informatics Association's annual symposium in San Francisco, Blumenthal stressed that health IT must be focused on the goal of making the healthcare system work better for patients and providers.



HITrust launches IT security certification program

By Joseph Conn / HITS staff writer

Posted: November 17, 2009 - 11:00 am EDT

The Health Information Trust Alliance, commonly known as HITrust, a consortium of health plans, pharmacy benefits managers, information technology vendors and data-miners formed to address health IT security issues, has announced the formal launch of a two-tier health IT security and privacy certification program.



Why Do Some Hospitals Successfully Implement EHRs and Others Fail?

Carrie Vaughan, for HealthLeaders Media, November 17, 2009

There are pieces of advice I hear repeatedly when talking with technology executives about implementing electronic health records and why some organizations are successful whereas others struggle. Phrases like "get physician buy in," "allocate more resources for training," and "spend more time planning on the frontend" come to mind. Unfortunately, the advice doesn't always come with strategies on how accomplish it.



Tuesday, November 17, 2009

Blumenthal Thanks Informatics Leaders, Predicts Big Changes

SAN FRANCISCO – If any of the 2,000-plus attendees of the American Medical Informatics Association annual symposium were hoping for a little preview of what to expect when the federal government unveils its definition of "meaningful use" next month, they didn't get it from David Blumenthal.

What they did get from the country's national coordinator of health IT during his keynote address Monday was a vote of confidence and his assurance that big changes are just around the corner.

"We're going to see major, major changes in the near future -- positive changes. And in many ways, we have you in this room to thank for them. You all saw the future way in the past," Blumenthal told a standing room-only crowd.



Information Exchanges Let Doctors Share Patient Data Efficiently

Several new networks are being launched across the country, and while they vary in size, scope, and clientele, the goals and challenges are similar.

By Marianne Kolbasuk McGee, InformationWeek

Nov. 17, 2009

As more doctors and hospitals make use of electronic health records, the next step in healthcare's transformation will be to ensure that doctors and other healthcare providers can exchange of patient data.

Multifaceted healthcare organizations are setting up internal data exchanges so their affiliated doctors, outpatient facilities, and hospitals can easily share data. But larger health information exchanges are also being launched that let unaffiliated providers within a state or region share patient information. All of these efforts potentially play a role in the federal government's vision of building a national health information network that would serve as a "network of networks."



eHealth Ontario improves the way Ontarians with diabetes receive care

TORONTO, Nov. 16 /CNW/ - The value of ehealth was brought to life today by Rob Devitt, Interim President and CEO of eHealth Ontario, as he told a packed room at the Ontario Hospital Association's 2009 HealthAchieve conference that eHealth Ontario was the driving force behind the work to identify the 906,577 patients living with diabetes and match them with their almost 9,000 family physicians.



Quality Forum Releases Health IT Data Framework

Janice Simmons, for HealthLeaders Media, November 16, 2009

The National Quality Forum (NQF) has released the Quality Data Set (QDS), a common technological framework to assist in defining clinical data used in measuring performance and evaluating improvement in patients' quality of care. The QDS framework will provide a standardized set of data that should be captured in patients' electronic health records and is applicable to all care settings a patient is likely to use in his or her lifetime.



Wireless medical device a winner

3M collaborates on Bluetooth scope

By Robert Downs
Pioneer Press

Updated: 11/13/2009 09:11:50 PM CST

Most people would not want their doctors chatting on a Bluetooth headset during a checkup. But what if that technology could save patients thousands of dollars?

A first-of-its-kind stethoscope developed by Maplewood-based 3M Co. and Connecticut-based Zargis Medical uses Bluetooth technology to wirelessly transfer sound waves from the heart and lungs straight to a computer. After 20 seconds of processing, software helps doctors identify heart murmurs or other ailments, Zargis CEO John Kallassy said.



Health Privacy Breaches Can Be Prevented

Why patient information is so often compromised - and what healthcare organizations can do about it.

As personal health records are increasingly being stored electronically, the number of data and privacy breaches is also growing rapidly – despite safeguards such as the Health Insurance Portability and Accountability Act (HIPPA).

Healthcare organizations, already racing to prevent such breaches, now face new mandates from Congress that further tighten data-security requirements, and include greater penalties for non-compliance.

Link to report:

Stemming the Rising Tide of Health Privacy Breaches: The Need for a More Holistic Approach



Telephone-Delivered Collaborative Care for Treating Post-CABG Depression

A Randomized Controlled Trial

Bruce L. Rollman, MD, MPH; Bea Herbeck Belnap, Dr Biol Hum; Michelle S. LeMenager, BS; Sati Mazumdar, PhD; Patricia R. Houck, MS; Peter J. Counihan, MB, BCh; Wishwa N. Kapoor, MD, MPH; Herbert C. Schulberg, PhD, MS Hyg; Charles F. Reynolds III, MD

JAMA. 2009;302(19):(doi:10.1001/jama.2009.1670).



Medicine examines electronic records

The push for health care reform is spurring discussion about the industry adopting electronic medical records. Advocates point to the cost savings and efficiency that will occur when the medical industry is brought into the digital age. Critics worry about issues such as security and the expense of new technology.



Blumenthal: Tear Down E-Health Barriers

Posted by Mitch Wagner on November 16, 2009 02:29 PM

The U.S.'s top e-health official urged healthcare organizations to tear down the barriers to effective exchange of e-health records in a message to healthcare providers.



Health info security laws a hurdle to health Internet

By Mary Mosquera
Friday, November 06, 2009

Federal agencies hope to use the government’s Connect software to share health information with private healthcare providers, but current information security and privacy laws significantly block their way, government health IT executives said yesterday.

Two key laws – the Federal Information Security Management Act (FISMA) and the Health Insurance Portability and Accountability Act (HIPAA) – are a particularly steep hurdle to electronic record sharing among federal agencies and private sector providers, they said.



CCHIT Chair Announces Retirement

John Commins, for HealthLeaders Media, November 13, 2009

The organization that certifies electronic health records will soon search for a new chairman.

The Certification Commission for Health Information Technology announced today that Mark Leavitt, MD, PhD, is retiring from his position as chair of the commission on March 31, 2010.




Wednesday, November 25, 2009

New Release of the Jon Patrick Essay on Cerner FirstNet Implementation in NSW Health.

The following arrived a few hours ago:

----- Begin Quote

Dear Colleagues, the essay discussing and analysing the rollout of Firstnet in NSW has been republished in Version 6.0. It contains more details than previous versions but has been remodelled in presentation based on comments from supportive colleagues at the AMIA and around the State.

You will find a difference in shift from an informal style of description to something more formal, but hopefully you will also find more rigour of thought and better substantiation of arguments.

There are a number of issues that I have not breached in the essay for which I have some evidence but would like more substantial information before I raise them in a public forum.

The attempt at censoring me has failed.

The University has given me an unambiguous statement that I am entitled to publish my opinions on the matter and have asserted they ill defend my right to do so.

I encourage you to broadcast the essay as widely as possible as I am interested in getting all feedback available whether in agreement or not my opinions.

The essay is available from the Health Information Technology Research

Laboratory website on the Essays page Essay No 6.


Professor Jon Patrick


Health Information Technologies Research Laboratory: www.it.usyd.edu.au/~hitru

----- End Quote.

Sounds like good news from all sorts of perspectives to me!


NEHTA Releases a Concept of Operations for the Health Identifiers.

The following appeared, along with a lot of other documentation a few days ago.


NEHTA releases Concept of Operations for Healthcare Identifiers Service

20 November 2009.

NEHTA releases Concept of Operations for Healthcare Identifiers Service.

One of the key foundations for a national approach to e-health will be a standard process across the health sector to accurately identify everybody involved in a healthcare transaction. A national Healthcare Identifier Services (HI Service) is being established to assign and maintain healthcare identifiers. NEHTA has released the Concept of Operations providing an overview of the proposed HI Service. The Concept of Operations covers the current state of healthcare identification; describes the HI Service and how the service will be used and will work; and documents key concepts and their usage.

The Concept of Operations and associated documents are located at Healthcare Identifiers

Email ehealthid@nehta.gov.au

At the simplest the purpose of the document is covered here:

This Healthcare Identifiers Service (HI Service) is the subject of this Concept of Operations document. The purpose of the Concept of Operations is to:

Describe the current state of healthcare identifiers in Australia

Describe the Healthcare Identifiers Service (HI Service), in such a way that key stakeholders can understand:

o What the service is

o Why the service is required (from a high level)

o How it will work

o How it will be implemented

  • The key privacy/policy underpinnings
  • Document key concepts and their usage
  • Illustrate key scenarios where healthcare identifiers will be used to highlight any gaps in expectations
  • Illustrate the impact relative to today’s situation as it relates to the proposed services and solution

(Page 9 of 83)

The document is quite useful but there are a few themes that emerge that are going to cause some issues I suspect.

First the management and governance framework for the HI Service that is planned is still not spelt out as far as I can tell.

Second NEHTA does not seem to have made available a document they reference which would be very important in getting all this into context:

NEHTA, Introduction to National e-Health Services, version 1.0, November 1 2009

My e-mailed request for a copy (to the address above) has gone ignored for 4 days at least. Typical.

Third there is still no reference to or provision of a Business Case that justifies the planned expenditure. We get a lot of motherhood about improved identification etc but there is just no evidence provided (in the whole documentation set) that the NEHTA HI Service proposal is actually fit for the purposes for which it is intended and is the best way of going about things.

The entire NEHTA thrust seems to be justified by these couple of paragraphs from the February 2006 COAG meeting outcomes (Appendix D)

“2. From February 2006, governments will accelerate work on a national electronic health records system to improve safety for patients and increase efficiency for health care providers by developing the capacity for health providers, with their patient’s consent, to communicate safely and securely with each other electronically about patients and their health. This requires:

· developing, implementing and operating systems for an individual health identifier, a healthcare provider identifier and agreed clinical terminologies; and

· promoting compliance with nationally-agreed standards in future government procurement related to electronic health systems and in areas of healthcare receiving government funding.”

Not wanting to stir the pot but it would be nice to know just what prompted this outcome – in detail.

Fourth review of the document makes it clear that there are all sorts of activities to be undertaken by Medicare Staff, Health Care Providers and their Staff and the HI Service itself. Just an indication of the scale of the budget for all this – and who will pay for providers time and effort would be helpful.

Last it is clear that unless there have been all sorts of secret meetings going on and payments arranged there is going to a exist a bright shiny service with no one having proven and widely implemented software to use the service.

This document makes me feel this HI Service is a bit of a chimera we are going to be waiting quite a long time to see it take its final form – legislative delays notwithstanding.

There is also, of course the small and large scale testing that needs to be done before the HI Service is made generally available. I wonder if there is a timetable anywhere that shows the critical path for having this service actually operational at any scale in 2010?


Here is How You Know the US Is Serious about Health IT!

This appeared today.

Grants to Fund Health I.T. Training

HDM Breaking News, November 24, 2009

The Office of the National Coordinator for Health Information Technology soon will post a funding opportunity notice for $80 million in grants to support the training of health information technology professionals in about 70 community colleges across the nation.

The funds, authorized under the American Recovery and Reinvestment Act, are intended to expand the health I.T. workforce by 50,000. Under the grant program, $70 million is dedicated for operating non-degree, six-month intensive training programs, says David Blumenthal, M.D., national coordinator. The remaining $10 million will go for development of educational materials, which Blumenthal calls "a national resource for anyone wishing to develop and conduct such programs."

Under the grant program, ONC will fund five consortia of community colleges in five regions across the nation. Federal officials expect the program to produce 10,000 graduates each year for five years. The program could include distance-learning initiatives.

More here:


Just where exactly is NEHTA and DoHA in the cycle of actually getting some funds to this?

We have a committee, grandly titled National Health Informatics Education Committee (NHIEC) which has now morphed into the Australian Health Informatics Education Council (AHIEC) which is developing a Strategic HI Education work plan. That is a plan to develop a plan of how to fix HI manpower issues.

The web site for this is here:


The current workplan is found here:


It seems to be rather a plan to work out what is needed. From the Executive Summary:

“This report and indicative workplan represents a systematic approach to describing the required HI competencies, defining the gaps, developing the strategies to address the capability gaps and monitoring the progress and effectiveness of the strategies implemented. The modular approach, with a mix of sequential and parallel implementations, provides a degree of flexibility in rolling out the workplan. While this flexibility is important, it does not detract from the urgency of the workplan implementation to achieve a workforce with the required competencies to drive the national health and e‐Health agenda.”

To date it is not clear just how much funding has actually been allocated to getting things up and running some five months after the report was finalised.

We clearly have a very long way to go to actually be rolling out courses across the wide brown land.

Time for the AHIEC to get seriously rolling I think! Maybe we might be able to leverage the courses being developed in the US?


Tuesday, November 24, 2009

Weekly Australian Health IT Links - 23-11-2009

Here are a few I have come across this week.


E-health system crucial to reform success

Elizabeth McIntosh - Friday, 20 November 2009

AGPN National Forum, Sydney

THE success of impending health system reform will require a fully functioning e-health system, according to a leading expert.

Addressing the AGPN National Forum, Dr Mukesh Haikerwal, National E-Health Transition Authority clinical lead, said e-health would lead to improvements in the safety and quality of patient care.



Computer games


Computers were supposed to make life easier, but for many GPs clinical software is becoming more complicated and frustrating. By Sarah Colyer

IT has been a nightmare for WA GP Dr Padminie Kain, who is desperately trying to recover more than 10,000 patient files after her software provider collapsed.



28 October 2009

Electronic Medical Record providing safer care in our public hospitals

The Deputy Premier and Minister for Health, Carmel Tebbutt, today announced that hospitals in the Greater Western Area Health Service (AHS) were preparing to roll out an Electronic Medical Record (eMR) system to assist clinicians and provide safer care for patients.



Professor Gavin Andrews

Web offers new window to treating depression

Friday, 20 November 2009

ANXIETY and depressive disorders, the internalising or emotional disorders, are the largest cause of disability in Australia. The National Mental Health Surveys show that less than half the people with these disorders see a health professional, and only a quarter get adequate treatment. Recently, Dr Norman Swan, presenter on ABC TV’s Catalyst, hosted a program about the University of NSW’s Research Unit for Anxiety and Depression’s web-based treatment for major depressive disorder...

In a randomised controlled trial of the web-based intervention versus wait list controls, 80% of the people diagnosed as having major depressive disorder completed all six online lessons, and 70% no longer met criteria for that disorder at the end of treatment.



iSOFT Group Limited (ASX:ISF) Interview With CEO Mr Gary Cohen On Latest Developments

Sydney, Nov 20, 2009 (ABN Newswire) - iSOFT Group Limited (ASX:ISF) recently met a major delivery deadline for the UK National Programme for IT (NPfIT), under which it had to implement Lorenzo 1.9 in a care setting by November, with the National Health Service (NHS) Bury Primary Care Trust chosen as the adopter site. How effective has this implementation been and what implications does it have for iSOFT's next steps under NPfIT?



Cop 'searched women's details for sex'


November 17, 2009 03:52pm

A FORMER detective was sexually motivated when he used the West Australian police computer system to access the details of more than a dozen women, a court has been told.

John Lawrence Curren, 46, pleaded guilty to 16 counts of unlawfully using police computers to access the details of 14 women when he appeared Perth Magistrates Court today.



Mirixa Australia Achieves Six Month Milestones

Over 40% of pharmacies nationwide now enrolled; technology-backed, pharmacist-delivered programs launched to assist patients in adhering to six common chronic care medications

RESTON, Va. and SYDNEY, Nov. 17 /PRNewswire/ -- Mirixa Corporation, the leader in pharmacy-based patient care services and the Pharmacy Guild of Australia, the peak body representing owners of pharmacies across Australia, announced today results of the first six months of operating activity of Mirixa Australia.



Clarke unleashes blast on privacy

  • Fran Foo
  • From: Australian IT
  • November 17, 2009 1:00AM

AUSTRALIAN Privacy Medal winner Roger Clarke has accused businesses and government agencies of "investing in image'' and "playing the public for fools'' over privacy concerns in the surveillance age.

In a broadside unleashed at the annual Privacy Awards dinner in Sydney, Dr Clarke said organisations had become "habituated to hands-off stances by parliaments and by regulators'', and simply "got on and did'' whatever they wanted.



Ludwig flags data privacy overhaul

  • Karen Dearne
  • From: Australian IT
  • November 17, 2009 1:00AM

THE Rudd government is planning to reform the federal Privacy Act to ensure businesses regularly assess the impact of new technology on their handling of personal data, Special Minister of State Joe Ludwig says.

"Rapid technological changes have meant a vastly increased capacity to collect, retain and disseminate personal information,'' Senator Ludwig told the Privacy Awards dinner in Sydney.



'One fit for all' costs Medibank $60m

  • Fran Foo
  • From: Australian IT
  • November 17, 2009 1:00AM

MEDIBANK Private will spend $60 million on IT projects this financial year as it integrates new businesses into the fold and prepares to finally bid adieu to 35-year-old systems.

Australia's largest health insurer is working to fit in the platforms Australian Health Management and Health Services Australia use after buying both companies earlier in the year.



ID theft laws stuck in queue

  • Karen Dearne
  • From: Australian IT
  • November 17, 2009 1:00AM

NEW laws aimed at preventing identity theft and giving victims a means of untangling the mess are languishing in federal parliament, 10 months after they were introduced to the Senate by then human services minister Joe Ludwig.

The Identity Crimes Bill adds three identity offences to fill gaps in existing laws: trafficking in identity data (up to five years' imprisonment); possession with intent to commit a crime and possession of equipment for the purpose of identity theft (both a maximum three years).



Wii boosts balance and muscle strength

by Jared Reed

Balance and muscle strength could get a boost from the new generation of fitness tools, early results from the Wii interactive gaming exercise program suggest.

Results from a pilot study in Queensland involving ten women, aged between 30-60, showed that balance and lower limb muscle strength showed significant improvement after a ten-week period exercising with Nintendo’s Wii Fit device.



Are You Ready To Lose Your Privacy?

We spend an increasing amount of our lives online where traditional privacy protections fail to cover us. Now governments are getting set to exploit that, writes Mark Newton

Imagine, for a moment, the kind of world you'd be living in if information about every letter you sent and received through the mail was kept in a government database. Your love letters, junk mail, subscription magazines, business correspondence all itemised, categorised and serialised, searchable by any government employee who feels like checking up on you.



Gartner lays out Top 10 strategic technologies

Analyst firm lays out what it thinks will be most important in 2010

Kathryn Edwards 20 November, 2009 12:30

At this week’s Gartner Symposium in Sydney, the analyst firm presented its top 10 strategic technologies for 2010.

Gartner senior analyst and mobile guru, Nick Jones, presented the strategic technologies, and defined them as the ones which will impact CIOs within the mainstream enterprise between the next 12 to 36 months.

“Strategic technologies will drive significant change, disruption, modifications to your strategy,” Jones said, urging all CIOs to explicitly address them in their strategy, plans and IT architecture.



Fedora Linux 12 arrives, ups multimedia support

Better tablet PC support also a feature

Rodney Gedda 18/11/2009 10:16:00

The Fedora 12 Linux desktop gets a new theme and other UI improvements

Fedora, the Linux-based operating system backed by Red Hat, has released version 12 with a view to improving the multimedia and graphics experience on the desktop.

Fedora 12 integrates the Empathy unified communications client that combines instant messaging, video, and audio.



Windows 7 tricks: 20 top tips and tweaks

A few pointers for the upgrade

Preston Gralla (Computerworld (US)) 12 November, 2009 04:20

Just got your hands on Windows 7 and want to bend it to your will? No problem. We've got plenty of tips, hacks and secrets to keep you busy for a long time, including automatically opening Windows Explorer to a folder of your choice, speeding up taskbar thumbnails, finding hidden desktop themes, forcing User Account Control to act the way you'd like, keeping your Explorer searches secret from others, and more.