Sunday, September 05, 2010

Weekly Australian Health IT Links – 05 September, 2010.

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment:

We are assured that this week we will know who is going to govern for the next little while. That will be a good thing as I suspect most people are a little sick of waiting for things to clarify.

On the e-Health front there has been continuing coverage of iSoft’s woes and the Health Informatics Conference from last week.

The first article cited below – and Prof Greenhalgh’s views – need to be taken pretty seriously. I believe and before we leap into implementing the still pretty obscure NEHTA / DoHA plans for their various forms of shared electronic records I think we need to carefully review all that has gone one in the rest of the world and try and work out an optimal way forward. To just steam ahead, without pausing for careful review, would be just silly in my humble opinion.


Doubts over value of records in emergency

THE oft-touted summary care record that would save the lives of unconscious patients in emergency situations was a myth.

It distracted from broader e-health gains, said a British researcher in the field.

Trish Greenhalgh, professor of primary healthcare at the London School of Medicine, says her detailed review of the National Health Service's Summary Care Record program found scant evidence that SCRs would have made any difference to patient outcomes.

"I'm quite irritated by politicians like Tony Blair who in 1998 said his vision was 'if I live in Bradford and I get sick in Birmingham, I want doctors to have my records on hand there'," she told the Health Informatics Conference in Melbourne.


Australia behind on e-health: HealthLink

  • Karen Dearne
  • From: Australian IT
  • September 01, 2010 10:05AM

NEW Zealand continues to outpace on e-health Australia still grapples with key design, funding and planning issues.

Tom Bowden, chief executive of Auckland-based secure messaging and integration specialist HealthLink, said Australia had failed to do the hard work on building basic capacity, setting standards and improving data quality.

"All the really flash stuff has been worked on and there's been lots of bright ideas, but the real effort is still to be done and we won't see solid progress until that occurs," he said.

"Nowhere near enough effort has gone into getting the quality of GPs' electronic patient records up to scratch, and organising standardisation of the information that's to be exchanged."

In contrast, 100 per cent of GPs were using fully functional e-medical records by 2000; 100 per cent have been doing clinical messaging and 95 per cent of hospitals have provided e-discharge summaries over the same period. Because of this infrastructure, New Zealand has been able to build and release a raft of more sophisticated applications.


E-health groups seek systems for 'data harvest'

Liz Tay|Sep 1, 2010 12:39 PM

US experts flag opportunity for software vendors.

E-health experts have called for information management systems to "harvest" data from electronic health records for medical research.

According to Donald Mon of the American Health Information Management Association (AHIMA), "secondary use" of data by researchers could improve medicine, patient safety and public health.

While current e-health software was "rich in functionality", Mon said products tended to store information as "free-text" data that could be read by a human but not easily analysed by a machine.

He explained that researchers needed quality e-health data that could be analysed based on clinical results, quality indicators and any public or population health trends.

Data had to be in a "computable form" so that relevant information could be "harvested" from e-health records for researchers to test hypotheses or conduct ad hoc investigations.

"Some systems are capturing a text stream when they could easily have captured [that information] as a numeric value," said Mon, AHIMA's vice president of practice leadership.

"There is huge opportunity for software providers ... We hope to take these already rich products and make them better."


Online CBT cuts anxiety and depression


By Louise Wallace

RESEARCH confirming the success of internet-based therapies for patients with depression and anxiety shows doctors can be confident in recommending them to patients, an expert says.

A systematic review of more than 20 randomised studies found for every two people who used a web-based intervention, one would be cured, said study co-author Professor Gavin Andrews. Most patients who completed internet-based CBT for depression, panic disorder, social phobia or anxiety for up to 13 weeks had reduced symptoms and better outcomes after treatment, the review found.

The benefits persisted after course completion, and most patients were satisfied with online therapy despite having less clinical contact, the review noted.


Tebbutt accused of hiding health data

Louise Hall

September 4, 2010

A DAY after the state government pledged to be open and transparent about the performance of the health system, leaked documents show hospitals in Sydney's west have fallen far short of recommended treatment times during winter.

The Minister for Health, Carmel Tebbutt, launched a new website, Your Health Service, on Thursday, saying it would give people ''the most current information, hospital by hospital'', to help them find the healthcare they needed.

However, the website is already six months out of date. Information about waiting times in emergency departments, for elective surgery and to be admitted to a ward based on the January to March period.


How hard is it to set up a national e-health record?


By Dr Linda Calabresi, Australian Doctor Medical Editor

IT was just your average Saturday morning surgery. The old regulars, the coughing executives who’d been too busy to get to the doctor during the week, the young mothers who finally had someone to mind the baby — you know the drill.

Among the morning’s list was an older Eastern European lady who I occasionally see when she’s in town visiting her daughter. A really delightful lady. But a really woeful historian.

Since I’d last seen her she’d been in St Elsewhere’s, apparently following an episode of chest pain.

“Did you have a heart attack?” I asked. Well — not quite sure about that one.

She had come in because she’d left her medications at home and she knew it was important she take them.

You can imagine how we spent the next 10 minutes. It was something of a cross between a game of charades and Russian roulette.

Unfortunately, her local doctor wasn’t available and in the end I ‘googled’ then called her local chemist, who kindly confirmed her suspected medication cocktail and was able to shed light on the identity of that “extra little white one”.


E-health rollout blueprint ‘too little too late’

30th Aug 2010

Caroline Brettingham-Moore

A NATIONAL E-Health Transition Authority (NEHTA) blueprint outlining the rollout of e-health in Australia has been labelled “too little too late” by health IT experts.

The 200-page document released late last month canvassed the current state of the health sector, targets being promoted by NEHTA and current strategies to deliver a national e-health system.

Dr Andrew McIntyre, director of software firm Medical-Objects, said the blueprint added to the “inertia” the industry had suffered over the past five years.

“They have been at this for so long and yet seemingly everything is still in the process of being sorted out,” he said.


iSoft's CEO quits after $383m plunge into the red

ISOFT chief executive Gary Cohen has quit less than three months after relinquishing the chairman role after a horror full-year result.

The Sydney health information technology company yesterday reported a $382.9 million loss, following a $34.7m profit last year, that included a hefty $341m one-off impairment charge, primarily related to goodwill.

The result increased the prospect that suitors, including private equity, could be set to launch a takeover bid for the company after months of speculation.

Industry insiders said the terrible earnings numbers, coupled with the loss of a chief executive who is also a large shareholder, makes the group vulnerable to a takeover. Private equity firms and major global software players such as Microsoft are tipped as possible candidates.


iSOFT records $383 million statutory loss

Boots CEO in wake of ailing operations

The long-time chief executive of troubled e-health giant iSOFT (ASX:ISF), Gary Cohen, has resigned without a statement in the face of disastrous annual results over the past year that have seen revenues shrink.

Cohen’s resignation was revealed today as part of the company’s annual financial results for the year to 30 June, in which it revealed revenues were down 20 per cent to $431 million over the previous year, and earnings before interest, tax, depreciation and amortisation (EBITDA) down 78 per cent on constant currency terms to $30 million.

It also reported a statutory loss over the financial period of $383 million.


iSoft’s Cohen stands down after losses

31 Aug 2010

Gary Cohen has resigned as the chief executive of iSoft as the company has announced major losses in its full-year results.

This morning, iSoft posted a statutory loss of £221m (AUS $383m) for the financial year 2010, with total revenue down 20% to £249m (AUS $431m).

In its announcement to the Australian Stock Exchange, the company also said that earnings before interest, tax, depreciation and amortisation (EBITA) had plummeted 77% to £17m (AUS $30m).

Last year, the company reported a profit of £20m (AUS $35m) for the year to 30 June 2009.


April deadline for iSOFT

Posted on: Wed, 01 Sep 2010 20:50:30 EDT

Symbols: OCCAF

Sep 01, 2010 (The Australian Financial Review - ABIX via COMTEX) --

Australian health software group iSOFT is under increasing pressure to improve its performance. Major stakeholder Oceania Capital Partners (OCP) has announced that it will decide whether or not to retain ownership of the group in April 2011.


Next Lorenzo go-lives put back

02 Sep 2010

Birmingham Women’s NHS Foundation Trust will not be going live with Lorenzo Care Management on Monday 6 September as planned.

The trust has confirmed that it has pushed back its go-live date, which was originally 10 May 2010, until it is sure that the system is “safe to be deployed.”

In a statement to E-Health Insider, the trust said: "Birmingham Women’s NHS Foundation Trust is now working towards a go-live date in early October to implement Lorenzo Care Management across the trust.

“Deployment plans are progressing at a safe and steady pace, and a series of checkpoints and a final assurance process are currently being worked through to ensure the system is ready to be deployed."


iSOFT to lay off 800 staff

Follows resignation of CEO, Gary Cohen

Renai LeMay 03/09/2010 10:59:00

Australian e-health giant iSOFT (ASX:ISF) will lay off 800 staff, constituting 17 percent of its total workforce, over the next financial year in a bid to halt its sliding financial fortunes.

On Wednesday the company’s chief executive Gary Cohen stepped down in the face of disastrous annual results over the past year that have seen revenues shrink. At the time iSOFT said it was planning to reduce staff numbers this year.

But sources said the company had already gone through two rounds of layoffs over the past year — one in November last year, and one in July.

A company spokesperson confirmed those rounds had already seen 290 iSOFT staff lose their jobs, and a further 800 more would go over the next year — more than 17 percent of the company’s total global workforce of around 4,500.


Web medicine an investment for the bush: broadband access

RESIDENTS in rural and regional Australia can expect improvements in essential healthcare services as a result of the hung parliament.

The three independents who represent country regions of NSW and Queensland have made it clear they will go in to bat for rural Australia in negotiating their terms.

With broadband high on the agenda, the provision of e-health services to the bush is also of major concern for regions that have been plagued by unreliable communications and disparate systems.

Speakers at the recent National Health Conference in Sydney said existing rural services were frustrated by inefficiencies which led to poor quality patient care.

Chief executive of the e-Health Transition Authority Paul Fleming said reliability was the big issue for any electronic health system and more bandwidth would be needed in the future for e-health to realise its potential.

AMA president Andrew Pesce also criticised the regular waste that occurs because doctors can't access patients' medical records.


Real-time prescription monitoring will combat abuse

28th Aug 2010

David Brill

TASMANIAN GPs will be the first in Australia to have real-time, 24-hour access to prescribing information – long touted as a major step in combating the problem of prescription shoppers.

From December, GPs state-wide will simply go online to find out which Schedule 8 drugs a patient has already received that day.

Currently, they would have to call the State Health Department during business hours for information, which could be up to six weeks out of date.

Dr David Knowles, chair of the RACGP’s Tasmania faculty, said the new system would be “a significant help” to GPs – not only in informing prescribing decisions but also facilitating conversations with patients to help them address their problems.


E-health funding enough for a prototype: national e-health record

THE $500 million committed by Labor for e-health records is not enough for a full national rollout.

It should deliver a prototype "that's impossible to ignore", Victoria's top health bureaucrat Fran Thorn says.

"I can't say there's a lot of money for e-health at this stage and that's a disappointment to me," she told the Health Informatics Conference in Melbourne last week. "But being an optimist, if we can use that $500m in a very targeted approach of building the prototype case for this, then I think it would be impossible for anyone to continue to ignore what in the end is a very small investment, in the order of a couple of per cent (of the total health budget)."

Signalling a tightening of control over the work program, Ms Thorn, who is secretary of the Victorian Department of Health, said the nation was in the second year of a 10-year strategy commissioned by the advisory body she chairs, the National E-Health Information Principal Committee, and adopted by health ministers through the Council of Australian Governments. "We do not have the money that we all believe should be invested in e-health yet, but the allocation will further a significant e-health trial that over time will include other things," she said.


e-Health funding not enough: Victorian Department of Health

$446 million in funding not enough for e-health record trial

The Federal Government's $446 million commitment to e-health is “not enough” and could deliver a "prototype" to sell the benefits of technology and healthcare, according to the Victorian Department of Health.

In the recently released budget papers, the documents for the health portfolio stated the sum would be spent over the next two years to “establish key components of the personally controlled electronic health record system”.

“This secure online system will enable improved access to healthcare information, commencing in 2012/13.” the documents said.

However, the allocated funding is not enough for a national rollout, Department of Health secretary, Fran Thorn, said last week at the health informatics conference in Melbourne.


E-health diverts funding away from other healthcare services

E-health has been used as a political football, which takes funding away from other health services, according to the medical practitioner who reviewed the UK government's e-health record implementation.

E-health has been used as a political football, which takes funding away from other health services, according to the medical practitioner who reviewed the UK government's e-health record implementation.

The comments were made last Tuesday at the health informatics conference in Melbourne, where ABC's Tony Jones moderated an e-health discussion with five industry representatives.

Panellists discussed a number of issues, including the merits of e-health, which was debated by UK professor Trisha Greenhalgh, (who conducted the independent review of Britain's national health service summary care record project) and technology vendor Intersystems's CEO Professor Stan Capp.


Waiting on a missed connection

August 30, 2010

Government intervention will be required to give Australian households super-fast fibre, writes Lucy Battersby.

As summer spreads across Scandinavia, thousands of Norwegians will take to the garden with a shovel, digging a trench between their house and a metal box at the end of their street.

Altibox, owned by the electricity provider Lyse, has found an ingenious solution to the prohibitive costs of installing fibre broadband to suburban and regional areas. It offers customers a $450 discount on installation costs if they dig a trench between their premises and the fibre node at the end of the street. So far about 136,000 households, or about 80 per cent of their customer base, have got their hands dirty.

Altibox will not connect a town to the backhaul unless 60 per cent of households sign up to its internet service, ensuring every fibre rollout is profitable. This is one of many different ways governments and businesses are encouraging the spread of fast, affordable broadband.


What's the NBN really worth?

Paul Budde, Election 2010

Published 6:44 AM, 30 Aug 2010 Last update 10:01 AM, 30 Aug 2010

When the NBN announcement was first made and the issue of the cost-benefit analysis came up, BuddeComm’s comment was that it would be necessary to be aware of all the ingredients of such a plan before one could carry out such an analysis.

This is not just an issue for Australia. Other governments are also grappling with it. If the analysis were to be based simply on the use of traditional telecommunications services, it wouldn’t even be worthwhile starting on it, as it would not hold together.

One could argue that this is national infrastructure – as distinct from simply telecommunications infrastructure – and that no national cost-benefit analyses were provided for previous large-scale infrastructure projects.




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