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."

Sunday, December 12, 2010

Weekly Australian Health IT Links – 12 December, 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:


Now here is an interesting join the dots exercise.

We had this appear a few days in an opinion piece.


December 10, 2010

E-health on the agenda

Ian Birks*

The Australian Government's E-health conference last week wrapped up two days of focus on the national development of e-health initiatives and Personally Controlled Electronic Health Records (PCEHRs).

There has been a strong government investment in e-health, ranging from $A466 million over two years to deliver better patient records, to Senator Conroy's announcement at the conference of a $A4 million e-health trial in NSW. This investment is essential and welcomed by the ICT industry as the right way forward. However, a key requirement for the success of schemes such as the PCEHR will be consumer engagement. Basing the PCEHR initiative on an opt-in system is something that may ultimately hinder its success.

Many of those users who stand to benefit the most from a personally-controlled record may not understand the benefits on offer. To base the success of the system on the requirement for users to actively opt-in is a risk.

Australia must embrace the opportunities offered by a digital economy on a wide scale if we are to see the benefits. Any user should have the right to opt-out based on personal preferences or concerns, but without high levels of engagement the system will not deliver the potential benefits on offer.

---- End Quote

*Ian Birks is CEO of the AIIA


So what we have is the CEO of the Australian Information Industry Association (AIIA) telling us that the planned PCEHR should be ‘opt-out’ rather than ‘opt-in’ and being rather dismissive that any one might indeed actually opt out (preferences and concerns being cited rather than the obvious range of genuine issues such as discrimination and so on)

If you have a look at the AIIA board of directors it is clear this organisation is focussed on the ‘big end of town’ - IBM, HP, Telstra, Microsoft and so on and that their main interest is in growth of the ICT sector.

What a godsend then that the Government has decided to invest close to a $billion in e-health and related activities. Think what the money-making opportunities are!

It seems to me it might be a worry for the AIIA if the consent model keeps the whole effort going a little more slowly and so slows cashflows. That 'opt in', is unquestionably the right way to go initially, as we learn if the PCEHR is a good idea and if the benefits are real and sustainable, seems not to interest the AIIA - or am I just too cynical?




From the editor

Confused by the PCEHR? You're not alone

Michael Woodhead

In an article in the MJA last week, Professor Enrico Coiera, Director of the Centre for Health Informatics at the University of NSW made the case for a national shared record (PCEHR), but warned that building summary care records (SCR) was not the way to do it.

We reported this incorrectly as saying that Professor Coiera was not in favour of a PCEHR at all. In fact, Professor Coiera was saying that a centralised summary care record system is not justified for several reasons.

It would, for example, require centralised summary databases, the classic “top-down” approach to e-health. This is something Nicola Roxon appeared to have ruled out this week, when she told the national e-health summit that "the government is not going to build a massive data repository … we don’t believe it would deliver any additional benefits to clinicians or patients – and it creates unnecessary risks.”



Leak of draft e-health document raises privacy concerns

PATIENTS will have limited control of their medical information, as a leaked document shows consumer access will be confined to a portal.

While Health Minister Nicola Roxon said consumers would "truly control" their personal electronic health records at her e-health forum last week, attendees did not see a draft concept of operations, showing a patient portal tacked on to a public/private providers' shared e-health record system (SEHR).

The confidential draft for the $467 million personally controlled e-health record (PCEHR) system was produced by the National E-Health Transition Authority, just before the forum.

The Australian has obtained a key system design diagram, which shows there is no mechanism for consumers to manage access by their doctors.



GPs switching to electronic records, survey shows

  • Karen Dearne
  • From: Australian IT
  • December 09, 2010 4:27PM

ALMOST two-thirds of GPs have switched to paperless medical records, with the others maintaining a hybrid mix of paper and electronic records.

The annual GP activity report by the Australian Institute of Health and Welfare shows 98 per cent of GPs are using computers for some clinical purposes.

Eighty-five per cent are using desktop systems to print out prescriptions, while 72 per cent are receiving pathology test results online and 54 per cent are also ordering pathology tests online.

While the data -- from the Bettering the Evaluation and Care of Health (BEACH) survey of GPs -- confirms previously noted trends, the big shift to electronic medical record systems is a surprise.



State's long wait for surgeon's knife

Julia Medew and Kate Hagan

December 10, 2010

SCORES of Victorians waited longer than the national median waiting time for surgery last year, including for heart, lung and brain procedures, new figures show.

In many cases, Victorians also waited longer than a year to go under the knife during the past financial year, depending on where they lived and what type of surgery they were waiting for.

The hospital data, released by the state government, revealed that Victorians waited 21 times the national median time for vascular surgery.



Information Technology Could Improve Prevention, Treatment of Depression

ScienceDaily (Dec. 6, 2010) — Could information technology and data mining techniques be used to improve the diagnosis and treatment of depression? That's the question scientists in Australia hope to have answered in a forthcoming issue of the International Journal of Functional Informatics and Personalised Medicine.

Maja Hadzic, Fedja Hadzic and Tharam Dillon of the Digital Ecosystems and Business Intelligence Institute, at Curtin University of Technology, in Perth, explain how depression is rapidly emerging as one of the major health problems now facing society. They add that the World Health Organization has predicted that depression will be the world's leading cause of disability by 2020. "We are noticing a spread of a depression epidemic throughout the whole world," the team says. "Usually, an epidemic, such as a swine flu epidemic, has a pathogen associated with it. But, there is no pathogen involved with the depression epidemic." Indeed, the precise causes of depression have not yet been identified although it is clear that many different biological, psychological and social factors are at play in its development.



Ovum: Mobile devices to propel consumer-based healthcare

Smartphone and tablet applications to fuel the trend of consumers taking healthcare into their own hands, according to the analyst firm

Mobile devices such as smartphones and tablets will drive a market that allows consumers to take healthcare in their own hands, according to analyst firm, Ovum.

The comment comes off the back of the Government’s demonstration of an e-health record iPhone application last week. The app allows patients to control their health records and gives doctors expedited access to those records.

There are numerous health apps available on Apple’s iTunes App Store.



Medicare launches online health directory

By Josh Taylor, ZDNet.com.au on December 9th, 2010

update Australian healthcare providers with health identifiers will now be able to gain information on other providers via an online directory, Medicare has announced today.

An individual health identifier is a 16-digit number that Medicare allocated to every resident of Australia following the passing of legislation in July this year. The government intends to use this number as the foundation for the construction of a personally controlled e-health record. Healthcare providers and institutions were also issued with a number.



Acquisition drives Healthe Care IT transformation

12 disparate patient management systems to be replaced

Acquisition has brought growth benefits but added an IT headache for Australian private health provider Healthe Care.

Faced with the challenge of trying to unite multiple facilities to create a more efficient business and provide improved customer service, the provider is now rolling out a common patient management system across 12 hospitals.

So far the system is in two of its hospitals with a view to completion in 2011. The move follows Definity Consulting conducting an IT architecture survey in 2009.

One of Definity's recommendations was to streamline the delivery of IT services by outsourcing IT support under a single managed services agreement.



Victoria extends rural telehealth trial

Live telemetrics, high definition video conferencing to be rolled out across all 16 hospitals in Loddon Mallee area

Telehealth video conferencing and live telemetrics equipment for trauma and critical will be extended to all 16 regional Victorian hospitals administered under the Loddon Mallee Rural Health Alliance following a successful, 20-month trial across four of the units.

The initial $5.2 million trial was funded under the Federal Government’s $118.6 million Clever Networks initiative and took place from June 2008 across hospitals in Mildura, Swan Hill, Machuka and Bendigo, connected to four metropolitan hospitals in Melbourne. The trial involved the deployment of eight mobile Virtual Trauma and Critical Care Units (ViTCCU) and seven fixed units across the regional hospitals, along with software and smart vitals devices from a consortium of companies including Telstra, Cerner, KPMG and Polycom.

The units were connected by a 100 megabits per second (Mbps) link provided by Telstra, running separately to the hospitals’ existing networks in order to avoid potential congestion.

Specialists at the Melbourne sites provided advice to primary treating doctors initially for critical care patients.



Bendigo Health jumps on e-health bandwagon

The hospital has implemented a number of electronic systems to automate and improve hospital practices

Bendigo Health is jumping on the e-health bandwagon, announcing a $100,000 upgrade of its health systems, in an effort to automate hospital practices, increase operational efficiency and patient safety levels.

The hospital, located in Victoria, has deployed a number of systems from AeroScout, including the Real Time Location System (RTLS), patient and temperature monitoring system, and staff safety technology.

The hospital’s information and communications technology manager, Phil Coppin, told Computerworld Australia, the new systems help the facility provide better clinical care, meet regulatory compliance around medications and pathology and improve staff safety to comply with occupational health and safety legislation.



Health, IBM revisit IT outsourcing deal

  • Karen Dearne
  • From: Australian IT
  • December 08, 2010 12:00AM

IBM Australia has kept its stranglehold on the federal Health Department, with a renegotiation of its service agreement over the next four years.

Briefing documents for the incoming Gillard government show former finance minister Lindsay Tanner gave the department approval to open discussions on a contract extension.

IBM has provided ICT services to Health since the department outsourced its IT infrastructure to the industry giant in 1999.

The current contract, estimated at $126.6 million, is due to expire in June 2011. The agreement has twice been renegotiated -- in December 2003 and again in December 2008.



Volume 16, Number 12–December 2010


Online Flutracking Survey of Influenza-like Illness during Pandemic (H1N1) 2009, Australia

Sandra J. Carlson, Craig B. Dalton, David N. Durrheim, and John Fejsa
Author affiliations: Hunter Medical Research Institute, Wallsend, New South Wales, Australia (S.J. Carlson, C.B. Dalton, D.N. Durrheim); Hunter New England Population Health, Newcastle, New South Wales, Australia (S.J. Carlson, C.B. Dalton, D.N. Durrheim, J. Fejsa); and Newcastle University, Newcastle (C.B. Dalton, D.N. Durrheim)

Suggested citation for this article

We compared the accuracy of online data obtained from the Flutracking surveillance system during pandemic (H1N1) 2009 in Australia with data from other influenza surveillance systems. Flutracking accurately identified peak influenza activity timing and community influenza-like illness activity and was significantly less biased by treatment-seeking behavior and laboratory testing protocols than other systems.



Australian cure for Irish health

SA developer PowerHealth Solutions has been engaged to help the Irish Health Service Executive reform health services through the introduction of patient-level costing and activity-based funding. www.powerhealthsolutions.com



e-Communications in Practice

One of the steps in the process of developing the foundations to enable a national e-health system is to ensure the benefits of e-health can be realised as soon as possible. To achieve this, the National E-Health Transition Authority (NEHTA) is focusing their efforts on e-communications in practice by implementing and delivering early e-health services for the most commonly exchanged health information.1

NEHTA was established by the Australian, State and Territory governments to develop better ways of electronically collecting and securely exchanging health information.The College works with NEHTA, where our directions are aligned, and to ensure that general practice needs are reflected in NEHTA’s work.



ISoft sale 'one of the options'

08 Dec 2010

ISoft is planning to sell its iSoft Business Solutions subsidiary, according to the Sunday Times.

The newspaper claims that the software firm - which is in negotiations with its bankers over debts of AUS $240m (£152m) - is planning to offload the subsidiary, which designs finance systems for the NHS.

The paper reports that iSoft Business Solutions has offices in Dublin and Belfast and made a loss of £634,000 last year despite sales of £3.5m. It says iSoft has yet to find a buyer.

ISoft declined to comment on the sale. However, during its annual general meeting last week, chairman Robert Moran said: “We have previously announced that we are considering a limited number of asset sales or business closures in order to reduce debt and improve cash flow. This process continues.”



Cabling for NBN rollout cut back

  • Annabel Hepworth and Mitchell Bingemann
  • From: The Australian
  • December 10, 2010 12:00AM

A PROPOSAL for every new home built after January 1 to be connected with fibre cable for the National Broadband Network has been abandoned.

This came after the Gillard government admitted the magnitude of the task meant the plan would have to be phased in.

Federal Communications Minister Stephen Conroy said yesterday new houses in developments of fewer than 100 premises - common in cities and towns - would be connected to Telstra's copper network or wireless services with slower internet speeds, and only later would be hooked up to the NBN.

The government wants the NBN Co to prioritise the delivery of the super-fast fibre in larger property projects.

An estimated 1.9 million new premises will be constructed while the $36 billion NBN is being rolled out.


New Zealand Spot - Seems Some Interesting Things Happening



Auckland pharmacies and hospitals to "talk" via health intranet

By Pharmacy Guild of New Zealand

From today, all Auckland pharmacies will have access to important patient information through TestSafe. A metro Auckland DHB initiative, TestSafe is a data repository that enables community pharmacists to access only relevant and pre-defined patient information through a secure health intranet connection.

TestSafe is part of a regional initiative by the three Auckland DHBs (Auckland, Counties Manukau and Waitemata) to improve relevant information sharing among community and hospital health care providers. It brings together results from DHB facilities, community laboratories and now community pharmacies.

At this stage, community pharmacists will have access to selected laboratory results and dispensing information for their patients. It is anticipated TestSafe will eventually include relevant information from hospital discharge notes that will give the pharmacist a more complete picture of the patient’s condition and treatment plan.



Pharmacists get access to health details of 1.1m

By Martin Johnston

5:30 AM Tuesday Dec 7, 2010

Sensitive medical records of hundreds of thousands of Aucklanders are in the hands of community pharmacists after they joined a computer network in a move expected to improve healthcare delivery.

By last year 1.1 million Auckland patients had diagnostic test results and drug dispensing reports stored on the TestSafe system run by the region's district health boards.

Set up in 2006 to improve healthcare safety and efficiency by sharing community laboratory test results among public hospital clinicians, TestSafe has been expanded by including some radiology and various other test results, plus drug dispensing reports.



DHBs start electronic patient records


Last updated 05:00 06/12/2010

Hospitals patients in the lower North Island should find doctors and nurses have better information on their prior care following a project that has been kicked off by the region's six district health boards to integrate health information technology systems.

Capital & Coast ICT director Stuart Wakefield is heading the project, which he said was a step on the way to creating a national system of online electronic health records by 2014.

Mr Wakefield said hospital staff would be able to get a single view of patient information that was stored on multiple software systems in the region through a portal they could access with one logon and password. "Most of this information is able to be shared today – it is just not particularly efficient the way that we do it."



Google takes PC software fight to Mircrosoft's Windows

  • Murad Ahmed
  • From: The Times
  • December 08, 2010 10:17AM

GOOGLE has made its most direct challenge to Microsoft with the launch of its new operating system that aims to defeat Windows.

It is a battle for the future of personal computing.

Users of computers running Chrome OS will be able to get online much more quickly as the system will turn on instantly and automatically log on to the web within seconds.

In the first public demonstration of the software in San Francisco, Google showed that a user can be surfing the net within 60 seconds of switching on their computer.

Chrome also brings users a step closer to being able to store all photographs, music and emails online rather than on a hard drive. The files would be kept in the "cloud" on the internet and be accessed from any device with an internet connection.

Eric Schmidt, Google chief executive, said: "Cloud computing will define computing as we know it."




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