Quote Of The Year

Quotes Of The Year - 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, April 18, 2011

Weekly Australian Health IT Links – 18 April, 2011.

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:

The big news of the week has been the release of the NEHTA PCEHR Concept of Operations.

The reaction has been interesting.

We have had a few rather sycophantic blogs saying how wonderful it all is.

We have had some journalists just regurgitate the Government line on how wonderful e-Health is and how great the PCEHR is and how quickly it will come.

We have had more technical and thoughtful journalists identifying a range of issues that are not well thought through.

We have had journalists from the specialist clinical newspapers identifying a few quite serious issues that are yet to be addressed.

We have had some interesting professional comment from a range of quarters.

All you can conclude from this spread of reaction is that there is a very long way to go.

We next need to see the Wave 2 project plans to assess how well all this will fit together in the short and long term.



Roxon sells her vision of handing power to the patients

FEDERAL Health Minister Nicola Roxon is finally out selling her vision to put a personally controlled electronic health record into the hands of every Australian who wants one by July 1 next year.

Last year the government allocated $467 million towards the national program, but details of the design, operation and regulatory arrangements have to date been largely discussed behind closed doors.

But with some major contracts already let for three lead sites, in Brisbane, the NSW Hunter Valley and Melbourne, and nine complementary "wave two" projects, work is now under way.

However, Ms Roxon says there's still time for community input into plans for the nation's future e-health framework, and she will welcome direct feedback on the PCEHR draft Concept of Operations to be released today.



E-health vision has Roxon revved up

HEALTH Minister Nicola Roxon is riding waves of excitement as she unveils the draft concept of operations for personally controlled e-health records, nearly a year after committing $467 million to realising her vision.

"It's exciting for us just to see things moving," Ms Roxon told The Australian. "The e-health initiative has been dogged by the go-slow of the previous government and we inherited the baggage. And because this is so complex, it has taken time to shepherd it into the right shape, develop the strategic vision and make the necessary decisions.

"I really think we're at that point now, and we're keen to show people how things will work, and get their feedback."



Draft plan for e-health disappoints: $500m records system a 'viewing service' for patients

ALMOST $500 million is being spent on an e-health record system that will not provide real-time medical information at the point of care.

Instead, it will serve copies of some clinical documents uploaded from doctors' systems in a voluntary program that puts the control of access in patients' hands.

The long-awaited draft concept of operations for the personally controlled e-health record, to be released today by the Health Department, shows how clinical documents will be pulled together by a "viewing service" and displayed in a format for viewing by patients and health professionals.



Doctors seek payment for e-health records

DOCTORS will have to be paid to set up personally controlled patient e-health records or the government's $466 million e-health system will not get off the ground, two doctors groups have warned.

The Australian Medical Association and the Royal Australian College of General Practitioners said yesterday that creating the records would take time and doctors would have to be paid to do it.



PCEHR access a sticking point

Controlling access to e-health records has emerged as one of the most difficult areas of implementing a Personally-Controlled E-Health Records (PCEHR) system, the long-awaited “Concept of Operations” shows.

In the blueprint (see link) for e-health records released today, the government says patients will be given the option of limiting who has access to their e-health records.

Under a three-tier system, all healthcare providers will have access to a patient’s Shared Health Summary but patients will also be given the option of choosing ‘limited access’ or ‘no access’ to prevent other health providers from accessing clinical records such as test and imaging results, referral and discharge summaries.



Long-awaited e-health blueprint released

12th Apr 2011

Shannon McKenzie and AAP

PERSONALLY controlled e-health records (PCEHRs) are a step closer, with the release of a blueprint showing how the long-awaited records will be stored and managed.

According to the draft concept of operations released by Health Minister Nicola Roxon, while the Federal Government will manage a national database to store e-health summary records, the more comprehensive medical records will not be stored in one central location.

Comprehensive patient information will be kept by individual doctors, pathologists and chemists across the country.



E-health record concept document leaves questions

Welcomed by industry, but the hard work is yet to begin

Industry has welcomed the release of the draft concept of operations for the Federal Government’s $466.7 million Personally Controlled Electronic Health Records (PCEHR), but complete clarity on the project remains lacking.

The 130-page document, released Tuesday by health minister Nicola Roxon, maps out the record’s function, possible information as well as proposed security and privacy settings and how the system will connect with clinical systems. The release of the document, which the Federal Government had previously been reluctant to offer publicly, came as it sought to incite further discussion around the project and iron out potential issues prior to going live on 1 July 2012.

Royal Australian College of General Practitioners (RACGP) e-health spokesperson and former clinical lead at the National E-health Transition Authority (NEHTA), Dr Nathan Pinskier, told Computerworld Australia that while the document was robust it left many questions open.



Tech metrics missing from e-health records blueprint

NBN expected to 'facilitate new opportunities'.

The National E-health Transition Authority (NEHTA) has released a 125-page blueprint for Australia's $467 million personally controlled e-health records system (PCEHR), but was unable to provide further detail on the technology required to deliver the service.

The draft report (pdf) made no mention of response times, latency or any other key technology details behind the PCEHR -- intended as a centralised system for collecting and sharing Australia's healthcare data.



How e-health records will work

By Suzanne Tindal and Luke Hopewell, ZDNet.com.au on April 12th, 2011

The Department of Health and Ageing (DOHA) today outed its draft operational blueprint for the development, implementation and ongoing operation of personally controlled e-health records (PCEHR).

Minister for Health and Ageing, Nicola Roxon, today told ABC Radio 612 Brisbane that the blueprint represents a "concept of operations" for the electronic health record system set to be made available to the general public in July next year.

"Any person who chooses to, from 1 July next year, will be able to be part of an electronic health system, and what that means is that important information about you can be accessed by you at any computer, and probably any iPhone and Blackberry, into the future, which will have your current medications, any particular allergies, information that you might want stored there about emergency contacts and others," said the minister.

According to the draft blueprint, the "system of systems" will give end-users access to a consolidated view of their medical history via a customer-facing online portal. End-users will also be able to access the system via a government-operated call centre.



Convoluted e-health plan needs KISS

By Suzanne Tindal, ZDNet.com.au on April 12th, 2011

After reading pages and pages of the government's personally controlled e-health record (PCEHR) draft plan of operations, I can't help feeling like we're on a freight train that's either heading towards a cliff or doesn't have an engine anymore.

The reason for this is the extremely convoluted nature of the system, which I feel will either lead to absolutely no one adopting it, or a breakdown later on because no one understands what's going on behind the scenes.

I mean, seriously, why should we have to have a passcode — let's say Code A — to say whether a provider can access our information and then another passcode — let's call it Code B — to say an organisation can access our limited documentation? You can also decide what you want to do in the case of a forgotten passcode. But the options are different for Code A and Code B.



E-health records ready next year

CATHY O'LEARY, MEDICAL EDITOR, The West Australian April 12, 2011, 2:15 am

Australians will soon have the chance to set up their own electronic medical files, which will allow hospitals, doctors and pharmacists to view their test results, immunisations and prescription drug use.

The Federal Government is today unveiling the first stage of its e-health system, known as personally-controlled electronic health records, or PCEHR.

It says the system, which is due to be in place from July 1 next year, is in response to concerns that limited access to health information increases the risk to patient safety, wastes time when staff have to collect or find information and sometimes causes unnecessary or duplicated tests and treatment.



E-Health Blueprint - Australian Medical Association

12 Apr 2011

The AMA welcomes the opportunity to raise concerns and provide input to the way that the proposed personally controlled electronic health record (PCEHR) will operate.

AMA Vice President, Dr Steve Hambleton, said today that the draft e-health records blueprint, Concept of Operations, will require careful consideration, particularly in respect to the medical information that will be stored on the PCEHR, and who will have access to it.

Dr Hambleton said that further consultation around the access to medical information is vital if the PCEHR is to get broad support from the medical profession and the community.

"If we do not get the right information on to the record, with the right people having access to it, we will be failing the people who most need an electronic health record," Dr Hambleton said.



Softly softly skewers e-health savings

By insisting on a softly softly approach to electronic health records, the Government has missed out on an opportunity to revolutionise health care in Australia, instead paving the way for a two track national healthcare system for the foreseeable future.

The release this morning of the 135 page draft concept of operations document regarding the use of personally controlled electronic health records (PCEHR), makes clear that individual Australians will be able to choose whether to sign up for the programme, determine who can access the information stored in those records, and withdraw from the system whenever they want.

While civil libertarians may applaud the approach, it will lead to significant problems for healthcare providers which will have to respond to the whim of individual patients. Even if a patient opts into the system, if they later opt out, it will be up to healthcare providers to then scramble to assemble health records for that individual.



Every detail of your ills at the touch of a button

Merle Spriggs and Craig Fry

April 15, 2011

Worrying questions hang over the plan for electronic health records.

A significant change is about to occur in the Australian health system that promises to revolutionise the patient-provider relationship. By July 2012, you will be able to sign up for your own personally controlled electronic health record.

According to the government body established to make this happen - the National E-Health Transition Authority - these new electronic health records will provide secure and timely access to information about your current medications, diagnoses, allergies, immunisations and your health treatment preferences.

Both you and your doctor will be able to access your health record. You can decide which information goes into it, and which health providers can access certain parts of it. If you find incorrect information, you will be able to have it corrected. There will also be scope for you to add information.

This week, the e-health authority released its 125-page blueprint for the development of electronic records in Australia. Individuals and organisations are being encouraged to provide feedback on the draft concept of operations, relating to the introduction of the proposed system.



Patient comments an e-record risk

12th Apr 2011

Mark O’Brien

UNVETTED input by patients into their personally controlled e-health records (PCEHR) may result in open criticism and defamation of doctors, experts have warned, raising a host of ethical and legal issues.

Speaking at the Medical Leadership conference in Sydney last week, Health Department secretary Jane Halton said patients could start applying for their own PCEHR from July 2012, with the system providing a section for the patients’ own notes and feedback.

However, there is no detail yet about what type of information patients would be allowed to enter.

MIPS medico-legal adviser Dr Rob Walters said any patient-created content would need to be vetted to ensure it did not contain defamatory material such as open criticism of a health practitioner’s standard of care.



Updated summaries vital for e-records


Paul Smith and Louise Wallace

GPs who agree to curate a patient's e-health summary would be exposed to indemnity risks if patients suffer adverse events because of incorrect or out-of-date information, Australian Doctor has been told.

As part of the rollout of personally controlled e-health records -- scheduled to start next July -- the Federal Government is planning to create e-health summaries for patients opting into the system. The summaries will contain basic clinical information on current medications, diagnoses, allergies and adverse reactions.

It is expected most patients will ask their GPs to take on a "curator role", ensuring the health summaries are accurate and up-to-date.

Medical defence organisations and the National E-health Transition Authority, the body responsible for creating the system, are discussing the indemnity implications. However, they stress the risks are manageable.



Limits to e-health records access defined


Michael East

Patients will have the option of limiting who can access parts of their e-health records, under a new blueprint released by the Federal Government today.

The draft ‘concept of operations’ document states that all healthcare providers will have access to patients’ shared health summaries.

However, the draft also states that patients will be able to limit access to certain clinical documents in their e-health record to prevent particular health care providers from viewing test results, referral and discharge summaries.

Patients will be given an access PINs or “passphrase”, which they may choose to reveal to other health care providers.



Electronic health records on track - Roxon

  • From: AAP
  • April 12, 2011 12:50AM

THE federal government is likely to manage a national database to store the summaries of electronic health records belonging to millions of Australians.

But more comprehensive records won't be stored in one central location.

Rather, patient information will be kept by individual doctors, pathologists and chemists across the country.

It will only be brought together electronically when patients or their doctors search the planned national e-health system using a 16-digit identification number.

Health Minister Nicola Roxon today will unveil a blueprint outlining how the system could operate from mid-2012.



Better safe than sorry

April, 2011

The impending roll out of e-health records has thrown the issue of IT safety into sharp focus, particularly for operators and staff. Beverley Head reports.

As of next year, Australians will be able to sign up for a Personally Controlled Electronic Health Record (PCEHR). The prospect of having a single record containing a complete medical and health history is seductive - but it could also pose a computer security issue for many aged care providers and recipients.

The Government has recently hired IBM to develop a $24 million computer system that is intended to ensure only the right people can access information stored in those PCEHR records. It's an important step, but there are some who worry it does not go far enough.

AusCERT, a leading security group based at the University of Queensland, is concerned that although the IBM system (known as NASH, or the National Authentication Service for Health) will authenticate people wanting to access the record, it does nothing to improve the security of the computer being used to access and read the record.



Patients to access doctors' secret medical notes under electronic health reforms

  • Blueprint for e-health system detailed today
  • Patients able to access their health details
  • System gives "power to patients" - minister

PATIENTS will be able to control their most sensitive health details and, for the first time, read their doctor's secret medical notes.

The reforms, designed to empower patients, will be detailed today in a blueprint for the Gillard Government's controversial electronic health system.

Queenslanders who are among the first in Australia to trial the system will be able to use even an iPhone to access and control their health records, including medications, referrals and medical history.

But retrospective records will not be automatically uploaded to the massive health data networks when the program launches in July 2012.



E-health blueprint gets green light

A national blueprint for the development of e-health records has been released by the Minister for Health, Nicola Roxon.

Due to be introduced on 1 July 2012, the planned e-health system will allow patients to manage their own healthcare better and Ms Roxon said the blueprint was a step towards the development of Personally Controlled Electronic Health Records (PCEHR).

“E-health records will drive safer, more efficient and better quality healthcare for Australians,” Ms Roxon said.



Slow start to healthcare identifier service

  • Karen Dearne
  • From: Australian IT
  • April 13, 2011 5:17PM

FEWER than 30,000 people have checked their healthcare identity number since it was issued to all Medicare users on July 1 last year.

The government has automatically allocated identifiers to 23 million people.

It is intended that all healthcare providers apply the number to any medical record associated with an individual.

None of the 400,000 health professionals with provider credentials have accessed the Health Identifiers service as yet, and only 10 of around 80,000 eligible healthcare organisations have registered with the operator, Medicare.



Queensland Brain Institute deploys modular storage system

Raw storage of 214 TB achieved over weekend-long deployment

The Queensland Brain Institute (QBI) has deployed a modular storage system in response to the daily increase in data growth of five terabytes (TB).

The institute - one of the largest neuroscience institutions in the world - was unable to keep up with the high volume of data, with IT manager, Jake Carroll, saying that the upgrade to the system was crucial for the future of the organisation.

“The old storage system wasn’t up to task, it didn’t have enough front-end host ports, didn’t have enough cache, CPU capability or density,” he said.

“Density is a big deal in this environment – it’s key and the solution we had at the time, we outgrew very quickly.”



Sleep doctors eye legal suit on 'unethical' plan

  • Adam Cresswell, Health Editor
  • From: The Australian
  • April 13, 2011 12:00AM

The peak body for Australia's sleep physicians is considering further action against a start-up company that invited doctors to join a co-operative that would give them a 50 per cent share of profits from the sale of medical devices.

The confidential arrangement would have allowed them to pocket an estimated $400 from the sale of each continuous positive airways pressure machine they recommended for patients, without any declaration of their involvement.

CPAP machines cost between $1000 and $2000 each, and have become the mainstay of treatment for sleep apnoea, in which the airways collapse briefly but repeatedly during the night, causing poor quality sleep.



Orion Health in running for six New Zealand Hi-Tech Awards

Orion Health has been named as a finalist in six categories in the New Zealand Hi-Tech Awards, including the Software Product Award for their Electronic Health Record (EHR) solution, Hi-Tech Company of the Year and Hi-Tech Company of the Decade.

The New Zealand Hi-Tech Awards recognise achievements in the New Zealand technology industry. Companies enter themselves into the categories and are then selected to be finalists by a panel of both international and local judges. Finalists must partake in a round of interviews with judges, who will question the companies on their submission. Finalists must demonstrate vision, leadership, innovation and success.



E-health needed for grey nomads: Intel MD

By Luke Hopewell, ZDNet.com.au on April 14th, 2011

Millions of Australians are heading towards retirement and a life as "grey nomads" without adequate electronic health applications to support them, according to Philip Cronin, general manager of Intel's Australia and New Zealand operations.

Speaking at the American Chamber of Commerce in Sydney today, Cronin said that in the next four years, 76 million baby boomers around the world will join the ranks of retirees.

"[That] may scare some of you in the room," Cronin said. Prompted by an audience member, he pointed out that when baby boomers retire in Australia, they'll buy a caravan and make their way out of the city.



AHPRA: expect three more years of problems

Problems with the new national registration system will persist for another two to three years in part due to its chronic underfunding, the head of the Australian Medical Council says.

In a submission (see link) to the Senate inquiry into the problem-prone national registration system, CEO Ian Frank says the government has underestimated the enormity of shifting from state-based registration to a unified national system managed by the Australian Health Practitioner Regulation Agency (AHPRA).



iSoft founder launches shares fight against Oceana Healthcare Technology Investments

ISOFT founder Gary Cohen has begun legal action against Oceania Healthcare Technology Investments, a subsidiary of Oceania Capital Partners, the biggest shareholder in takeover target iSoft.

Mr Cohen claims his company RJL Investments has pre-emptive rights over shares owned by OCP held by OHT in iSoft.

In a statement to the ASX yesterday, OCP said Mr Cohen had written to the group claiming that following its support of Computer Sciences Corporation's bid for iSoft, "OHT is required to give to RJL a transfer notice" in respect to about 15 per cent of OCP's shareholding in the healthcare software company.

OCP's total shareholding in iSoft is about 24 per cent.





Unknown said...

You missed http://www.ehealthcentral.com.au/2011/04/its-the-pcehr-silly-season/ ... not philosophically where you are at, but a thoughtful article.

Dr David G More MB PhD said...

I didn't miss it. I read it and rejected it as it was written by someone who really has no clue and who is paid to offer supportive views by NEHTA. When he stops being sponsored, and continues blogging, then we will listen. Till then, despite what he claims and all the disclaimers - the conflict is obvious.

Paid sponsored commentary is different from paid journalism. Most of us can tell the difference. Your problem if you can't!

My blog has a view, he has his. Mine is sponsorship free - his is sponsored. Choose what you read!