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."

Tuesday, April 26, 2011

Weekly Australian Health IT Links – 26 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:

I hope everyone had a good Easter / Anzac Day break and observed and enjoyed the days in the way that felt right for them.

It seems the NSW Health Department under its new Minister is trying to work out just how to proceed with Health IT and how to deliver the IT systems and services for that State’s Public Health System that are still in various stages of evolution and completeness.

Victoria also seems to be making a bit of a meal of working out just what is to happen to the HealthSMART program.

As Cerner has a stake in both these programs it is probably worth pointing out that Cerner in the US seems to be going from strength to strength with the share price now well north of $US110. Given the share price was around $20 a decade ago that has been a pretty good investment! Such excellent share price appreciation certainly suggests that first Cerner is servicing its home market to the satisfaction of most (but certainly not all) customers and second that NSW and Victoria need to be careful in how they approach getting the local issues resolved - lest Cerner decide there are good reasons to concentrate on other markets and downscale what they provide here. The short term upheaval that might cause could be considerable!

No matter what happens it would be really helpful if some researchers could discover just what are the factors that lead to differences in vendor and customer satisfaction in both differing jurisdictions and with differing software. I think this is a seriously under researched and understood area.



Hospital IT systems failing patients, says expert

CONCERN at the use of Cerner's FirstNet software in NSW hospital emergency departments has been escalated by Sydney University e-health expert Jon Patrick.

"All the evidence shows this clinical information system wastes staff time and increases risks to patient safety," he says in an updated report on FirstNet.

"I can't spot any point in the workflow where there's not some fault in the system, or disruption to the way ED doctors work.

"The relevant question now is whether the FirstNet system is safe enough for use."



Can we enforce Healthcare Interoperability standards by law?

Posted on by Grahame| Leave a comment

Professor Jon Patrick says:

“It’s not enough to say we’re providing standards, we’ve got to have laws that say you cannot place software in a health environment unless it meets standards,” he said. “Then we have to test the software against the standards.”

As a consultant who works with both standards and health software development, I’m naturally very much in agreement with Prof Patrick.



E-record push will fail without incentives

19th Apr 2011

Mark O’Brien

GPs have warned the Federal Government its personally controlled e-health record (PCEHR) scheme could be undermined – and patients left out-of-pocket – if it refuses to pay GPs for creating and maintaining the new records system.

According to the draft blueprint released by Health Minister Nicola Roxon last week, the $467 million scheme will allow all patients to opt in to a PCEHR from July 2012.

A shared health summary containing relevant details of the patient’s medical history, such as allergies and medications, is to form a key part of the PCEHR, and patients will be able to nominate a healthcare provider to create and maintain this summary.



Digitising data is not the point: personal e-health records must do more than share data between computers

THERE'S one key question about the $500 million being spent on Nicola Roxon's personally controlled e-health record system: will it computerise the sector, sweep paper records into the bin, connect doctors to each other and give real-time access to critical medical information?

It might, eventually, but e-health experts aren't holding their breath.

The long-awaited draft concept of operations for the system reveals a simple viewing platform containing some personal health data. It's not a blueprint for a system that will take information out of manila folders and put it into dynamic formats, ready for sharing and use in new ways.

"We're spending half a billion dollars on something that holds a copy of documents held in existing medical provider computer systems," says AushealthIT blogger David More. "This approach does not facilitate clinical decision support or the sophisticated intelligence and analytics tools which deliver most of the benefits from e-health records."



GPs: Axe Medicare Locals to free up health funding

19th Apr 2011

Byron Kaye

JUST weeks out from what is predicted to be a tight Budget, GPs have pointed the way for the Gillard Government to reach its all-important surplus: freeze the rollout of super clinics and scrap Medicare Locals altogether.

Winding back incentive payments for pharmacists to dispense generic drugs also rated a high mention in MO’s latest national poll of 150 GPs.

Asked where health spending should be cut in the May Budget, 77% of GPs nominated the super clinics program – now $630.4 million deep in promised Commonwealth funding.



SHINING A LIGHT IN: Victoria’s major IT projects under review

IT Policy - Government Tech Policy

Several of Victoria’s major government watchdogs and the new Coalition government itself have taken the first steps in bringing the state’s trouble-plagued technology projects to heel, putting one flagship project on ice and scheduling others for a series of reviews that will govern their future.

Under the previous Labor government, which had held power from 1999 through to late 2010, a number of technology projects in the state had gone off the rails.

Perhaps the most high-profile of these has been the project to replace Victoria’s public transport ticketing system. Known as myki, the project was kicked off in 2002 and saw massive contracts awarded – including a $494 million deal with the Kamco Consortium in 2005. However, it gradually ran off the rails, with bugs plaguing the rollout and issues of probity being revealed in the contract process.



AMA attacks AHPRA complacency

The transition to national registration by AHPRA has been “an absolute debacle” the AMA claims.

In a submission (see link) to a Senate inquiry into problems with national registration, the AMA says the serious disruption cannot be passed off as ‘teething troubles’ and the AMA is worried that AHPRA now considers most problems ‘fixed’ when they clearly are not.

The AMA says patient care has been put at risk because of the disruptions, and yet AHPRA still does not have business protocols in place for the unique requirements of medical registration .



Patients lose out in regulation fiasco

Mark Metherell

April 21, 2011

MORE than 3500 doctors and other health practitioners have been temporarily deregistered, leaving patients without Medicare payments after what had been hailed a historic advance in national regulation.

The full scope of the administrative fiasco unleashed by the new Australian Health Practitioner Regulation Agency is unfolding in submissions to a Senate committee inquiring into the chaotic changeover from state-run to national registrations.

John Kolbe, the president of the Royal Australasian College of Physicians, said the changeover had prompted ''a number of incidents that are a cause for concern'' with specialist physicians reporting their registration had been cancelled without warning after they had failed to renew it.



Eye tracker research sharpens tools for e-learning

AUSTRALIAN researchers will use eye tracker technology to measure nurses' responses and understanding of electrocardiographs and how people interpret X-rays.

Central Queensland University has set up a world-class eye tracking facility to undertake the projects and other e-learning research.

The facility was developed at the university's Learning and Teaching Education Research Centre at Noosa, on the Sunshine Coast.

The Swedish-designed eye tracker is used largely for commercial market research, but it is also valuable for measuring the effectiveness of educational materials, according to researchers.



Pathologists sign up for e-health

Pathologists have agreed to implement an electronic system to ensure GPs stop ordering unnecessary tests.

As part of a new five year funding agreement with the Federal government, the pathology industry has agreed to assist GPs “to better request pathology services” with a new Electronic Decision Support Tools, following concerns they are ordering too many tests.

Details of the program have not yet been finalised, but there are plans for doctors to have access to pathology services guidelines on their desktop to help them decide which tests to order.



Pennine Care ditches Lorenzo

15 April 2011 Jon Hoeksma

Pennine Care NHS Foundation Trust has withdrawn from taking the Lorenzo electronic patient record system from local service provider CSC.

The move casts fresh doubts about the future of the National Programme for IT in the NHS.

Pennine was meant to be the last of four ‘early adopter’ trusts taking Lorenzo from CSC; the LSP for the North, Midlands and East of England.

Installation at Pennine would enable CSC to belatedly meet contractual commitments and unlock milestone payments. Without Pennine, CSC would appear no longer able to fulfil these commitments.



CSC says iSoft deal not just about NHS

18 April 2011 Jon Hoeksma

CSC says that its planned acquisition of iSoft is not just to shore up its NHS contracts but is about the firm’s international ambitions in healthcare.

Andrew Spence, CSC’s director of healthcare strategic development, told eHealth Insider: “The UK is important and continues to have a pull, but there will not be another national programme in the UK - while it is quite likely that there will be similar programmes in many other countries.

“The UK is a really mature market for us; this deal is really about creating opportunities for us outside the UK. In areas like Europe, Latin America, the Middle East, Australia and even the US we can see fantastic opportunities.”



Cohen challenge

GARY Cohen, the founder and former executive chairman of the healthcare systems provider iSoft has questioned whether the proposed $180m takeover of the company by Computer Sciences Corporation of the US has been structured to provide a special benefit to a major iSoft shareholder. On April 2, iSoft announced a recommended cash offer of 17c a share from CSC. The acquisition would be by way of a scheme of arrangement and the parties have entered into a scheme implementation agreement (SIA).

ISoft directors said the proposal arose from a strategic review initiated by the directors aimed at maximising value for shareholders and to reduce group debt. Upon completion of the scheme CSC will repay iSoft's senior banking facilities and convertible notes in full.

Oceania Capital Partners (OCP), which owns 24.5 per cent of iSoft, announced that it supported the acquisition, subject to a superior proposal.



Insider view: Jon Hoeksma

EHealth Insider’s editor says it’s time to be frank on where CSC is with Lorenzo; and the only way to do it is to have an independent review of progress to date.

21 April 2011

The news that Pennine Care NHS Foundation Trust has decided not to implement Lorenzo after two years of trying represents a watershed moment for the Department of Health.

It has repeatedly told CSC, the local service provider for the North, Midlands and East of England, that it must get the iSoft electronic patient record live and bedded down at four ‘early adopter’ trusts to retain its National Programme for IT in the NHS contract.

Pennine was the last of these early adopters, although it was the first mental health trust to take the system that is already live – if not exactly bedded down – at one primary care trust (Bury) and two acute trusts (University Hospitals of Morecambe Bay and Birmingham Women’s).

A letter from NHS chief information officer Christine Connelly to MP Richard Bacon indicates that the DH is now looking for another mental health trust willing to step into Pennine’s shoes. Yet rather than simply seeking to press on regardless, the Department should be asking some more fundamental questions.



Former iSOFT CEO files to delay sale

Gary Cohen, former CEO of health IT company iSOFT (ASX:ISF) has filed court proceedings that could hold up the planned sale of the company to CSC

Former iSOFT (ASX:ISF) chief executive, Gary Cohen, has initiated court proceedings that could delay the sale of the company, Oceania Capital (ASX:OCP).

Cohen family company RJL Investments has claimed in a filing that it is due four weeks' prior notice before Oceania subsidiary, Oceania Healthcare Technology Investments, sells around 15 per cent of its 24 per cent stake.

The delay could give Cohen time to secure a better offer than the $0.17 per share bid from US company CSC, which iSOFT has tentatively accepted.



iSoft ex-CEO supported CSC buy: investor

By Renai LeMay, ZDNet.com.au on April 18th, 2011

One of the key investors in troubled e-health software giant iSoft has claimed that the company's former executive chairman Gary Cohen was supportive of a buyout of the company by IT services giant CSC — despite the fact that Cohen last week filed legal proceedings in what appeared to be an attempt to block part of the acquisition.

CSC confirmed several weeks ago that it would attempt to buy troubled iSOFT in a move slated to finally give CSC full control over the company it has long partnered with in the UK Government's national health technology systems makeover. The move is also expected to bring long-awaited stability to iSoft, which has struggled financially in recent years.

However, Fairfax and News Ltd newspapers have reported that Cohen — who quietly resigned from executive duties at iSoft in August last year — was planning a counter-offer for iSoft.




Doctors breaching patient privacy: Orwell redux

David J Handelsman, Leo A Turner and Ann J Conway

MJA 2011; 194 (8): 403-404

Legislative changes made without public discussion allow disclosure without patient consent

Of all the ethical principles underlying medical practice, confidentiality is so fundamental that its breach is an illegal, high-order betrayal of responsibility. Disclosing personal medical information without consent profoundly violates the autonomy, beneficence and privacy that patients have always rightly expected.1 Although disclosure without consent has only rarely been necessitated by an urgent threat to life or health, two recent legal erosions of doctor–patient confidentiality illustrate how privacy-invading legislation can so easily and silently harm individuals who do not form sufficiently clamorous rights-demanding groups. In one, a state government directs that private medical records be lodged in an Orwellian sounding “Central Register” without regard for the individual’s knowledge, and risking privacy breaches by seeking consent for disclosure to third parties. The other permits disclosures of a patient’s medical information against their wishes even without any urgent threat to the life or health of another person. Both represent unreasonable intrusions on privacy and erosion of personal liberty.



NBN sell-off remains an option

MANY citizens are dismayed by the federal government's failure to conduct a cost-benefit analysis on the expensive National Broadband Network.

As time goes by, the dismay of some may turn to reluctant resignation, but they shouldn't give up yet.

If the government runs full-term, the next federal election must be held by November 2013. The NBN would still largely be a pipedream then. NBN Co's corporate plan projects that construction won't be completed until December 2020. In mid-2013, only 15 per cent of premises will be able to access the NBN -- 11 per cent through fibre-to-the-premises. And only 5 per cent would actually be connected.

Fortunately, by that time, "only" $7 billion of NBN Co's $35.9bn total projected capital expenditure would have been spent.




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