Monday, May 02, 2011

Weekly Australian Health IT Links – 02 May, 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

It has been an interesting and rather truncated week with Easter and ANZAC Day at one end and the marriage of two young English twentysomethings at the other.

As far as e-Health as concerned there are some issues raised further down are slightly tangential but important to keep in mind. We have warnings of how systems and security can go wrong and how we need to be alert to all sorts of risks that might not be instantly obvious.

The other theme for the week seems to be the reaction to the rather fiscally tight approach to the funding of the PBS in providing reasonably priced medications to Australians.

I provided some commentary here:

I really think those governing us need to think carefully about what is fair and reasonable and what it not and should adjust priorities to make sure we fund those things that are vital - within the nation’s capacity - and distinguish carefully between what are necessary and what are discretionary expenses. We can’t live beyond our means and we should not waste public money but we can afford, into the foreseeable future, to do the basics properly.

On that point there are some great comments from former Finance Minister Lindsay Tanner.

Tanner draws back curtain on budget conjuring tricks

April 30, 2011

Michelle Grattan - Political Editor

LINDSAY TANNER, former and well-respected finance minister, is something of the poacher-turned-gamekeeper. In his new book Sideshow: dumbing down democracy, a scathing attack of the media's trivialisation of political coverage, Tanner admits that in his time he, like his colleagues, conspired in the game.

As the budget approaches, his insights into the conjuring that goes on are valuable. He became adept at "the dark arts", he confesses, "using some of what are now the standard tricks employed to maximise political appearances".

These included switching between different forms of accounting, choosing different indicators of spending "according to which . . . suited the argument better", classifying annual spending as capital, and making commitments beyond the years of the budget period.

When you hear, for example, on budget night what the government is doing on mental health, remember Tanner's salutary warning: "It sounds impressive when the responsible minister announces that health spending is to increase by $1 billion dollars over the next four years, and it sounds even better when we're told that it will be at record levels. But there's a fair chance that we're being misled by such claims.

Full article is here:

Show just how the politicians will try to conn us. Not good at all!

Last - just thought I would mention the blog has now had over 250,000 individual visits and over 400,000+ page views. Thanks to all who browsed!


GPpartners open up on e-health trial

By Josh Taylor, on April 28th, 2011

Since signing on as a first release site for the government's $466.7 million e-health record program last year, GPpartners in Brisbane has been charged with the job of getting GPs onto the e-health bandwagon before July 2012.

GPpartners is a division of General Practice located in Brisbane, and serving 800 general practitioners, 200 GP offices and several public and private hospitals in the city. The organisation has several e-health programs such as secure messaging already in place and, according to GPpartners spokesperson Simon Carr, GPpartners was picked for the trial because of the organisation's long history in e-health.

"We have for a long, long time been supporting our general practices in e-health improvement and practice improvement," he said. "We were approaching government for some time around funding to improve e-health in our local area and as that was all happening, the e-health reform agenda started to develop. We have a great deal of experience and I think our experience with change management, and getting GPs to adopt change, is really what got us over the line."

GPpartners has employed a team specifically to visit general practices and get them prepared for the e-health transition. This begins with signing GPs up for Health Provider Indentifiers, he said, which — along with the practice identifier — is necessary for sharing individual healthcare information via an e-health record.


AMA calls for $328m Victorian e-health initiative

Medical associations calls for HealthSMART to be replaced with iPads, improved medical interfaces

The Victorian branch of the Australian Medical Association (AMA) has called for more than $18 million in funding over four years from the state government to roll out iPads and supporting infrastructure to doctors.

The grant comes as part of $328 million in funding the association has pushed from the Victorian Government across the 2011-2012 financial year and three-year forward estimates as a means of replacing the scrapped HealthSMART initiative and improving patietn safety through ICT infrastructure.

In a submission to the state treasurer (PDF) ahead of the budget due to be handed down in Parliament next week, the association called for all public hospital-based doctors to be provided a handheld device to be used for drug charts, medication management and patient records.


HL7 Fresh Look Task Force

Posted on by Grahame

The HL7 board has authorized a new “Fresh Look” Task Force to examine the best ways we can create interoperability solutions, with no pre-conditions on what those solutions might be. The idea is that, knowing what we now know from what has already been created within HL7 and by other groups outside of HL7, what would be our best approach to interoperability solutions?

I have accepted an invitation to be a member of this task force. It’s my belief that this is a real fresh look; none of the sacred cows are off the table for re-examination.


Vic doctors want $328m for e-health

After just a few short months in office, Victoria’s new State Government has already canned the previous administration’s plans to roll out Apple iPads to every public sector doctor in the state and placed Victoria’s flagship $360 million e-health project HealthSMART on ice. But not everyone is happy to see e-health investment so dramatically rolled back in the state.

In a submission to the state’s upcoming budget process recently published online (PDF), the Victorian branch of the Australian Medical Association has called for the new Coalition State Government to commit $328 million over four years to ICT initiatives in the state’s health sector.

“Despite the promises of HealthSMART, Victoria still does not have ICT infrastructure that caters adequately for the needs of patients. The potential quality and safety benefits of IT are not being realised, costing time and money, and leading to poorer patient outcomes,” the AMA wrote in its submission, news of which was first published by Computerworld.


Vic dental agency seeks CIO

Government agency Dental Health Services Victoria (DHSV) has advertised for a chief information officer-level IT executive to lead delivery of ICT services to over 60 community health agencies throughout the state.

The agency — which employs about 560 staff, according to its website — was established in 1996 to improve management of the state’s public oral health services, doing so through the Royal Dental Hospital of Melbourne and over 60 community health agencies throughout the state.

The agency has not responded to a request for comment about whether it previously had someone in the position or whether it’s a new role. However, the group has implemented major IT projects in the past, according to a case study available online at the website of HealthSMART, a separate segment of the Victorian Government overseeing a state-wide e-health infrastructure project


NEHTA confirms use of IHI pseudonyms

The National E-Health Transition Authority (NEHTA) has confirmed an individual may legitimately choose to have a pseudonymous IHI if there is some danger to their person, such as in the case of victims of domestic violence.

NEHTA made the statement today in response to a report yesterday that Medicare will allow individuals to register for 16-digit individual healthcare identifiers (IHIs) using false names and dates of birth.


NZ colleagues offer warning over Medicare Locals impact

21st Apr 2011

Byron Kaye

NEW Zealand’s most influential GP has delivered a stark warning to the Australian Government as it prepares to unleash the first Medicare Locals: Don’t make the same mistake the NZ Government did.

Dr Peter Foley, chair of the New Zealand Medical Association, said Australia must learn from the hugely unpopular introduction of Crown Health Enterprises – similar to Australia’s Medicare Locals (MLs) – which he said had failed to ensure adequate GP leadership.

“If the [Australian] Government truly regards general practice as central to the delivery of primary healthcare… then this position must not be undermined by any top-down direction of how that might be delivered,” Dr Foley told MO.


Preventive care crucial to unclogging hospitals

Julia Medew

April 30, 2011

THOUSANDS of sick Victorians are filling hospitals each year because their illnesses are not being prevented or adequately managed by GPs and other specialists.

Statistics on avoidable hospital admissions collected by the Victorian Department of Health reveal that, in 2009-10, 180,858 people were admitted to hospital with conditions that could have been avoided with early interventions delivered by primary-care practitioners such as GPs, dentists or physiotherapists. It is a 24 per cent jump from 2000-01, when there were 145,570 such admissions.

People with diabetes complications made up the biggest group, accounting for 63,185 or one-third of all avoidable admissions in 2009-10. Dental conditions were the next most common at 16,443 admissions, followed by 14,547 admissions for emphysema and chronic bronchitis. Other conditions on the list include asthma, high blood pressure and vaccine-preventable illnesses.

Note: Health IT with Clinical Decision Support can help here!


Recruitment of overseas GPs 'threatened'

Kate Hagan

April 27, 2011

SIGNIFICANT delays in registering health professionals under a new national body is threatening Australia's ability to attract overseas doctors to work in rural areas, workforce groups say.

Submissions to a Senate inquiry into the Australian Health Practitioner Regulation Agency, which replaced state-based registration boards last July, reveal serious misgivings about its performance.

The Australian Medical Association said the transition had been ''an absolute debacle'' and put patient care at risk. Some doctors discovered that their registration had lapsed after being advised by Medicare, the AMA said, leaving subsequent uncertainty about whether their patients were entitled to rebates.


Online calculator for melanoma risk

Julia Medew

April 27, 2011

MELBOURNE doctors have created a skin cancer calculator for people to work out their risk of getting a melanoma in the next five years.

The interactive website, created by doctors at The Alfred hospital's melanoma service, is designed to alert people at risk to the need for preventive measures and relevant screening.

Victoria Mar, a dermatologist with the service, said the calculator assessed the best available evidence for individual risk factors such as age, hair colour, complexion, where you live and family history. It also asks users to identify how many different moles they have on their body.



$126m GP helpline on track to open in July

A $126 million after-hours doctor advice helpline is on track to open on July 1, although the National Health Call Centre Network is yet to sign up a service provider for its program.

A Health Department spokeswoman said the network had finalised its evaluation of tenders for the plan, announced in last year's federal budget.

"It has selected a preferred provider and is currently negotiating terms and conditions," she said.


Taxpayers to foot bill for broadband service double-up

THOUSANDS of small housing estates will receive brand new temporary copper connections, which will be disconnected at a cost to taxpayers as the National Broadband Network is rolled out across the nation.

Telstra yesterday confirmed the telecommunications giant had been given responsibility to provide infrastructure for a basic telephone service in new housing estates with fewer than 100 premises.

Communications Minister Stephen Conroy has given Telstra scope to use fibre, high-speed wireless or copper networks to provide this service, which will become redundant when the $36 billion NBN is rolled out across the nation.


Sony cyber theft a wake-up call

THE theft of personal records belonging to 77 million gamers worldwide has prompted a security expert to warn that Australia is particularly vulnerable to computer hacking.

Internet security expert Bill Caelli said Australia did not have a law that made it compulsory to warn consumers when hackers stole their personal or credit card details.

He supported calls for laws that made it mandatory for companies to reveal hacking to those affected, with criminal provisions where personal and financial details may have been stolen.


Sony's Norio Ohga, father of the CD, dies

  • From: AFP
  • April 25, 2011 11:23AM

FORMER Sony president Norio Ohga, who helped transform the music industry with the development of the compact disc format, has died at the age of 81, the company said.

The music school graduate served as president from 1982 to 1995 and led the electronics manufacturer to become an entertainment empire with a portfolio encompassing music, movies and computer games.

During the development, Ohga, a passionate baritone singer, pushed for the 12-centimetre format with 75 minutes of recording capacity to fit Beethoven's Ninth Symphony without interruption.





Anonymous said...

What are these self-declared geniuses at GP Partners doing with this Wave 1 money?

One of the shonkiest processes I've ever seen run.

Anonymous said...

Corruption! Corruption! Corruption! If there is a change of government expect a Commission to investigate the indefensible section process, the conflict of interest with the nexus of individuals around DSTC/Partners/NEHTA. People will go to prison. Fraud is theft is a criminal offence.

Anonymous said...

I have often pondered the mess we are in and wondered if it is corruption or stupidity?? This is Hanlon's Razor which is an eponymous adage which reads:

"Never attribute to malice that which is adequately explained by stupidity."

An extension of this is:

A practical observation on the risks of stupidity was made by the German General Kurt von Hammerstein-Equord in Truppenführung, 1933: "I divide my officers into four classes; the clever, the lazy, the industrious, and the stupid. Each officer possesses at least two of these qualities. Those who are clever and industrious are fitted for the highest staff appointments. Use can be made of those who are stupid and lazy. The man who is clever and lazy however is for the very highest command; he has the temperament and nerves to deal with all situations. But whoever is stupid and industrious is a menace and must be removed immediately!" (From wikipedia)

I am afraid that NEHTA are stupid and industrious. They target anything that works and try and bring it down to their own level, which is pretty low.

I am starting to understand the principle of small government, its really damage minimalization rather than a right wing ideology!!!!

Anonymous said...

Thank you May 08 10:03:00 PM, I too have often pondered the mess we are in. I have done so with the hindsight of 30+ years experience in the field of healthIT. I agree that NEHTA is industrious as evinced by the most amazing pile of documents and reports produced by NEHTA over the last 5 years. So in that sense lazy it is not.

And I don't believe that NEHTA is stupid either. It employs far to many PhD and other degree laden individuals to be designated stupid. However, that does not make NEHTA clever.

The mess to which you refer stems predominantly from the leadership and the culture of the organisation which evolves from the leadership.

Constant questioning, new ways of thinking, and an open mindedness to embrace the possibility that NEHTA's way and DOHA's way is not and has not worked is the first step to getting out of the mess to which you refer. That requires informed, mature, experienced, competent leadership. I hope you and others agree. Of course, whether anything can be done about it at this late stage is entirely another matter altogether.

Anonymous said...

"Of course, whether anything can be done about it at this late stage is entirely another matter altogether."

I agree - basically nothing can be done to any degree because NEHTA is now so well funded by the jurisdictions which have sunk an enormous amount of money down the deep hole they dug together that no-one knows how to climb out of the hole. Let us all pretend that all is well and keep doing what we have been doing and hope....

and hope ...

and hope ....

until ...

Anonymous said...

I have a collection of brilliant experts who work on eHealth matters, but their expertise is narrow and they cannot see the big picture or how the application of their expertise makes a huge difference to another area of eHealth.

Yes, Nehta do have some experts, but those experts do not understand the big picture and I doubt anyone at Nehta actually does. They are rudderless and this giant ship is flailing its way around the harbour running over small and large craft, while government just keeps applying more power, rather than fixing the rudder. They will run aground, hopefully sooner rather than later, as the damage done in the meantime will take some time to repair.

Anonymous said...

Monday, May 09, 2011 11:02:00 AM said "I have a collection of brilliant experts who work on eHealth matters, but ....... ".

Yes and so do a number of other companies - more often than not small to medium enterprises. The problem is (has been, and I am sure will remain) that the leadership of NEHTA do not understand how, and do not have the skills and confidence, to tap into that well of potential which exists in companies like yours. I recall a few years back someone was proposing a rather creative way to bring such collaboration about but it all seemed too hard or perhaps it was just politically unattractive.

Anonymous said...

Yes I'm sure all of the above is true. But the 2nd post was specifically about the staging of the 2nd round PCEHR tenders. It was about whether that was a truly defensible and independent selection process based upon merit or if it was in some way biased or 'corrupt'.

Now lets assume a scenario where DOHA for whatever reasons is the one that wants the 2nd round tenders. NEHTA does not want them as it believes they are not strategic but it is forced to handle the process, so that DOHA is apparently at arms length from it.

Next lets assume that a decision is made somewhere (maybe in DOHA) to award the tenders to certain select groups e.g. Partners, government enterprises (Medibank Private) ahead of or independently of actually reading any tenders.

Were something like that set of circumstances to be true, then the tender process is not fair. Money is being transferred fraudulently to the benefit of some, who might for example benefit personally if a company was to float or be bought or make lots of money down the track. In this sense the tender process would have been a sham and therefore a fraud, and then it is also a crime, no?

Anonymous said...

I am not sure anyone in DOHA has even read their own Medicare legislation and certainly do not appear to understand the fundamentals of building large scale systems. It would appear that the tender process was a sham and many of the successful tendering organizations have had little involvement in eHealth. Perhaps that allows them to speak on the same level to the NEHTA and DOHA selectors? You would need to be a good liar or a fool to take the plans seriously. Given the lack of stated milestones the definition of success will be very kind to the players and I am sure we will hear another gem, just like health connect where we all learnt "its all about change management". What will we learn this time? "Never tender unless you have already had the pat on the back"

Anonymous said...

Yes, let's keep it focused. Monday, May 09, 2011 4:10:00 PM said "In this sense the tender process would have been a sham and therefore a fraud, and then it is also a crime, no? "

The answer is Yes it seems to have been a sham and a fraud. But hey - what's new. Think back to how the GP Partners project first got funded - a special grant from DOHA!! Oh. All that DOHA is doing this time is putting more money behind the money it has put in previously.

And how right you are about NEHTA - arms length removed project manager of a DOHA scam - I agree. NEHTA may well not want to have anything to do with it but it is beholden to do its master's bidding or be starved of funds - so it has no choice.

You've nailed it in one but so what? Is there anything anyone can do about such a situation? Your suggestion that it is a corrupt process is probably very very close to the truth but how do you expose this?

Anonymous said...

"how do you expose this?"

We are left to rely on the core morality of the many fundamentally good people who know the truth directly. There are many ways to put this information into the public and remain anonymous. A crime is a crime, no matter what NDA or contract you have signed. And I suspect, failure to disclose makes you vulnerable when the shit hits the fan.

Or the senate estimates committee starts to ask some more direct questions.

Dr David More MB, PhD, FACHI said...

Of course I am always happy to let the sunshine in on any major issues I happen to become aware of!

The blog has done this a few times in the past!


Dr David More MB, PhD, FACHI said...

I have had some feedback that suggests some may be concerned about the suggestions in some of the above anonymous comments regarding possible distortions of appropriate processes and the like.

If you are concerned by these suggestions please contact me at and we can discuss these concerns.

It seems to me that where no names etc are cited, and the posting is anonymous, it is up to the reader to make their own assessment as to how seriously a comment is to be taken.


Anonymous said...

Maybe one way to remove the apparent concerns expressed by the posters above would be to make that selection process more transparent? Perhaps without publishing the actual bid documents, if there was information released on the ranking and scoring of bids (perhaps with bidders agreement where needed), and a description of the process itself, then any lingering doubts would surely be dispelled. Light trumps dark.