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, May 16, 2011

Weekly Australian Health IT Links – 16 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

The big news of the week was the Federal Budget where we have seen more funding for Telehealth and still seem to have a drop dead date for funding of the PCEHR at June 30, 2012.

This news is covered below and in a blog earlier in the week. See here:


The National Prescribing Service effort to improve prescribing and post marketing surveillance is to be commended and is a great idea - subject to the appropriate privacy and security controls. The use of aggregate health information for such purposes is very important and can obtain information that is just not available any other way.

It is also good to see that CIO’s in the Health Sector see continuing improvement in e-Health investment.

As a last point I am aware that a draft review of the Standards base that is intended to underlie the PCEHR has come up with a large number of problems, ambiguities and issues. The bottom line appears to be that the Wave 1 and 2 sites are going to essentially make it up as they go along rather than receive coherent guidance from NEHTA and DoHA as to what Standards are to be used. The potential implications of this for any actual delivery of working pilots are obvious.



New program to monitor medicine use

12th May 2011

Mark O’Brien

THE National Prescribing Service will oversee a new $16 million program to monitor the uptake and use of prescription medicines, collecting data from a network of 500 general practices and up to 2.5 million de-identified patient records.

NPS CEO Dr Lynn Weekes (PhD) said the MedicineWatch program, announced in Tuesday’s Federal Budget, would complement existing data sources and investigate how medicines are prescribed and their positive and negative impacts on health in Australian patients.

“Often the long-term safety and effectiveness of medicines can only be established once a drug has entered the market and is being used by millions of people experiencing its benefits and risks,” she said.

“In an Australian first, MedicineWatch will provide important data on how medicines are being used, in what conditions and with what outcomes.



Pay telehealth rebates now, say experts: life-saving services available now are being held up

  • UPDATED Karen Dearne and Fran Foo
  • From: The Australian
  • May 10, 2011 8:36AM

MEDICARE rebates should be available for existing telehealth systems instead of waiting for the $36 billion National Broadband Network to take shape, medical specialists have warned.

The government had an opportunity to save more than $3 billion annually through widespread adoption of online telehealth services, they said.

One area largely ignored is remote monitoring. Technology available now uses the humble copper telephone line to transmit data over the internet for routine health checks from the comfort of patients' homes.

Jeff Alison, head of cardiac rhythm management services at MonashHeart in Melbourne, said the lack of Medicare rebates for people using such facilities was an impediment to rolling out remote monitoring technologies.

In contrast, most countries in Europe offered reimbursements for remote follow-up.



Human Services is e-health over again

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

It's funny watching the parallels between the health identifier program and the Department of Human Services consolidation.

Remember how strongly the medical community felt about having everyone's health data in a single database, just waiting to be stolen and used against them?

So the National E-health Transition Authority and co came up with a complex system that meant that any data would reside in individual repositories and be linked together via the identifier, only to be requested and used when required.

We seem to be seeing the same situation with the Department of Human Services now.

Back in December 2009, when the consolidation of Centrelink, Medicare and other agencies was announced, Human Services Minister Chris Bowen said that although the consolidation would mean an easy flow of information between agencies, the government would not have a "master file" on citizens and would "not be merging agency databases".



Code of conduct applies to e-health consults

10th May 2011

GPs involved in e-health consultations must fully abide by the professional code of conduct or face disciplinary action, the Medical Board of Australia has warned.

The board said in a communiqué last week it expected GPs to comply with its Good Medical Practice: A Code of Conduct for Doctors in Australia regardless of the type of patient visit.



Funds injection to spur virtual consultations: initially, rural patients will get most benefit

FROM July, patients living in remote, regional and outer metropolitan areas will have access to video-conference consultation with doctors based in city hospitals.

Although the details aren't final, there's $120.5 million in the budget to fund new Medicare rebates for telehealth services, meeting Julia Gillard's election promise to deliver 500,000 online consultations with GPs and specialists over four years.

A spokeswoman for Health Minister Nicola Roxon tells Weekend Health the department is on track for the July 1 introduction of telehealth rebates. But the budget paper shows it will be a slow start, with $12.3m allocated in the first year and an expectation that only 2.7 per cent of medical specialists will be able to participate. There will, however be a steady increase, with $21.2m on offer in year two with 4.5 per cent uptake; $38.4m in year three with 8 per cent uptake; and $48.6m, with 10 per cent participation, by 2014-15.



Government has presence of mind to help those in need


13 May, 2011 04:00 AM

Budget papers reveal a new look at the delivery of mental health services.

The key message arising from the federal budget is the acknowledgement by the Government that putting new money into old systems won't work. The Government is making new choices about where to invest and these are exciting.

There are overdue investments in the Early Psychosis Prevention and Intervention Centre and also funding for headspace, new services for new clients. In relation to the centre in particular, there is a solid evidence base to justify this spending. The key issue will be if headspace director Professor Pat McGorry and his colleagues have enough funding under this budget to ensure the national roll-out can be achieved without compromising the integrity of this model of care.


The commitment of some funding for new e-health approaches is also a very positive sign. There is mounting evidence that for some treatments, e-mental health care is at least as effective as face-to-face services and this is critical if we are to address the needs of regional Australia.



Hospital IT spending surge ahead

A majority of hospital CIOs are planning to increase their IT spend this year, according to a new survey.

Research published by industry analyst firm Ovum says 55% of CIOs at Australian hospitals plan to increase IT spending in 2011, 22% of them expecting a significant boost. None of the respondents expect spending cuts this year.

External spending plans seem fairly evenly split, with an average 35% expected to go on hardware and 30% on software.



Hospital CIOs ramp up tech spend in 2011

Technology spending in Australian hospitals is on the rise, with 55 percent of domestic hospital CIOs indicating they will increase spending during 2011.

According to research conducted by Ovum as part of its Healthcare Business Trends Survey, 42 percent of global CIO will increase spending by up to 5 percent. Of those, 22 percent reported plans to significantly boost spending compared to 14 percent with the same intention last year.



NZ Community Pharmacy trial of Electronic Prescription Service under way

Staff Writer

Editing and Researching news and stories about global and local Pharmacy Issues

In a media release by the NZ Health Quality & Safety Commission an e-prescription initiative has been launched in New Zealand.

The community trial of the New Zealand Electronic Prescription Service (NZePS), which enables general practice doctors to send prescriptions to community pharmacists electronically, began in late March in Auckland. The trial is the first phase of a national NZePS roll-out plan.

In the first phase of the trial, a GP and a pharmacy system – My Practice and Healthsoft – will test an initial version of the Service.

Auckland firm Simpl has been chosen to be the transaction broker vendor in the trial. Simpl was selected from a number of companies who responded to an independent Expression of Interest process run by the National Institute of Health Innovation on behalf of the National IT Health Board. Simpl developed an ePrescription Service for the Pharmacy Guild of Australia in 2008 which the firm’s chief executive Bennett Medary says is used by 6500 doctors and 2950 pharmacies.



Red Cross hires IBM for software overhaul

By Luke Hopewell, ZDNet.com.au on May 10th, 2011

IBM has secured a new contract with the Australian Red Cross Blood Service to work through the service's first national overhaul of its critical blood management software.

The win sees IBM working as an implementation partner with the Blood Service to continue the roll-out of its National Blood Management System that kicked off in March.

The system tracks the supply chain of blood products and facilitates testing, inventory and distribution management facilities for the service's red cell, plasma and platelet stock.



Budget 2011: Millions set aside for Human Services IT

  • Karen Dearne
  • From: Australian IT
  • May 10, 2011 10:03PM

THE Gillard government is pressing firmly ahead with welfare services reform, earmarking hundreds of millions for the integration of Medicare, Centrelink and the Child Support Agency into a super-agency in tonight's budget.

It has allocated $373.6 million over four years to integrate the three agencies' ICT infrastructure including a shared gateway linking the separate portfolio networks; a single security management system to protect sensitive information across payment systems, a consolidated data management system and common staff portal, desktop and email system.

There will also be a new data recovery centre to backup customer data in the event of a system failure.

Budget papers say $295.4m of this funding,including $205.3m in capital, will be met from existing Department of Human Services resources.



BUDGET 2011: Govt spends on e-mental health portal

The Federal Government has allocated $14.4 million to the five year development of an online mental health portal

The Federal Government has allocated $14.4 million over five years for the establishment of a single e-mental health online portal in an effort to make services easier to access for users.

The portal, outlined in the 2011 federal budget and part of the government's National Mental Health Reform initiative, will provide online training and support to general practitioners, indigenous health workers and other clinicians working in the mental health field.

It will also consolidate existing “scattered” websites and telephone services to enable people to access numerous online or telephone based services through what the government describes as a “virtual clinic”.



Budget 2011: E-health communication trumps spending

Peak health groups have called for greater focus on standards, rather than spending, for effective e-health implementationg

Australia’s peak health industry bodies have warned of the Federal Government’s e-health solutions becoming “siloed” without greater attention to standards surrounding implementation of technology for doctors and practitioners.

Both the Australian Medical Association (AMA) and the Royal Australian College of General Practitioners (RACGP) expect there to be little in the way of further funding for e-health initiatives in Tuesday’s federal budget, following the government’s $467 million pour in to personally controlled electronic health records (PCEHR) last year. The government has also committed nearly $400 million to subsidising telehealth services from 1 July next year.

Any health funding announced by federal treasurer, Wayne Swan, is expected to be put toward mental health schemes.

However, AMA federal vice president, Dr. Steve Hambleton, told Computerworld Australia that even without additional funding, the industry required a greater, whole-of-sector approach to the looming initiatives.

“E-health has grown up in isolation, we’ve got to start talking about protocols we can communicate to each other nationally,” he said. “NEHTA [National E-Health Transition Authority] is trying to do that, but hospitals have different software in each state and only recently have we started getting a single unique healthcare identifier.



Alfred Health scans its digital future


Victoria’s Alfred Health has taken a major step toward the future of Medical Recordkeeping with its implementation of Cerner Provision Document Imaging (CPDI) digital scanning system.

During 2010, Alfred Health became the first Victorian site to adopt the Cerner scanning platform, as part of its quest to provide clinicians with improved access to medical records. It is now handling over 10,000 documents a day via a solution that includes Kofax Ascent Capture 7.5 software and Bowe Bell & Howell/Kodak scanners.

With a Cerner clinical information system in place since 1999, including online access to pathology and radiology results, the decision was made in 2007 to add a scanned medical record component. A business case was developed and funding was made available by the Victorian Department of Health (formerly DHS) in 2008 through a capital advance/interest free loan. Following a tender process, Cerner Provision Document Imaging (CPDI) was chosen in 2009. This was followed by a 12 month implementation period.



Medicare snubs Senate registration inquiry

Senators have criticised Medicare Australia for failing to show up at a Senate inquiry into national registration and for refusing to reveal how many doctors have had their Medicare rights withdrawn due to registration lapses.

Senators expressed their dismay at hearings (link) last week, at which the AMA said the disruption caused by the new national AHPRA system had caused more concern in the profession than the medical indemnity crisis of 2002.

AMA vice president Dr Steve Hambleton said thousands of doctors had complained about the new system, with many only discovering they had been deregistered after having their Medicare rebates rejected.



FEDERAL BUDGET: Will it match the previous year?

More than half of last year's ICT allocations still to be spent + pre-Budget comments

Analyst, Intermedium, has outlined ICT funding in the 2010/11 Federal Budget to allow comparison with tonight's budget.

It found $1.8 billion in ICT budget allocations in the 2010-11 Commonwealth Budget - much of which is still to be spent.

This number was calculated through a systematic collection of all measures listed in the 2010-11 budget papers which it judged to be ICT related.

When a budget measure is not entirely ICT related but is deemed to have significant ICT components, a percentage was estimated by Intermedium researchers and the allocation calculated accordingly.

Last year, electronic health and national security dominating the distribution of ICT in the budget measures.

The largest single ICT allocation in 2010-11 was the establishment of Personally Controlled Electronic Health Records (PCEHR), valued at a total of $466.7 million over two years.



Moved by good vibrations: tablet prototype helping the blind to 'see' diagrams

A DEVICE that makes it easier for the visually impaired to build a picture of graphic information could soon be trialled in Victorian schools.

The multimodal computer tool, known as GraVVITAS (Graphics Viewer using Vibration, Interactive Touch, Audio and Speech), has a touch-sensitive tablet PC at its core and uses vibration and sounds to guide the user around a diagram.

Developed by Monash University's Faculty of Information Technology, the device offers a practical, low-cost approach to providing refreshable and accessible graphics to the blind.

Clayton School of IT head Kim Marriott has developed GraVVITAS with PhD student Cagatay Goncu in partnership with Vision Australia.



E-health sector pins hopes on budget boost

THE e-health industry will be hoping for new budget funding in the communications and regional services portfolios tonight.

With $467 million being spent on personal e-health records by July next year and a further $350m committed to tele-health initiatives from this July, observers are not expecting any new money for health IT projects.

But, as the house inquiry into the role and potential of the National Broadband Network is demonstrating, medical connectivity cannot wait for the NBN.

Take the University of Wollongong's graduate medical school, which is delivering doctors back into the rural and regional areas they came from.



Hospital CIOs ramp up tech spend in 2011

Technology spending in Australian hospitals is on the rise, with 55 percent of domestic hospital CIOs indicating they will increase spending during 2011.

According to research conducted by Ovum as part of its Healthcare Business Trends Survey, 42 percent of global CIO will increase spending by up to 5 percent. Of those, 22 percent reported plans to significantly boost spending compared to 14 percent with the same intention last year.



Budget 2011: Labor ends voluntary net filtering scheme

  • Fran Foo
  • From: Australian IT
  • May 10, 2011 8:59PM

THE Gillard government will scrap its voluntary internet filtering grants program to save $9.6 million over three years.

A combination of reasons led to the decision, including moves by Telstra, Optus and Primus to voluntarily block child abuse websites.

"Consultation with industry has identified limited interest in the grants due to the increasing range of filtering technologies readily available to online users, including browser and search engine filters," the government says in the 2011-12 budget papers.



The Chromebook FAQ

We explain what Google's 'Chromebook' notebooks are all about

One of the big announcements at Google's I/O developer conference is the release of notebooks running the search giant's Chrome OS.

What, exactly, is a Chromebook? Is it just like a netbook?

'Chromebook' is the term starting to be bandied around by Google and others to describe the laptops designed to use the Chrome operating system. A netbook refers to a mini-laptop (generally models with up to 10.1-inch displays) with not-too-powerful specifications that runs a regular desktop operating system (usually some version of Windows). We expect you will be able to buy a Chromebook in all kinds of sizes; one of the initial offerings has a 12.1-inch display, which makes it larger than a netbook.





Anonymous said...

David, in regard to standards you said "the Wave 1 and 2 sites are going to essentially make it up as they go along rather than receive coherent guidance from NEHTA and DoHA as to what Standards are to be used".

Now this simply cannot be true.

Given that there were 80 or so applications for funding under Wave 2 it is quite impossible to believe that of the 70 or more which were not successful that none of them presented a clearly defined standards pathway for their development. For if they did they surely would have been superior candidates over any ad hoc 'we will make it up as we go along' applicants.

It seems to me you need to go back and correct your statement. Alternatively, if there were better qualified applicants with well-defined standards-compliant projects which did not getup they need to be brought forward and given some well deserved exposure.

Why is not a list of all applicants with their project titles readily available for all to see?

Dr David G More MB PhD said...

You missed the point I was making. The Government is yet to work out what they want as far as I can tell!

How can the providers know what to do - if the Government who is paying them doesn't?


Anonymous said...

You say "The Government is yet to work out what they want" and you ask ""How can the providers know what to do".

Just a minute. The Government has been going out to providers (stakeholders) for years calling for submissions and seeking input in terms of what is required, and what the users want.

Now that hasn't worked. Why? Because the users don't really know what they want and if they think they do they don't have the experience, discipline and insight (or so it seems) to know what is practicable, achievable and affordable within a realistic timeframe. The end result is that based on all this collected stuff of what the user wants one is led to assume that too is what the government wants; else why would it ask the users what they want? Catch 22 indeed. Squirrels in a cage are smarter than that.

So much for a totally ineffective and useless way of defining what the Government wants and what the user wants.

Which leads to the question "How can the providers know what to do?"

Well it depends on your definition of providers. Let us remove the ambiguity. If providers means the health service providers and professionals - the Government keeps asking them because that is just about the only way the Government seems able to find out what 'it' wants.

On the other hand - if you mean by providers - the software developers - the people that analyse the needs of an organisation, see a problem where improvements can be made, and develop and implement solutions to that end - then we have another problem which has never ever been addressed by Government.

As far back as I can remember the Government has told the developers what is needed. The Government has almost never asked the developers. In fact NEHTA and Government have never engaged with developers - they just listen to the sales speel and nod wisely.

The developers, on the other hand, listen to the Government's fantasizing and wishlists and nod in despair at Government's inability to understand the obvious - work with the developers to do the job that needs to be done and in the process fund them to do the job in a commercially viable and realistic way.

Oh no, that wouldn't work either because ......... or would it?

Dr David G More MB PhD said...

Not wanting to make a meal of this the bottom line is that if all the Wave 1 and 2 sites are eventually going to be formed up into something useful they need to be based on agreed Standards.

Those have not been sorted out so we have a fair bit of wheel spinning until they are.

Now getting quality provider input - for the vendors - that is a whole different issue!


Anonymous said...

"Now getting quality provider input - for the vendors - that is a whole different issue!"

Now I'm confused. Do you mean - for the vendors? - or - from the vendors?

Dr David G More MB PhD said...

Getting clear stable requirements from clinicians for software to be developed from can be a challenge as most who have tried will attest. Part art and part science.

"The shifting sands of desire" can mean you specify and build something and the clever little clinicians have figured out how it could be made just that little bit better! Seen it a zillion times.


Anonymous said...

As someone who might do a lot of the work from conception to delivery I think this is a healthy process, it’s just not one that works with BUFD (Big up-front design). I have often done a bit of work and seen that it’s positive but not really quite right and modified it as a result of initial implementation.

It’s evolution, which in the software world can be called "extreme programming". In the standards world it advances like a glacier, but glaciers do advance. At the moment we appear to have a complete lack of design after years of complete over design. The pendulum needs to swing to supporting what’s working and improving things incrementally but it appears that we will have to wait for the big implosion before that will occur.
What we have at the moment is the mother of all ice-dams and a warming climate. There are a few people swimming just below the ice dam commenting about how pleasant this balmy weather is. Scrat aka Doha are still chasing that elusive acorn however. Time to head for the boat!!

Keith Heale said...

Anonymous (May 17, 2011 12:04 PM) said "..The pendulum needs to swing to supporting what’s working and improving things incrementally.. " That is exactly the message that was delivered by several overseas speakers at the ehealth conference in Melbourne in November 2010. These were speakers who had a track record of achievement in their own countries. Unfortunately it's not the message that folks in DOHA or NEHTA want to hear, so "it appears that we will have to wait for the big implosion before that will occur.."