Monday, August 29, 2011

Weekly Australian Health IT Links – 29th August, 2011.

Here are a few I have come across this week.

Note: Each link is followed by a title and a few paragraphs. 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 main news of the week seems to be that we have had another ‘Petronius Arbiter / Charlton Ogburn’ moment with NSW Health and a new re-organisation is under way. It really does remind one of the quote:

“We trained hard, but it seemed that every time we were beginning to form up into teams we would be reorganized. Presumably the plans for our employment were being changed. I was to learn later in life that, perhaps because we are so good at organizing, we tend as a nation to meet any new situation by reorganizing; and a wonderful method it can be for creating the illusion of progress while producing confusion, inefficiency, and demoralization.”

The point is picked up here by a UNSW Health Academic.

Endless tinkering makes a healthcare paradise - but for the patients

Jeffrey Braithwaite

August 26, 2011


Restructuring healthcare has been criticised everywhere for being disruptive and costly, but it hasn't stopped governments doing it. I have lost count of the number of reorganisations of the NSW health system, particularly after 16 years of Labor mismanagement.

The latest round, announced on Wednesday, slashes 150 management jobs to redirect $80 million to frontline hospital services. Will it do anything to improve the health of your family?

The best research says each substantial reorganisation puts people in the system back by at least 18 months. They often generate angst for patients and staff. Everyone takes their eye off the care they should be providing and neglects the decisions they should be making, instead obsessing over organisational arrangements. Organisational chart-itis, you could call it.

- End Quote.

All I can say it is hard to disagree. There really is a need to get is right and just leave things alone in an organisational sense so people can focus on what they are meant to be doing.


NSW creates IT agency

  • Karen Dearne
  • From: Australian IT
  • August 24, 2011 4:53PM

THE NSW Government will establish a new agency, eHealth NSW, to plan and co-ordinate all health IT activities statewide.

It is part of a major restructure for NSW Health announced by Health Minister Jillian Skinner today that will slash 300 head office and middle-management roles to "free up more than $80 million” for frontline services.

Ms Skinner said eHealth NSW would drive innovation, improve implementation of "vital” e-health initiatives, and provide IT support to facilities across the state.

The changes are based on recommendations made in the Director-General’s Governance Review, released today.


NSW eHealth agency established under department restructure

The agency, to be implemented by the year's end, will improve implementation of e-health projects and provide support to local districts and facilities

The NSW government has moved to restructure the Department of Health and has established a new agency, eHealth NSW, to reflect the growing role of technology in health provision.

According to NSW health minister, Jillian Skinner, the agency will drive innovation, improve implementation of electronic health initiatives and provide support to the local health Districts and their facilities.

The restructure has also resulted in the elimination of 200 middle management positions to free up more than $80 million for front-line services and provide better support for local health Districts.


NSW creates health IT agency

The New South Wales State Government has opened a new page in its long and troubled history implementing electronic health solutions, committing yesterday to creating a dedicated agency to service the area, amid a much wider shake-up of the health sector in general driven by its new Coalition Government.

The state’s director-general of health, Dr Mary Foley, yesterday handed down a landmark report (PDF) into future governance arrangements for the state’s health department, with new Health Minister Jillian Skinner immediately welcoming the report and pledging to implement its recommendations. Among a number of other conclusions, the report noted that eHealth should be recognised as “the way of the future” in healthcare. However, it noted, NSW wasn’t currently making the most of its opportunities.

“In NSW, the current ICT governance model can be regarded as a ‘half-way house’, with staff and functions spread between the department, which has a strategic role, Health Support Services, which is responsible for rolling out major corporate and clinical systems, and area health-based ICT services which are currently located in the clusters,” the report states.


NSW govt consolidates e-health strategy

By Luke Hopewell, on August 25th, 2011

The New South Wales Department of Health has announced plans to restructure its e-health operations into a single agency before the end of the year, in a bid to make NSW the leading state in Australia for e-health delivery.

The new eHealth NSW agency will be made up of fragments of the NSW Department of Health and Health Support Services to deliver a "whole-of-NSW Health" approach to e-health delivery.

"In NSW, the current ICT governance model can be regarded as a 'half-way house', with staff and functions spread between the department, which has a strategic role, Health Support Services, which is responsible for rolling out major corporate and clinical systems and Area Health Service-based ICT services," the government said in its report into agency governance released yesterday (PDF).

The report added that NSW eHealth will develop a master plan complete with delivery dates and realistic timelines for the roll-out of projects like personally controlled e-health records, telehealth initiatives and e-prescribing systems.


E-health records a 'nightmare', says AusCERT

By Darren Pauli on Aug 24, 2011 3:29 PM

Filed under Risk

Health records need to be more secure than bank data.

The Government's plan to introduce electronic health records is a "nightmare" for security according to the head of industry group AusCERT.

According to Grahame Ingram, information security risks were amplified because of the highly sensitive nature of patient data held under the e-health scheme.

"It is a nightmare scenario," Ingram said. "That they think they have the security to safeguard the data is just a nightmare."

The Government had compared e-health security to systems used by major banks, but to Ingram, that fell short.


Online health records at risk from malware

It's the same problems as banking, but different, says AusCERT

  • Stilgherrian (CSO Online (Australia))
  • — 25 August, 2011 20:34

AusCERT general manager Graham Ingram has questioned the wisdom of Australia's National E-Health Strategy plans to make medical records available online, pointing to the difficulty of securing end-users' computers.

"I do not believe that personal health records should be available over the internet to end machines until they can secure them," Ingram told the Security 2011 Expo and Conference in Sydney this week.


Time for Government to pick partners who will deliver e-health to patients

The Health of the Nation series is an independent project by the Weekend Australian’s journalists. It surveyed Australians about key health questions. The published results on electronic health records should have the Gillard Government worried.

It is time the Government picked true partners to ensure the success of Personally Controlled Electronic Health Record (PCEHR), rather than trying to please all groups.

With a $466M budget allocation on the PCEHR before 1 July 2013, a low uptake will be highlighted just before a Federal election expected in September 2013. Many health and consumer organisations are sitting on the sideline giving negative commentary and even blocking progress. These groups have invested none of their own funds in e-health, but the Guild on the other hand is one of the very few organisations putting its money where its mouth is and backing the project. That does not mean our support is being acknowledged by the Federal Government.


Diagnosis good for e-health rollout, Brad Cable says

THE man steering the $500 million e-health record rollout, Brad Cable, says that next July "you and I will have the ability to log in and actually see our own personal record and be able to give GPs and others access to it".

Accenture's local health and public service head, Cable says he's not fazed by the complexity and tight deadline for delivery of the national system.

"If we hadn't had experience doing e-health records elsewhere it would be quite daunting," he said.

"But (federal Health Minister) Nicola Roxon noted they'd looked to select us based on our track record and what we bring is fundamental to being able to meet what they want and in that timeframe."

Last week, the Gillard government gave an Accenture-led consortium that includes Oracle, Orion Health and Telstra contracts totalling $77m for the build of its personally controlled e-health record program.


E-health plan 'smokescreen for ID card'

THE Gillard government's $500 million e-health record program is a smokescreen for a national identity scheme linking social welfare databases, claims Australia Privacy Foundation chairman Roger Clarke.

Dr Clarke said the program was a guise to mask the creation of an ID regime in the health sector, following past failed attempts to introduce national identity cards.

"If the personally controlled e-health record falls over and the smokescreen disappears, the bureaucrats won't care," Dr Clarke told The Australian.

"Because they will have achieved their goal of a centralised patient identification regime and everything behind it, such as the individual healthcare identifiers, will continue.

"IHIs are an enabling mechanism for linkage between agencies, allowing the creation of virtually centralised national databases."

An IHI was assigned to everyone on the Medicare database last year to support the program, but the system is not yet operational.


Workers staying silent on mental health, with bosses kept in the dark

THE stigma surrounding mental illness remains strong enough for nearly four in 10 sufferers to not disclose the condition to their employers.

And even for those who do, understanding and support from employers and managers is severely lacking, a study by Sane Australia reveals.

The Working Life and Mental Illness study, to be published today, which surveyed 520 people with a mental illness, finds the majority don't believe their manager understands mental illness and its impact in the workplace.

"Fewer than half of managers (43 per cent) were said to understand how it affected people in the workplace," the report says, with only 30 per cent of sufferers offered flexible working arrangements.


Telstra e-health role under AGIMO scrutiny

Does the eHealth records plan meet data centre procurement guidelines?

Plans to use Telstra's cloud computing offering to store elements of the Federal Government's personally controlled e-health record (PCEHR) are in limbo after it was discovered they do not yet meet whole-of-government procurement guidelines established by the Department of Finance and Deregulation.

The Department of Health and Ageing is in discussions with the Australian Government Information Management Office (AGIMO) - a subset of the finance department - over how use of Telstra's secure infrastructure-as-a-service would align with guidelines mandating government departments use a whole-of-government endorsed data centre supplier.

Telstra was among the eight parties included in Accenture's successful consortium bid for the infrastructure portion of the $466.7 million records project. However, it has not been named as a supplier to AGIMO's whole-of-government data centre panel.


It's like putting a man on the moon

Published on Tue, 23/08/2011, 03:02:31

No goal is too big when you have inspiration.

CEO of the National E-Health Transition Authority (NEHTA), Peter Fleming, has likened the once thought impossible but successful job of putting a man on the moon to one other major task currently at hand – the creation of the Personalised eHealth Record (PCEHR) system for all Australians.

During the Health Infomatics Conference in Brisbane, earlier this month, Mr Fleming described the establishment of the eHealth system as a massive “challenge”. But, he said, once overcome, it will significantly change the world in which we live and make a huge difference to the health care system of the future.


DoHA confirms next round of PCEHR funding in negotiations

The third round of funding for the project will be allocated to the National e-Health Transition Authority (NeHTA) by November 2011

The Federal Department of Health has confirmed it is in negotiations for the third tranche of funding to be allocated to the National e-Health Transition Authority (NeHTA) for the $466.7 million Personally Controlled Electronic Health Record (PCEHR) project.

Speaking to Computerworld Australia, a spokeswoman for the Department of Health and Ageing (DoHA) said negotiations were progressing in line with the end of the previous stage with a new allocation to be made by November this year.

The spokeswoman could not comment on the exact amount of funds to be allocated to NeHTA, but said it would be dependent on contract deliverables and used to build upon the work completed so far.


Primary Health drops $300m HCN sale

  • Karen Dearne
  • From: Australian IT
  • August 22, 2011 7:07PM

MEDICAL software maker HCN is off the auction block as Primary Health Care scraps plans to sell-off its technology division.

Instead, the company will implement a new three-year strategic plan "to capitalise on, and be a beneficiary of, the upcoming e-health change in Australia".

The future for HCN, market leader for doctors' desktop systems, has been in doubt since May when Primary confirmed it may sacrifice the asset to pay down debt.

It's understood managing director Ed Bateman's medical centre and pathology lab group was hoping to raise up to $300 million.


Medicare Local one month on: The technology behind Brisbane's first facility

E-health records, CMS database key to the future

The first Medicare Local in Australia will play a key role in the adoption of electronic health records.

With the Lutwyche site up and running, CEO of Metro North Brisbane Medicare Local, Abbe Anderson, is turning her attention to expansion and the personally controlled health record (PCHR).

“We are one of the key providers behind the electronic health records,” she said.

“The types of things we’re testing out locally is enrolling general practices so we help them to get their Individual Healthcare Identifiers, so all of us in Australia have one of these but they need to be put into the system and used, and it’s one of the big challenges to organise this.”

Anderson, spoke to Computerworld Australia about the IT challenges that come part and parcel with being the first Medicare Local opened by the Federal Department of Health and Ageing.


Gillard plugs Medicare Locals

Prime Minister Juila Gillard has hailed the axing of general practice divisions and establishing Medicare Locals as a gravitational shift in Australia’s health system administration.

Nineteen Medicare Locals have already been established, with more on the way. The organisation is designed to shift the focus of the health system from hospitals to primary and community-based care.

According to the prime minister, there is no “one size fits all” for Medicare Locals. “What works in Western Sydney won’t necessarily work in Bunbury, which is why locally-run organisations are looking at the health needs of their communities and targeting services to meet those needs,” she said in a statement.


Computers may predict deaths

COMPUTER analysis of routine blood tests can predict which hospital patients are likely to experience a critical event the next day, according to preliminary Australian research.

Melbourne researchers used a computer program to examine six million blood tests taken from patients in the wards and emergency department of the Austin Hospital in the past 5 years, and combined this data with hospital records of critical events.

“We wanted to see if the blood tests contained patterns of abnormalities … to predict whether a patient would, the next day, die, go to intensive care, or receive a MET [medical emergency team] call”, said Professor Rinaldo Bellomo, director of intensive care research at Austin Health.


NBN cost to 'widen the digital divide'

THE company rolling out the National Broadband Network wants the ability to increase prices for business broadband and super-fast services by up to 5 per cent more than inflation for three decades, prompting warnings of an end to the era of falling communications prices.

While NBN Co has proposed charging retailers such as Optus and Telstra $24 a month for access to the cheapest entry-level and most popular services, it is also planning to seek approval from the competition regulator to be able to increase prices by up to 5 per cent more for other services.

Opposition communications spokesman Malcolm Turnbull said the NBN was going to make broadband access less affordable and widen the digital divide. "It's a poor deal for taxpayers and an even worse deal for consumers," Mr Turnbull said yesterday.


NBN speeds not needed for e-health

The high speeds of the National Broadband Network are not needed to implement e-health and telehealth programs, a dissenting report from Liberal Senators concludes.


Stars fade as universe starts to run out of gas

Deborah Smith

August 22, 2011

GALAXIES are running out of gas - a discovery that explains why fewer stars are being born now than in the past. The culprit for this dimming of the lights appears to be the mysterious dark energy that pervades the cosmos and is pushing it ever faster apart.

A CSIRO astronomer, Robert Braun, said that star formation peaked early in the universe's history, about 8 to 10 billion years ago, then began to decline.

At first the drop-off in star birth was slow. ''Now it's really plummeting,'' Dr Braun said.

To find out why, he and his colleagues looked back in time with the Mopra radio telescope near Coonabarabran. They compared galaxies that existed between 3 and 5 billion years ago with those today, and found the older ones had much more hydrogen gas in them - the stuff from which stars are born.




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