Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Monday, July 30, 2012

Weekly Australian Health IT Links – 30th July, 2012.

Here are a few I have come across the last week or so.
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

Overall, quite a lively week on the NEHRS front with the Health Department disagreeing with The Australian on just how badly they managed the system start-up. Right now I would suggest there is delayed delivery and the major bug that remains unfixed suggests (as of Sunday) the The Australian may be closer to the truth. As far as the specifics I am sure it will be ages before the details of exactly went on will come out.
It is interesting to note the total sign ups to the NEHRS are still really tiny in the context of the population.
Also of note it seems the COAG Meeting provided no clarity on NEHTA funding with the matter apparently having been referred to a committee.
Elsewhere we cover some small initiatives in Telehealth and Mental Health as well as some rather more left field things such as the Minority Report user interface and a seemingly pretty badly managed health provider privacy breech.
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Govt trumpets online e-health sign-ups

Summary: Amid reports of ongoing troubles with the implementation of the national e-health record system, the Department of Health has highlighted the success of the system, with 3563 signing up so far.
By Josh Taylor | July 25, 2012 -- 06:32 GMT (16:32 AEST)
The Australian Department of Health and Ageing has spruiked its success in signing up over 3500 users to its personally-controlled e-health record system in over three weeks, amid claims of issues plaguing the system since its launch.
In 2010, the government promised that it would create an electronic health record system by 1 July 2012, so that every Australian who wanted a record of their medical history online could sign up for one.
Despite there not being an online registration form made available when the system first launched, more Australians have signed up online for an e-health record than through any other method. According to stats provided to ZDNet, as of 24 July 2012, a total of 3563 people have signed up for e-health records, with 87 per cent (or 3099) of these registering online. The remaining 13 per cent (or 464) registered via phone, in writing or in person.
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Consumers favour online PCEHR registration

The latest figures released by the Department of Health and Ageing show consumers have a strong online preference when registering for an eHealth record.
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E-health records system went live despite known bugs

THE Gillard government knowingly launched the national e-health records system despite warnings from its own e-health agency that it had more than 60 high-severity and critical bugs.
The personally controlled e-health system was pushed live and accessible to the public without a back-up system that would have ensured patient data was available at all times.
The consumer portal, where people enter personal information, medical history and medication details, contained hundreds more bugs of different severity levels as the system went live, The Australian can reveal.
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Government fires back over safety of PCEHR

The federal government has responded to allegations the personally controlled electronic health record (PCEHR) system compromised patient safety in going live on July 1.
This week The Australian newspaper reported the federal government “knowingly launched the national e-health records system despite warnings from its own e-health agency that it had more than 60 high-severity and critical bugs.”
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Future of NEHTA funding a key issue at COAG meeting in Canberra

THE future of the National E-Health Transition Authority is likely to be settled at the Council of Australian Governments meeting in Canberra tomorrow.
The National Partnership Agreement on E-Health, which underwrote $218 million for NEHTA's operations in the past three years, expired on June 30.
Intended to support delivery of the healthcare identifier service and other national e-health objectives, the agreement provided commonwealth, state and territory funding on a 50:50 basis.
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Experts in the dark over patient e-health control

24th Jul 2012
THE chief clinical expert advising the government on its e-health record system has claimed doctors involved were not properly informed about the final design as efforts continue to overturn patients’ ability to delete documents from the record.
The National E-Health Transition Authority (NEHTA)national clinical lead Dr Mukesh Haikerwal said his “original understanding” was that patients who wished to remove specific documents from their record would do so in consultation with the doctor who created the document.
Instead, the system allows patients to “effectively remove” documents without providing any clue to a practitioner who later accesses the record that the document was ever there.
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Health Department to outsource PCEHR operations and management

  • by: Karen Dearne
  • From: Australian IT
  • July 25, 2012 3:31PM
THE Health Department wants to outsource its operational and management responsibilities for the personally controlled e-health record system to a single provider.
It has released a tender calling for "provision of project support services" for the PCEHR program, which went live earlier this month despite warnings that the system was unstable and plagued with known bugs.
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Aus Govt looks to outsource e-health record management

Summary: The Australian Government is looking to outsource the management of its Personally-Controlled E-health Record system.
By Josh Taylor | July 26, 2012 -- 00:15 GMT (10:15 AEST)
The Department of Health and Ageing has gone to tender for an organisation to support the operation of the Personally-Controlled E-Health Record (PCEHR) system.
The Federal Government's e-health record system was launched on 1 July after two years of planning and hundreds of billions of dollars worth of investment. Although it hasn't been a smooth start for the program, over 3500 people have so far registered for their own e-health record.
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Online GP guide for back pain launched

25 July, 2012 David Brill
A new online tool has been launched to guide GPs through the diagnosis and management of low back pain.
Back Pain Choices comprises a step-by-step guide to patient management, drawing on evidence-based guidelines from Australia, the US and UK.
It was launched Wednesday as a joint project by the NPS and the George Institute for Global Health.
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Pathways help Hunter doctors with patient referrals

Updated July 27, 2012 07:24:26
Hunter doctors taking up a new Pathways program, which gives local advice about referring patients to specialists.
An innovative web-based support program for Hunter region doctors is being rolled out across the Hunter, helping GPs ensure their patients get the right care from specialists.
Health Pathways is a collaboration between the Hunter Urban Medicare Local and Hunter New England Health, and was developed in response to feedback from doctors.
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Mouldy medical records no more

Updated July 27, 2012 07:08:25
Mouldy medical records have now been destroyed after months of scanning and transferring the data onto a computer system.
Around two years after mouldy records forced a staff walkout at a Newcastle medical storage facility almost all of the offending material has now been transferred to computer.
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New e-mental health tool all about real-time monitoring

A new free online tool based around the concept of self monitoring has been launched to assist people with mild-to-moderate anxiety and depression.
myCompass is an “interactive self-help service” that assesses user symptoms, then provides a personalised and interactive program designed to help a person work through their mental health issues. The initiative has been developed by a team of health professionals at the Black Dog Institute, and funded by the Australian Government.
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New e-Mental Health Tool Launched

A new online mental health tool, myCompass, that assesses user symptoms, then provides a personalised support program, has been launched.
23 July 2012
Minister for Mental Health Mark Butler today launched a new online mental health tool designed to support people living with a mental health issue such as anxiety or depression.
Developed by a team of health professionals at the Black Dog Institute, and funded by the Australian Government, myCompass is an online tool that assesses user symptoms, then provides a personalised support program.
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Telehealth trial declared a success

Date July 24, 2012

Brad Howarth

Ease-of-use is emerging as the critical factor for the uptake of telehealth consulting in Australia.
A six-month trial implementation of telehealth at the Royal Children's Hospital in Melbourne has been declared a success, with more than 150 patients seen and countless hours saved for families and clinicians.
The director of neurology at the Royal Children's Hospital Professor Andrew Kornberg said previous telehealth attempts, including trial consultations via Skype, had not worked, as connection dropouts and scheduling difficulties led doctors to stop using it after just one or two bad experiences. The new system uses GoToMeeting, a web-based videoconferencing service from Citrix Online.
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PCEHR “soft” approach yields dividends

Department of Health and Ageing officials have dubbed the federal government’s “softly-softly” approach to PCEHR registrations a success.
According to eHealthspace.org calculations, an average of 135 individuals per day are signing up for an electronic record. The PCEHR was launched on July 1.
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Paternity firm slapped over privacy breach

THE largest Australian company in the field of drug, alcohol and paternity testing has been found to have breached the Privacy Act for displaying on the internet confidential, sensitive information about hundreds of customers and their orders for testing kits.
But Privacy Commissioner Timothy Pilgrim found Medvet had acted quickly last July to resolve the privacy breach, despite The Australian establishing the company had not fixed the problem after being told three months earlier that customers' information had become readily available on Google.
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Researchers work on biometric shoes for secure ID

  • From: AP
  • July 23, 2012 7:03AM
A LAB is working to perfect special shoe insoles that can help monitor access to high-security areas, like nuclear power plants or special military bases.
The concept is based on research that shows each person has unique feet, and ways of walking. Sensors in the bio-soles check the pressure of feet, monitor gait, and use a microcomputer to compare the patterns to a master file for that person. If the patterns match the bio-soles go to sleep. If they don't, a wireless alarm message can go out.
"It's part of a shoe that you don't have to think about," said Marios Savvides, head of Carnegie Mellon University's new Pedo-Biometrics Lab, in Pittsburgh.
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Physician robot to begin making rounds

The robot can be controlled by an iPad and can make hospital rounds while the doctor observes remotely
The maker of Roomba, the robotic vacuum, has stepped up its game and Tuesday unveiled a 5-ft., 4-in.-tall, 140-pound "telemedicine" robot aimed at aiding hospital patients in emergency situations, especially during nighttime hours when staffing is lower.
The robot, dubbed RP-VITA (Remote Presence Virtual + Independent Telemedicine Assistant), is the result of a collaboration between iRobot and InTouch Health, a telemedicine robotics vendor.
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'Minority Report' software hits the real world

Date July 24, 2012 - 9:18AM

Rob Lever

The software behind the film Minority Report, where Tom Cruise speeds through video on a large screen using only hand gestures, is making its way into the real world.
The interface developed by scientist John Underkoffler has been commercialised by the Los Angeles firm Oblong Industries as a way to sift through massive amounts of video and other data.
We think the future of computing is multiuser, multiscreen, multidevice. 
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New protein could rival antibiotics

Date July 29, 2012

John Elder

AUSTRALIAN scientists have made a breakthrough in finding a powerful alternative to antibiotics - at a time when the World Health Organisation is predicting a bleak future in which bug-killing drugs are so ineffective that ''a child's scratched knee or a strep throat could kill again''.
The threat of the world returning to a pre-antibiotic era has been fretted about for at least a decade because of microbes becoming increasingly resistant to drugs.
But Monash University researchers, in collaboration with Rockefeller University and the University of Maryland, have published a paper revealing the structure and workings of PlyC - a flying saucer-shaped protein that kills bacteria that cause infections from sore throats to pneumonia and streptococcal toxic shock syndrome.
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Enjoy!
David.

3 comments:

Cris Kerr said...

PART 1 OF 2: THIS NEWS ITEM IS INTERESTING...

http://www.medicalobserver.com.au/news/experts-in-the-dark-over-patient-ehealth-control

Experts in the dark over patient e-health control
24th Jul 2012
Mark O’Brien

THE chief clinical expert advising the government on its e-health record system has claimed doctors involved were not properly informed about the final design as efforts continue to overturn patients’ ability to delete documents from the record.

The National E-Health Transition Authority (NEHTA) national clinical lead Dr Mukesh Haikerwal said his “original understanding” was that patients who wished to remove specific documents from their record would do so in consultation with the doctor who created the document.

Instead, the system allows patients to “effectively remove” documents without providing any clue to a practitioner who later accesses the record that the document was ever there.

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PERHAPS MARK O'BRIEN MISUNDERSTOOD WHAT DR HAIKERWALL WAS SAYING… HE MAY HAVE BEEN REFERRING TO THE INTENT THAT A PATIENT COULD, DURING CONSULTATION WITH THEIR DOCTOR, REQUEST A DOCUMENT NOT BE UPLOADED.

AND THAT REMAINS THE CASE AS FAR AS I KNOW, HOWEVER; ALL INTERESTED PARTIES WERE INFORMED OF THIS INTENTION VIA THE PUBLICLY RELEASED PCEHR CONCEPT OF OPERATIONS DOCUMENT OF SEPT 2011, ITS ADDENDUM, AND IN THE SUMMARY OF CHANGES THAT OCCURRED BETWEEN THE DRAFT AND FINAL DOCUMENTS (SEE REFERENCES 1, 2 AND 3 BELOW).

Cris Kerr said...

PART 2 OF 2: REFERENCES…

(1) Concept of Operations for the PCEHR, 12 Sept 2011 release
http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/CA2578620005CE1DCA2578F800194110/$File/PCEHR-Concept-of-Operations-1-0-5.pdf

PAGE 47: 4.2.2 Managing changes to clinical documents and correcting errors

PAGE 48: Effective removal of clinical documents

' ... If the individual requests a clinical document be ‘effectively removed’ from their PCEHR, the individual will be required to indicate that they understand the implications of its removal (namely that the clinical document will no longer be accessible via their PCEHR and this may mean that in the future the individual may not receive the benefits of having this information available via their PCEHR in future episodes of care).

A clinical document that has been ‘effectively removed’ from an individual’s PCEHR is not deleted. An effectively removed clinical document is no longer considered part of an individual’s PCEHR12 and is locked and a reason for removal is noted, preventing further access by an individual or their healthcare providers (including using emergency access). An effectively removed clinical document is only accessible to the PCEHR System Operator and may only be accessed for legal reasons. ... '

PAGE 73: 5.5.4 Emergency access

' ... Emergency access cannot be used to access clinical documents that have been effectively removed from a PCEHR (see Section 4.2.2). ... '


(2) Personally Controlled Electronic Health Record Concept of Operations ADDENDUM, January 2012
http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/pcehr-conops-adden-toc/$file/PCEHR%20ConOps%20Addendum.pdf

PAGE 10: SECTION: 3.2.2. Restoring Effectively Removed Documents

' ... To address scenarios where a document has been mistakenly removed, the PCEHR System will provide a list of effectively removed documents. This function will allow the consumer or the System Operator on the consumer’s request, to locate and restore access to effectively removed documents. ... '

(3) Table 7: Summary of feedback and key changes by theme
http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/PCEHRS-Intro-toc~appc

' ... Access control, security and privacy

The ability to mark a clinical document as ‘no access’ has been removed to ensure that all clinical documents in an individual’s PCEHR are available in an emergency.

Individuals will still have the option to mark clinical documents at either a ‘general access’ or ‘limited access’ level to control access to clinical documents in their PCEHR (see Section 5.5).

Individuals will also have the ability to ‘effectively remove’ a clinical document from their PCEHR (see Section 5.5). Once a clinical document has been effectively removed from a PCEHR it is no longer considered to be part of an individual’s PCEHR and is not accessible by either the individual or healthcare providers (including using emergency access). The individual may at a future point in time ask to have the clinical document restored to their PCEHR. ... '

Cris Kerr said...

FURTHER, AND ALSO IN THE SUMMARY...

Table 7 : Summary of feedback and key changes by theme
http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/PCEHRS-Intro-toc~appc

' ... Education for stakeholders

A number of the submissions noted an interest in being involved in unit testing, interface testing and user acceptance testing

A Change and Adoption and a Benefits Realisation Partner have recently been appointed. More information will be forthcoming in this area from these partners. ... '

' ... Platform mobility

Mobile device based support is currently out of scope and proposed as a future work item. The decision to leave mobile devices as a potential future work item, rather than having it included in the system build for 1 July 2012, is based on security concerns with such devices. ... '

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AND YET, THERE IS MUCH TALK ALREADY OF MOVING QUICKLY TO MOBILE APPLICATIONS, CONSUMER & CLINICAL SUPPORT SYSTEMS WITHOUT ANY CONCERN FOR ASSOCIATED RISKS RELATED TO SECURITY OR ‘CONFLICT OF INTEREST CREEP’, eg; SUPPORT FOR 'MEDICAL MARKETING CHANNELS'.