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, September 23, 2013

Weekly Australian Health IT Links – 23rd September, 2013.

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

A surprisingly interesting week with e-Health getting some attention - in part due to the e-Health heir apparent being left out of the ministry and the senior health minister being so relaxed that he has been given Sport as well as Health and the Assistant Minister - Senator Nash - appearing to need a lot of briefing since having not apparently been all that involved in Health to date.
It is interesting to note that as of Sunday we still do not have an updated website for the Health Minister. I wonder when that will happen?
Now remember DoHA does not exist - it is now just DoHS or DoHaS!

Sector calls for transparency and end to mistakes in PCEHR

MEDICAL experts and industry players have urged Tony Abbott to rectify the national e-health record system's "significant mistakes and missed opportunities" and ensure transparency is a key plank in its delivery.
In the lead-up to the election, Mr Abbott vowed to overhaul the cumbersome personally controlled e-health record (PCEHR) program, calling for a review.
Details on who will conduct the review and its parameters are still scant as Mr Abbott only yesterday announced his frontbench, to be sworn in tomorrow.
Peter Dutton has been appointed health minister, as expected, while Nationals NSW senator Fiona Nash is assistant health minister.
Andrew Southcott, previously opposition parliamentary secretary for primary healthcare and the Coalition's e-health spokesman, missed the cut.

$1 billion e-health system rejected by doctors as 'shambolic'

September 19, 2013
Sue Dunlevy National Health Correspondent
AUSTRALIA'S billion-dollar e-health system is in danger of becoming an expensive white elephant with doctors refusing to use it.
A key clinical adviser to the government who quit in frustration last month has described the system as "shambolic".
And the medical software industry says the body running the system, the National E-Health Transition Authority, lacks the skills to do the job and warns patient safety could be at risk.
Dr Mukesh Haikerwal who resigned in frustration from work on the e-health record says he's uploaded 150 patient records on to the system but "no-one can read it".
Patients who want a hospital or specialist to see their e-health record have to take their own ipad to the consultation to show the record because hospitals and specialists don't have the software to read it.

I’m still an advocate for PCEHR: Haikerwal

19th Sep 2013
DR MUKESH Haikerwal remains an advocate for the government’s personally controlled e-health records (PCEHR) system despite serious concerns about the accuracy of clinical records and the system’s useability.
Dr Haikerwal, who recently quit his post as NEHTA’s chief clinical lead, told MO the system was still “some time off” being a reliable, useful and widely accessible resource for doctors, and there remained much to be gained from the work already completed.
“We all know there are issues with the program and project that need to be fixed up but the positive side is that there is something to be worked from and built on,” he said.

New health minister: Abbott announces changes

16th Sep 2013
OUR new health minister is announced while the news is not so good for doctor frontbenchers as Tony Abbott names his new ministry.
Peter Dutton will be officially sworn in as Australia’s new health minister this week after Prime Minister-elect Tony Abbott confirmed this afternoon that the bulk of his Opposition front bench would be retained in the cabinet.
Mr Dutton had been widely anticipated to hold on to health, having served as shadow health minister for the last six years but in an unexpected move he will also hold the portfolio of minister for sport.
However, there will be some change to the management of the health portfolio, with shadow parliamentary secretary for primary healthcare and former surgical registrar, Dr Andrew Southcott, among the few Opposition frontbenchers to be dropped.

Optimism over Coalition’s ministry

17th Sep 2013
HEALTH groups remain optimistic about the prospects of the Coalition ministry, despite criticism of the lack of standalone portfolios for mental health and science
The Mental Health Council of Australia (MCHA) has called on Prime Minister-elect Tony Abbott to ensure mental health remained a priority “despite removing it as a dedicated portfolio”
“We hope that the new Abbott government recognises that mental health cuts across traditional portfolio boundaries,” MHCA CEO Frank Quinlan said.
“The urgent establishment of the promised review by the National Mental Health Commission will provide an important opportunity to bring true reform to this complex area of public policy.”

Man sent someone else's eHealth details

September 17, 2013
An Adelaide man who was mistakenly sent another person's confidential eHealth login details says he is concerned about the apparent privacy breach.
The man, who wishes not to be identified publicly, says he got an email from the National eHealth Record System operator about having successfully registered.
But he says he had made no such application.

Aussie eHealth record data mishap defended by Department of Health

Summary: A report claiming that data is being leaked from the government's eHealth records system is being denied by the Department of Health on the basis that it never sends out passwords, and certainly never in plain text.
By Michael Lee | September 18, 2013 -- 07:17 GMT (17:17 AEST)
The Australian Department of Health has moved to allay concerns over the alleged leak of confidential eHealth login details, stating that even if it had mistakenly sent login details to the wrong person, they are useless without further details.
On Wednesday morning, an unnamed Adelaide source told ABC News that he had mistakenly been sent an email from the National eHealth Record System Operator that appeared to be intended for someone else with the same last name.
The unnamed man claimed to have been sent a "private login password", leading to speculation that the eHealth system was securing patient records using plain text passwords. Such practices are deemed insecure by modern standards for a number of reasons, including the fact that most email communications are insecure, and that passwords are often reused by users across several services.

National e-health still has a future despite problems: CIOs

Under fire national program lacking the right policy framework for broad adoption
Technology heads in the healthcare sector continue to back the federal government’s controversial and slow moving national e-health record program, saying it has a future despite lacking the critical mass it needs to succeed.
As of July 31, 612,391 Australians had registered for an e-health record, according to a recent National E-Health Transition Authority (NEHTA) report. A further 4500 organisations had registered in the personally controlled e-health record (PCEHR) system and 4585 shared health summaries had been uploaded as of 22 May.
The scheme has come under fire in recent months. In July, Australian Doctor polled 514 general practitioners with two-thirds indicating they will not take part. Earlier this week, a man was accidentally sent another person’s e-health details.

Tough times continue for pharmacists

Jessica Gardner
Outgoing Pharmacy Guild of Australia president Kos Sclavos has called on the new Coalition government to support a national e-health record system that would allow pharmacists to play a greater role in the management of medications and improve patient outcomes.
Mr Sclavos, who will step down from the Guild presidency in October after eight years at the helm, said the current maintaining of e-health records was an opt-in system. For the prescription of certain drugs, he supported an opt-out program that would allow pharmacists to identify if drugs were being inadvertently or deliberately misused.
“Pharmacists are the medication experts,” he said. “A more interventionist approach to some parts of the health system could generate big savings.”

Hefty privacy fines on way, GPs warned

16 September, 2013 Antonio Bradley
GPs are being warned to review the way they handle patient information ahead of a law change next year that brings with it potential fines of $340,000 per practitioner.
The large fines, which can reach $1.7 million per practice, are the pointy end of a new privacy law which comes into effect in March and applies to all businesses and their staff.
Though GPs are not expected to be fined, the potential is still there, particularly for those practices that send patient data overseas for transcription or storage.
The new law for the first time requires all practices to have a privacy policy that describes how information is collected and used, and that gives details on how patients can complain about a breach of privacy.
Currently, general practices are only required to have a privacy policy if they wish to be accredited.

Labor’s legacy

17th Sep 2013
AS THE curtains close on one of Labor’s most difficult periods in government, Byron Kaye looks back over six years of health programs, promises and problems.
A week before the Australian electorate ended Labor’s tumultuous six-year reign, Tanya Plibersek did something out of character. The normally unflappable health minister showed signs of frustration. The woman who would have marked two years in the portfolio in December was spruiking her party’s health record when she all but admitted that the bad feeling towards her party’s policies was starting to bite. “It just drives me crazy,” she said.
Ms Plibersek was being asked by MO about the $600 million-plus GP Super Clinics program and its favoured status among Coalition and doctor ranks as a symbol of Labor’s big promises, flawed delivery and inadequate consultation with industry. The pink batts scheme. The rort-friendly school halls program. GP super clinics...
Not as far as Ms Plibersek was concerned.

Setting health data connectivity on FHIR

As eHealth is adopted around the globe and a multiplicity of eHealth software programs proliferates, the adoption of health data interchange standards has become more and more important.
Australian health technology expert Graham Grieve has been deeply involved in the development of healthcare standards for over a decade, and in 2009 was awarded the HISA Don Watson Award for Effectiveness in Health Informatics in 2009 in recognition of his work.
Grieve is one of the architects of a new health information standards framework called FHIR (Fast Health Interoperable Resources) which will be released for trial in coming months, with one of the first large-scale tests to be performed in Sydney in October at a ‘connectathon,’ where developers and health information professionals attending will trial the new system.
The Connectathon will be on Sunday October 27, just before the annual International HL7 Interoperability Conference 2013 (IHIC 2013) which will be held on Oct 28th and 29th at the North Sydney Harbourview Hotel.

Push to expand telehealth MBS items

13 September, 2013 Paul Smith
The Federal Government is under pressure from a state health minister to extend Medicare rebates to GPs for telehealth consultations with public hospital specialists.
Under current rules, MBS items for GPs to sit in on telehealth consultations can only be claimed when the specialist is in private practice.
However Queensland Health Minister Lawrence Springborg says the arrangement is unfair -- both to GPs and public hospital patients -- and is calling for the system to be revamped.
"Medicare funds are for consultations with doctors with a right of private practice," Mr Springborg said.
"It excludes patients under the care of public hospital specialists which is unfair given that, if you are a private hospital patient under the care of the same GP, maybe the same specialist, you get access [to the telehealth rebates]."

Telehealth can cut costs for cancer patients

17th Sep 2013
TELEHEALTH consultations for cancer patients significantly reduce travel and accommodation costs, an analysis of a Queensland model has found.
Researchers led by the director of the department of medical oncology at the Townsville Hospital, Associate Professor Sabe Sabesan, reviewed 605 teleoncology consultations conducted with 147 patients.
They compared the cost of providing the services with estimated expenses associated with face-to-face care.
Projected costs included anticipated aeromedical retrievals as well as the likely travel and accommodation required for patients, specialists and patient escorts.

Telehealth reduces healthcare use, but produces too many alerts

September 20, 2013 | By Susan D. Hall
Self-monitoring along with nurse oversight helped reduce care costs by $2,931 per person among patients with chronic obstructive pulmonary disease (COPD) in an Australian study published in Telemedicine and e-Health.
Participants were taught to measure their blood pressure, weight, temperature, pulse, and oxygen saturation levels daily and transmit that information by telephone to a secure website, monitored by a nurse. There were fewer emergency room visits and hospital admissions among the telehealth group--nearly half as many--vs. a control group, though not at a statistically significant level. However, the cost savings added up from the use of fewer resources, according to the paper.
In addition, the telehealth participants reported increased confidence in their ability to manage their condition and less anxiety.
However, a review of health failure patients treated by a Massachusetts home health agency monitoring similar data found only three percent of alerts were associated with ED visits and hospitalizations. Because the nurses had to follow up on every alert, that meant they spent a lot of time trying not to miss the few meaningful alerts, according to a second study at Telemedicine and e-Health.

New health recall portal launched

GS1 Recallnet Healthcare, an electronic product recall notification management system for therapeutic goods, has been launched with the support of the National E-Health Transition Authority (NEHTA).
GS1 Recallnet Healthcare is an online portal designed to improve patient safety by streamlining the management of product recall and non-recall notifications.
GS1 Australia’s CEO, Maria Palazzolo said it was designed to provide an electronic product recall notification management system in the Australian healthcare sector to improve patient safety by enhancing the speed, efficiency and accuracy of the recall process for therapeutic goods.
“Therapeutic product recalls always present a significant challenge to the Australian healthcare industry and this portal will improve the therapeutic product recall notification process for the benefit and safety of all Australians,” she said.

Robots starting to feel the love

Date September 19, 2013

Mark White

Machines have been used to help dementia sufferers with some amazing results.
Thomas would sit still all day at his aged-care home. The 82-year-old had not spoken for two years. Staff would serve him coffee and leave him be.
One day, a group of researchers led by Wendy Moyle, from Queensland's Griffith University, were running a test involving a Paro robot seal called Millie. They had been used in Japan to help children with developmental disorders, and to comfort victims of the 2011 tsunami. Professor Moyle wondered if a Paro could improve the quality of life for dementia sufferers by making them less anxious - the seals are covered in antibacterial plush fur and sensors, and squirm and squeal when stroked.

More Australian Privacy Principles released for consultation

Deadline for replies is 21 October
The next set of draft Australian Privacy Principle (APP) guidelines have been released for public feedback by the Office of the Australian Information Commissioner (OAIC).
APPs 1 to 5 were published in August. This covered new requirements for agencies and enterprises about how they manage personal information, including the requirement to have a clearly expressed and up-to-date privacy policy.
Australian Information Commissioner Professor John McMillan said the guidelines outline how the OAIC will interpret and apply the APPs which come into law on 12 March 2014.
Australian Privacy Commissioner Timothy Pilgrim said the second stage of these draft guidelines gives guidance about new requirements for agencies in how they use or disclose personal information, undertake direct marketing activities and send data off-shore.

Octfolio software to help manage asbestos

A NEW software platform aims to help map, manage and eradicate asbestos, the deadly building material.
Octfolio's asbestos information management software launches this week along with a supplementary website.
The platform has been in development for three years and beta versions are already in use with Ergon Energy, Byron Shire Council and the Department of Finance and Deregulation.
Octfolio is owned by investment outfit Tulla Group, founded by one-time Elders Resources chief executive Kevin Maloney who is also Tulla chairman.

Gaming may improve older player's memory

Date September 15, 2013

Elizabeth Lopatto

Video games, largely considered the province of the young, may help the elderly, according to a study looking to boost memory among those ages 60 and older.
A car-racing game played for 12 hours helped 60- to 85- year-old players improve their memory and attention span, and the effects lasted for six months, according to research published in the journal Nature.
Nintendo, the Kyoto, Japan-based maker of the Wii console, and closely held Posit Science of San Francisco, are among companies that have targeted the elderly and baby boomers with video games meant to improve their minds. Video games may offer the same memory benefits that games such as Sudoku have shown in population studies, said Maria Carrillo, the vice president of medical and scientific relations at the Chicago-based Alzheimer's Association.

Digital charts slower than pen and paper

13 September, 2013 Dr Elizabeth Lord
Electronic hospital charts might look snazzy, but they are "significantly more time-consuming" than old-fashioned paper-based systems, Canadian researchers say.
An Ottawa Hospital study found doctors who completed their patient's record electronically took 40 minutes longer on average than those who used the time-honoured paper and pen.
Surveys confirmed doctors were unconvinced the electronic records had done anything to streamline their documentation processes.
"Physicians participating in the study were not satisfied with the electronic medical record and they did not see more patients by using it," the researchers wrote in the Emergency Medicine Journal.

What went wrong with the NBN

September 21, 2013
David Ramli and James Hutchinson
The National Broadband Network Company was to be the Labor government’s crowning achievement in the vein of Medicare and the Snowy River Dam Project.
Where high speed broadband was traditionally restricted to corporate networks and international links, Labor would connect it to 93 per cent of homes and businesses, from the sandstone manors of Bellevue Hill to the valleys of Tasmania and everywhere in between.
But four years on the reality is murkier. Its founding chief executive has been pushed out the back door while the entire telecommunications industry is despondent.
The current chairman Siobhan McKenna – despite attempts to confront the company’s mismanagement – has been earmarked for replacement.

Bionic eye shines light on darkness

Date September 16, 2013

Bridie Smith

Science Editor, The Age

For the first time since they lost their sight, Australian patients given a bionic eye have been able to see their environment.
The three patients trialling early prototype devices have been able to locate shapes on a screen after the device's camera was connected with a stimulator to produce an image using 20 electrodes.
Previously, Dianne Ashworth, Murray Rowland and Maurice Skehan had seen only flashes or spots of light as each of the 20 electrodes in their 24-electrode bionic eye were activated for testing.

Google promises new thinking for health company, Calico

  • AFP
  • September 19, 2013 3:00PM
GOOGLE is launching a new company focused on health and well-being, and hinted at cooperation with long-time rival Apple in the venture.
A Google statement said the company, Calico, would put a particular focus on "the challenge of aging and associated diseases."
Arthur Levinson, chairman and former chief executive of the biotech firm Genentech and chairman of Apple, will be Calico's chief executive and a founding investor.
Announcing the new investment, Google CEO Larry Page said: "Illness and aging affect all our families. With some longer term, moonshot thinking around healthcare and biotechnology, I believe we can improve millions of lives."

Coming soon to you: the information you need

Date September 18, 2013 - 6:53AM

Drew Turney

The day when your hat can extrapolate your mood from your brain activity and make a spa appointment on your behalf may not be far away.
The next big thing in the digital world won't be a better way for you to find something. If a confluence of capabilities now on the horizon bears fruit, the next big thing is that information will find you.
Welcome to contextual search, a world where devices from your phone to your appliances will join forces in the background to make your life easier automatically.
Contextual, or predictive search, started with the now-humble recommendations pioneered by companies such as Amazon – where metadata applied behind the scenes led you to products with similar attributes via pages that made helpful suggestions such as "customer who bought this also bought...".


Anonymous said...

David said:

"Now remember DoHA does not exist - it is now just DoHS or DoHaS!"

Maybe the new Department should be known as DoSH?

Ms Halton's lost Ageing, which must say something, being that her specialty at Uni was ageing.

Anonymous said...

I am wondering is there a career in eSport?

Enrico Coiera said...

"I am wondering is there a career in eSport?"

Not a bad thought. eSport is already here and working, unlike some of eHealth. All you need it to pop down to the shops and buy a Wii or other game console, and off you go - play any eSport you like! Or if you want to bet as you watch your TeleSport images on your TV, you can do that via secure messaging to your favourite e-bettingshop.

Why you might ask, is there such a difference between eSport and eHealth? Well, for starters, think how much money is to be made from eSport or TeleSport. Massive private investment yields massive rewards.

Healthcare has always had a different economic model, especially when there is a public sector provider meeting otherwise unmet and unfunded needs. As we know now, this does not mean that the public funder can't invest in infrastructure, but the global experience suggests they don't have the expertise to deliver it. Or that they build the wrong 'it".

Other reasons dear readers?

Bernard Robertson-Dunn said...

Sport is easy. For each sport there is a set of rules and an agreed way of participating (at least, within quite closely defined constraints)

Health is a lot murkier.

Health information is poorly defined and can change as new medical knowledge becomes available. And different people put different value on their own information.

There are many, often competing, participating entities in a national health system.

Health systems have to work within a range of different State and Federal legal jurisdictions and they are often driven by political ideologies

As I've pointed out before on this site, a national health information system has to work with state and/or local systems.

re what this government may or may not do will be critically dependent on the terms of reference of any review. They can choose one or more from audit, assurance and assessment:

Audit is where you assess a project/company/activity against what it is required to do according to the law, rules and regulation. These are usually non-negotiable and compulsory. Audit is about compliance.

Assurance is where you ask a company/project the question “what did you say you would do?” and then compare what they said they would do against what they did. If they said they were going to make concrete life jackets then you look at how well they made those concrete life jackets. You don’t question the objective of making concrete life jackets. Assurance is about mechanisms and process. Assurance is mostly about cost.

Assessment is where you assess the objective and effectiveness of what they are doing. In this case you might conclude that, while their concrete life jackets are of the highest quality, they don’t actually succeed as life jackets. Assessment is about achieving objectives and outcomes. Assessment is mostly about value.

IMHO, there needs to be an assessment of current initiatives (both state and federal) based upon total information, full (i.e. all) system functionality and how they can or cannot deliver health outcomes.

Anything short of assessment is a political cop out.

FWIW, here's my view of the PCeHR.

Health outcomes are delivered by local e.g. hospital, specialist and GP based systems where the patient is directly involved in healthcare. A national/federal health information system like the PCEHR plays no role in direct health care and so cannot contribute to patient health outcomes. It wouldn't surprise me if NEHTA is finding it difficult to identify and validate any benefits of the PCEHR that justify the many millions that have been spent so far and the millions still to be spent.

Where it might play a part is in statistical/research/financial data analysis. There may also be a hidden benefit to a federal government in that a summary of an individual's health information is held in a central database. There may or may not be privacy safeguards, but perception trumps reality. Even if reality fully and completely protects an individual's information, patients may not trust the federal government.

Predicting what may or may not happen to the PCEHR is not possible, because we do not see the world in the same context as politicians and senior public servants. They have their own agenda and priorities and decisions regarding future initiatives will be driven by their objectives. If we are lucky, they will have the public good at the top of their priorities.

Unfortunately, hope is not a good strategy.

Anonymous said...

So what is the connection between national health and sport? Why combine these departments? I can see how exercise is important to health. But Sport?
Here are some possible links...
Professional cycling and 'medication'
Football and 'dietary supplements'
Tennis and tennis elbow?
Running and nose/other orifices...