This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Quote Of The Year
Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"
Monday, October 07, 2013
Weekly Australian Health IT Links – 7th October, 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.
A quiet week on the surface but it does seem that Telstra is up to something with all these purchases recently. One has to wonder just how successful it will be and just how these various bits and pieces are to be formed into a coherent offering - or is that not the plan? Hard to know what else could make these purchases actually provide a real return on their cost.
Otherwise we find the new (now rather less new) Government is very, very, very quiet on e-Health!
ONLY 1178 residents in Orange have signed up for the federal government’s eHealth record system giving them, their doctor, pharmacist and other healthcare providers online access to their health information, despite it being up and running for more than a year.
Since August 12, health department staff have signed up 1100 residents for the optional service at the Orange Medicare Office.
The eHealth record system was rolled out in July 2012 to allow any registered healthcare provider including general practitioners (GP), pharmacists, and allied health professionals to access a patient’s eHealth record.
As a privacy measure, it is up to the individual to choose who can access their information.
“You control what goes into it, and who is allowed to access it,” a health department spokesman said.
IT is encouraging that recent research in the MJA and a subsequent news story in MJA InSight have created so much interest in the value (or otherwise) of telehealth.
What should be our priority in pursuing telemedicine — to enhance clinical care, achieve cost–benefit advantage or to meet society’s needs?
There is no doubt that digital solutions do not always have instant acceptance. One prime example is the personally controlled electronic health record (PCEHR), which has been contentious more for its promise to deliver than its potential value.
Few will argue that the internet has changed "the way we live, work and play”. There is universal acceptance of digitally recorded, formatted and communicated information in all aspects of life. It is a sequitur that digital electronic health records will achieve acceptance with one format eventually emerging above others to serve medical needs.
Telstra has further bolstered its positioning in the healthcare technology space buying a 50 per cent stake in health technology provider Fred IT Group.
Fred IT provides eHealth solutions (IT services, medical dispensing software) to GPs and pharmacists and Telstra’s Head of Health, Shane Solomon said the investment was part of Telstra’s ongoing focus on building capability in the health sector.
Telstra Health has announced it is making a “significant investment” in Fred IT Group, in a move welcomed by the Pharmacy Guild of Australia.
The telco’s health arm is “taking a 50 per cent interest in Australia’s leading provider of IT services and dispensing software to pharmacies”, according to a release.
The strategic partnership between Fred and Telstra Health reinforced Fred’s commitment to providing IT innovation and leadership for pharmacy and pharmacy customers long term, the Guild has said.
“The investment will position Fred to continue to invest strongly in e-Health and IT solutions which are vital in improving patient health and safety, creating new ways for community pharmacy to service customers and manage businesses”.
TELSTRA has expanded its focus on the health sector by acquiring a 50 per cent stake in software firm Fred IT Group, which provides IT services and dispensing software to pharmacies.
The undisclosed investment follows Telstra's acquisition of healthcare software company DCA and investments in e-health record player IPHealth and online health appointment booking company Health Engine.
"We are excited by the opportunities this investment presents and we will work with the Fred IT Group to build on the great foundations they have established," Telstra head of health, Shane Solomon, said.
Telstra has finalised its investment in the Fred IT Group, taking a 50% interest in Australia’s leading provider of IT services and dispensing software to pharmacies.
The investment in the Fred group follows Telstra’s acquisition of healthcare software company DCA eHealth Solutions and more recent investments in electronic health record specialist IPHealth and one of Australia’s leading online health appointment booking companies, Health Engine.
Telstra’s Head of Health, Shane Solomon said the investment was part of Telstra’s ongoing focus on building capability in the health sector.
“Community pharmacies play a vital role in providing services and advice to millions of Australians and Fred IT Group is at the leading edge of companies offering eHealth solutions to the community, GPs and pharmacists.
NEW guidelines from the Therapeutic Goods Administration and the US Food and Drug Administration will do little to slow the proliferation of medical smartphone applications if the “app” retailers ignore them, say concerned Australian experts.
The sale and use of apps and attachable devices for smartphones by doctors and patients is a “huge grey area” and “fraught with traps”, the AMA’s dermatology spokesman Professor Stephen Lee told MJA InSight.
The AMA is so alarmed at the explosion of medical apps, they have fast-tracked discussions on the issue in time for the November Federal Council meeting, Professor Lee, of the University of Sydney, said.
He said the use of apps, particularly by patients looking for a quick diagnosis or risk assessment, was “fraught with traps”.
On 13 September 2013, the Therapeutic Goods Association (TGA) published guidance about Australia's regulatory arrangements for medical software and mobile medical 'apps' on its website.
The TGA first undertook to regulate medical software and apps in 2011, after the United States Food and Drug Administration released draft guidelines on the issue. This is the first time that the TGA has published formal regulatory guidance about medical software and medical apps.
WHAT MEDICAL SOFTWARE DOES THE TGA REGULATE?
Medical software is regulated by the TGA as a “medical device” under Chapter 4 of the Therapeutic Goods Act 1989 (Cth) (the Act).
Generally, medical device software that is intended to control a device, or influence the functions of a device will fall into the same classification as that device itself.
Last week, another smartphone-enabled medical device, an asthma wheeze monitor, was launched by Australian medical technology company iSonea Limited, backed with a high-profile ad campaign featuring Australian Olympian Cathy Freeman.
The company claims the digital device is a world-first for monitoring wheeze via smartphone technology, and with an estimated 2.3 million Australians with asthma, it’s likely to be a commercial success.
The user holds the AirSonea device against their throat to record breathing sounds, which the smartphone app then transmits to a cloud-based site for analysis by proprietary wheeze detection algorithms and software – a far simpler process than the peak-flow monitors traditionally used to monitor asthma through forced breathing.
If a patient has an eHealth Record a clinician will be able to view their information in the NSW Health Clinical Portal.
This will deliver the benefits of improving information sharing between hospitals, community health, general practitioners (GPs) and consumers – closing the loop between primary and acute patient care.
“Such consensus groups gather political power from their expertise on healthcare IT standards, but they are seldom aware of all the problems real software companies dealing with real customers are facing. After many months or years, and hundreds or millions of dollars or euros spent, this little group of experts define a data model, a message or a schema, and they want to enforce it on everybody. Your customer gets frustrated, because that seldom matches the way clinical practictioners want their data collected, because the conventional top-down standards are much more concerned about the information needs of central governments or large medical hardware corporations than with the routine clinical documentation, which is the essence of medical decision making that really impacts on patient outcomes.”
This is both true and false. I can’t decide which it’s more of. I’ll confine my comments to HL7, which is where I can speak with some knowledge.
Electronic Health Record Initiative Covers Municipalities in the 6th Regional Healthcare District of Passo Fundo and Will Benefit Thousands of People by the End of 2014
SYDNEY, Aust. -- September 24, 2013 -- After implementing a project for public healthcare informatics for the Government of the Federal District, which has become a model in Brazil and other countries, InterSystems, a global leader in software for connected care, has extended its Brazilian government relationships with a new implementation of InterSystems TrakCare® , an Internet-based unified healthcare information system, for an electronic health record system for the State Government of Rio Grande do Sul.
Called SIGS (Sistema Integrado de Gestão em Saúde), the implementation covers municipalities in the 6th Regional Healthcare District of Passo Fundo. By providing the municipalities with a complete information technology infrastructure, including world-class software systems and a new data centre, the Government of Rio Grande do Sul plans to modernise the public healthcare network to improve services to the community. The new infrastructure provides access to clinical information stored in TrakCare via a cloud computing platform, allowing healthcare teams including physicians, community health workers, nurses and dentists to share information such as a patient’s medications.
YORKTOWN HEIGHTS, NY – Can big data improve human decision-making? That was the question that MIT's Irving Wladawsky-Berger put to a panel of IBM clients at the company's research colloquium on cognitive computing Wednesday. The meat of his discussion focused on Douglas Johnston, a surgeon with the Cleveland Clinic. We'll share their interchange here.
“I think that what's happening now with data science,” said Wladawsky-Berger, “is we can now turn these microscopes on ourselves, systems where the critical components are people, communities, and organizations, and get a level of understanding we didn't have before.”
“In healthcare in general we’ve been applying data science poorly,” admitted Johnston. “We have a medical literature that is contradictory, and we are relying on 100 year old transcription technology for our records. We still have to dig through those records to get the data. I see the results are failing because it's garbage in and garbage out.”
Michael Dalli's old black Nokia mobile is ringing, so the 42-year-old excuses himself to answer it. Softly spoken, the wheelchair-bound father of one politely tells the caller he is busy and to ring back in half an hour. Then he apologises for taking the call. ''It's a pre-paid phone and I try not to exceed $50 a year,'' he explains.
To avoid using his credit, he always answers his mobile. He has no voicemail, does not text and saves calls ''just for emergencies''. In the age of smartphones, he also does not have mobile access to the internet. More pressingly, there is no internet connection in his Sunshine West home - he can't afford it.
''It's almost like I have a double disability,'' he said. ''I have multiple sclerosis, I'm confined to a wheelchair, but I feel like my other senses are also being denied because I don't have access to the internet.''
The digital domain is creeping off our desktops and onto our bodies, from music players that match your tunes to your heart beat, to mood sweaters that change colour depending on your emotional state – blue for calm, red for angry.
There are vacuum shoes that clean the floor while you walk and fitness bracelets, anklets and necklaces to track your calorie burning.
We're talking about paradigm changing devices, capabilities that people haven't thought of before.
"Everyone agrees the race is just beginning, and I think we're going to see some very, very big leaps in just the next year," said tech entrepreneur Manish Chandra at a wearable technology conference and fashion show in San Francisco Monday that was buzzing with hundreds of developers, engineers and designers.
Cyber criminals have accessed information about 2.9 million Adobe customers including names, encrypted credit card numbers and expiration dates. The attackers also took customer IDs and encrypted passwords.
According to Adobe CSO Brad Arkin, the cyber criminals did not remove decrypted credit or debit card numbers from its systems.
“We deeply regret that this incident occurred and we’re working with law enforcement to address the incident,” he wrote in a blog post.
The company is resetting customer passwords to prevent unauthorised access to Adobe ID accounts.