Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Friday, January 31, 2014

How Much Access Should Patients Have To Their Medical Records? The More The Better It Seems!

This appeared a few days ago.

Is it wise to let patients read your notes?

16 January, 2014
Giving patients immediate access to doctors' medical notes following a consultation is being touted as a new standard of care following a US study.
The year-long OpenNotes study involved sending 20,000 patients a secure message following consultations with their GPs inviting them to read the doctor's notes via an online portal.
Jan Walker, from the Beth Israel Deaconess Medical Centre, in Boston, US, said many doctors had been wary of the project, concerned about increased workflow and what she described as an "avalanche" of questions from patients about the information in their medical notes.
"They were also really worried about the impact on their patients, whether the notes would be confusing or worrisome," she said in an interview with the New England Journal of Medicine.
Researchers found that about 80% of the patients used the system to read their notes — but there were no incidents of patients being harmed as a result of accessing the information.
"We were surprised that it went across all types of patients, including the elderly and those with chronic illness and those with only high school education," Ms Walker said.
"They said they understood more about their care, that they felt more control."
She added: "Doctors [also] reported very little impact on their workflow.
"In fact, they heard very little from patients throughout the study ... a minority of doctors did report that they changed how they wrote about cancer, substance abuse and mental health and obesity.
"They said they used fewer acronyms, adding more explanation to the note as they wrote it."
Doctors continued to make the ultimate decision on whether records were amended or updated.
…..
In an editorial, called the Road Toward Fully Transparent Medical Records, the authors wrote: "Despite the challenges, nearly two million Americans already have access to notes, and we anticipate that open records will become the standard of care, accompanied by electronic tools that explain medical terminology and abbreviations, translate notes into different languages, and adjust for health-literacy levels.
…..
The full article here:
Clearly there are some patients for whom this may not be a great idea (the seriously mentally ill and the mentally impaired possibly) but for the vast majority the US experience seems to be very, very positive.
The question with all this is how it can be best implemented with minimal disruption for those clinicians and patients for whom it makes sense while maybe using a different approach for psychiatrists. Children’s medical records may need special care as they become more autonomous as teenagers
The practicalities of achieving this is an electronic world also needs careful consideration. I seriously don’t believe the PCEHR is any sort of answer for this - and that the Kaiser / UK approach of providing portal access to the primary record would be a better tack to adopt.
I think this is likely to be a trend we will see a great deal more of over time.
David.

Thursday, January 30, 2014

An Important Learning Experience On Health Care Application Safety Is Planned For The Middle Of Next Month.

I was alerted to this a day or so ago.

Follow up workshops: Clinical Safety for Healthcare Applications

Posted on January 28, 2014 by Grahame Grieve
Back in November I ran a clinical safety workshop for the MSIA in Sydney. I had several requests for follow ups in Melbourne and Brisbane, so I will be holding follow up workshops on March 11 (Melbourne) and Mar 13 (Brisbane). I’ll do more if there’s sufficient interest.
Here’s some quotes from the announcement:
This workshop provides a set of tools and knowledge that will help healthcare application designers create safer software. Attendees will work through real, practical examples that demonstrate clinical safety issues in application design, and also cover general clinical safety thinking, coding, presentation, data management issues, and the looming regulatory process.
The workshop is for people who make decisions about software design, or manage the software design process – whether their background is clinical, programming, or otherwise.
Testimonials
“The Clinical Safety Workshop was not what I expected, but so much more. Grahame did not condescend to dictate specific software tricks to write safe software. Rather, he engaged with participants to help them understand for themselves a philosophy and approach to developing safe and effective health software using skills we already know. Suited to senior technical management, architects and code cutters alike.”  Mat Hudson, CEO RadLogix Pty Ltd
Grahame brings together his years of experience in medical software and standards development to address one of the most important issues related to using information and associated machines in the provision of health care and that issue is safety.  The workshop I attended was both academically rigorous and practical. I would not hesitate to recommend it for anyone wanting to work with information and knowledge in health and in my view there is no-one that doesn’t! Michael Legg, Conjoint Associate Professor, School of Medical Sciences, University of New South Wales
The workshop will cost $700, or $500 for employees of companies that are MSIA members (the program was prepared in association with the eHealth Industry Clinical Safety and Security Committee auspiced by the MSIA)
Hopefully, I’ll see you there.
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Here is the link:
By the time you read this a registration facility will be available at the following link I am assured:
This post is a public service for my readers and I stand to make not a cent, but have had to spend a moment of two of my time creating the blog.
Regular readers of this blog will fully understand how interested I am in all aspects of this area of endeavour if only because of a concern that if software development in the Health IT space is not cognizant of the possible risks issues around safety could come back to bite us and erode public confidence.
Note that the coverage provided is both on mobile as well as traditional applications.
For those that can benefit this is a must not miss event.
David.

Wednesday, January 29, 2014

Just Why This Is Going On With The Future Of The PCEHR Being Under Review?

This appeared in a major journal of record a few days ago.

Wealth of health on site

Jan. 23, 2014, 6:25 a.m.
The Western NSW Medicare Local (WML) and Blayney Family Medical Practice are encouraging residents and surrounding communities to register for a Personally Controlled Electronic eHealth record (PCEHR) by holding a registration day on Friday, February 7.
WML will be helping and registering community members for a free eHealth record and then doctors will be able to upload a summary of their health information to the system.
Any visitors can attend the registration day and get an eHealth record and have their own GP upload their health summary later.
An eHealth record is an electronic summary of a patient's key health information drawn from their existing patient records.
Information can be uploaded by an authorised healthcare professional which is typically a person's regular GP.
Information that can be uploaded includes medications, test results, discharge summaries, allergies and details of any immunisations.
The doctors are in favour of everyone registering for an eHealth record, according to Suba Vijayakumar, Practice Manager at the Blayney Family Medical Practice.
"It's in our patients's best interests to have all their health information accessible in one online location, no matter where they are or whoever they go to," she said.
"We are very excited about the potential for the eHealth record and how it can help patients control and take ownership of their own medical history."
Stephen Jackson, Deputy CEO at WML, said the team has been promoting meaningful use of the eHealth record system across the region.
More information on the activities is found here:
As you will be aware Blayney NSW is a major metropolis in Western NSW  on the Mid-Western Highway with a population of a little over 3000 souls.
You can see some great pictures of the very neat town here:
There are three questions that spring to mind here:
1. Why are none of the doctors in the practice quoted rather than the lay staff?
2. Why is it that this activity is being funded when the PCEHR is under-review?
3. I wonder what the WML staff imagine ‘meaningful use’ means in the context of the PCEHR?  I note they make it clear that registration is the goal and that filling in and use of the record is to come at some time later.
Surely there other things that might make a larger difference to the health of those living in Blayney that registering them for a PCEHR which they may or may not use later?
David.

Tuesday, January 28, 2014

I Wonder Do These Provide A Hint As To What The PCEHR Enquiry Might Say?

These appeared last week.
First we had.

Govt mulls PCEHR overhaul

21/01/2014
The Federal Government is considering its response to a review of the controversial Personally Controlled Electronic Health Records system.
The three-member review panel, which was chaired by UnitingCare Health Group Director Richard Royle and included AMA President Dr Steve Hambleton, delivered its report to Health Minister Peter Dutton on 20 December.
Though details of the report and its recommendations have not been disclosed, it is believed to suggest wide-ranging changes to the PCEHR to improve its clinical usefulness and encourage its adoption by patients and doctors.
Mr Dutton said the review looked into significant concerns about the progress and implementation of the PCEHR, and its report “provides a comprehensive plan for the future of electronic health records in Australia”.
In its submission to the review, the AMA called for a fundamental change to the system to reduce patient control.
The AMA said the ability of patients to remove or restrict access to information in the PCEHR undermined its usefulness, because doctors could not be confident that it provided the comprehensive medical information needed to make an accurate diagnosis or properly assess the safety of proposed avenues of treatment.
AMA Vice President Professor Geoffrey Dobb said the capacity of patients to remove information from the record without trace was a fundamental flaw of the system.
“To encourage use of the PCEHR, GPs, community specialists and emergency department specialists must be confident that it contains accurate, up-to-date information,” Professor Dobb said. “Without a fundamental change to increase clinical confidence, the PCEHR does not serve the best interests of patients. As a result, it would be rejected by many doctors, and would fail.”
The full article is found here:
Then we had.

The five most pressing health priorities in 2014


21/01/2014

Trying to identify just five top priorities in an area as complex and ethically fraught as health care is a tough challenge, but that was the task Australian Medicine set for seven of the nation’s leading health advocates and thinkers, including AMA President Dr Steve Hambleton, the nation’s Chief Medical Officer Professor Chris Baggoley, health policy expert Dr Lesley Russell and World Medical Association Council chair Dr Mukesh Haikerwal. Here they provide their thought-provoking and insightful responses.
AMA President Dr Steve Hambleton
1.  Make population health a cross-portfolio priority for all levels of government
Population health is not just about treating illness. It’s also about keeping people well, and all portfolios (Agriculture, Defence, Education, Employment, Environment, Finance, Foreign Affairs and Trade, Health, Immigration and Border Protection, Industry, Infrastructure and Regional Development, Social Services, Treasury etc) need to do their part to fight the threat of non-communicable diseases which stem from tobacco, alcohol, over-nutrition and under- exercise. 
2. Continue the investment in closing the life expectancy gap between Aboriginal and Torres Strait Islander peoples and all Australians
All governments need to keep up the investment, but not just in the health portfolio. There is stark evidence that investing in the social determinants of health and a good education, starting at birth, are major predictors of health outcomes.
3. Fix e-health and the PCEHR
We must be able to talk to each other in the same language -general practice, hospitals (public and private), public outpatients, private specialists, aged and community care. Too often the right message just does not get through. Let's get the (e) rail gauge right and use it. 
4. Reduce unwarranted clinical variation
The fastest way to save health dollars and achieve better outcomes is to (as Professor Lord Ari Darzi advised at the 2012 AMA National Conference) “close the gap between what we know and what we do”.  We know we are doing a good job and are very cost effective. If we embrace the move of learned colleges toward clinical audit and self-reflection we can make best practice even better.
5. Invest in research
The human papillomavirus vaccine will save millions of lives. Research delivered and refined the place of statins, also saving millions of lives. We need new ways of treating infections, perhaps more antibiotics or better ways to use the ones we already have.
Heaps of other views here:
To me these article suggest there are priorities for the AMA in:
1. Standards and interoperability.
2. Governance and control of clinical information
3. Data quality
4. Clinician Trust and Use.
Given both these articles have come out from the AMA after Dr Hambleton finished the PCEHR review for the Health Minister we can conclude these issues may have been canvassed in the comprehensive plan given to the Minister.
What is your take on these clues?
David.

Monday, January 27, 2014

Weekly Australian Health IT Links – 27th January, 2014.

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

Well, we are through the silly season and the year actually begins this week after the December / January hiatus.
For those just coming back to work all you really missed was the Government going around floating all sorts of ways of saving money including some ideas around the health sector. There have been no decisions announced on e-Health or the Medicare Locals.
All is can say is Happy Real New Year!
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Older Aussies happiest to share e-records with GPs

21st Jan 2014
LESS than half of older Australians are willing to share the full contents of their personally controlled electronic health record (PCEHR) with allied health and other non-GP health professionals involved in their care, a survey has revealed.
While 95% of 80 regional Australians over-65 surveyed by researchers from Monash University said they were happy to share their full record with their GP, just 44% said they would allow allied health professionals the same access.

Respondents from Victoria’s Bendigo region were also reluctant to grant full access to others involved in their care. Some 48% said they would share their records with diagnostic laboratories, 46% would allow pathology staff access and 44% were happy for their pharmacist to see their record in full. 
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Wealth of health on site

Jan. 23, 2014, 6:25 a.m.
The Western NSW Medicare Local (WML) and Blayney Family Medical Practice are encouraging residents and surrounding communities to register for a Personally Controlled Electronic eHealth record (PCEHR) by holding a registration day on Friday, February 7.
WML will be helping and registering community members for a free eHealth record and then doctors will be able to upload a summary of their health information to the system.
Any visitors can attend the registration day and get an eHealth record and have their own GP upload their health summary later.
-----

Industry in dark on privacy law

HALF of all organisations are not even aware of amendments to the Privacy Act that could see fines of about $1.7 million imposed when it comes into effect next month.
IT vendors and privacy advocates hope the startling low awareness figure will shock corporate Australia and smaller players into action.
"Fifty per cent of organisations in Australia don't even know about the legislative changes," Capgemini Australia testing services director Shane Lonergan said. "It's across the board from tier-one to tier-two organisations ... they're major players (in the dark)."
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Google search doesn't reveal doctors' bad behaviour listed on AHPRA site

Date January 23, 2014

Amy Corderoy

Health Editor, Sydney Morning Herald

People are being put at risk because there is no way of telling from internet searches if their doctor has broken the rules or is working under sanctions from medical regulators, experts warn.
More than 680,000 health practitioners, including doctors, nurses, and dentists, have their registration status published by the Australian Health Practitioner Regulation Agency (AHPRA), including information about whether special conditions have been placed on their practice because of past bad behaviour.
But lawyers and patient advocates say patients are being left in the dark because the results do not show up in search results. One barrister told Fairfax Media she had clients who had been harmed by a doctor they had researched online, only discovering when they sought legal advice the doctor had conditions placed on them.
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Australian privacy laws and health information

Australia privacy rights are regulated by Commonwealth and Australia privacy rights are regulated by Commonwealth and State legislation and the laws protecting confidential information under the common law.
Australian privacy laws govern the collection, use and disclosure of “personal information”. Further, individuals are provided with a right of access and correction of their own personal information. There are also data security, data quality and cross-border transborder data flow requirements.
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Govt mulls PCEHR overhaul

21/01/2014
The Federal Government is considering its response to a review of the controversial Personally Controlled Electronic Health Records system.
The three-member review panel, which was chaired by UnitingCare Health Group Director Richard Royle and included AMA President Dr Steve Hambleton, delivered its report to Health Minister Peter Dutton on 20 December.
Though details of the report and its recommendations have not been disclosed, it is believed to suggest wide-ranging changes to the PCEHR to improve its clinical usefulness and encourage its adoption by patients and doctors.
Mr Dutton said the review looked into significant concerns about the progress and implementation of the PCEHR, and its report “provides a comprehensive plan for the future of electronic health records in Australia”.
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The five most pressing health priorities in 2014

21/01/2014
Trying to identify just five top priorities in an area as complex and ethically fraught as health care is a tough challenge, but that was the task Australian Medicine set for seven of the nation’s leading health advocates and thinkers, including AMA President Dr Steve Hambleton, the nation’s Chief Medical Officer Professor Chris Baggoley, health policy expert Dr Lesley Russell and World Medical Association Council chair Dr Mukesh Haikerwal. Here they provide their thought-provoking and insightful responses.
AMA President Dr Steve Hambleton
1.  Make population health a cross-portfolio priority for all levels of government
Population health is not just about treating illness. It’s also about keeping people well, and all portfolios (Agriculture, Defence, Education, Employment, Environment, Finance, Foreign Affairs and Trade, Health, Immigration and Border Protection, Industry, Infrastructure and Regional Development, Social Services, Treasury etc) need to do their part to fight the threat of non-communicable diseases which stem from tobacco, alcohol, over-nutrition and under- exercise. 
2. Continue the investment in closing the life expectancy gap between Aboriginal and Torres Strait Islander peoples and all Australians
All governments need to keep up the investment, but not just in the health portfolio. There is stark evidence that investing in the social determinants of health and a good education, starting at birth, are major predictors of health outcomes.
3. Fix e-health and the PCEHR
We must be able to talk to each other in the same language -general practice, hospitals (public and private), public outpatients, private specialists, aged and community care. Too often the right message just does not get through. Let's get the (e) rail gauge right and use it. 
-----

Public Hospitals Connected to the PCEHR

By the end of 2013, over 4,700 General Practices and 600 Community Pharmacies will be using the eHealth record system.  There are also around 200 public hospitals across Australia submitting discharge summaries for patients with an eHealth record, and more connecting every month.
Check whether your local hospital is able to submit discharge summaries to the eHealth record system in the table below.
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Email overload costs hospitals millions

January 23, 2014 | By Katie Sullivan
Medical centers pay a high price for the convenience of email--millions of dollars each year as well as a loss in doctor productivity, according to a research letter published in the Journal of the American Medical Association Pediatrics.
Ian Paul, M.D., and Benjamin Levi, M.D., Ph.D., both of the Penn State College of Medicine, examined how long it would take to go through more than 2,000 mass emails Paul received during the 2009-2010 academic year, and what that equated to in dollars.
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Qld Health aftermath: Govt still seeking to redress overpayments

So far staff have pledged to repay $3.5 million out of some $120 million worth of overpayments
Queensland Health staff have committed to handing back overpayments worth $3.5 million, the state government announced this morning.
The overpayments are a product of the Queensland Health payroll system debacle. In total 2500 Queensland Health staff members have signed up to repay money, according to Queensland's health minister, Lawrence Springborg.
"I hope to see the number of Queensland Health staff using the new online repayment system continue to rise so we can all put Labor’s payroll debacle behind us," Springborg said.
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Data Armageddon: preserving data can be tricky business

Date January 24, 2014

Drew Turney

There's a crisis looming in scientific data, with a leading scientific journal estimating 80 per cent of current scientific research will be lost in 20 years.
The study, published in Nature, included all data – even paper stored in garages or mouldy basements – but digital-only information may be under even greater threat. Digital conservation and what's called "digital archaeology" (picking up the pieces of data loss) is going to be an increasingly important strategy.
Rackspace chief technology officer Alan Perkins had to restore data from files written by discontinued and unsupported software. "I had to reverse-engineer the encrypted data," he says. "And I noticed several repeating characters every 673 characters, which let me decipher it."
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Vic govt updates ICT strategy

Plans to implement whole-of-government infrastructure as a service roadmap
The Victorian government is preparing to move to the next stage of its ICT strategy.
The Victorian government on Monday sought comment on an update to the plan that was launched in February 2013. The government strategy has a rolling two-year plan with an annual update that is designed to keep it up to date.
“The strategy is driving the delivery of better services, reducing duplication, encouraging innovation and improving ICT procurement and project management across government and, as we move towards the second stage, we need to ensure that the Victorian Government takes advantage of the opportunities arising from the ever-evolving ICT industry,” said Victorian technology minister, Gordon Rich-Phillips.
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Who goes there?

IF Roman armies of ancient times had perpetually used the Latin for "watchword" to verify their identities, friend may have been indistinguishable from foe in battle. Military security would have been breached and Rome's glorious battle history and, ultimately, human civilisation may have panned out differently.
Yet fast forward to 2013 and "password" was the second most commonly used password online, pipped only by "123456". In 2012, "password" was actually No 1.
Splashdata's annual "worst passwords" list illustrates that many take warnings about hacking, identity theft, malware, ransomware and online fraud lightly. Put bluntly, the fastidiousness of the Roman tesserarii, who managed the distribution of watchwords, puts many of us to shame in terms of password security.
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NSW Health begins hunt for new IT leader

Super-CIO wanted for new eHealth body.

NSW Health has begun advertising for its new IT chief, who will take over the soon-to-be-established entity eHealth NSW in an expanded CIO role.
The agency plans to appoint an inaugural chief executive of eHealth NSW by April. The successful candidate will "have a thorough understanding of healthcare delivery within a complex health system, as well as current trends, issues and policy directions in e-health," according to the NSW government's jobs website.
The role encompasses responsibilities once held by departed NSW Health CIO Greg Wells, but will operate at a more senior level, answering directly to director-general Mary Foley.
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Update on Personally Controlled Electronic Health Records - legal and privacy issues

As part of the 2010/11 Federal budget, the Government announced a $466.7 million investment over two years for a national Personally Controlled Electronic Health Record (PCEHR) system for all Australians who choose to register on-line, from 2012-2013. This initiative has the potential to be a revolutionary step for Australian health care, in terms of both consumer's access to their own health information and improvement in information which will be available to health professionals when they treat a patient.
To date, the uptake has been slow. NeHTA scorecard as at 29 October 2013:
  • The total number of people who registered for an eHealth record as at 29 October 2013 was 1,042,966.
  • More than 5,681 healthcare provider organisations have signed onto the eHealth Record system.
  • 8,105 individual doctors, nurses and other healthcare providers throughout Australia has been authorized by their organisations to access the PCEHR system;
  • More than 15.25 million documents have been uploaded into the PCEHR system.
With respect to the number of providers with HPI-Is that have been linked to access the system, it is NeHTA’s understanding that these numbers are linkages via the provider portal and exclude any linkages through local clinical information systems, so the total number of authorized users can be significantly greater.
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WA Health replaces CIO

Western Australia’s Department of Health has installed another acting executive to head its extensive IT operations.
Bill Leonard has taken over the role of acting CIO at the 40,000-strong organisation.
He replaces Dr Andy Roberson, who had filled in for the past 12 months but has now stepped down to return to his “substantive role” as deputy chief health officer and director of disaster management, regulation and planning.
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WA Health boss denies covering up hospital IT problems

'I was not gilding the lily'.

Former WA Health director-general Kim Snowball has defended himself against accusations he intentionally downplayed IT problems plaguing the construction of the state’s flagship Fiona Stanley Hospital.
The $2 billion facility will open to patients in October 2014, six months later than originally planned. Delays in the opening of the "paperless" hospital have been attributed to complex and unfinished IT.
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Is the stethoscope on its way out?

Date January 24, 2014

Jasper Copping

London: The cold sensation of the doctor's stethoscope has been familiar to patients for decades.
But the device could soon be replaced by new technology, a leading scientific journal has predicted.
It claims that a new generation of hand-held ultrasound devices, modelled on smartphones, are able to diagnose heart, lung and other conditions quicker and with more accuracy than the 200-year-old stethoscope.
The editorial article, in Global Heart, the journal of the World Heart Federation, says: "Many experts have argued that ultrasound has become the stethoscope of the 21st century."
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Aussies invent gizmo for Parkinson's falls

  • AAP
  • January 25, 2014 12:00AM
AUSTRALIAN scientists have invented a device that warns people with Parkinson's disease when they are in danger of a bone-breaking fall.
Although backed by serious science, it's a simple headband that gives people time to stabilise themselves before they suffer an unexpected freeze in their walking, which is common in Parkinson's disease.
Most Parkinson's patients are older than 60, and broken bones are one of their biggest dangers.
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Brisbane technology could help 71,000 blind people use computers

HE has his own way of seeing my hand, which he shakes, taking "feedback" from its touch. "Michael Curran," he says, folding a collapsible white blind cane in three places. His right hand touches the corner of his kitchen bench upon which he knows, subconsciously, sits a cane fruit bowl with two oranges and two red apples. He knows the colours of orange and red because he saw them long before his vision turned black.
He walks to his lounge room and points to a sofa with a pile of laundry on it, ready to be folded. "Would you like to sit here?" he asks, and then points to a hardwood table to his left. "Or at this stupidly large dining table?"
In this modest lowset brick home in the quiet, suburban Ferny Grove, in Brisbane's west, Michael Curran, a 30-year-old computer software designer, fully blind since he was 15, and his wife, Amy, not fully blind but vision-impaired, raise their two daughters, Gabrielle, five, and Hannah, three. Michael and Amy fell for each other when they were vice-president and treasurer, respectively, of the Young Blind Citizens Victoria advocacy group, where they ran sessions for blind youths about moving out of home as a blind citizen, forming relationships, finding work, becoming a parent. They moved to Queensland in 2010.
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January 23, 2014

MMRGlobal Granted Patent for Personal Health Record Mobile App

MMRGlobal, Inc., also known as MyMedicalRecords, announced this week that it has received a U.S. patent for an app that allows users to store personal health records in the form of voice mail, faxes, email, file upload and other forms of media on their personal devices, according to a statement released by the company. The app will also include an interface that collects and displays prescriptions for submission to pharmacies, allows users to annotate health records and set up appointment rem­­­inders.
"This 10th health IT patent comes at a unique time when awareness of the importance of online access to medical information is at the forefront of everybody's mind,” CEO Robert H. Lorsch said in the statement. “The eHealth market, and specifically the use of Personal Health Records and other products and services including PHRs, EMRs, telemedicine and wireless services that utilize portions of MMR's intellectual property, continues to grow. Additionally, MMR has 18 pending patent applications in the U.S. plus additional applications issued or in various stages of examination globally."
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MLs need to go: GP survey reveals

22nd Jan 2014
THE AMA has reignited its opposition to Medicare Locals, saying a survey of GPs found almost three quarters believed the organisations were failing to make healthcare delivery easier and should be shut down.
The AMA survey was released as 1700 primary healthcare workers and GPs await the outcome of a review of MLs ordered by Health Minister Peter Dutton. Mr Dutton, who had previously said MLs were an unnecessary bureaucratic layer that should be scrapped, has refused to speculate on how he will respond to the review until it is completed.
By contrast, the AMA, which had initially called for the ML rollout to be frozen on grounds that their corporate structure diluted GP leadership, has more recently softened its stance. In an editorial for MO last year, AMA president Dr Steve Hambleton wrote that it would be too expensive to unwind the organisations and they should instead be “shaped” to improve support for GPs.
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Health Exchange Woes Illustrate Need for Escape Clauses

·         By Clint Boulton - Reporter

CIOs should include detailed project requirement rules in their vendor contracts to indemnify themselves against poor-performing vendors, said Jeff Muscarella, an IT sourcing consultant for NPI Financial LLC. He said adding certain escape clauses will better prepare CIOs when vendor disputes end up in court.
Such vendor management is one of the key problems with health exchanges created under the Affordable Care Act. Despite technical difficulties afflicting state exchanges in Minnesota, Oregon and Massachusetts, contractors responsible for the website-crippling glitches are still on the job. Mr. Muscarella said the complex nature of the health exchanges make it difficult to let contractors go. Difficult, but not impossible, provided CIOs define the rules.
Project Governance. CIOs must include a set of clauses that define how IT problems will be tracked, managed and resolved. This process should cover problem resolution, typically starting with project managers for the customer and the vendor, and then escalating to the vice presidents of IT, if necessary. Failure to resolve these problems usually spurs the CEOs of each party to meet. If the vendor doesn’t observe this clause to the letter, the client can void the contract. “If they don’t manage the project accordingly, that’s grounds for termination,” Mr. Muscarella said.
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The rise of artificial intelligence

Date January 23, 2014

Iain Gillespie

Recent advances in making computers work like the human brain have pointed the way to a new era in artificial intelligence, and chances are you have already used some of the software improvements involved.
Breakthroughs in deep learning, a process that imitates the brain with digital ''neural networks'' that gather information and react to it independently, have prompted the world's technology giants to invest billions of dollars in a fierce competition to lead the field.
Google co-founder Sergey Brin has been quoted as saying he wants to build the equivalent of the sentient computer HAL from the film 2001: A Space Odyssey, except that it wouldn't kill people. Deep learning might bring that objective a step closer.
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Astronomers glimpse 'cosmic web'

  • John Ross
  • The Australian
  • January 20, 2014 5:00AM
SCIENTISTS say they have recorded the first glimpse of the "cosmic web", a colossal network of giant intersecting threads which holds the universe together.
Astronomers have speculated for years that gigantic voids in the universe are crisscrossed by “filaments” of dark matter. These filaments siphon together gases and other material, forming galaxies along their length and tightly packed clusters of galaxies at their junctions.
However, dark matter emits little if any radiation, including light. Consequently, the threads of the cosmic web have only been observed in computer simulations.
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After 10 years on Mars, rover Opportunity makes big water find

Robotic rover finds evidence of an older, milder water environment on Martian surface
After 10 years on Mars, NASA's rover Opportunity has discovered evidence of an ancient wet and mild environment that is much older than previously thought.
The discover is giving scientists further indication that the Red Planet might have been able to sustain life.
"These rocks are older than any we examined earlier in the mission, and they reveal more favorable conditions for microbial life than any evidence previously examined by investigations with Opportunity," said Ray Arvidson, Opportunity's deputy principal investigator and a professor at Washington University in St. Louis.
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Enjoy!
David.

Sunday, January 26, 2014

Australia Day Holiday

As most will be off having fun seems little point in publishing a blog for Monday. So enjoy the poll results, respond to the new one and have a great holiday.

Normal service resumes, of course, tomorrow!

David.

AusHealthIT Poll Number 202 – Results – 26th January, 2014.

Is Promoting The Concept Of e-Health And The PCEHR As A Panacea For Much That Ails The Health Sector Deceptive and Misleading Advertising?

For Sure 78% (32)

Probably 10% (4)

Possibly 5% (2)

No Way 7% (3)

I Have No Idea 0% (0)

Total votes: 41

It seems 88% of readers are pretty sure that promotion of e-Health and the PCEHR has been less that open, truthful and honest.

Again, many thanks to those that voted!

David.