Wednesday, September 30, 2015

FHIR IS Really Starting To Make Some Real Headway! Look Forward To Reports From The Field On Successful Use.

This appeared a few days ago.

FHIR DSTU2 is published

Posted on September 22, 2015 by Grahame Grieve
The FHIR team is pleased to announce that FHIR DSTU is now published at http://hl7.org/fhir. The 2nd DSTU is an extensive rewrite of all parts of the specification. Some of the highlights this version accomplishes:
  • Simplifies the RESTful API
  • Extends search and versioning significantly
  • Increases the power and reach of the conformance resources and tools
  • Defines a terminology service
  • Broadens functionality to cover new clinical, administrative and financial areas
  • Incorporates thousands of changes in existing areas in response to trial use
As part of publishing this version, we have invested heavily in the quality of the process and the specification, and the overall consistency is much improved. A full list of changes to the FHIR standard can be found at http://hl7.org/fhir/history.html#history.
In addition, DSTU2 is published along with several US-realm specific implementations developed in association with the ONC: DAF, SDC, and QICore.
More here:
All we can do now is make sure those who need to know are planning how FHIR fits into their future so that when the final Standard is available as its Version 1 they are ready to adopt - if they haven’t already. It becomes clearer by the day there is something very useful emerging here!
How far FHIR has come is illustrated in the following blog from Thomas Beale.

Yet another e-health standards comparison, corrected

25/09/2015 wolandscat
Recently HSCIC and NHS England published an Interoperability Handbook, intended to help provider CIOs and others steer the difficult waters of obtaining interoperable health IT solutions. The target audience is listed as:
CCG Clinical Leaders, Chief Clinical Information Officers, Chief Information Officers, Directors IMT
so the publication can be understood primarily as an aid to procurement and in-house planning and development of EHR and other clinical information solutions.
I won’t provide a proper analysis of the document here, other than to say that it is likely to be a useful resource for its audience, and a good starting point for ongoing conversations and education in the e-health solutions area within the NHS (even just establishing standard nomenclature in the NHS for talking about the relevant concepts is a worthwhile exercise). Interoperable solutions are a huge engineering enterprise, so hopefully it will be understood that documents like this one act as useful reference points, but in no way replace the needed human resources and competencies to plan and deliver actual solutions.
However, I do have some comments…
One of the things the document does is to identify technical standards for use in the planning, development and procurement activities. Since procurement is widely recognised to be one of the weakest points in the NHS environment (at least in terms of outcomes for broad health data interoperability), understanding and being able to use standards is a crucial part of establishing a platform environment for sustainable health computing.
Lots more here:
What Tom shows is where FHIR (and openEHR and many others) fit in the scheme of things and how the Standards present and future fit together. It also shows that there is a wide scope we need to successfully address to really get the information and knowledge flows we need in the Health Domain.
We are slowly making headway I reckon, but jinx there is a lot of hard work still to come. It is clear when looking at all this those seeing the PCEHR as the answer to even a small part of that ails us as smoking something that is probably illegal.
David.

Tuesday, September 29, 2015

Is Extra Work On Training For PCEHR Use A Waste Of Time Until You Fix The PCEHR Itself? You Bet!

This appeared a few days ago:

My Health Record education and training package

The AHHA is developing the national My Health Record education and training package for health providers, on behalf of the Commonwealth Department of Health.
To have your say on the training package and what it should include, please respond to this short survey (link is external) by 15 October 2015.
More information about this consultation is available below (also available for download here). We invite you to share this survey with your colleagues.

Stakeholder consultation to inform the development of national My Health Record education and training package

The Australian Healthcare and Hospitals Association (AHHA) have been contracted by the Australian Government Department of Health to design and develop the national My Health Record education and training package.
The initial stage of this project involves a series of consultations with stakeholders which will inform the development of the training package. The package will be targeted at clinical and non-clinical staff employed in a number of clinical settings including general practices, community pharmacies, residential aged care facilities, medical specialist, allied health and hospital settings. The package will be tailored to the conformant Clinical Information Systems, such as medical records or dispensing software, which provide connection to the My Health Record System
The AHHA will be contacting stakeholders and individual healthcare providers to participate in an online survey and/or interviews and focus groups. Your participation in this consultation process will support the development of a package which meets your training needs, and will support your ability to confidently use the My Health Record system.
More here:
Here is the intro to the survey:

My Health Record Education and Training Survey

The Australian Healthcare and Hospitals Association (AHHA) has been contracted by the Australian Government Department of Health to design and develop the national education and training package for the My Health Record, previously known as the Personally Controlled Electronic Health Record (PCEHR).
The package will be targeted at clinical and non-clinical staff employed in a number of clinical settings including general practice, community pharmacy, residential aged care, medical specialist, allied health and hospital settings. It will be tailored to the conformant Clinical Information Systems, such as medical records or dispensing software, which provide connection to the My Health Record system.
This survey seeks your views about the training you and/or your staff require to use the My Health Record system, and your experience of previous training you may have undertaken to use the PCEHR. Your participation in this consultation process will support the development of a package which meets your training needs, and which will support your ability to confidently use the My Health Record system. It will take approximately 10 minutes to complete the survey.
For more information about this survey, please email Daniel Holloway at the AHHA.
Here is the link:
If ever there was a cart before the horse effort this is it!
Surely you have to optimise the new system, prove it works well and is clinically useful, guarantee it does not interfere too much with clinical workflow and is privacy protective and then develop the training materials.
I don’t blame the AHHA - this again is a reflection of the craziness of the e-Health Branch at DoH!
David.

Monday, September 28, 2015

Weekly Australian Health IT Links – 28th September, 2015.

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 busy week with lots of material that may turn out to be pretty controversial. Will be interesting to watch how things emerge over the next few weeks.
The news on FHIR DSTU is very important as there is clearly building support to see just how much difference it can make. Watch this space.
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E-health PIP under the spotlight

21 September, 2015 0 comments
GPs may have to upload a mandatory number of files to their patients' personally controlled electronic health records before they can claim incentive payments as part the Federal Government's latest attempt to boost the system.
The suggested clampdown on accessing the E-health Practice Incentives Programme - worth up to $50,000 a year - is set out in a consultation document released by the Department of Health earlier this month.
Under the current PIP scheme, practices have to meet five criteria to access the payments. The criteria include applying to access the universal PCEHR system and installing software that marries up with it.
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Govt moots clampdown on e-health PIP

Tessa Hoffman | 21 September, 2015 | 
GPs may have to upload a mandatory number of files to their patients' personally controlled electronic health records before they can claim incentive payments as part the Federal Government's latest attempt to boost the system.
The suggested clampdown on accessing the E-health Practice Incentives Programme - worth up to $50,000 a year - is set out in a consultation document released by the Department of Health earlier this month.
Under the current PIP scheme, practices have to meet five criteria to access the payments. The criteria include applying to access the universal PCEHR system and installing software that marries up with it.
However, the health department’s paper says that while the PIP has been successful at encouraging practices to adopt systems that allow them to access PCEHRs, this had not translated into active participation in the system.
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24 Sep 2015 / by MediSecure / in Latest News

ePIP to be changed to encourage PCEHR use

The Practice Incentive Program, eHealth incentive (ePIP) looks set to change from February 2016 to encourage general practices to actively use the PCEHR system. (ref)
The ePIP was introduced in 2012 and has five requirements that practices must fulfil to receive a payment of up to $50,000 per annum. An estimated 72 per cent of practices Australia wide are known to be participating in the ePIP scheme.
Criterion number four of the ePIP requires practices to submit the majority of their prescriptions to an electronic prescription exchange service (PES), such as MediSecure.
The fifth ePIP measure is the one pertaining to the use of the PCEHR, which the Federal Government is considering reviewing and is to be renamed My Health Record. Currently, in order to receive the ePIP payment practices simply need to show readiness to use the PCEHR by using software that is compliant with the system.
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Telstra secures multi-year Medibank Private contract

Telstra has sealed a three-year multi-million dollar contract with Medibank as its exclusive partner for delivery of telecommunications services.
The contract incorporates mobile, voice and data carriage, managed WAN and LAN services, and service management, and the agreement will see Australia’s largest private health insurer achieve savings of 37% as it consolidates from eight suppliers down to just one - Telstra.
As part of the deal, Telstra will refresh LAN and WAN equipment to mitigate network risks and improve capability, while delivering the latest in enterprise mobility services.
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Telstra signs multimillion-dollar contract with Medibank

Telstra will exclusively provide voice, data, WAN, LAN, and managed services to Medibank, providing savings, efficiency, and greater network security to the health insurance company.
By Corinne Reichert | September 21, 2015 -- 21:30 GMT (07:30 AEST) | Topic: Telcos
Telecommunications carrier Telstra has signed a multimillion-dollar three-year contract to exclusively provide telco services to health insurance company Medibank Private, with the latter saying that this will improve its efficiency and result in significant savings for the company.
The deal will see Telstra provide Medibank, which has 3.9 million members in Australia, with voice, mobile, data, service management, and managed WAN and LAN services. According to Telstra, this will enable Medicare to save around 37 percent of its current telco-related expenditure by unifying its services under one provider, rather than the eight providers it used prior to this.
Under the deal, Medibank's WAN and LAN equipment will be updated by the telco in order to increase capability and lessen the risk of network disruption. Telstra will also automate its service management solution and implement its new Mobile Business Fleet Plus plan.
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Online tool reports on aged care antibiotic use

Serkan Ozturk | 21 September, 2015 | 
Tracking antibiotic prescribing for UTIs in aged care homes is set to become easier with the launch of an online reporting tool.
Under the scheme, developed by NPS MedicineWise, doctors and nursing staff working in residential homes will be able to ask their local pharmacists to run reports on their antibiotic use for UTIs in a bid to curb inappropriate antibiotic prescribing.
The reports will compare data and patterns of antibiotic use and identify residents who could benefit from a review of their current medications.
“Reflecting on a facility’s current practice of prescribing of antibiotics for UTIs is highly beneficial,” said Dr Lynn Weekes, chief executive officer of NPS MedicineWise.
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Specialist Doctors site cleared of ad breach

24 September 2015
A WEBSITE which claimed to list Australia's best specialists has been cleared of breaching advertising standards by the Medical Board and AHPRA.
The Specialist Doctors site, which was taken offline pending discussions with AHPRA, sparked a flurry of comment when it was launched early last month.
Questions were raised over whether the three doctors behind the site had breached advertising guidelines.
But in a statement, AHPRA said the founders did nothing wrong.
"It does not appear that the practitioners involved in the Specialist Doctors' website have breached the Medical Board of Australia's advertising guidelines," it said.
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Top tips for GPs on e-mental health

23 September 2015
STRONG evidence suggesting e-mental health can help treat mild to moderate depression and anxiety is the basis of a new RACGP e-Mental health guide for GPs. 
E-mental health refers to the use of the internet and related technologies to deliver mental health information, services and care. 
The guide, funded by the Black Dog Institute and put together by an expert panel of GPs, is based on cognitive behavioural therapy (CBT) and goes through the pros, cons and preparation of working e-mental health (EMH) into primary care.
It links to the main online resources such E-Mental Health in Practice (EMHPRac), beacon, Mindhealthconnect and the Black Dog Institute’s GP training initiative. 
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George Institute study finds SMS helps heart attack survivors heed health message

Date September 23, 2015 - 1:00AM

Amy Corderoy

Health Editor, Sydney Morning Herald

A simple SMS could be lifesaving, say doctors running a trial to prevent heart attacks.
Their study, which reminded heart attack survivors about how they could stick to a healthy lifestyle and the importance of getting regular medical check-ups, found text messages were so powerful in some cases that they produced a similar effect to medications. 
Sydney cardiologist and study leader Clara Chow believed rolling out SMS reminders to heart attack survivors could save more than 1880 lives in one year alone.
Heart disease is one of the most common causes of death in Australia and about 55,000 people go to hospital with a heart attack every year.
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My Health Record education and training package

The AHHA is developing the national My Health Record education and training package for health providers, on behalf of the Commonwealth Department of Health.
To have your say on the training package and what it should include, please respond to this short survey (link is external) by 15 October 2015.
More information about this consultation is available below (also available for download here). We invite you to share this survey with your colleagues.

Stakeholder consultation to inform the development of national My Health Record education and training package

The Australian Healthcare and Hospitals Association (AHHA) have been contracted by the Australian Government Department of Health to design and develop the national My Health Record education and training package.
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An easy-to-use blood pressure app

24 September 2015
I FREQUENTLY ask patients to monitor their blood pressures at home. I also frequently have patients turn up for review of these blood pressures having forgotten the piece of paper they have been written on. SmartBP will hopefully mean these days are over.
Logging on to Smart BP for the first time prompts the user to complete a profile including age, sex and weight. From here it is then just a matter of starting to record BPs on the home page. Notes can be added, e.g. medications taken or ‘morning reading’. 
Retrospective recording can be done by changing the date recorded at the top of the blood pressure entry screen. There is then the ability to graph blood pressure recordings as well as pulse rate or weight and save or share them in the form of email or text.
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Call for new communications minister to help improve sector ICT capability

By Natasha Egan on September 23, 2015 in Technology Review
Mitch Fifield may have moved on from aged care but he has not escaped the sector completely as one peak vows to meet with the minister in his new role to lobby for ICT support on a platform of productivity.
With Sunday’s cabinet reshuffle, Senator Fifield was named Minister for Communications, Minister for Arts and Minister Assisting the Prime Minister for Digital Government two years and three days after becoming Assistant Minister for Social Services and the minister responsible for aged care.
The editor in chief of online technology publication iTWire, Stan Beer, referred to Mr Fifield as “a relatively unknown Victorian Senator” when announcing his promotion to the communications portfolio, which was previously held by Prime Minister Malcolm Turnbull.
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Yet another e-health standards comparison, corrected

25/09/2015 wolandscat
Recently HSCIC and NHS England published an Interoperability Handbook, intended to help provider CIOs and others steer the difficult waters of obtaining interoperable health IT solutions. The target audience is listed as:
CCG Clinical Leaders, Chief Clinical Information Officers, Chief Information Officers, Directors IMT
so the publication can be understood primarily as an aid to procurement and in-house planning and development of EHR and other clinical information solutions.
I won’t provide a proper analysis of the document here, other than to say that it is likely to be a useful resource for its audience, and a good starting point for ongoing conversations and education in the e-health solutions area within the NHS (even just establishing standard nomenclature in the NHS for talking about the relevant concepts is a worthwhile exercise). Interoperable solutions are a huge engineering enterprise, so hopefully it will be understood that documents like this one act as useful reference points, but in no way replace the needed human resources and competencies to plan and deliver actual solutions.
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Tim, Telstra, and the tech takeover of the NHS

Tamasin Cave 22 September 2015
Tim Kelsey’s legacy to the NHS isn’t just the botched care.data project. He’s also been pushing a vision of digital salvation, that his new firm is already starting to benefit from.
Tim Kelsey, the NHS’s man for all things data and digital, has had it in the neck a lot recently. Could this be why he is off to Australia to work for telecommunications giant, Telstra (more on them below)?
As the driving force behind the expensive, error-strewn care.data programme, Kelsey was always going to be a controversial figure. People are rightly concerned that this vast database of all our medical records, which was sold as benefitting the health service, would also be of huge commercial value to pharmaceutical companies, private health insurers and others.
 A 2014 paper by Kelsey’s old employer McKinsey adds weight to the idea that the intention was always to commercialise our data. The paper reveals that one of the ambitions for care.data is to create “Product lines of data insight available to “customers’”. “Is there a product and a matching customer,” it asks, and “what are they interested in knowing?
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OzForex lures Telstra Health exec to CTO role

Former tech boss leaves in management shakeup.

By Andrew Sadauskas
Sep 23 2015 11:39AM
Foreign currency trading firm OzForex has appointed Craige Pendleton-Browne as its chief technology officer as part of a major reorganisation of its leadership team.
Pendleton-Browne has experience as a CTO in both the UK and Australia, with previous employers including News Corp and EMI Music.
He began his most recent role as CTO at iCareHealth in February 2014, just months before the aged care electronic health records vendor was acquired by Telstra Health.
Pendleton-Browne replaces David Higgins, who first joined OzForex as a software developer in September 2012 and has served as CTO for the past six years.
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Revolution hits pharmacy workflow

23 September, 2015
A pharmacy automated dispense system has won direct endorsement from a Pharmacy Guild of Australia affiliate.
Gold Cross has announced the new endorsement of the Rowa Automated Dispensary system from Queensland firm Dose Innovations, saying it will bring “a new level of automation and customer-focus to Guild member pharmacies”.
According to Gold Cross, the system will revolutionise the workflow of a standard pharmacy, automating the back office work of a dispensary, taking control of stock management, inventory control, order management, order checking and receiving – allowing staff extra time to focus on patient-centred activities.
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Fixing Qld Health’s IT systems: start with the plumbing

Step one in massive program of work.

Queensland Health will eschew a big bang transformation of its legacy systems in favour of a lower-risk, incremental approach to systems replacement in the hopes of reviving its IT fortunes.
While much attention has been on the department's disastrous implementation of an SAP payroll system in recent years, payroll is just one of the agency's many applications that are fast approaching a deadline for replacement.
Its HCBIS patient administration is rapidly nearing end of life, the agency still has a lot of desktops on Windows XP, and many disparate identity access management solutions need to be consolidated, just to mention a few of the big tasks the department has ahead of it.
And that's without considering the detailed list of items on the state government's 20-year, $1.26 billion plan for e-health released earlier this month.
Health’s new CTO (and former Suncorp CIO) Colin McCririck and chief architect Brendon Kirby are the new blood brought in to reinvigorate the agency’s IT.
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The AMT v20150930 September 2015 release is now available for download

Created on Friday, 25 September 2015
The AMT v20150930 September 2015 release is now available for download from the NEHTA website.
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FHIR DSTU2 is published

Posted on September 22, 2015 by Grahame Grieve
The FHIR team is pleased to announce that FHIR DSTU is now published at http://hl7.org/fhir. The 2nd DSTU is an extensive rewrite of all parts of the specification. Some of the highlights this version accomplishes:
  • Simplifies the RESTful API
  • Extends search and versioning significantly
  • Increases the power and reach of the conformance resources and tools
  • Defines a terminology service
  • Broadens functionality to cover new clinical, administrative and financial areas
  • Incorporates thousands of changes in existing areas in response to trial use
As part of publishing this version, we have invested heavily in the quality of the process and the specification, and the overall consistency is much improved. A full list of changes to the FHIR standard can be found at http://hl7.org/fhir/history.html#history.
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HealthEngine Affirms Its Position as the Leading Online Health Marketplace Partnering with Global Dental Software Experts, Software of Excellence

2015-09-24 09:00
PERTH, Australia, Sept. 24, 2015 /PRNewswire/ --  Leading global dental practice management software provider, Software of Excellence, has selected HealthEngine as its partner for delivery of online appointment directory solutions.
The newfound partnership means more dentists will have greater access to a wide range of tools and solutions that enable them to focus on providing the best possible dental experience for patients and not worry about the operation, management and marketing of their practice.
Currently, HealthEngine services more than 1,800 dentists through its Online Health Directory and Appointment Marketing, with this number set to rise significantly in the coming months.
Existing Software of Excellence clients can benefit from HealthEngine's integrated online marketing solutions that work seamlessly with their existing practice management software; allowing practices to attract new patients through Australia's largest online health marketplace, and boost their online reputation with a greater search engine presence.
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Telehealth scheme lets GPs set own fees

Tessa Hoffman | 23 September, 2015 | 
A new player spruiking pay-by-the-minute GP phone consults has entered the telehealth market.
TeleConsult, launched this week, is described by its founders as “the world’s first pay-as-you-go real-time, electronic consulting platform”.  
It offers consultations via landlines, smartphones, tablets or desktop computers and a video option is to be added soon.
The start-up, which is in talks with a GP corporate over a partnership deal, is the brainchild of Sydney respiratory physician Dr Jonathan Rutland, who says he wants to give doctors a time-saving alternative to face-to-face consults.
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Senator Mitch Fifield to oversee NBN rollout as comms minister

George Brandis remains attorney-general in Turnbull cabinet
Prime Minister Malcolm Turnbull has announced the new ministry for the Coalition government.
Prime Minister Malcolm Turnbull has appointed Senator Mitch Fifield to the communications portfolio as part of the new-look Coalition ministry.
Turnbull, who has been acting as communications minister since he ousted Tony Abbott for the top job, announced the changes to his ministry at a press conference this afternoon.
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NBN formally launches FTTN, aims for 500k premises by mid-2016

National Broadband Network FTTN product includes 'up to' speed tiers
NBN today officially launched its fibre-to-the-node offering, with the company aiming to have half a million premises able to order FTTN services by the middle of next year.
Under NBN's plan for a 'multi-technology mix' National Broadband Network, FTTN and fibre-to-the-basement (FTTB) will eventually connect 4.5 million premises.
NBN is aiming to have 3.7 million premises ready to sign up for FTTN services by mid-2018.
FTTN/B is intended to make up the biggest component of the fixed line network, connecting 38 per cent of Australian homes and businesses (followed by hybrid fibre-coaxial, HFC, at 34 per cent; fibre-to-the-premises, or FTTP, will be used to connect 20 per cent).
FTTN is the "next step on our MTM journey," NBN's chief customer officer, John Simon, said today at the launch of the technology.
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NBN musters all its energy for do-or-die broadband

Mitchell Bingemann

In five days it will be do or die for the National Broadband Network when it presses the launch button for a 780-tonne rocket that will hurl its satellite weighing more than an elephant into orbit.
If all goes according to plan, the rocket will tear through the earth’s soupy atmosphere with the thrust of 100 F100 fighter jets and enter the vacuum of space where it will beam fast broadband services back to Australia’s 200,000 most far-flung homes and businesses.
If things don’t go according to plan, the rocket and satellite, which has been the culmination of three years’ hard work and $2 billion in funding, will explode before crashing into the Atlantic Ocean.
Back in 1992 it took only 48 ­seconds for Optus to feel the agony of a failed rocket launch when a Chinese Long March rocket carrying its B2 satellite exploded at the remote Xichang launch centre in western China.
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UQ team develops needle-free disease detection through nanotechnology patch

Date September 21, 2015 - 12:01AM

Marcus Strom

Journalist

Could this be the end of the blood test?

Dr Simon Corrie from the University of Queensland explains how nanotechnology patches could be used to detect diseases without the need for needles.
An Australian research team is developing a nanotechnology patch that will detect disease-carrying proteins direct from your skin.
The device, once applied in the field, could remove the need for invasive blood extraction and lengthy diagnostic delays in laboratories.
Building on earlier work used to develop vaccination patches, the University of Queensland team hopes that detecting diseases such as malaria and dengue fever in the field will improve detection rates and the efficacy of drugs to counter such diseases.
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Enjoy!
David.

Sunday, September 27, 2015

What Utter Hipocracy - DoH is Really Just Policy Nonsense!

We have the spectacle today of the Government releasing the review of MBS Items for value for money and clinical utility. They are demanding evidence that things are useful, safe, make a difference and actually work etc.

See here for all the details:

http://www.health.gov.au/internet/main/publishing.nsf/Content/MBSReviewTaskforce

At the same time we have a proposal on ePIP - to spend more money on the PCEHR. This is an that is an utterly evidence free proposal as there is zero evidence on what the PCEHR can do and deliver - if anything!

See Today's blog for links:

http://aushealthit.blogspot.com.au/2015/09/is-government-outsmarting-itself-with.html

Seems we have an ongoing fiasco of lack of intellectual capacity and honesty from a hopeless bureaucracy! Just exactly what is the evidence that the PCEHR is or can make a difference to patient care or costs? We are all waiting!

How about a value for money and quality review of the PCEHR? We need it! BTW  the review of the MBS Schedule is a perfectly reasonable thing to be doing - the trick will be to have the evidence properly assessed and valued. There is no way the bureaucrats who keep wasting money on the PCEHR can be expected to get the MBS Review even close to right!

Pretty sad.

It is also ridiculous to see the instant politicisation of what really should be a scientific, evidence based review. A pox on all their houses for this.

David.

Is The Government Outsmarting Itself With The Changes To The ePIP Program? The Blowback Might Be Considerable.

This seems to me to be the biggest news of the week.
24 Sep 2015 / by MediSecure / in Latest News

ePIP to be changed to encourage PCEHR use

The Practice Incentive Program, eHealth incentive (ePIP) looks set to change from February 2016 to encourage general practices to actively use the PCEHR system. (ref)
The ePIP was introduced in 2012 and has five requirements that practices must fulfil to receive a payment of up to $50,000 per annum. An estimated 72 per cent of practices Australia wide are known to be participating in the ePIP scheme.
Criterion number four of the ePIP requires practices to submit the majority of their prescriptions to an electronic prescription exchange service (PES), such as MediSecure.
The fifth ePIP measure is the one pertaining to the use of the PCEHR, which the Federal Government is considering reviewing and is to be renamed My Health Record. Currently, in order to receive the ePIP payment practices simply need to show readiness to use the PCEHR by using software that is compliant with the system.
According to statistics from the Department of Health, of the estimated 72 per cent of practices that are currently receiving the financial ePIP incentive for eHealth preparedness, just 16 per cent are actually uploading clinical information to the federal PCEHR system. Clearly, the Government believes that pushing practices to be PCEHR prepared is no longer enough to promote its use.
More here:
There was also coverage here:

Govt moots clampdown on e-health PIP

| 21 September, 2015 |  
GPs may have to upload a mandatory number of files to their patients' personally controlled electronic health records before they can claim incentive payments as part the Federal Government's latest attempt to boost the system.
The suggested clampdown on accessing the E-health Practice Incentives Programme - worth up to $50,000 a year - is set out in a consultation document released by the Department of Health earlier this month.
Under the current PIP scheme, practices have to meet five criteria to access the payments. The criteria include applying to access the universal PCEHR system and installing software that marries up with it.
However, the health department’s paper says that while the PIP has been successful at encouraging practices to adopt systems that allow them to access PCEHRs, this had not translated into active participation in the system.
Only 16% of the 4569 practices receiving the payments had actually uploaded clinical information to patients records, it says.
And just 242 practices had uploaded five or more shared health summaries, which include details on current prescriptions, allergies and immunisation, between August 2014 and February 2015.
More here:
A consultation paper was issued a few weeks ago - 10 pages - and it can be read here:
It is difficult to know why it has taken a while to be noticed but it is not easy to find on the DoH site and seems only to be published by interest groups like the AMA and RACGP.
See here:
Bluntly what is going on here is the Government is conducting a pretend consultation (as always it seems it does) and is planning to start insisting that GPs upload patient records to the PCEHR to continue to receive their (quite substantial) payments per practice.
In passing I would note that as far as I am aware there has never been a published audit showing the impact and value of earlier PIP e-health initiatives, which means it has been pretty easy to get ongoing cheques.
This also means that this is the first part of a proposed ePIP that will be easily monitored by DoH and thus mean there will be some interesting responses to these enforcement and monitoring initiatives (getting between GPs and their perceived money and all that.)
There is also a risk that compulsion will lead to less that trustworthy data being uploaded - which could be seen as a rather perverse incentive.
My issue with all this - other than the potential risks relating to data quality and privacy - and the possible government misuse of personal information - is the lack of any evidence at all that the PCEHR is actually of any use and that the cost of this ePIP program will just add to the money wasted on this unproven national e-Health folly.
Where are the explicit and detailed plans describing how the utility of the PCEHR will be made attractive and the evidence this will actually work. Of course if the system had been useful and well-designed up front none of this funding would be needed.
This really is a self-propelled unproven fantasy that reminds one of a run-away train. Sadly it is also costing all of us a fortune!
How we can have an ill-conceived system such as the PCEHR consuming virtually all our e-Health funds while good, evidence based  and valuable projects are just ignored beats me!
David.

Looks Like The AMA and The Government Have Fallen Out Over The MBS Review!

AMA Media is tweeting.

17 minutes ago
PM & Health Minister have lost medical profession's support in MBSreview. True intentions revealed today - cuts to services, funding.
      

#auspol

This might get pretty messy!

David .