Monday, December 14, 2015

Weekly Australian Health IT Links – 14th December, 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

An amazingly busy week with all sorts of stuff happening. Too much to summarise so you will just have to browse your way down!

Health Department struggles with own e-record system

Tessa Hoffman | 8 December, 2015 |
It is tasked with looking after the e-health records of millions of Australians, but a scathing report has found the Department of Health has dropped the ball on its own e-record management system.
A report by the Australian National Audit Office, published last week, has revealed glaring inadequacies in the department’s handling of its transition to a single system to store official records.
The model was adopted in mid-2013 to replace four separate systems. But two years after the changeover, the auditor found that staff were unable to use the system properly — locating only 18% of the records the auditor asked them to find.
3 December, 2015

Computers can create a bad vibe

Overuse of computers by clinicians makes for a less satisfying patient experience, according to a study in JAMA Internal Medicine.
Posted by Dr Mic Cavazzini
Patients in clinical consultations that involved high computer use were much less likely to rate care as excellent compared to those in visits with low computer use. And researchers rated clinicians in those consultations as showing less positive affect and more criticism or disagreement.
In the US study, consultations with patients who spoke English as a second language or who had low health literacy were video-recorded. Eye contact and rapport- building were quantified, and patients were interviewed after the consultations. But not all of the reported associations were linear with increasing levels of computer use.
Indeed computers can be a force for good in the consultation, said Dr Christopher Pearce, GP and Director of Adjunct Professor at Monash University. “One of things that was quite controversial about my earlier studies was that patients respond to the computer; some in an inviting way and some in an excluding way.” It was up to individual physicians to pick up on this preference from the patient, he said.
The simple arrangement of a consultation room can make a huge difference, added Dr Pearce. “Even in the side-by-side setting patients are often looking at the screen when the doctor is looking at the screen. We are now fascinated by screens.”

3 tips on using computers during consultations

4 December 2015
PATIENTS don’t like it when a doctor spends a disproportionate amount of time interacting with the computer screen instead of them.
High computer use is associated with poor patient satisfaction, report British researchers who  recorded 71 encounters between 39 doctors and 47 patients with chronic disease.
Doctors who used the computer a lot during a consultation are prone to using negative language with their patients, write the researchers in JAMA Internal Medicine.
“Concurrent computer use may inhibit authentic engagement, and multitasking clinicians may miss opportunities for deeper connection with their patients,” they write.

Opt-out trials for online 'My Health Records'

Australia December 11 2015
Trials of opt-out arrangements for the newly named ‘My Health Record’ system will occur in the North Queensland and Nepean Blue Mountains Primary Health Network Areas.  If these trials are successful, rules will be passed (instead of legislative changes) to implement the opt-out system nationally.  These are some of the consequences of the Health Legislation Amendment (eHealth) Bill 2015 (Cth) (Bill) that has recently been passed.
An independent evaluation of the trials is proposed to be carried out in 2016, and will inform the decision of whether to implement the opt-out system nationally.
The My Health Record system (System) was implemented in July 2012 under its former name, the ‘Personally Controlled Electronic Health Record’ system.  The System allows healthcare providers to upload key health information of a patient to a personal online health record, which can be shared between doctors, hospitals and other healthcare providers.  Currently, individuals wanting to participate in the System are required to opt-in by registering themselves.  This has resulted in only 1 in 10 Australians using the System.

Are we making the best use of data to improve health care?

Editor: Melissa Sweet Author: Jennifer Doggett on: December 09, 2015

Jennifer Doggett reports:

Whether it’s big or small, linked or discrete, qualitative or quantitative – data is at the centre of all health services research and has been a key theme of the #HSR15 conference in Melbourne this week.
A number of presentations demonstrated new and innovative ways of using data to challenge commonly held assumptions about the health system and to generate solutions to challenging problems.
For example, Professor Gary Freed from the Universities of Michigan and Melbourne, demonstrated how he used hospital emergency department (ED) data to show that by far the greatest number of ED presentations are among children from 0-4 years old – and not (as is often thought) older age groups.

Two-thirds of major NSW Health IT projects are running late

Auditor calls for internal review.

By Paris Cowan
Dec 8 2015 11:21AM
Six of the NSW Department of Health’s nine largest technology projects are running behind schedule, prompting the state’s auditor-general to call for a review into the way IT initiatives are managed.
The health system’s IT authority, eHealth NSW, currently has nine projects worth more than $20 million on its books.
These include the $170 million statewide electronic medications management rollout, a $90 million rostering overhaul, and the $31 million migration into the GovDC data centres.
But more than half have seen their schedules slip by between one and five years.
According to a report (pdf) handed down by acting NSW auditor-general Tony Whitfield today, eHealth NSW blamed the delays on “the complexity of change management processes involved across health entities, as well as vendor/supplier capability and capacity issues”.

New digital portal for mental health support

By Natasha Egan on December 7, 2015 in Technology Review
Mental health treatment is set to get a digital upgrade under Federal Government reforms, which includes a focus on making use of Australia’s leading digital technology and a new gateway to promote online services including e-therapies and self-help programs.
Those in the digital space were keen to work with the government to advance the innovation agenda that had stagnated over the last decade due to a lack of government investment, direction or will, mental health services said in response to the reforms.
Announcing the government’s package on 26 November, Minister for Health Sussan Ley said the reforms would see individualised and integrated care packages for people with severe and complex needs and services commissioned through the Primary Health Networks (PHN).

Walid Jammal: Real urgency

Walid Jammal
Monday, 7 December, 2015
DESPITE repeated calls by many health bodies and coroners, we are still hampered by the absence of a national system of real-time electronic reporting and recording of controlled drugs. 
Tasmania is the only state to have introduced a real-time electronic reporting and recording of controlled drugs (ERRCD) system. Although the system is often talked about on the mainland, I have been struck by how few people know how it works in detail.
I recently visited the Pharmaceutical Services Branch (PSB) of the Tasmanian Department of Health and Human Services to explore their system — Drugs and Poisons Information System Online Remote Access (DORA) — which the PSB told me had successfully delivered a reduction in inappropriate prescriptions and dispensing of drugs of dependence (DOD).

Judge throws Qld govt's case against IBM out of court

State could be liable to pay IT giant’s court costs.

By Paris Cowan
Dec 7 2015 4:01PM
Supreme Court Justice Glenn Martin has spiked the Queensland government’s attempt to sue IT contractor IBM over its role in the $1.25 billion failure of its health payroll replacement project.
Justice Martin today sided with the IT giant, agreeing that a 2010 waiver of liability signed by both parties was ‘properly constructed’ and the state’s latest attempt to drag IBM through the courts was therefore legally invalid.
“The history of attempts to improve the efficiency of government services in Australia is not one of consistent outcomes. There have been many successes, some indifferent results and a few spectacular fiascos," Martin said in handing down his judgment this afternoon.

Queensland can't sue IBM over health payroll system: judge

Date December 7, 2015 - 5:37PM
The Queensland government's lawsuit against IBM Australia over the disastrous health payroll system has stalled, after the Supreme Court upheld a legal challenge by the technology giant.
The Newman government launched legal action against IBM in 2013, arguing the company had misrepresented its capability to deliver the $6 million contract on time and on budget.
IBM challenged the lawsuit and pointed to a 2010 agreement which the company said released it from the damages claim.
A trial was held in the Brisbane Supreme Court earlier this year, and on Monday Justice Glenn Martin ruled in favour of IBM.

Innovation: $250m fund to bolster bionics potential

  • The Australian
  • December 8, 2015 12:00AM

Rosie Lewis

Sarah-Jane Tasker

Australian-designed bionic eyes and implant devices that treat epilepsy are a step closer to becoming commercially available after the government announced it would establish a $250 million fund to ­invest in biomedicines.
The biomedical translation fund will be launched next year and will be financed by taking money from one of the Abbott government’s signature budget measures, the $20 billion Medical Research Future Fund, over the next two years.
The government said the fund would not directly impact the underlying cash balance but had booked $10m over the forward ­estimates for its set-up and running costs, with transactions not counted against the budget.
The Bionics Institute in Melbourne, whose research helps ­improve the performance of the Cochlear implant, is hoping to use some of the money to take its ­bionic eye through to commercial production and continue to ­develop its neurobionics devices that treat and diagnose psychiatric disorders and neurological conditions such as epilepsy and Parkinson’s disease.

Fitness bands more than fancy bangles; potential game changers for health

Bruce Wednesday 09 December 2015, 4:38PM
Fitness is hot this Christmas, if only on people’s wrists, as the popularity of fitness trackers and wearable technology grows.
Anecdotal evidence gathered by New Zealand Doctor, from some key electronic outlets, points to the FitBit fitness trackers being by far the best-selling fitness trackers, followed by Jawbone and Garmin.
If a patient hasn’t talked to you about one of these devices it’s likely only to be a matter of time.
North Shore GP and eHealth ambassador Heidi MacRae of Medplus says she is seeing increasing numbers of patients with fitness trackers.

Health Informatics For Medical Students Report

We are pleased to advise publication of the final report of an Australian national project to develop competency-based health informatics and ehealth curriculum for clinicians.
‘An online health informatics subject for clinical health profession students in Australian universities’ is now available from
This project is a collaboration among The University of Melbourne, University of Tasmania and Western Sydney University with support from the Australian Government Office for Learning & Teaching.

Online medical clinic offers sick certificates for $35

Paul Smith | 7 December, 2015 | 
The man behind a virtual medical clinic offering online sick certificates for $35 saying he's reducing the "pain" patients experience spending hours in a doctor’s waiting room.
The Medic clinic website — which tells customers they can "get a medical certificare in 5 minutes" — has been operating the service for just one week.
Patients go online, fill out a basic medical questionnaire and then have a brief video consultation with a doctor.
Depending on the doctor’s decision, patients are then emailed a PDF sick certificate to give to their employers.

Australian sick note website 'just out to make a quick buck'

The Medical Observer Tuesday 08 December 2015, 10:20AM
A new telehealth website offering medical certificates in five minutes is “just out to make a quick buck”, the Australian Medical Association says.
Dr Brian Morton, chair of the AMA Council of General Practice, says the service (The Medic) raises legal and ethical questions.
“[However] it’s up to employers if they’re prepared to accept certificates from the service,” he says.
“Clearly there’s no examination done, but why on earth does the employer require the certificate in the first place?”

Your private health data could be sold for profit

11:00pm, Dec 8, 2015
John Stapleton
Experts fear private medical records could be given to insurance providers and pharmaceutical companies.
Experts fear private health data could be vulnerable under a new law. Photo: Getty
Whether you have a heart condition, diabetes, a rare blood disorder or are in fine health, this is all information which could be potentially turned to profit.
And now experts fear your private medical records could soon be available to the highest bidder.
A scandal has arisen in the wake of the so-called eHealth Bill, which passed into law this month amidst considerable controversy. The law now creates an opt-out not opt-in strategy for all medical records, meaning the health histories of almost all Australians will soon be online.
3 December, 2015

Anonymous GP data can be cracked: warning

The Privacy Commissioner has sounded a warning shot that companies dealing in “anonymous” prescribing data may nevertheless be revealing doctors’ and patients’ identities.
Posted by Antonio Bradley
Commissioner Timothy Pilgrim has acknowledged that sophisticated technology is now capable of re-identifying anonymous data, by means such as cross-referencing anonymous data with other data sets.
Previously, trading in de-identified data was thought to be relatively safe, as it was not covered by the Privacy Act so could not attract financial penalties.
But the new stance has the potential to disrupt the market for patient and prescription data, with the Commissioner signalling there may be future crackdowns on companies that do not protect against re-identification.
“The face of privacy, personal information, and data protection is changing,” Mr Pilgrim told a privacy conference in Melbourne late last month.

As ageing population grows, so do robotic health aides

Date December 7, 2015

John Markoff

The ranks of older and frail adults are growing rapidly in the developed world, raising alarm about how society is going to help them take care of themselves in their own homes.
Naira Hovakimyan has an idea: drones.
The University of Illinois roboticist recently received a $1.5 million grant from the National Science Foundation to explore designing small autonomous drones to perform simple household chores, like retrieving a bottle of medicine from another room. Dr Hovakimyan acknowledged that the idea might seem off-putting to many, but she believes that drones will not only be safe, but will become an everyday fixture in elder care within a decade or two.
"I'm convinced that within 20 years drones will be today's cellphones," she said.

Telehealth to take centre stage

December 6, 2015
The total global healthcare industry is expected to grow at a rate of nearly 7% over 2015-2016. Latin America has the highest projected growth at 12.7%, and Asia, (excluding Japan), is second with growth projected at 11.5%.
Australia continues to face increased healthcare expenditure. In 2013-2014, total government funded healthcare was nearly 68%. Federal government healthcare expenditure declined from 43.5% in 2008-2009 to 41.2% in 2013-2014. In real terms, out of pocket expenditure increased by 6.2% from 2012-2013 to 2013-2014. Public hospital services accounted for 29.6% of total health expenditure, followed closely by primary healthcare spending.
Australia’s complex funding system with multiple sources of funding, such as, national insurance, private insurance and government and state funds that cover fragments of the care continuum have created redundancies and inefficiencies in the system. In a recent research, the State of Victoria highlighted the need for a complete overhaul of the insurance system.

Data breach notification scheme ‘long overdue’

The government yesterday released an exposure draft of a bill to create a mandatory data breach notification scheme
Creating a mandatory data breach notification scheme is a “long overdue initiative,” according to Internet Australia CEO Laurie Patton.
The government yesterday released an exposure draft of legislation to create such a scheme
The scheme as currently drafted would oblige businesses to report a “serious data breach” to the Australian Information Commissioner and notify individuals whose data is affected by a breach.

Garvan, Telstra and the government in talks over genome project

  • The Australian
  • December 7, 2015 12:00AM

Mitchell Bingemann

The Garvan Institute of Medical Research is holding talks with Telstra, the government and a host of hi-tech research institutions to create an ambitious $400 million project to decode the mysteries of the human genome and potentially unlock new ­medicines to treat cancers and rare diseases.
The project will help researchers better understand the genetic precursors for diseases. Once complete, it will create a new ­genomic medicine service for the health system, offering better ­diagnosis and the potential for more effective treatments.
The project would be closely modelled on the British government’s 100,000 Genomes Project, a four-year £300 million ($617m) scheme between government and medical, research and technology institutions to sequence the human genomes of 25,000 cancer patients, 15,000 people with a rare disease and 35,000 healthy relatives. The British project — run by Genomics England, a state-owned company set up in 2012 — has ambitions to map 10,000 genomes by the end of this year and 100,000 by 2017. A genome is an organism’s complete set of genetic instructions, which in a human runs to about three billion DNA pairs. The Australian understands the Garvan Institute has been holding informal discussions in recent months with public and private institutions, including Telstra and the federal government, to discuss how they can form a syndicate to bring a similar project to Australia.

New Licensing Agreement supports adoption of Clinical Terminology

Created on Tuesday, 08 December 2015
Adoption and use of clinical terminology in Australia has received a major boost with the signing of a licensing agreement between the CSIRO and the National E-Health Transition Authority (NEHTA) to grant users within Australia free access to a comprehensive suite of tools to support browsing, authoring, mapping, maintaining, and querying terminology.
These tools will be invaluable for implementers of clinical terminology to move towards unified clinical coding and improved patient safety.

Specifications Maintenance Schedule now available

Created on Tuesday, 08 December 2015
Software vendors can now plan ahead with NEHTA's specifications maintenance schedule. The schedule is updated on a regular basis.
NEHTA is committed to supporting vendors on upcoming end product releases. The specifications maintenance schedule is another step to providing useful resources.

Why is hacking so easy and security so hard?

Friday 4 December 2015 11:18AM
It's been called a 'cyber Wild West'. Despite all we've learned about online fraud and malicious attacks, networks are still being hacked on an industrial scale. So why is it so hard to stop the bad guys? Stilgherrian explores the wild world of online security, a land of 'bug bounties' and 'pentesters'.
Nathaniel Wakelam is a so-called pentester—a penetration tester. His job is to test the security of organisations' computer networks by breaking into them—with their permission. He's a hacker, but he's on our side, which is good, because he nearly always wins.
'In the entire time that I've been breaking into networks as a job, I've seen three networks out of thousands where I was actually stopped in the process of either breaking in or stealing data,' he says.
'You can find an issue in five minutes, you can find an issue in days or months. It really does depend, from what I've seen, on the amount of time that someone wants to actually spend on a target.'

Latest products, services and ventures

December 6, 2015
The Rust Report has created a new section announcing just-released products, services and initiatives new to the marketplace. For information regarding possible listings please email
Orion Health launches Rhapsody Version 6.2
Orion Health, a leading population health management and healthcare integration company, has announced the release of Rhapsody Integration Engine Version 6.2. The new version of Rhapsody delivers a number of customer focused innovations to help users work smarter. Plus, it builds on the FHIR capabilities introduced in Rhapsody 6.1, the first integration engine to implement the new HL7® Fast Healthcare Interoperability Resources (FHIR®) standard. The Rhapsody dashboard has been enhanced to provide at-a-glance monitoring via multiple channels such as a tablet, smart phone, and monitor. Key health indicators are clearly displayed, showing the health of all Rhapsody environments. The Management Console includes new features to help customers monitor and maintain a healthy Rhapsody deployment. Searching, browsing and navigating for information is now faster and easier. The Java Runtime Environment (JRE) has been upgraded to Java 8 across all Rhapsody components for all supported platforms, achieving an estimated 15% improvement in performance.

Malware is so yesterday – new attack vectors are cheaper

Designing new malware to keep ahead of the increasingly efficient malware scanners is becoming expensive. The new attack vector in 2016 is you – or rather your willingness to click on a web link.
According to Kaspersky Labs 2015 marked the moment when demand for new malicious programs reached saturation point, as the number of new malware files detected every day fell by 15,000, from 325,000 in 2014 to 310,000.
Kaspersky Lab’s experts believe this is mainly due to the fact that coding new malware is expensive and cybercriminals have realized that they can get equally good results using intrusive advertising programs or legitimate digital signatures in their attacks.  This approach appears to be working, as results show that despite the cost-cutting in malware creation, in 2015 the number of users attacked by cybercriminals increased by 5%.


Dr Ian Colclough said...

Dr Walid Jammal describes DORA the Tasmanian ERRCD system for prescription monitoring of drugs of addictions.

Walid Jammal concludes by saying that “Critics have claimed that what has been achieved in Tasmania is too difficult and expensive to roll out nationally”.

What do ‘these critics’ mean?
Who are they?
What are their credentials?
In what way is it too difficult to roll out nationally?
What is the dollar value of “too expensive”?
Where are the costings?
What are these critics really saying?

If the Coroners had more power to drive through change instead of making recommendations for the bureaucrats to thumb their noses at we would have Real Time Prescription Monitoring in place in Australia today.

It is not that difficult and it is not that expensive.

So what underlying reasons can we find that might account for the claims of these ‘critics’?
• Resistance to change?
• Fear of the unknown?
• Bureaucratic inertia?
• Comfortable existence?
• Additional workload?
• Ineptitude?

If the public sector is so incapable of embracing innovative solutions and driving change then perhaps Australia’s Coroners should be more forceful in recommending the private sector be engaged to deliver RTPM, integrated with the eScript Exchanges already serving all doctors and pharmacists throughout Australia.

Let us not forget, that more deaths occur in Australia from prescription drug overdose than from motor vehicle accidents.

Anonymous said...

Maybe critics want some actual detail of a proposed solution not puff pieces?

Is it a separate system or does it integrate with desktop software - both GP desktop and pharmacy desktop? It sounds like a web site.

How is authentication done - are users (GPs, pharmacists) required to have yet another username/password? Who keeps all the permissions etc up to date?

How do the prescription records get into the system - what is technical mechanism by which hospital and GP prescriptions end up in the central server in real time? Again what is the level of integration?

How are patients identified in the system? National identifiers, or name DOB? Can a patient refuse consent to be identified?

Maybe DORA is the greatest thing since sliced bread, but all I've seen so far is non-technical spruiking of it as a "solution".