Monday, April 11, 2016

Weekly Australian Health IT Links – 11th April, 2016.

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

The biggest news this week was the draft Digital Health Strategy being disclosed for review. Thus far the comments are not all that positive and suggest there is still a good deal of work to do.
Otherwise all sorts of other stuff is happening - browse and click away!

Health lifts game for chronically ill

The Department of Health is to improve digital heath records and data around health outcomes as part of a new commitment to Australians living with complex chronic illness.
In what the Prime Minister, Malcolm Turnbull termed the biggest health system reforms since the introduction of Medicare 30 years ago, eligible patients will receive coordinated healthcare packages tailored to their personal needs.
The Department said that in addition, Medicare would introduce a more modern payment system for doctors and service providers to allow them greater flexibility in the delivery of a broad range of healthcare services.
It said digital health measures including the new My Health Record, telehealth services, remote health monitoring and medication management technologies would be aimed at improving patients’ access to services and increasing the efficiency of the health system.
April 4, 2016

Will Health Care Home fail on the back of MyHealthRecord’s fail?

Posted by Jeremy Knibbs
MyHealthRecord appears to be key to engaging with the ‘revolutionary’ Health Care Home Medicare reform, despite being plagued with problems and low GP uptake.
“One is tied to the other,” according to Dr Steve Hambleton, chair of the advisory group that helped shape the pilot and current NEHTA chair.
“I would think that a high-performing Health Care Home would want to opt in,” Dr Hambleton said. “And if you don’t want to be a Health Care Home then you won’t have access to the new funding model.”

My health records project remains sick

The former Labor government introduced a personal electronic health record which despite enormous cost - "more than a billion dollars in cumulative funding" ("Health Band-aid", April 2) - is deemed to be flawed and has signed up a small fraction of the population. Now the Turnbull government is going to tip more money into the renamed My Health Record and make it apply to all citizens with the addition of an "opt-out" mechanism.
Meanwhile, frustrated private health providers are developing their own in-house app-based approaches to records. This is fine but what it means is that instead of thousands of paper-based record silos around the country we will end up with thousands of electronic silos with no interoperability. The government's controlling  "top-down" approach does not work and has failed to engage meaningfully with stakeholders including clinicians.
  • Apr 5 2016 at 6:00 PM
  • Updated Apr 5 2016 at 6:00 PM

Health and education sectors the next to feel online disruption

by David Binning
Growing digital platforms, faster networks and smarter portable devices are driving massive changes in the way people work.
In today's globalised marketplaces, organisations are able to connect with and recruit workers from anywhere in the world. Likewise, workers are able to work for whomever they choose and from anywhere.
While the concept is relatively new, it's fast gaining acceptance as shown by the rapid success of online workplaces such as Australia's and US-based rival

Real-time system needed, but not ‘silver bullet’

A Victorian coroner has called for a real-time prescription monitoring system to reduce pharmaceutical drug related harms and deaths following the death of a 47-year-old man who doctor shopped extensively to obtain a range of medicines including large amounts of diazepam.

Pharmacy Guild Victorian Branch president Anthony Tassone says such a system is needed, but it would be only part of a broader health solution.
Frank Frood, who suffered from severe asthma, died from bronchopneumonia on a background of methadone and benzodiazepine use.
The coroner noted that the PBS summary of PBS benefits paid for medicines dispensed to Frood in the two years before his death ran to 26 pages; he was going to great lengths to “prescription shop” to obtain diazepam.

Reimburse online medicine and relieve logjams, says e-health boss

  • The Australian
  • April 8, 2016 12:00AM

Sarah-Jane Tasker

The founder of Australian digital health start-up CliniCloud has called on the Turnbull government to introduce a reimbursement for online services, arguing it is the way forward in healthcare in an ageing population.
Chief executive Andrew Lin said support for telemedicine played into Prime Minister Malcolm Turnbull’s innovation agenda and the recent launch of the Healthier Medicare package that was aimed at supporting ­patients with multiple chronic conditions.
Mr Lin said Australia had been slow to embrace consumer-facing digital health systems because of a lack of government incentives.

The Department of Health does not seem to know a lot about online security.

Not super keen on the government storing all of your personal information in its e-health system? No problemo, 
just provide the government with all of your personal informationon an unencrypted website.
Or at least that was the plan, until those meddling kids on Twitter shamed the government into encrypting 
the sitebadly at first, and then finally up to proper standard.
Late last year, Health Minister Sussan Ley announced an overhaul of the e-health record system. Patients 
would be automatically signed up to the record system unless they specifically requested not to be included. 
At the start of this year, the Department of Health with the Department of Human Services began its trial 
in north Queensland and western Sydney for about 1 million patients, which would cost about $41 million.
  • Apr 7 2016 at 11:45 PM

'Try before you buy' plan for doctors and hospitals

Consumers should be able to compare and review doctors, their performance and the price of procedures in the same way customers use online comparisons to buy banking and telecommunications products, according to a new blueprint for a consumer-led health industry.
As the federal government struggles to encourage GPs to join its e-health system in which patients' own health records are recorded online, a new report argues it is hospitals and health providers that need to open their books to patients so they can make informed decisions on medical procedures and choice of specialist.
The George Institute for Global Health, one of the world's largest health and medical research institutes, and the Consumer Health Forum of Australia, will release on Friday an eight-recommendation report that calls for the health industry to undertake the same sort of digital transformation seen in finance, telecommunications and e-commerce.

MedsASSIST now rolling out

The Pharmacy Guild is now rolling out MedsASSIST, the codeine real-time monitoring system that it says will help pharmacists monitor consumer use of codeine containing products to ensure safe and effective use.

“Since the MedsASSIST pilot commenced in February in approximately 140 pharmacies in Newcastle, NSW and North Queensland regions, we have collected data on more than 50,000 transactions,” the Guild says.
“The system is demonstrating its effectiveness in identifying patients who may be at risk of developing codeine dependency. It is also demonstrating that the overwhelming majority of consumers are using these products safely.

e-Health standards – beyond the message mentality

Posted on by wolandscat
I just spent a few days in Crete at an experts workshop of the European e-Standards project that aims to bridge well-known gaps in e-health standards and SDOs. I’ll comment on that effort in another post, for now I will just say thanks to Catherine Chronaki for the invitation, wonderful choice of venue and excellent workshop.
As is usual in these situations, being present in a beautiful place (Thalori village, southern Crete) with many interesting people (some old friends, others new acquaintances) and especially that vital ingredient: a world-class traditional band of musicians who played the paint off the walls of the Taverna until 3:30 am Saturday morning led to some new thoughts on standards (as well as a vastly improved appreciation of Cretan music).
In the e-health domain, the orthodox view in many standards organisations, is that ‘we can only standardise what is on the wire, because we have no control over what is in systems’. I would call this the ‘message mentality’, even if the physical communications have graduated over time from literal messages.

Qld govt ordered to pay legal costs in IBM payroll stoush

Final failure in state’s bid for compensation.

By Paris Cowan
Apr 4 2016 2:27PM
The Queensland government has suffered another defeat in its legal fight with IBM, today being ordered to pay the IT giant's costs following its failed bid to sue the company for its role in the notorious Health payroll project.
State supreme court judge Glenn Martin today ordered the government to pay all of IBM’s costs incurred as part of Big Blue's appeal against the action, which commenced in February 2015.
He agreed with IBM that a legal waiver signed back in 2010 gave IBM the right to demand costs on an “indemnity basis” - or over and above the default “standard basis” that usually sees successful parties in a lawsuit claw back less than 100 percent for what they have spent defending a case.

Now Qld Govt has to pay IBM’s costs in failed litigation

blog Things are not going well for the Queensland Government in its lawsuit against IBM over the incredibly botched payroll systems upgrade project at Queensland Health.
First the judge in the case threw the case out of court in December last year, pointing out that the Government had signed a waiver of liability over the issue (a fact that even sites like Delimiter have been pointing out to the Queensland Government repeatedly), and now that same court will force the Queensland Government to pay Big Blue’s court costs on the issue. The Australian newspaper tells us (we recommend you click here for the full article):
“… the government argued IBM had misrepresented its credentials for delivering the system … But the claim was unsuccessful and Justice Glenn Martin on Monday ordered the State of Queensland pay IBM costs incurred by the proceedings on an indemnity basis.”

Qld Health, IBM payroll court battle officially over

State to foot the bill for entire proceeding.

By Paris Cowan
Apr 7 2016 12:53PM
The Queensland government will face a mammoth legal bill for the full 2.5 year duration of a lawsuit it commenced against IT giant IBM in the state’s Supreme Court, following the official end of the case.
Today the state was ordered to pay the second round of costs in its failed attempt to sue its one-time IT partner over the $1.2 billion collapsed Queensland Health payroll replacement.
Supreme Court Justice Glenn Martin this morning formally dismissed Queensland’s original 2013 claim against IBM after the parties agreed to end the proceedings, officially shutting down the case.

Data breaches: The first 24 hours are critical

The average cost of a significant Australian data breach is $2.82M – finding and remediating the breach quickly is the best start.
According to Rick Ferguson, country manager, Australia and New Zealand, Absolute, a persistent endpoint security and data risk management solutions provider, there is a direct correlation between how quickly an organisation identifies and contains a data breach and the resulting financial consequences.
With a global survey by the Ponemon Institute and IBM finding that the average cost of an Australian data breach is AUD$2.82m, it is imperative that companies be prepared in order to limit the damage from such an event.

Driver health checks go digital in NSW

Taking paper out of the equation.

By Paris Cowan
Apr 5 2016 12:00PM
The NSW government will remove an inefficient, paper-based process used by truck drivers, the elderly and people with medical conditions to annually renew their driver’s licence with an integrated, electronic model.
Currently, heavy vehicle licence holders, drivers aged 75 and over, and people who suffer from illnesses that could affect them behind the wheel like epilepsy, sleeping disorders and diabetes have to visit a doctor once a year to certify that they are physically able to continue driving safely.
Motorists must then transmit the doctor’s certificate by mail or in person to their local motor registry to have their licence renewed.

NSW Takes Another Step Towards Digital Driver's Licenses

Hayley Williams Today 2:00 PM
Following the government initiative to digitise drivers licenses (and other licenses) by the end of 2018, the process of driver health checks are due to go digital from the middle of the year.
The unnecessarily time-consuming, paper-based process is currently required by truck drivers, drivers over 75 and people with illnesses that have the potential to affect them while driving, such as epilepsy, sleeping disorders and diabetes. People who meet these categories are required to visit a doctor once a year in order to confirm that they are medically fit to keep driving safely.
Under the current system, affected parties have to deliver a doctor’s certificate either in person or by mail to have their licence renewed, a process that is soon to be replaced with an electronic system.
This process is being simplified into an electronic system that can be integrated into a GP’s practice software, allowing them to submit a form directly to the RMS licence review unit. The electronic form has been developed in partnership with e-health firm HealthLink, with an investment of $1.2 million from RMS. “This digital service developed by HealthLink means the 400,000 people who go through this process each year can now cross the visit into a registry or service centre off their to-do-list,” said Transport Minister Duncan Gay.

Most Australian GP clinics aren't using e-health records

Battle still to be fought on adoption front.

By Paris Cowan
Apr 6 2016 10:06AM
Only 300 Australian GP clinics are using the federal government’s electronic health records system on a weekly basis, the Department of Health has revealed, highlighting the uphill battle Canberra faces getting doctors on board with its e-health drive.
In a response to questions on notice from the senate community affairs committee, the department shared the disappointing average, recorded between 22 October 2015 and 11 February 2016.
Australia is home to approximately 28,000 GP medical businesses, according to 2010 figures from the Bureau of Statistics.
The new Australian Digital Health Agency (ADHA) is still without a chief executive and board just 3 months out from its official starting date of 1 July, according to a report in Pulse+IT. Labor has demanded that the government consult with it on senior economic positions but this is not thought to include the establishment of the ADHA, which will take over responsibility for the My Health Record and the role of the National E-Health Transition Authority, which will be dissolved. In other news from Pulse+IT, Australia's leading general practice software vendor MedicalDirector has been sold by owner Primary Health Care to a private equity firm for $155 million. MedicalDirector has reported healthy revenues of over $30 million annually for the past couple of years. In Primary Health Care's most recent financial results, it reported revenues of $21 million for the first half of the 2016 financial year, up by 12.3 per cent on the previous period, for earnings before tax of $6.8 million. The sale is expected to complete before the end of the financial year.

All the bottom-line action

April 4, 2016
Tenable Network Security has announced that Healthdirect Australia, a public health care company providing a range of free services on behalf of the Australian national government, selected SecurityCenter Continuous View to improve security visibility and ensure compliance across its 100 percent Amazon Web Services (AWS) cloud environment. When the Australian Signals Directorate (ASD) passed a government mandate in 2012 requiring all federal services to comply with stringent security standards in the Australian Government Information Security Manual (ISM), the Healthdirect IT security team had to rethink its security approach. “As a business that conducts a majority of our work with the federal government, we knew that our bottom line would be directly impacted if we weren’t able to meet the demanding compliance requirements put in place by the ASD,” said Bruce Haefele, chief architect, Healthdirect Australia.

Apps make gadgets less disruptive to sleep

  • Daniela Hernandez
  • The Wall Street Journal
  • April 5, 2016 2:00PM
As more people head to bed with smartphones and tablets, there’s increasing focus on the so-called “blue light” the devices emit.
Some research shows the light may disrupt the body’s biological rhythms, including a 2012 study that found reading an iPad for two hours caused a decrease in the hormone melatonin, which makes people feel sleepy.
Another study showed that reading on an iPad before bedtime could make it harder to fall asleep.
In recent years, consumer-tech companies have been developing free apps meant to minimise the amount of blue light consumers are exposed to while using their smartphones, tablets and laptops.

Queensland Metro-North selects Orion Health

Medical referrals are still largely handled manually – go to a GP, get a referral to a specialist, post/fax the referral to make an appointment or bring it with you. It is not efficient.
New Zealand based Orion Health has developed a global healthcare platform that advances population health and precision medicine solutions for personalised care across the entire health community.
Brisbane based Metro North Hospital and Health Service serves over 900,000 people, and employs more than 16,000 staff in five hospitals and eight community health centres, along with oral and mental health facilities. It has selected Orion’s Referrals Management platform to enable healthcare professionals to submit, track and manage patient referrals as the individual moves from home to hospital to community care.

Fujitsu wins $15m Tassie emergency dispatch deal

Work begins to replace 25-year-old CAD.

By Paris Cowan
Apr 7 2016 10:14AM
The Tasmanian government has chosen Fujitsu to complete the $15 million replacement of its 25-year-old emergency services dispatch system.
The government funded the project in last year’s state budget, addressing findings of the 2013 Tasmanian bushfire inquiry that the current systems used by Tasmania's police, fire fighters, and ambulance services are not up to the job.
Fujitsu will install a single integrated instance of the Capita Vision computer-aided dispatch (CAD) solution in place of the separate legacy solutions currently in use. The new CAD will also be used by the state emergency service, which currently relies on a manual pager-based process to assign volunteers to tasks.

An app to help sift through medical literature

7 April 2016
WITH so many journals available it is impossible to sift through all that is floating around in the medical literature. Docphin is a free app which aims to collate and sort journal articles of relevance to the user.
After downloading the app, registration allows for tailoring available content. Those lucky enough to be affiliated with an institution can enter those details and have access through the app to the journals available to the institution.
To search, there are a number of options. Medstream provides a list of Docphin picks as well as new articles appearing in recently browsed journals.

US Healthcare’s alarming lack of mobile security

More than 27 million Android devices with medical apps installed also potentially have at least one high-risk malware — yet 65% of doctors share patient data via SMS text message and 33% via Whatsapp.
According to the US Department of Health and Human Services, more than 260 major healthcare breaches occurred in 2015. Of those breaches, 9% involved a mobile device other than a laptop. The risk to patient and personal data in the healthcare industry only grows as more doctors and healthcare employees use mobile devices in their work.
Skycure,  a leader in mobile threat defense, has announced the results of its second healthcare focused Mobile Threat Intelligence report. It found that the number of doctors who use mobile devices to assist their day-to-day practice were exposed to network threats that significantly increase over time. In a single month, 22% of mobile devices are at risk of a network attack and reaches 39% after four months.
4 April, 2016

Is Telstra Health a lame duck? Connect the dots

Posted by Jeremy Knibbs
Telstra Health has invested in 20 companies in two years and has been much feted as the company guiding our e-health future. It looks like it just ran aground on the isle of ‘strategic review’.
Last  week’s sale of Medical Director to a private equity group may have marked the beginning of the end of Telstra’s sometimes puzzling foray into e-health. According to industry insiders, Telstra Health had been in negotiations to buy 50% of Medical Director for $50 million and start a joint venture with Primary Health Care Ltd. 
Such a move would have benefited both Primary, which didn’t have the capital, know-how or assets to transform the business, and Telstra Health, whose assets to date are disparate and in dire need of something that might connect them into some semblance of a strategy.

Why MedsASSIST is the answer for codeine

4 April, 2016 Sanofi Consumer 
Promoted Content
Pharmacists nationally will be monitoring codeine use as part of the real-time monitoring system MedsASSIST with the full roll out of the program expected to be Australia-wide this month. 
Developed by a consortium of organisations including the Pharmacy Guild and Pharmaceutical Society of Australia, MedsASSIST allows pharmacists to record codeine purchases and identify patients at risk of misuse.
The program was initiated after the proposal to reschedule codeine prompted intense debate, dividing doctors and pharmacists. According to a spokesperson for the Pharmacy Guild, MedsASSIST is the Guild’s long-term solution to address codeine misuse and will inform any further submission to the TGA, which is expected to make its scheduling decision by June.


Anonymous said...

Dr Hambleton said “I would think that a high-performing Health Care Home would want to opt in,” “And if you don’t want to be a Health Care Home then you won’t have access to the new funding model.”

That's plain enough. If doctors don't opt in to My Health Record they will miss out on the new incentive payments. It matters not whether the system works or is useful or is hard to use. All that matters is that the doctor has opted in which might make a High-Performing Health Care Home a low performing one.

Bernard Robertson-Dunn said...

While Dr Hambleton said creating the records was “dead easy” and took less than 90 seconds per patient, February saw fewer than 400 GPs updating a shared health summary with the program.

Of all people I would have assumed Dr Hambleton would know something about My Health Record, but to claim that creating a health record takes only 90 seconds is absurd.

A health summary document, which is the only bit of the system that could be of use and then only to some people, is going to take a lot longer than 90 seconds - if done properly and safely.

It looks as though he's drunk the kool-aid - which is a silly thing for a doctor to have done.

Bernard Robertson-Dunn said...

This Health Care Home thingie.

I would have thought that the people in a Health Care Home would be one of the least likely group to need a My Health Record. They probably won't be traveling, some might need to see a new specialist, probably not many.

The chronically sick will have someone taking the lead in their health care - that person will have their own eHR which will contain far more data than the My Health Record.

Am I missing something?

Dr Ian Colclough said...

No Bernard, you are correct.

By comparison with the Government's My Health Record the chronically ill will have a My Personal Health Record which they will own and control and which will be fed and updated by their health service providers; quite differently from the way the Government has and is approaching the problem..

Without expanding too far My Personal Health Record will be developed and supported by an alliance or consortium of expert health software vendors within a techno-friendly environment in which each vendor owns some of the equity. The business model is novel.

Anonymous said...

Is Telstra Health a lame duck? Posted by Jeremy Knibbs. Connect the dots.
Who conceived Victoria's HealthSmart?
Who conceived Telstra Health ?Smart.

Bernard Robertson-Dunn said...

Thanks Ian.

It doesn't take a lot of high powered Health Information Management/Informatics expertise to realise that a patient has two sorts of health data:

1. Detailed health care data used by one or more health professionals in making health care decisions. It probably comes from a variety of sources (tests, X Rays, specialists etc).

2. A health summary that contains an up-to-date snapshot of a patient's health status with whatever extracts from their history that is currently relevant. It will have been created after significant thought, analysis and care. Not in the Hambleton 90 seconds. It would be a major investment in a patient's health care journey. It would need updating as the patient ages, even if they are not ill.

The My Health Record isn't of either type and is unlikely to ever be. It may or may not have a health summary. If it does it may or may not be up-to-date. It will probably have a lot of low level data which is meaningless without context and patient care narrative. There's no owner - the patient doesn't own the data the various and multiple authors own the data.

Why would a Nominated Representative take the time and effort to duplicate what's in the system they have full and controlled access to? The patient can decide to delete or hide data in the MyHR. Access control is actually woeful. The government can get at all of what's in the MyHR to the detriment of both patient and health care professional. And it's attached to the Internet.

If a health care professional doesn't have an eHR, why would they upload all that printed stuff to the MyHR when they can walk over to the physical files and look it up - when needed?

This is problem analysis 101.

Anonymous said...

April 12, 2016 11:24 AM "Without expanding too far My Personal Health Record will be developed and supported by an alliance or consortium of expert health software vendors ..."

As a software developer my company would be very interested in participating in such a development. Over many years we have spent far too much time and valuable resources engaged with NEHTA and the government's PCEHR only to find that every time we think some progress has been made nothing gets delivered that is of any use.