Quote Of The Year

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

Monday, June 27, 2016

Weekly Australian Health IT Links – 27th June, 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

So much happening just too hard to summarise. Just read down the headlines and have fun reading the ones that interest you.

Labor admits health IT system requires refresh

The Australian Labor Party has admitted the country's health IT system needs an update and has not ruled out involving the private sector, despite accusing the prime minister of doing the same.
By Asha Barbaschow | June 20, 2016 -- 01:31 GMT (11:31 AEST) |
The federal opposition has admitted that the computer systems behind Australian health need to be modernised, with Labor leader Bill Shorten saying this should occur "at some point", not dismissing the idea of private sector engagement.
Opposition health spokeswoman Catherine King said she would not rule out involving the private sector in the inevitable IT improvements, which would need to happen within five years.
"But under no circumstances would you flog it off," she told ABC radio on Monday.

Access To Core Information Critical To e-Health Record Success

16 Jun 2016
Doctors and other health workers need to have access to core clinical information in electronic medical records if the Federal Government’s My Health Record system is to deliver an improvement in patient care, the AMA has said.
Releasing the AMA’s updated Position Statement, Shared Electronic Medical Records 2016, today, AMA President Dr Michael Gannon said that giving patients the ability to block or modify access to critical information such as medications, allergies, discharge summaries, diagnostic test results, blood pressure and advance care plans compromised the clinical usefulness of shared electronic medical records loaded on the My Health Record system.
“Doctors treating a patient need to be confident that they have access to all relevant information,” Dr Gannon said. “Shared electronic medical records have the potential to deliver huge benefits by giving health workers ready access to critical patient information when it is needed, reducing the chances of adverse or unwarranted treatments and improving the coordination of care.

Doctors want patient control over e-health records revoked

AMA demands minimum patient data set that can’t be altered.

By Paris Cowan
Jun 16 2016 3:59PM
The Australian Medical Association has strengthened its calls for the reversal of full patient control over My Health Record data so clinicians can have more confidence in the under-patronised system.
AMA president Dr Michael Gannon said the ability of patients to control what is entered into their personal health record and who can access it is contributing to a lack of faith in the MyHR system amongst doctors, who have been sluggish adopting it as a result.
“If patients are able to control access to core clinical information in their electronic medical record, doctors cannot rely on it,” Gannon said, unveiling the AMA’s revised policy towards electronic health records today.

AMA President Dr Gannon - 2UE - My Health Record - 15 June 2016

Dr Michael Gannon discusses the electronic health record, My Health Record.
According to Dr Gannon, the system is probably not quite fit for purpose at the moment. Dr Gannon has indicated that the Government is currently penalising General Practitioners who do not upload patient health summaries to this system and as a result, are withdrawing practice incentive payments to GPs. A recent AMA survey of medical practices found that just 24 per cent considered themselves able to comply with the requirement, while 39.5 per cent said they were unable to, and 36 per cent were unsure.
Dr Gannon also discussed the current freeze to Medicare rebates and the effect this is having on patients.

Less than a quarter of GP practices ready for e-health changes: survey

 June 15, 2016
The Australian Medical Association has written to Health Minister Sussan Ley and Shadow Health Minister Catherine King urging them to reconsider new rules regarding GP compliance for the new My Health Record System.
They have conducted a survey across 658 practices and found that just 24% of medical practices are ready to comply.
The new rules that came into effect last month penalises practices that fail to upload shared health summaries for at least 0.5 per cent of their standardised whole patient equivalent each quarter.
Practices that can’t upload this quota are ineligible for payment under the newly-branded PIP Digital Health Incentive.

One in three practices set to lose e-health PIP incentives

Jo Hartley | 14 June, 2016 | 
UPDATED Friday 17 June
More than one-third of GP clinics are in danger of losing tens of thousands of dollars a year in payments for failing to meet new E-health Practice Incentives Program rules that came into force last month. 
The AMA issued the warning after a survey found just 24% of practices thought they would be able to upload the required number of shared health summaries to the MyHealth Record system. 
To be eligible for the newly branded PIP Digital Health Incentive, practices must upload summaries for at least 0.5% of their standardised whole patient equivalent every quarter. 

Easier, online access for local health records

June 17, 2016, noon
THOUSANDS of Lithgow residents are now able to access their My Health Record created as part of a national trial.
A My Health Record is an online summary of a person’s important health information such as medications, allergies and medical history that can be shared with healthcare providers.
People can now add personal information, customise their privacy settings and nominate representatives to assist them in managing their information ahead of GPs and other health professionals contributing information from mid-July.
Carers, such as parents or legal guardians, can now also apply to access the records of any people in their care such as children or people without capacity to manage their own My Health Record.

2% of people are opting out of the eHealth trials

21 June, 2016 
About one in every 50 people involved in pilot trials of the My Health Record on Australia's east coast have elected to opt-out.
This is consistent with the experience elsewhere in the world, the health department says.
Some 971,000 people in the two opt-out trial areas in northern Queensland and NSW's Nepean-Blue Mountains region got access to their newly created records last week, a spokeswoman confirmed.
About 1.9% of people in both trial sites have chosen to opt out, she said.

Ownership challenge for My Health record

Bianca Phillips
Monday, 20 June, 2016
THE government’s My Health record system gives the patient full control over who can access and add clinical information about them. This is far from the notion of physician ownership of health records declared in Australian case law.
Breen v Williams was a decision of the High Court about a patient’s right to access their medical records from a clinic. At that time, patients receiving private care did not have rights of access under the federal Privacy Act and the court determined that the professional could therefore refuse production. Historically, the right of access was only available to public patients under the Freedom of Information Act.
Now federal and state legislation affords all patients the rights to access, amend and define some uses of their health records, with some exceptions (see s6D(4)(b)). The physician can refuse access on the grounds that it may pose “a serious threat to the life, health or safety of any individual, or to public health or public safety”. Ordinarily, however, the physicians’ rights of possession and management of the record are not exclusive.

9 medico-legal challenges with telehealth

24 June 2016
MEDICAL indemnifier Avant says it is fielding an increasing number of enquiries and concerns from members about the medico-legal risks of telehealth services.
While the nascent technology allows more timely and cost-effective care, it comes with several challenges, Avant says in a discussion paper.
These include:
1. Patient selection
"Clinically appropriate patient choice remains one of the most important considerations. Ultimately, it remains the responsibility of the doctor to determine when it is appropriate to provide health care by telehealth." 
2. The limitations of non-face-to-face consultation
"The inability to examine the patient when deemed necessary may lead to bias that in turn may lead to errors in diagnosis and treatment. Inappropriate testing and prescribing may be more likely to compensate for the limitations posed by being unable to examine the patient. Further, telehealth services are generally (except in certain circumstances) not reimbursed by Medicare."

Queensland earmarks $119.9 million for health tech

Funding for continued roll out of clinical and administrative support systems and technology equipment replacement
Rohan Pearce (Computerworld) 15 June, 2016 08:00
The Queensland government has earmarked $119.9 million for health ICT in 2016-17.
The funding will go to the “continued state-wide roll out of clinical and administrative support systems and technology equipment replacement,” budget documents state.
“These systems will ensure the right information and technology is available to the right people at the right time in line with emerging technologies and will ensure the sustainability of eHealth service delivery.”

End in sight for Queensland Health's Windows 7 migration

Original budget revised upwards from $11 million to $25.3 million
Rohan Pearce (Computerworld) 22 June, 2016 09:25
Queensland Health says the largest part of a massive migration program that will see its standard operating environment shift from Windows XP to Windows 7 is expected to be completed by mid-July at the latest.
“By project end over 62,000 workstations located across Queensland will have been successfully migrated from Windows XP to Windows 7,” Colin McCririck, chief executive at eHealth Queensland, Department of Health, told Computerworld Australia.
“The core objective of the program — migration of the workstation fleet off Windows XP — will be largely complete by end June/mid-July 2016, with only a relatively small number of devices remaining on Windows XP.

My Health Records fees: The reason you could have to pay more at the doctor

June 14, 2016 10:00pm
Sue Dunlevy National Health Reporter News Corp Australia Network
DOCTORS could have to charge patients a new fee to recover the $60,000 they stand to lose annually if they don’t use the government’s new electronic My Health Records.
The problem is doctors can’t use the records because only one in ten Australians have them after successive governments failed to make the $1 billion program work.
The Turnbull Government is requiring doctors to upload patient health summaries to five My Health Records every three months or they will lose an e-health incentive payment worth up to $60,000.
An Australian Medical Association survey has found just one in four GP practices are able to meet the requirement that came into effect on May 1.

Practices worry they'll lose thousands under eHealth change

14 June 2016
MORE than a third of practices fear they won't be able to satisfy new rules tying digital health incentive payments to the uploading of shared health summaries, a survey suggests.
Many are concerned that they stand to lose tens of thousands of dollars under rules requiring practices to upload shared health summaries for 0.5% of their standardised whole patient equivalent every quarter.
The AMA surveyed 658 practices, of which 24% said they'd be able to comply with the requirement. About 40% said they wouldn't be able to and about 36% said they were unsure.

EPAS hospital system compromising patient care, SA doctors' union says

Posted 15 May 2016, 6:03pm
Patient care is being put at risk by SA Health's new electronic system EPAS, according to a doctor's union, which received a list of complaints from members following a recent rollout.

Key points:

  • Union receives 11 pages of complaints about EPAS
  • American system does not understand some Australian drugs
  • Union head says EPAS must be fixed or abandoned
  • Health Minister confident about EPA rollout at new Royal Adelaide Hospital
In the most serious complaint, a clinician at the Repatriation General Hospital (Repat) in Adelaide cited a rapidly deteriorating patient in an operating theatre urgently needing blood.
Staff rang the lab and were told to put the blood request through the new $422 million EPAS system.

Electronic Enterprise Patient Administration System: Asset or liability?

June 14, 2016 9:30pm
Medical Reporter Brad Crouch The Advertiser
THE controversial electronic Enterprise Patient Administration System replacing public hospital patients’ paper records goes “live” at The Queen Elizabeth Hospital on June 29. EPAS has encountered ongoing delays, a $200 million budget blowout and a conga line of clinical critics — but also is slowly gaining fans.
Instant health access ends the paper chase
DR Jim Holland likes his sport and his job. Now he can browse patients’ records in real time — checking anything from their latest blood pressure to their most recent medication on his smartphone — while watching the footy on his day off.
For the clinical director of the Noarlunga Hospital emergency department, it is a world away from fossicking around for paper records or talking over a patient’s condition with colleagues on the phone. Dr Holland is a fan of EPAS and predicts others eventually will be equally enthusiastic — once they master the system.

Health Minister Jack Snelling tips likely increase in cost of troubled EPAS computer system, which is critical to operation of new RAH

Daniel Wills, State Political Editor, The Advertiser
June 19, 2016 2:17pm
Subscriber exclusive
HEALTH Minister Jack Snelling has forecast a likely increase in the cost of a troubled computer system critical to the operation of the new Royal Adelaide Hospital.
The State Government is currently rolling out the Enterprise Patient Administration System to hospitals across the state, which allows clinicians to electronically access records.
The new RAH has been built without space for old-fashioned paper records.

South Australian govt fights to keep using MS-DOS system

A local government department in South Australia is continuing to use software that runs only on an MS-DOS-based system, even though its licence for the product ran out in March.
The SA health department has been using the Chiron patients record system, which was developed in the 1980s, in several of its rural units.
At that time, the operating system predominantly used on personal computers was MS-DOS, renamed from PC-DOS, and sold by Microsoft.
The department has been the sole user of Chiron since 2008.

Earn $90k for good spin on ‘flawed’ health record system

SA HEALTH is offering more than $90,000 for six months for a spin doctor to convince the media and public its controversial electronic records program EPAS is a good plan.
South Australia Health hopes to hire a spin doctor for a six-month stint to convince the public that its highly criticized Enterprise Patient Administration System is worthwhile. The electronic records system is years behind schedule and over budget by over $200 million. Hospital physicians have formally complained that the system cut clinical activity by 50 percent, and have written a letter listing 37 major flaws and pleading for it to be shut down. SA Health named Allscripts as vendor of choice for the 80-hospital, $225 million project in November 2010 and signed the contract a year later.

New IT system causes chaos at Cairns Hospital

blog There is absolutely no doubt that electronic health records system implementations have an extremely chequered history in Australia. Over the past half-decade and beyond, the nation has witnessed the abject failures of this new type of system in a number of state health systems. And it must be said that the issue is ramping up in severity in the Federal Government, with the Personally Controlled Electronic Health Records system (now MyHealth) soaking up hundreds of millions of dollars but having little to show for it.
Now a new catastrophe has appeared in Far North Queensland. The Cairns Post reports (we recommend you click here for the full article):
“Senior doctors have warned of a budget crisis developing at Cairns Hospital, with health bosses asking them to no longer use pens, and to switch off lights in unused rooms.

Dr Google has a lot to answer for

Four-fifths of women and 69% of men are turning to the Internet for answers to medical questions (Googling symptoms/possible treatments). What is scary is that of those 87% are aged between 18 and 24.
No, this is not an advertisement for your local GP, many of whom can now consult online, but a finding from a global Future Health Index conducted for Philips. Tech is overtaking bedside manner.
A total of 40% of patients aged 18-24 admit to not going to a Health Care Professional (HCP) when they needed to, with the main reasons being limited time, denial they need to visit, and fear of their HCP's reaction or negative results. This highlights the fact that younger Australians aren’t seeking to prevent healthcare issues and delay addressing them when they do appear.

Telstra’s National Cancer Screening Register a big step forward

  • Shane Solomon
  • The Australian
  • 12:00AM June 14, 2016
I welcome the questions Antony Harrowell raised last week about the detail and rationale on Telstra Health delivering the National Cancer Screening Register contract. However, I also want to ­discuss the opportunity that technology can provide to transform healthcare and improve accessibility, quality and efficiency.
The concept of a register was established by the Australian and state and territory governments as a tool to support the National Cervical Screening Program and the expansion of the National Bowel Cancer Screening Program. A contract to implement and operate the register has been awarded to Telstra as a result of a competitive tender process.
The register is a significant step forward in Australia’s fight for cancer prevention as it will facilitate effective delivery of the ­national screening programs and provide a platform for multiple national population screening programs into the future. It is also intended to place participants at the centre of their care by allowing them to share their screening records with health professionals, safely and securely, wherever they reside in Australia.

Telstra unveils its Smart Home hub

Telstra has showcased its smart home solution, revealing 10 smart devices ahead of the launch of its central hub later this year.
By Corinne Reichert | June 22, 2016 -- 02:31 GMT (12:31 AEST) | Topic: Telcos
Telstra has unveiled the Telstra Smart Home hub alongside 10 smart devices for the home, with the product "targeting every Australian" to launch later this year.
The product effectively works as a hub to control Internet of Things (IoT) devices in the home, controlled through an app across smartphones and tablets.
Telstra showcased a smart lightbulb, a window censor, a door censor, wide-beam motion censors, a smart power plug, the Lockwood smart door lock, a smart thermostat, an outdoor Wi-Fi camera, an indoor Wi-Fi camera, and the Smart Home hub itself.

DTO takes over MyGov

PM's pet agency seizes control of infamous portal.

By Paris Cowan
Jun 24 2016 6:45AM
Malcolm Turnbull’s digital transformation office has formally taken the reins of the high-profile MyGov digital services portal.
MyGov is the commonwealth-wide platform that delivers a single interface to Australians wanting to access online government services like tax returns and health records. Until this point the website has been led and controlled by the Department of Human Services.
But the DTO has now taken over the technical operation of the platform, a spokeswoman for the Coalition confirmed to iTnews.
The Department of Human Services will, however, maintain an involvement in the program at an administrative and support level.

Queensland Health CIO quits

Colin McCririck leaves for private sector role
Rohan Pearce (Computerworld) 24 June, 2016 13:46
The Queensland Health chief information officer and CEO of eHealth Queensland, Colin McCririck, has resigned.
The CIO has left his position to take a private sector job overseas. McCririck joined the Department of Health in 2015 as CTO before being appointed CIO and chief executive at eHealth Queensland in December.
He has worked to deliver the state’s eHealth investment strategy, released last year, a Queensland Health statement said.
“He has guided major projects such as the recent eHealth Queensland Expo, interoperability and the integrated electronic medical record program,” said Queensland Health director-general Michael Walsh.

Federal Government puts new record system for student vaccinations out to tender

Steven Scott, The Courier-Mail
June 23, 2016 12:00am
THE Federal Government has put a new record system for students’ vaccinations out to tender in a move that could see it operated by the private sector.
Bill Shorten will leap on the plans today to bolster his scare campaign that the Liberals will privatise Medicare.
The Opposition Leader will call on Malcolm Turnbull to guarantee the School Vaccination Register will not be sold to the private sector and vow to rip up any contract for the register with a private provider if Labor wins.

'Privatisation' of school's vax register on cards, Labor claims

Carmel Sparke | 23 June, 2016 | 
Labor has widened its attack on the Liberal party over Medicare, warning it could deliver the vaccination records of Australia’s high school children into private hands.
Opposition health spokeswoman Catherine King says a tender request for establishing an Australian School Vaccination Register, that closed in January, could see children's immunisation statuses held by a private company.
Such sensitive data should only ever be handled by the government or a not-for-profit organisation, Ms King said in a statement on Thursday.
“Handing this sensitive data over to a for-profit company would be just another example of the Liberals’ approach to health and putting profit over patients,” Ms King said.

Alert: Check medical alarms are NBN compatible

NBNCo has issued a reminder to users of medical alarms to ensure their alarm device is compatible with the National Broadband Network.
The company warns that anyone with an alarm device needs to check with their device or retail provider about their current medical alarm, as existing devices may not be compatible with the NBN and are unlikely to work during a power blackout.
Information on the NBN's Medical Alarm Register helps identify households with medical alarms and where support may be needed to help minimise a break in service.  
NBN Executive General Manager of Migrations, Katarzyna Stapleton, says “it’s important those using a medical device register early and begin the process now to help us identify households which may need assistance during the rollout of the nbn network.

Flu season is here: MedicalDirector says it’s not too late to vaccinate

Nine out of 10 people who were diagnosed last winter with influenza (commonly known as the flu) did not have the influenza vaccine. The message is clear - get vaccinated!
The data was captured by MedicalDirector’s General Practice Research Network (GPRN), a nationally representative cohort of GPs that provide quality de-identified patient-based research and insight into Australia’s health issues. According to the data, around 140,000 Australians presented to their local GP with influenza in both 2015 and 2014; significantly worse flu seasons than 2013 which saw 95,000 flu visits. 
The past two flu seasons have been particularly tough. As we head into the winter months, the best way to avoid the flu virus is to get a vaccination from your GP,” advises MedicalDirector chief medical officer, Dr Andrew Magennis.
RESAPP HEALTH (ASX: RAP) is developing healthcare solutions to assist doctors and empower patients to diagnose and manage respiratory disease without the need for additional hardware.  ResApp has been granted an exclusive license from the University of Queensland for technology that uses sound to diagnose respiratory diseases including pneumonia, bronchitis, chronic obstructive pulmonary disease and asthma.  ResApp was formed to commercialise this technology by developing the world’s first clinical–tested regulatory-approved respiratory diagnostic application for smartphones. http://www.resapphealth.com.au/

Online doc reviews may have privacy implications

Jun 13, 2016 12:02pm
Patient feedback and reviews have become a big part of the business of healthcare, but even the most glowing reviews can raise privacy issues if they inadvertently give away identifiable information, according to MedPageToday.
Recently, University of California’s San Diego Medical Center solicited reviews of its 500 physicians with a survey of outpatients, intending to make the results public. However, hospital leaders were forced to halt the initiative two weeks ago when they realized they didn't inform the patients that their reviews would be published, sparking concerns the patients could have included details that could be used to identify them.

Why users should be nagged about security updates

No matter what operating system one uses, security professionals are generally agreed on one thing: when it comes to online security, the user is the weakest link.
This may well be the reason why many help-desk support people have coined a term to explain the most stupid of user acts: luser error.
The fact that users of digital devices are their own worst enemies when it comes to security is what drives companies that supply the code that runs these devices to act in an anal-retentive fashion when it comes to security updates.
And in the light of that, Apple's behaviour, of nagging its users to patch when patches are available, is understandable. There are several reasons why Apple and every other major or minor vendor is taking the right approach, even though users (lusers?) may think otherwise.


Anonymous said...

I'm amazed at claims a Liberal government will "privatise" Medicare. What is your definition of "private" considering most GP's, specialists, pharmacies, drug companies and allied health professionals are non-government employees ie. private. They receive money from the Federal government via Medicare claims but the services and products are already privatised. *slap the forehead* Duh. Hospitals and other state run services are not privatised but the complicated arrangements hide the fact that Medicare has outsourced running Public Hospitals to the States & Territories. The Labor party’s simplistic view is a result of either being uninformed, deliberately deceitful or unintelligent to work it out for themselves.

Going slightly off-topic: the real facts of economics and reality cannot be explained with election slogans and headlines of any person/party/group. However, they should start by learning: how to win playing Monopoly; “supply & demand economics”; the effects of incentives & disincentives; business process optimisation.
~~~~ Tim

Bernard Robertson-Dunn said...

The push is to outsource, not privatise.

It's the economists in treasury who are most likely behind the privatisation push, just as they were in the days of whole of government outsourcing. Because the whole of government initiative failed miserably they are using the term privatisation. Unfortunately that term is even more odious with the population than outsourcing.

Medicare (previously the Health Insurance Commission) is a payment engine. The econorat's argument is that if you can package it as a well defined service it is easy to outsource/privatise. There-in lies the problem.

Just like Information Systems, it's not as simple as defining it as a service - health data is much too sensitive and it is hard to convince the public that it's just a payment service. It's as much about perception as reality.

The politicians and many public servants don't understand all this, just as they don't understand the complexities of health information. Simplistic solutions are easy to sell to the ignorant.

Just my opinion, although, for my sins, I have worked in Medicare/HIC, Medibank, DHS, Centrelink and DoH.