Monday, April 10, 2017

Weekly Australian Health IT Links – 10th April, 2017.

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

Good to be back. Lots of interesting material to review. I have to say not much has changed since I took the forced break, which I am keen not to repeat!
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My Health Record: the resuscitation of e-health, or a data placebo?

Australia March 28 2017
Ahead of the upcoming Digital Health Show to be held in Melbourne on 29 & 30 March, we thought it would be an opportune time to examine the current state of play in Australia with respect to digital health records management.
In this article we discuss the My Health Record system and provide some observations about the challenges and opportunities facing this important healthcare initiative.
My Health Record: CPR for the PCEHR
Like a phoenix rising from its ashes (or perhaps a resuscitation scene from ER) the Personally Controlled Electronic Health Record (PCEHR) digital health system has been given new life under the new My Health Record platform (MyHR).
Launched in July 2012 as one of the foundations of the National e-Health Strategy, PCEHR failed to make a significant impact on digital health due to poor uptake by both consumers and the medical professions. In November 2013, the Australian Government commissioned a review of PCEHR by a panel of health and IT experts, which was completed in the record time of 6 weeks and released in May 2014 (PCEHR Review). Deloitte was then engaged to run the public consultation process, with their report being released in September 2014 (Deloitte Report).
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Healthcare app ready to zap the fake doctors

  • The Australian
  • 12:00AM April 4, 2017

David Swan

A new piece of homegrown software aims to tackle a recent rash of fake doctors investing in Australian healthcare facilities, with the technology handing health providers the power to track on-the-job skills and nip the issue in the bud.
XapiApps — pronounced “zappy apps” — is an Adelaide outfit whose learning experience software is already deployed in hospitals in Washington DC, Maryland and Nebraska. Chief executive Nick Stephenson believes its process of integrated checks of day-to-day performance can raise a red flag to identify untrained or inexperienced medical staff.
Mr Stephenson said the recent case of the alleged NSW fake doctor Shyam Acharya, who allegedly posed as Dr Sarang Chitale to enter Australia and worked at four NSW hospitals over 11 years, would have been stopped early had the hospitals used the app.
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HealthEngine raises $26.7m to fund market expansion

Australian online health directory and booking service HealthEngine has raised $26.7 million in a Series C funding round, to add to its product portfolio, expand into other markets, make acquisitions and boost staff numbers.
The fund raising was led by Sequoia India and mark’s its first direct investment in an Australian-owned and headquartered tech star-tup.
The funding round also attracted new investors including private equity fund Alium Capaital and several other high net worth investors. And follow-on investments were received from Go caspital, Carsales.com.au founder Greg Roebuck, and the founders of the Lux Group, one of Australia’s largest e-commerce companies.
HealthEngine enables patients to connect online and make appointments directly with quality health practitioners in their area, which the company says ultimately transforms the way in which Australians access and use healthcare services.
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We can gain a lot by sharing our sensitive health data

Sam Crosby
Published: March 29, 2017 - 12:00AM
Years back, I worked with a group of people who had contracted Hepatitis C. The experience of one woman stayed with me. 
Julie looked every inch your average working mum. Hep C was a hangover of a past life she was desperate to escape. 
But when she confided her positive status to a co-worker, word spread throughout her office. 
She found herself shunned by one group of fearful colleagues, and pitied by another.
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31 March 2017

EHR and challenges of the modern medical note

There was a time when documentation was an almost inconsequential process. After seeing a patient, the doctor would scratch a note, close the folder, and file it on a shelf until the next visit.
Things are different and the medical note has evolved. As it’s evolved, electronic health records (EHR) have brought efficiencies to the medical note while introducing new challenges. And like the cognitive biases that impact patient care, the problems inherent in documentation need attention.
Thinking about these challenges becomes important in documenting care and training the next generation of health professionals. Here are a few that I think about.
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CSIRO and Queensland Government signs agreement to extend e-Health research

The $25 million joint venture agreement will enable AEHRC to continue to develop and deliver evidence-based digital health innovations and solutions

04/04/2017
Last week, OpenGov posted a news report on CSIRO Data61’s partnership with the Queensland Government to create Australia’s first Functional Programming Open Lab. Continuing the drive to embrace digital technologies for better outcomes, Queensland Health and the CSIRO have signed a five-year agreement extending the Australian e-Health Research Centre (AEHRC).
Health and Ambulance Services Minister Cameron Dick said the $25 million joint venture agreement would see the AEHRC continue to develop and deliver evidence-based digital innovations in an increasingly digitally enabled health system.
“With increasing digital disruption, Queensland’s Advancing Health 2026 strategy expects that the majority of clinical systems in our health service will be digital by 2026,” Mr. Dick said.
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Opt-out system agreed for My Health Record

Antony Scholefield | 27 March, 2017 |  
Australian health ministers have officially agreed to a national opt-out model under which every patient will have a MyHealth Record created for them by default.
Yet precisely when the model will be rolled out remains to be seen.
Federal, state and territory health ministers met in Melbourne on Friday, where, according to a communique, they agreed "to a national opt-out model for long-term participation arrangements" in the My Health Record system.
The agreement precedes the release of findings from two pilot trials of opt-out enrolment systems, in North Queensland and NSW's Blue Mountains, which included nearly one million patients.
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A GP says this algorithmic referral is just as good as a regular one

3 April 2017
The GP behind a new website that uses computer algorithms to generate new specialist referrals, bypassing doctor oversight, maintains the system is safe.
In fact, argues Qoctor director Dr Airfric Boyland, the virtual clinic's algorithm "would rival a lot of GP referrals".
Qoctor has sparked a stormy response from GPs after it began offering specialist referrals for a select range of conditions, including sleep apnoea and acne, this week.
Patients pay $20 and fill in an online questionnaire before their answers are processed through an algorithm that determines whether they should get the referral.
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Online sick note provider expands into specialist referrals

Rachel Worsley | 29 March, 2017 |  
A “virtual” medical clinic first launched to provide sick notes is now offering patients specialist referrals via online questionnaires, without consultation with a doctor.
Qoctor was first launched as Dr Sicknote in 2015 when it employed GPs to issue sick notes, carer’s certificates and repeat specialist referral letters, based on teleconsults with patients.
But the service, billed as "your quick, online doctor", is now taking its model a step further.
By answering an online questionnaire and nominating their choice of specialist, patients are emailed referrals for a select range of interventions, including vasectomy, female sterilisation, Mirena coils, laser eye surgery and conditions such as acne and obstructive sleep apnoea.
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Telemedicine: think intercontinental collaboration

6 April 2017
When Australian doctors think telemedicine, it’s often in the context of rural patients Skyping in to big-city specialists.
But according to a report in Paediatric Dermatology, the horizons could be much broader.
The case report features telemedicine on an intercontinental scale.
The case involved a one-month-old baby in Botswana, who presented with several, rapidly enlarging nodular lesions within a giant congenital melanocytic naevus affecting 80% of her body.
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Media release

New platform launched to help elderly and families navigate in-home care system

Launch coincides with major changes to Government’s Home Care Packages
Australians struggling to navigate the aged care system can now use CarePilot – a free to use online platform that offers expert advice and user-friendly tools to select and book support services, keep organised, manage funds, and connect with family members.
Created by a team of healthcare professionals, CarePilot is an Australian first that aims to give families, the elderly and those with disabilities more choice and control over in-home care services. The platform (www.carepilot.com.au) provides users with a single touch point to find and manage in-home care, combining online tools with on-demand professional advice.
The launch coincides with the Australian Government’s push to give people more choice and control in how they organise aged care support. Changes to Home Care Packages have now come into effect, giving eligible Australians more flexibility in how they allocate their funds.
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  • Updated Apr 7 2017 at 10:30 AM

Virtual reality finds a new use in conquering depression

by Paul Biegler
Two things surprised me when I faced Shane Warne's devilish googly on centre pitch at a packed MCG.
The first was that I lobbed the chisel-jawed celeb for six. The second was that, when the crowd stood up and roared approval, I turned to them and waved my bat in appreciation.
The virtual crowd that is.
I was, of course, dispatching Warney in an immersive virtual reality (VR) cricket game. But I had never expected it to be so lifelike I'd be hoodwinked into thinking those adoring fans were real.
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3 April 2017

The doctor will see you … never

Posted by Dr Edwin Kruys

The young woman was in tears. When she came in she had initially asked for a referral to a surgeon for a breast augmentation. During the conversation it turned out that her partner had made it clear her breasts were too small.

We ended up having a chat about relationships and body image. At the end of the consultation she decided she needed some time to think things over and talk to good friends, and that she would come back if she needed further assistance.

The problem with online referrals

At first sight, the Qoctor website seems an easy, convenient online medical service that provides sick certificates and referrals.
The site tells visitors: “(…) we understand that a well person who simply needs a letter to see a specialist should be able to get one without requiring a GP consultation.”
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30 March 2017

Can ‘robots’ write referrals and scripts, legally?

Posted by Jeremy Knibbs
The relaunch of Drsicknote as Qoctor has highlighted a potentially huge loophole in Medical Board of Australia regulations for telehealth, which would allow this group, and others, to write scripts and generate new and repeat specialist referral letters without any human oversight.
Qoctor relaunched last week with the promise of specialist referral letters for patients generated by a computer using a questionnaire and algorithms developed by the company’s doctors.
The group also plans to offer the same service for certain categories of prescriptions.
TMR can’t find a precedent for such an offering in Australia, which is effectively the first fully hands-off artificial intelligent healthcare delivery system under the management of GPs.
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Pioneers in e-health for children, up for two awards

Wednesday, 5 April 2017, 10:15 am
Press Release: Make Lemonade
Pioneers in e-health for children, up for two awards
April 5, 2017
It’s hardly big news that a ground-breaking, game-changing virtual digital health business, Navilluso, has reached the finals in two innovative categories of the New Zealand Hi-Tech awards.
Kaitaia’s Navilluso Medical, owned and run by Dr Lance O’Sullivan and his wife Tracy, is digitally trail-blazing the way patients are treated…in the Far North, Gisborne, Christchurch, South Auckland Wellington, Whanganui and Hamilton.
Dr O’Sullivan, the 2014 New Zealander of the Year, says Navilluso’s premier platform is imoko which is a pioneering telemedicine service for children using simple technology.
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New Health app will deliver a connected healthcare experience

03 Apr 2017 By Rowan Wilkie

Telstra’s Health’s Rowan Wilkie talks about a new application that is under development that has the opportunity to be a one stop shop for Australian consumers for their health information, appointments and records.

Just like banking, transport or retail, the health sector is going through a fundamental transformation driven by digital technology.  Given the complexities inherently involved in delivering healthcare and the sensitivity of health data however, some of the changes and benefits technology can bring are not yet as obvious to patients and consumers.
It is clear that technology will play a key role in supporting healthcare organisations to enhance interactions between patients and providers.  Indeed, there is great benefit to be derived from connecting up different parts of the health sector.
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Surgical follow-up? There's an app for that

By Australian Hospital + Healthcare Bulletin Staff
Friday, 24 March, 2017
A mobile app used by patients who underwent ambulatory breast reconstruction required fewer in-person visits during the first 30 days after the operation. Using the app did not affect complication rates or measures of patient-reported satisfaction, according to a study published online by JAMA Surgery.
Looking for cost-effective healthcare delivery models that ensure a high degree of patient satisfaction and convenience is challenging.
John L Semple, MD, of the Women’s College Hospital, University of Toronto, led the trial that randomly assigned 65 women undergoing breast reconstruction to receive follow-up care via a mobile app (49%) or at an in-person visit (51%) during the first 30 days after the operation.
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Labor calls for independent review of govt digital transformation efforts

Husic warns of digital dysfunction and disorganisation within government
Rohan Pearce (Computerworld) 05 April, 2017 13:23
Ed Husic, the shadow minister for the digital economy, has called for a thoroughgoing, independent review of the government’s IT spend and digital transformation programs.
During an address at the Australian Information Industry Association Navigating Digital Government Summit, Husic cited the fraught online Census, Centrelink’s much-criticised data-matching program and the Australian Taxation Office’s high-profile system failures as examples of government IT going off the rails.
An “arms-length”, independent review is needed to establish why “so many government ICT projects and upgrades have gone wrong”, determine whether the government is getting value for money from its expenditure on technology, assess oversight arrangements and map out potential ways to improve the government’s digital transformation program.
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EPAS system savaged by South Australian coroner investigating death of Stephen Herczeg

Posted Sun at 9:04am 2 April, 2017
South Australian coroner Mark Johns has launched a scathing critique of the troubled electronic patient record system, saying its faults may prevent him from establishing the truth.
Mr Johns is currently inquiring into the death of former Socceroo, Stephen Herczeg, at the Queen Elizabeth Hospital (QEH) last September.

What is South Australia's EPAS patient record system?

Mr Herczeg, 72, suffered traumatic internal injuries after an oxygen tube was connected to his catheter.
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HISA NSW: Engaging with My Health Record

More than 60 people attended the recent Newcastle event discussing Towards an Inclusive My Health Record. The event was delivered in collaboration between the Hunter Medical Research Institute (HRMI), University of Newcastle and HISA NSW for the second year running.
The impact of My Health Record on healthcare safety and decision-making was the focus of the evening.
Speakers discussed gaps and areas for growth in public-facing information about My Health Record, and ways that both health and disability organisations can begin to engage with this digital innovation in safe and inclusive ways.
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Former NAB exec to take charge of govt’s Digital Transformation Agency

Government recruits Gavin Slater to take on DTA CEO role
Rohan Pearce (Computerworld) 05 April, 2017 11:54
The federal government has recruited Gavin Slater to take on the role CEO of the Digital Transformation Agency.
Slater comes to the DTA from NAB, where he held senior roles for more than a decade, including as group executive — personal banking before his departure in July last year as part of a restructure at the bank. (That leadership reshuffle also saw the departure of Renee Roberts, NAB group executive — enterprise services and transformation.)
The DTA is the successor to the Digital Transformation Office, with the government announcing the creation of the agency in October. The DTA has a wider remit than the DTO, taking on a range of ICT functions previously overseen by the Department of Finance.
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Is government IT getting worse?

By Paris Cowan on Apr 6, 2017 2:00PM

Opposition says the public isn’t happy.

Labor’s digital transformation spokesman Ed Husic says public confidence in the government’s ability to deliver modern digital services has gone down the gurgler, hit by high-profile tech prangs like with the Census, ATO and Centrelink.
He told the AIIA's digital government summit yesterday that these sagas weren’t just teething pains.
“A whole row of front teeth have been knocked out after the government stumbled and tripped over its botched digital transformation efforts," Husic claimed.
“And the response to this has been some cosmetic surgery."
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  • Updated Apr 4 2017 at 12:15 AM

CSIRO urges PM to expand 'sandbox' exemptions

Australia's high-tech medical industry has contracted 15 per cent, losing almost 13,000 jobs offshore in the past five years, according to a CSIRO blueprint for arresting the decline.
A comparatively high company tax rate is listed as one of the reasons why Australia is losing innovation, skilled scientists and high-tech manufacturing offshore.
The government's chief scientific and research body recommends Australia focus on internet speeds and capacity, cybersecurity and better use of health data such as the government's under-used My Health Record.
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TGA to fast-track codeine program

3 April, 2017 Heather Saxena  
Federal health minister Greg Hunt has asked the TGA to fast-track a codeine education “strategy” as upscheduling looms.
This follows criticism by the federal opposition that there is a lack of public information about the upscheduling of codeine products.
Shadow health spokesperson Catherine King say the government should not to “stuff up the removal of OTC codeine”.
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Guild pulls the plug on real-time monitoring

29 March, 2017  
The Pharmacy Guild has pulled the plug on MedsASSIST, the real-time system that records sales of analgesics containing codeine.
The voluntary system will close down at midnight tomorrow — nearly 10 months early — partly to protect pharmacists from further claims of privacy breaches.
Pharmacists were left exposed to complaints because state and federal governments failed to introduce legislation to make recording of codeine sales compulsory.
“It was always crucial to have every pharmacy across Australia required by law to use a real-time system for the recording of codeine supply,” the Guild says in a statement.
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Shock and disappointment at MedsASSIST demise

Pharmacists across Australia are expressing disappointment at the discontinuation of MedsASSIST, amid fears of stockpiling

The Guild has announced that the decision-making tool will be wound up at 10pm on Thursday, March 30.
MedsASSIST was rendered obsolete by the TGA’s decision to upschedule codeine-containing OTC preparations to prescription only, the Guild says.
GSK has already announced that it will discontinue its OTC codeine, including Panadeine, in the lead-up to the upschedule.
Researcher and pharmacist Penelope Wood, a pharmacotherapy clinical adviser at Western Victoria Primary Health Network in Geelong, says that the end of MedsASSIST is “disappointing… it’s going to put a lot of pressure back on the pharmacist again, because there’s no way to monitor this”.
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Hunt intervenes to hold off MedsASSIST shutdown

Greg Hunt has intervened in support of MedsASSIST, prompting the Guild to hold off its shutdown

MedsASSIST – the real time recording system developed by the Guild to help reduce the misuse of combination analgesic codeine containing medicines – was scheduled to be discontinued nationally from this evening, Thursday 30 March 2017.
Following yesterday’s announcement of the switch-off, Minister Hunt has expressed his strong support for continuing MedsASSIST, particularly in the period between now and 1 February 2018, when the codeine containing medicines will be up-scheduled to prescription-only.
Minister Hunt has made clear to the Guild’s leadership that he is committed to working in partnership with the Guild to keep MedsASSIST open until 1 February 2018.
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How can GPs drive software changes to improve healthcare for Aboriginal and Torres Strait Islanders peoples?

3 April 2017
Background:
Changes to the software used in general practice could improve the collection of the Aboriginal and Torres Strait Islander status of all patients, and boost access to healthcare measures specifically for Aboriginal and Torres Strait Islander peoples provided directly or indirectly by general practitioners.
Objective/s:
Despite longstanding calls for improvements to general practice software to better support Aboriginal and Torres Strait Islander health, little change has been made. The aim of this article is to promote software improvements by identifying desirable software attributes and encouraging GPs to promote their adoption.
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Australian Digital Health Agency report animation

THE CLIENT
The Australian Digital Health Agency has been tasked with improving health outcomes for Australians through the delivery of digital healthcare systems and the national digital health strategy for Australia.
The Agency is responsible for all national digital health services and systems, with a focus on engagement, innovation and clinical quality and safety. Their focus is on putting data and technology safely to work for patients, consumers and the healthcare professionals who look after them.
THE CHALLENGES AND SOLUTIONS
The Australian Digital Health Agency commenced operations in July 2016 and immediately conducted extensive research into the state of Australian digital health.
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Bringing Digital Health to Central Australia — introducing Dr Sam Goodwin

Wednesday, 05 April 2017
Australia's digital health system is currently developing and evolving to best serve the community's needs, and arguably, people living in the most remote areas of the continent stand to benefit the most. Recently, Tim Kelsey, CEO, Prof Meredith Makeham, Chief Medical Advisor and I travelled to the Northern Territory to meet with a number of stakeholders, among them, Dr Sam Goodwin, the Executive Director of Medical and Clinical Services with the Central Australian Health Service. Having lived and worked in the area for 11 years, Dr Goodwin gives first-hand insights into the challenges faced by remote communities and how digital services can make a significant, positive difference.
The Central Australian Health Service covers a two million square kilometre expanse in the Northern Territory and parts of Western Australia, Queensland and South Australia. Between 60,000-80,000 residents come under its jurisdiction, a high percentage identify as indigenous Australians.
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Putting in place the digital foundations for better health and care

Friday, 31 March 2017
Tim Kelsey
Chief Executive Officer
Follow Tim Kelsey on Twitter @tkelsey1
South west of Alice Springs the bush has come to life: creams and shades of blue that aren’t predicted for this time of year flourish because of the unusual rains. We stop at a vantage point that marks the life of the great Aboriginal artist Albert Namatjira who described in his watercolours the pale distended limbs of Valley Ghost gum trees and the rest of this unique outback world. Albert was a resident of Hermannsburg (or Ntaria in Aboriginal designation) and this is where we are heading: a community of 900 mainly indigenous people about an hour and a half from Alice.
I am standing with Taren, 32, in the corridor by the staff room in the health clinic. She is telling me about the bus. This is how it goes: there is a 12 seater bus that drives every day into Alice Springs to take patients to their appointments at the hospital. On an average day, twice that number of local residents need a seat on that bus – and those that are unlucky miss their appointment. Those that do get a seat face the additional complication of potential accommodation in Alice Springs – which is scarce and expensive. Imagine how that feels if you are an expectant mother: on your own in a hostel in Alice Springs awaiting your outpatient appointment with a midwife.
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Enjoy!
David.

3 comments:

Anonymous said...

The authors have forensically argued some powerful points about My Health Record. Weighing up all the evidence one can quite legitimately conclude the MYHR project has no future and should be terminated.


Anonymous said...

It may just be me but I find these stories from the ADHA almost offensive, most certainly playing the identity politics card. Everyone is a victim of circamstances now only with over priced under performing digital databases and apps can we save you poor people.

Disgraceful I find that offensive.

Anonymous said...

Here we go again - http://online.isentialink.com/heraldsun.com.au/2017/04/10/0dbea0ea-c116-4618-89a0-7cab309f6b39.html

Surely they could constrain access to the GP then allow inderviduals to extend the whitelist. Quoting only 147 accounts have implemented additional restriction as a mark of inderviduals being happy to let anyone see their details shows how either indifferent they are are how incompetent they are or both. ADHA is a leaderless thoughtless ....