Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Monday, May 29, 2017

Weekly Australian Health IT Links – 29th May, 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

All in all a really busy week with all sorts of news, private sector activity and a few technical issues in Qld Hospitals.
Enjoy the browse.
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22 May 2017

Restoring hope and humanity to healthcare

Posted by Dr Eric Levi
Where we are today in health care is the product of our contemporary society. The drive to modernisation and industrialisation is palpable. Clinicians after clinicians have detailed the despondency, despair and desperation they feel when their clinical work is suffocated by bureaucratic burdens from Health Administrators. Read the comments from Episode 1: The Dark Side of Doctoring. This is not only for doctors and not limited to Australia alone.
It does not have to be this way. You did not go into years of training and sacrifice just to be strangulated by non-clinical tasks, programs, guidelines & protocols. We have sadly seen many colleagues who succumbed to the pressure by becoming hardened, calloused, depressed, angry, anxious, irritable, rude, disrespectful, short-fused, disillusioned and even suicidal. It does not have to be this way. For the sake of our patients and future generation of doctors, nurses and health care workers, we can shift the focus back on to the patient.
There is an elephant in the room. The elephant in my operating theatre is different to the elephant in your ward or the clinic. For some, it is a clunky Electronic Health Record software. If you have to keep on correcting and teaching a whole hospital full of well-educated doctors and nurses how to use the computer, then there’s something not user friendly with the computer. For another, it is the multi-layered paperwork process that hold back good treatments for patients. For yet another it is the unspeakable culture of bullying and harassment. It is not a single problem with an easy solution.
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Productivity Commission report signals a radical shift in health data treatment

May 22 2017
The Productivity Commission (Commission) has released its long awaited final report into Data Availability Use (Report). As we recently reported, the Commission’s Report contains a number of sweeping recommendations geared towards shifting attitudes and changing complex legal frameworks in order to promote the easier sharing of data held by both the private and public sectors.
In line with its draft report, the Commission used the health sector as an example to illustrate the structural barriers and distrust about data use and sharing currently prevalent within certain industry sectors, all of which prevent the easy sharing of data for both individual and national benefits. The Commission noted:
The implications of this situation are significant. At the individual level, patients are required in many cases to act as information conduits between the various health care providers they see. Inadequate information can lead to errors in treating patients… At the system level, inefficient collection and sharing leads to data gaps and unnecessary expenditure…
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Turnbull to spend $131m linking up govt datasets

By Allie Coyne on May 25, 2017 9:53AM

Creates Data Integration Partnership for Australia (DIPA).

The federal government has allocated $131 million to a new program that aims to link up disparate datasets on government programs to analyse the long-term effectiveness of its policy delivery.
It will establish the Data Integration Partnership for Australia (DIPA) within the Department of Prime Minister and Cabinet, paid for out of the public sector modernisation fund contained in this year's federal budget.
The DIPA will connect all the separate datasets from across the public service in an effort to better examine how well government programs are delivering on their aims.
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Five Queensland hospitals affected after cyber attack

Published: May 25 2017 - 11:33AM
Five of Queensland biggest hospitals are suffering from major IT problems after efforts to prevent a possible cyber attack backfired.
Health Minister Cameron Dick has told state parliament authorities installed a number of security patches in response to the global ransomware attack that has affected hundreds of thousands of computers worldwide.
But those patches are now causing system slowness.
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Queensland Health’s electronic medical records system hit by “very serious ransomware attack”

Janelle Miles, Kara Vickery, The Courier-Mail
May 25, 2017 11:53am
MOVES to protect Queensland Health computer systems from an international cybersecurity attack are believed responsible for a failure within the state’s electronic medical records system in five key public hospitals.
The eHealth failure, described in an internal email obtained by The Courier-Mail as a “major incident”, resulted in Cairns Hospital yesterday declaring a Code Yellow, for an “internal emergency”.
Health Minister Cameron Dick told State Parliament today patient safety had not been compromised but log-on issues “may result in some delays to patient admission or discharge”.
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Human Services casts doubt on Watson

By Ry Crozier on May 23, 2017 6:50AM

Redoubles efforts to bring AI into operations.

The Department of Human Services will soon begin a fresh drive to embed artificial intelligence deeper within its operations, but a production deployment of IBM’s Watson technology is now uncertain.
The department recently revealed it is piecing together an executive level two (EL2) team within its CIO group to lead a software-based infrastructure transformation.
The team is being given a wide remit, championing everything from platform-as-a-service (PaaS) and infrastructure-as-a-service (IaaS) adoption to automation and orchestration, and the potential of big data.
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Practice software should better reflect the importance of preventive interventions

23 May 2017

IMPROVING PRACTICE SOFTWARE

We need to better reflect the importance of preventive interventions, writes Dr Oliver Frank.

The Issue

Despite making an average of six visits to general practice annually, Australians receive only about half of the preventive and other care indicated for them.
Patients mostly don’t know what care is indicated, when each element of care was last performed, the findings or results, or when it is due to be performed next.
They want and expect their GPs and practice nurses to tell them.
Most clinical software packages have no facility to give patients a summary or list of the preventive and other care that is indicated and due.
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Can the private sector save the My Health Record?

25 May 2017

FEATURE

The private sector is stepping in to make the My Health Record more meaningful, writes Neil Bramwell.
Tom Skotnicki was already on the liver transplant list at a Melbourne hospital when complications in his complex chronic conditions necessitated an emergency admission to another hospital.
As an external communications consultant for the E-Health Transition Authority, this was a man conversant with how his medical data was being stored and used.
The emergency admission was the perfect opportunity to put the utility of a shared medical record to the test.
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Music streaming services an affordable tool for healthcare workers

  • The Economist
  • The Australian
  • 12:00AM May 25, 2017
In one scene of Alive Inside, a documentary film, a member of a nursing home’s staff offers headphones to a wheelchair-bound man named Henry. He is unresponsive and hunched over but, as Cab Calloway plays, he sits up, opens his eyes wide and begins singing and moving his arms and hands. The music triggers memories for Henry; family members say he always has been a huge fan of jazz and blues. A shorter version of the film is available on YouTube, and it has been viewed more than two million times to date.
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Australia’s largest digital health marketplace, HealthEngine, integrates My Health Record

Perth, 25 May 2017: HealthEngine, Australia’s latest online healthcare marketplace, has today partnered with the Australian Digital Health Agency by integrating the My Health Record platform, enabling its millions of users to book appointments and access their medical history in one place.
Through the HealthEngine platform, the My Health Record system will enable patients to  view and share their medical history with multiple doctors, hospitals, and other healthcare providers instantaneously.
With 58.4% of appointments booked and attended in less than twenty four hours, patients cannot always access their preferred healthcare professional when needed. This integration effectively enables practitioners to attain a holistic view of a first-time patient’s health history, to prescribe tailored treatment and advice accordingly.
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Tasmania puts $67m towards improving IT

By Allie Coyne on May 25, 2017 4:56PM

Big focus on digital transformation.

The Tasmanian government has set aside $67.5 million in its state budget for 2017-18 to improve existing IT systems and deliver on its digital transformation goals.
Much of the funding falls under a $50 million "digital transformation priority expenditure program".
The largest chunk of the total pot will go to an ICT priority infrastructure drive at the state's health service. "Program deliverables" will be managed through the state's structured infrastructure investment review process (SIIRP) being run by Treasury.
The final cost of the project - which the government expects will be $18 million - is yet to be finalised.
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University of Newcastle builds VR experiences to save babies’ lives

  • The Australian
  • 12:00AM May 26, 2017

Chris Griffith

Virtual reality will be used to teach midwifery students how to resuscitate babies at birth.
The University of Newcastle says it has developed virtual reality and augmented reality programs covering anatomy and birthing techniques.
“The technological advance, securing UON (University of Newcastle) as a leader in the field, is likely to have significant impact on the future of education around the world, as well as substantial benefits for industry,” the university says in a news release.
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ASIO should be given easier access to medical records: Lindt cafe coroner

Geir O'Rourke | 25 May, 2017 |  
ASIO should be given easier access to doctors' medical records to help the agency identify potential terrorists, the coroner investigating the Lindt cafe siege says.
The recommendations by NSW state coroner Michael Barnes were handed down on Wednesday in a 472-page report into the siege that claimed the lives of the terrorist Man Haron Monis and two hostages.
The report says that Monis had no diagnosable psychiatric disorder that deprived him of the ability to understand the nature of what he was doing as he planned and executed his 2014 attack.
But Mr Barnes called on the NSW Government to rewrite state privacy legislation to make it easier for ASIO to gain “appropriate access to health-related information” about suspected potential terrorists.
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How harmful are healthcare hackers?

Antony Scholefield | 24 May, 2017 |  
When news broke of one of the biggest health data breaches in Australian history, media reaction was swift.
“Donors sexual secrets revealed” was one headline on the story about the Red Cross Blood Service and how its records of some 550,000 blood donors had been inadvertently posted online.
The information included people’s names, contact details and details of sexual health conditions, including their HIV status.
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What happens when kids want e-health privacy?

26 May 2017
Young people and modern technology are usually a perfect match.
But when it comes to e-health records, it’s not a simple case of putting the new technology straight into youngsters’ hands.
Especially when it allows them to access or control their digital health records.
To assist GPs in navigating this minefield of family care, the Royal New Zealand College of General Practitioners (RNZCGP) has just released a guide on patient portals and children, which could also help GPs in Australia.
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Vic Health tackles infosec after pathology malware infection

By Ry Crozier on May 24, 2017 10:56AM

Sets up working group to push new controls statewide.

Victoria’s Health department has shortlisted 72 cyber security controls for the state’s health services to implement following a malware infection at Melbourne Health last year.
The state’s auditor-general Andrew Greaves today revealed the department had directed all health services “to complete a cyber health check baseline assessment” last May after Melbourne Health fell victim to a malware infection that downed its pathology systems.
It spent weeks grappling with mutations of the Qbot malware, and had to fast-track an operating system upgrade project to recover.
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Rise of the machines: Are radiologists doomed?

Brett Evans | 23 May, 2017 |  
There’s a phrase no one ever wants to hear from any doctor: “You might like to sit down — I’m afraid I’ve got some bad news.”
In an article published late last year in the Journal of the American College of Radiology, Dr Ezekiel Emanuel gave a whole specialty some very ‘bad news’.
Radiology, according to Dr Emanuel, a high-profile US oncologist, might have just one more decade to live.
“The ultimate threat to radiology — the one that could actually end radiology as a thriving specialty,” he wrote, “is machine learning.”
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This iPad attachment provides a simple way to explain lesion images

24 May 2017

PRODUCT REVIEW

DermLite Connection Kit for iPad
Price: $95 (available online)
Review model supplied by: Reviewer
Pros: Inexpensive and easy to use
Cons: Occasional focusing issues, sometimes disconnects
The Verdict: ★★★★
1=useless 2=useful 3=recommended 4=should have 5=must have now
Placing an iPad in front of my patient we both stare at the sharp, zoomed-in image of a lesion with distinctive chaos and unattractive clues.
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CU LAB: Health care: the new frontier for cyber security

Australia May 18 2017
Find out why cyber security is an issue in health care with our expert, Tim Webb.
Please click here to view the video. 
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How to make digital health a viable solution in Australia

May 25, 2017
‘We’re all in this room because we share a common vision, putting to work digital enablement to help out patients. Yet there is still some work to be done - we’re not where we want to be yet.’
Tim Kelsey, Chief Executive Officer, Australian Digital Health Agency, kicked off his presentation by bluntly stating that digital health services in the country still have a way to go.
He stated at present, that 2 out of 3 hospital admissions there will be an error with medications, leading to more deaths from incorrect administering of medication than from traffic accidents.
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Clever electronic cap tracks your medication

By Australian Hospital + Healthcare Bulletin Staff
Tuesday, 16 May, 2017
Pillsy is an ordinary-looking pill bottle with a smart electronic cap, enabling users of medication to have dosage information sent directly to an iOS/Android app on their smartphones.
Users start by transferring their medication or vitamins to the Pillsy bottle, then use the app to input the dosing schedule. From there, the Pillsy cap will flash and beep when it’s time to take a pill. Additionally, it will warn the user if they accidentally try to take an extra dose.
If the user misses a dose, a reminder will be sent to their phone in their choice of a lockscreen notification, text message or voice message. Should they not be near their pills at the time, the user can instruct the app to remind them when they get back within Bluetooth range of the bottle.
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Chamonix launches health record app

May 24, 201711:18am
Newsbites Finance
Chamonix, a health consultancy agency, has launched Healthi, an app to make it easier to manage health records.
Healthi allows Australian residents to access their family's health records in the national My Health Record System.
Using Healthi, consumers can view previous medical history, and provide professionals with their health records on the spot.
Over 1,000 consumers have been actively using the app - ranging from parents, schools, to medical professionals - and the general public.
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Melbourne Health deploys OnBase by Hyland for records digitisation

Melbourne Health has digitised its health record and data in advance of a future electronic medical record (EMR) system tender and anticipated integration using the OnBase by Hyland enterprise information platform.
The Melbourne-based healthcare provider will also deploy the enterprise OnBase software solution in its finance department to support back-office functions, such as payroll.
Rhonda Carroll, director of information and performance at Melbourne Health, said the flexibility of OnBase was central to the decision to select and implement the technology in both clinical and administrative applications, enabling users to have immediate and secure access to critical information.
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MidCentral Health taps Alcidion to improve patient experience

The MidCentral District Health Board has awarded Australian healthcare software company Alcidion a $1.6m contract for its Miya platform, which it will use to manage the flow of patient care information from reception through the hospital wards and specialist clinical areas to discharge. 
The CEO of MidCentral District Health, Kathryn Cook, said the main driver of the investment had been improving patients’ journey through the hospital. “We are focused on removing blocks in our system, reducing patient wait times, and optimising the availability and use of hospital beds.” 
Electronic patient journey boards will be deployed in over 20 ward and clinical service locations, with service specific configurations for the emergency department, medical access and planning unit, maternity, children’s, mental health, medical and surgical units. 
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Electronic notifications

22 May 2017
The local hospital is getting a bit of a handle on electronically transmitted Emergency Department Notifications to the general practice clinics in the town. These look like a Discharge Summary, but aren’t.
There might be helpful things in them. The information in the compulsory field of “Problem/Diagnoses This Visit” may or may not be correct. It hails out of a drop-down menu which, as we know, doesn’t always give us the choice we desire. Or perhaps someone accidentally clicked on the wrong thing.
The Clinical Synopsis has the “History” as collected by what appears to be the front-desk triage nurse or a clerk. It also contains the “Discharge Plan" which is just simply “Home” or “Admit”.
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Healthshare connects patients and practitioners through free VC

Australia’s largest digital health platform provider Healthshare has released a free communication platform combining video conferencing functionality, a patient diary and clinical note capability, aimed predominantly at psychologists and other mental health professionals to use in conjunction with their patients and clients, but which is also suitable for allied health professionals and medical practitioners. https://au.connect-me.com/
As part of the Federal Budget announcement, mental health practitioners have welcomed the greater investment in mental health, in particular access to telehealth and telemedicine for psychology services. Services must be improved to meet increasing demands and to ensure that people with a mental illness receive high quality and targeted services. 
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MyGov gets a makeover

By Allie Coyne on May 21, 2017 1:19PM

Three govt agencies partner to improve portal.

The federal government has delivered a promised facelift to its myGov government services portal in an effort to make it easier to use.
MyGov operator the Department of Human Services teamed up with the Digital Transformation Agency and the Australian Taxation Office to deliver the revamped site.
The DTA did the discovery and alpha phases solo, while the ATO stepped in to help DHS out with the prototype stage and then the beta product. The ATO is one of ten agencies to provide services through myGov.
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DTA and Human Services give myGov a 'timely' makeover

The Australian government has revamped its myGov website in response to user feedback.
By Asha McLean | May 21, 2017 -- 22:20 GMT (08:20 AEST) | Topic: Innovation
The Department of Human Services (DHS) has unveiled a new-look myGov, developed with the help of the Digital Transformation Agency (DTA).
In a joint statement, Minister for Human Services Alan Tudge and Assistant Minister for Cities and Digital Transformation Angus Taylor called the revamp to the service website timely, claiming more than 242,000 logins are made every day.
Such updates to the portal, which boasted 10 million users as of August last year, includes simpler navigation through the website, as well as easier access on mobiles and tablets.
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MyGov: “we listened and we got it” says minister after digital makeover

By Marie Sansom on May 23, 2017
The federal government’s troubled myGov website has had a digital makeover to make it more intuitive to navigate, nicer to look at and easier to access using mobile phones or tablets.
The overhaul was made more pressing by the large jump in traffic to the government services portal over the last two years. The federal government said that myGov had 10 million users and dealt with more than 242,000 logins every day: twice the number of logins from just two years’ ago.
It is a pivotal website that millions of Australian must interact with daily, dealing as it does with a huge range of services. MyGov was launched in 2013 to provide a single access point for ten different agencies providing services including Medicare, tax, Centrelink, the National Disability Insurance Scheme and My Health Record.
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22 May 2017

Tool to streamline consults

Patients now have access to a step-by-step guide to help them get the most out of their visit to a general practitioner and improve shared care.
The Australian Commission on Safety and Quality in Health Care partnered with Healthdirect Australia to create the Question Builder web-based tool.
The tool gives patients a chance to think about the questions they would like to ask their GP or specialist, and to think about the questions they may be asked by their doctor.
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Govt, Aust Post to create online ID system

Australia Post and the federal government's Digital Transformation Agency have agreed to team up and create an online identification system to make it easier for the public to access the government's digital services.
The two will work to integrate the ID technology which is used by Australia Post into the Commonwealth’s Digital Identity Framework.
Australia Post managing director and group chief executive Ahmed Fahour said the partnership reinforced its commitment to helping people "connect to important government services such as health and community services".
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The DTA has a half-billion dollar watchlist of IT projects

By Ry Crozier on May 23, 2017 12:03PM

And it's expected to grow.

The Digital Transformation Agency will keep tabs on at least half a billion dollars worth of IT projects across federal government as part of a new project watchdog role it was handed earlier this year.
In February the DTA’s new digital investment management office was given the task of compiling a report and public list of Commonwealth IT projects worth more than $10 million by the middle of this year.
DTA chief operating officer Peter Alexander today said the process had so far identified 56 projects worth at least $10 million, though several large agencies were yet to catalogue all of their sizable projects.
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Enjoy!
David.

6 comments:

Anonymous said...

I note the data mining ducks are starting lineup, new data agency and changing legislations. Hope this gets done properly

Anonymous said...

David your first article highlights a very worrying trend amongst the medical industry, as a part time patient this trend deeply saddens me, as these folks are the backbone of civilisation and emulate a core characteristic of the human race, that need to tend our sick and bring comfort to those we hold dear and those we no very little about. Why is it this noble and generous part of our community seemly allowed to accumulate such high numbers of this kind of illness and high number of fatalities? I really struggle with this

A concerned and appreciative citizen.

Bernard Robertson-Dunn said...

At the Federal level in this country, Health is in a miserable mess. Apart from the eHealth/MyHR debacle, we get this:

"Health Minister Greg Hunt shoots down department's secret hospital plan"
SMH
29 May 2017
http://www.smh.com.au/federal-politics/political-news/health-minister-greg-hunt-shoots-down-departments-secret-hospital-plan-20170529-gwfcmk.html

As revealed by Fairfax Media on Monday, the nation's most senior health bureaucrats – Department of Health Secretary Martin Bowles and his deputy Mark Cormack – are members of a secretive taskforce formed to develop the policy around a "Commonwealth Hospital Benefit" (CHB).

Health Minister Greg Hunt immediately ruled out adopting the policy.
Related Content

"Not government policy. Won't be government policy. Will never be government policy," Mr Hunt said.

Mr Hunt said the taskforce – funded by the department but run by a private think tank called Global Access Partners – pre-dated his time in the portfolio and he had already told bureaucrats he was not interested: "I've rejected it once. If it ever comes forward, I'll reject it again."

Bernard Robertson-Dunn said...

And it isn't just the Department of Health Bureaucrats who are stuffing up.

Re Data Mining.

Have a look at what the Productivity Commission has to say about health data and "Data Availability and Use" in their massive report.

http://www.pc.gov.au/inquiries/completed/data-access/report

Health data is referenced all over the place but the coverage is is inconsistent, incoherent and quite simply, often wrong.

The report gives all the appearance of having been written by different people (or uncritical extractions from different sources) by people who do not understand the details of MyRH and that the devil is in those details.

Here are a couple of examples/extracts:

"E.2 The development of eHealth in Australia

Now that most healthcare providers engage in some form of electronic recordkeeping, the main focus of current eHealth policy in Australia is not the digitisation of recordkeeping systems themselves, but the creation of an Australia-wide database for electronic health records (EHR) that can be accessed by the patient and by any healthcare provider authorised by the patient."

This gives the impression that there is a centralised source for all patient health records - there isn't. MyHR is only a small subset of patient data.

It also gives the impression that the patient "authorises access". This is totally untrue. The default is full access to all content, and access controls do not and cannot apply to key documents, the Shared Health Summary being the prime and most important example.

Similarly in E.5 Health policy in the United States — implementing data-driven reform

"The implementation of the Act, and other related legislation, included policies that address several aspects of access to and use of data. These policies introduced financial incentives for providers to implement electronic health records, and share their information with other healthcare services. It also puts an emphasis on interoperability — unlike Australia, where each individual will have one eHealth record, in the US each healthcare provider maintains an electronic file about a patient."

The statement "...unlike Australia, where each individual will have one eHealth record" demonstrates a woeful lack of understanding of MyHR and all the other health records littering the health landscape that MyHR does nothing to alleviate.

The Government has established a Taskforce in the Department of the Prime Minister and Cabinet to prepare its response to the Productivity's Final Report. The Taskforce is sharing its initial views on the report recommendations on Thursday at a meeting run by the OAIC.

I shall be there and, given half a chance, will express my views in a forthright manner.

My view, in summary, is "Any research utilising health data should use primary, clinically based sources not the MyHR which is an untrustworthy, secondary, selective and unreliable system totally unsuitable for data analysis."

At least PM&C isn't the Department of Health. Will PM&C listen? Your guess is a good as mine.

Anonymous said...

Not government policy. Won't be government policy. Will never be government policy," Mr Hunt said

That usually means by next year it will be a fine deal, just waiting for everyone's attention to be focused on the MYHR failure

Anonymous said...

That what we pay the CEO for lots of theatrical covfefe will do nicely, never you mind Tim will fix it