Quote Of The Year

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


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

Monday, November 13, 2017

Weekly Australian Health IT Links – 13th November, 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

A huge week with a lot of very interesting opinions emerging and lots of private sector activity.
Many links to follow here.
9 November 2017

Grahame and the Argonauts

Posted by Jeremy Knibbs
What does it say if the My Health Record project is not agile enough to pivot around a game changing and locally developed technology such as FHIR?
My favourite Saturday night movie as a kid was Jason and the Argonauts. It’s a story sourced from Greek mythology about a hero, Jason, who leads a band of intrepid outcast adventurers across the oceans and into battles with the likes of giant bronze statues that come to life, skeleton armies, and seven-headed snakes, in a quest to obtain the fabled golden fleece.
The fleece has magical healing powers and holds the key to Jason rallying the people of Thessaly to take back the throne and deliver his people from oppression. Unbeknown to Jason, he has been sent on his deadly fleece endeavour by the King of Thessaly who hopes Jason will perish on the mission.

How the Australian Digital Health Agency is helping create a seamlessly-connected digital healthcare system for Australia

Author: Priyankar Bhunia
6 Nov 2017
Building an evidence base is one of the key priorities, to reassure clinicians and demonstrate to them how basic digital information-sharing services can really transform healthcare.” 
A major transformation is underway in the Australian healthcare system. The Australian government allocated AU$374.2 million in its 2017-18 Budget to be invested over two years, for the nationwide rollout of an opt-out model of My Health Record and to ensure every Australian is a part of it, unless they choose not to be.  
In June, the Australian Digital Health Agency (The Agency) released a Request for Tender (RFT) to develop a Strategic Interoperability Framework for Australia, with the objective of contributing to the deployment of a seamless digital health eco-system. 

SA pours another $49m into troubled EPAS

By Justin Hendry on Nov 7, 2017 6:45AM

For a major system upgrade.

The South Australian government has funnelled another $49 million into the Department of Health’s troubled electronic patient administration system (EPAS) for a "major upgrade" intended to make the system run better.
It brings the total cost of the project to $471 million to date.
The state-wide system, underpinned by Allscripts technology, has long been a cause for concern, suffering numerous delays, usability issues and cost overruns since the project was initiated six years ago.

SA Liberals would halt controversial EPAS electronic patient record system if elected

November 08, 2017
South Australia's Opposition Leader would pull the plug on the rollout of the state's controversial electronic patient records system if elected next March.
Speaking at a breakfast hosted by the SA branch of the Australian Medical Association (AMA) today, Liberal leader Steven Marshall slammed the State Government's rollout of the EPAS software, describing it as "completely mishandled".
"This is a program which needs urgent review," he told the gathering of doctors, also attended by Premier Jay Weatherill and SA Best party leader Nick Xenophon.

Technology is fine, but the GP consultation is artform

6 November 2017


We need to make sure that the pros of a technology revolution in primary care do not come at the cost of real communication.
The opening keynote address at the RACGP’s annual conference this year was delivered by Dr Jay Parkinson, CEO and founder of Sherpaa, an American digital health disruptor.
It was a very interesting choice for the opening address. Essentially, an American guy gets up and tells a room full of hard-working Australian GPs why their job will soon no longer be needed.
Sherpaa is a web-based medical service that offers 24/7 desktop, mobile and phone access to full-time doctors who reply swiftly to patient messages, to guide, or ‘Sherpa’ patients through the medical system. 

10 standards for communicating within the health system

New AMA guide is designed to reduce duplication and waste
6th November 2017
The AMA has developed a guide outlining 10 minimum standards for communicating among health services, GPs and other treating doctors. 
It is hoped the guidance will improve quality of care for patients and also reduce duplication and waste in the health system.

How the tabloids made 'secondary use of data' sexy

8 November 2017


The concept of ‘secondary use of data’ does not sound like a salacious topic for tabloid journalism.
But a few years ago, it was all over the front pages of the UK’s notorious Daily Mail and other papers.
“NHS plans to harvest patient details” and “details being shared despite patients asking for them to be kept secret” were just a few of the headlines and teasers.
Secondary use of data refers to using millions of patient records to explore public health trends — in theory, without exposing any individual patient’s medical history. It can be a boon for health research because it shows links between different conditions and demographic factors.

Pharmacists, Digital Health Agency partner on My Health Record initiative

The peak national body representing pharmacists, the Pharmaceutical Society of Australia (PSA), is partnering with the Australian Digital Health Agency in a move designed to help increase the number of pharmacists using My Health Record - a digital system that enables healthcare providers to share secure health data and improve the safety and quality of patient care.
The Minister for Health Greg Hunt announced the partnership on Thursday and said the PSA represented 30,000 pharmacists working in all areas of pharmacy across the country, and is “ideally placed to develop and deliver education, training, information, and communications for the pharmacy profession”.
“This partnership will help PSA to increase the number of pharmacists working in all practice settings registered, able to view, and automatically upload medicines information to My Health Record.

How the government plans to convince pharmacists to use My Health Record

Shane Jackson says the benefits are safety and more effective care
10th November 2017
The Federal Government has given the PSA responsibility for improving pharmacist uptake of My Health Record.
Under a partnership deal with the Australian Digital Health Agency (ADHA), the PSA will deliver education and training to pharmacists.
Minister for Health Greg Hunt says the aim is increasing the number of pharmacists registered to use My Health Record.

My Health Record: what you can do!

Andrew Daniels shares his thoughts on how My Health Record can help pharmacies build digital health capabilities, as published in Post Script Australia on Monday 6 November 2017.

Pharmacies should understand why My Health Record is important and how their customers can participate, writes Andrew Daniels.

Already 5,160,000 Australians have a My Health Record and by the end of 2018, a My Health Record will be created for every Australian, unless they decide not to have one.
As more people get a My Health Record pharmacy staff are likely to be queried about it. So what is My Health Record?

Electronic drug management systems are not all made equal: new guidelines claim bad implementations cause medication errors

Lynne Minion | 09 Nov 2017
Electronic medication management systems are not a panacea for unnecessary hospital drug deaths, with poorly implemented systems creating their own errors, according to an updated guide by the Australian Commission on Safety and Quality in Health Care.
Launched today as part of federal and state government efforts to reduce drug deaths caused by clinical error, the third edition of the Electronic Medication Management Systems: A guide to safe implementation has looked into Australian hospitals using EMM to see quality isn’t guaranteed.
Medication errors are the second most common type of medical incident reported in health organisations, and omission or overdose of a drug is the most frequent type of medication error, the guide claims.

Strategic Change: The Digitisation of Australian Healthcare

Australia November 9 2017
With affordable, universal coverage and access, healthcare in Australia is amongst the world’s most advanced. Second only to the UK according to the Commonwealth Fund’s International Health Policy Survey, Australia’s health system ranks best on efficiency and healthcare outcomes. Yet at home, many Australians feel that healthcare should be more affordable and more efficient, citing high out-of-pocket costs and long hospital wait times as flaws in the current system.
Australia’s notable lack of technology in healthcare is a contributing factor to increased costs and lower standards of care. The industry is heavily regulated and expensive to innovate in, so the uptake of digital services has been slow and fragmented. Acknowledging the need for digital innovation, the Council of Australian Governments has recently endorsed the Australian Digital Health Agency’s (the ‘Agency’) Strategy. The Strategy is the product of consultation with consumers and healthcare industry professionals, and aims to deliver coordinated health information through digital channels to tailor and improve the quality of Australian healthcare. The Agency’s CEO Tim Kelsey stressed the need for this initiative, stating that Australia is facing rapidly rising demand for services, and that harnessing the power of technology will support high quality, sustainable healthcare for all Australians.

Interoperability: a personal view

Created on Thursday 10 November 2017
By Bettina McMahon, Chief Operating Officer and Executive General Manager for Government and Industry Collaboration and Adoption.
Northcott is a not-for-profit organisation that provides services and innovation for people living with disability. Today Northcott is one of the largest not-for-profit disability service organisations in Australia and provides empowering, personalised services to over 13,500 people with disability, their families and carers each year.
Northcott CEO Kerry Stubbs recently invited me to visit Northcott’s offices to see how people with disability receive personalised services and how this lines up (or not) with health services.
As I meet with case managers, occupational therapists, speech therapists and accommodation managers, it becomes clear to me that an extraordinary amount of effort goes into creating seamless services for their customers. When it comes to interactions with the health sector, the head of operations Lee tells me there is great opportunity to share information between a person’s healthcare providers and Northcott’s service providers. “Right now, there are few formal information flows between all the people providing health and care services to a person with disability. Often it’s up to the customer or their family to pass this information along, and if they’re ill or under stress, this just adds to the pressure a family is facing.”

$2.8 Million Investment Towards Aged Care Evolution

The Australian Government will invest $2.8 million in detailed business case planning for a major project to further develop and improve My Aged Care, Australia’s aged care gateway.
Page last updated: 07 November 2017
7 November 2017
The Turnbull Government will invest $2.8 million in detailed business case planning for a major project to further develop and improve My Aged Care, Australia’s aged care gateway.
Continuing modifications of MyAged Care aim to make it even more responsive and benefit the more than 1.2 million older people, their families and representatives who use it each year.

Individual patient billing history should be instantly accessible

8 November 2017



In practices that do not universally bulk bill, a GP who sees a patient usually seen by someone else might want to have an idea of how much the patient is expecting to be charged, based on how much they have been charged in the past. 
Clinical and administrative systems marketed for general practice have no facilities to make accessing this information quick, easy and unobtrusive.


On entry to the  software billing function — or when the GP has entered an item number — the system should automatically display the most recent billings for that patient, including date of service, doctor, item number and fee charged.

Infections, complications and safety breaches: why patients need better data on how hospitals compare

November 8, 2017 6.27am AEDT


  1. Stephen Duckett
Director, Health Program, Grattan Institute
  1. Christine Jorm
Associate professor, University of Sydney
Australia’s health system is an information industry – it is awash with data. Tragically, though, the data is not well collated, not put into the hands of the people responsible for acting on it. Nor is it shared with patients.
Multiple “data sets” measure the safety of hospital care in Australia, but they are rarely linked, sometimes incomplete, and almost always delayed. We have lots of data about hospital safety, but it’s not used to make us safer when we have to go to hospital.
Information on patients’ experiences with their hospital care are often not reported back to public hospitals at unit or ward level, which makes working out where to start on improving care that much harder. Information about patients’ experiences in private hospitals is rarely reported publicly at all.

Online medical certificates: genuine fake, genuine, or just fake?

Australia November 8 2017
“Why risk your job and your career? There’s no longer any need for a fake medical certificate when you can get a genuine medical certificate in 5 minutes online or from your mobile phone.”
So reads the advertisement from one online medical certificate provider.
Online medical certificate platforms claim that their value is in freeing-up an under-resourced health care system by providing a faster and easier service to patients with “minor” ailments and sickness.

Time to take patient safety records out of the data black hole

Australian hospitals need to release more records on patient safety and treatment outcomes in the interests of driving better care, the Consumers Health Forum says.
A new report issued today (Wednesday) by the Grattan Institute, finds that while hospitals routinely collect large amounts of data on patients, little ever reaches the public or doctors outside hospitals.
“Given modern day expectations of transparency and accountability, hospitals and governments should be enabling the orderly release of these data to doctors and patients,” the CEO of the Consumers Health Forum, Leanne Wells, said.

You may be sick of worrying about online privacy, but ‘surveillance apathy’ is also a problem

November 8, 2017 12.49pm AEDT


  1. Siobhan Lyons
Scholar in Media and Cultural Studies, Macquarie University
We all seem worried about privacy. Though it’s not only privacy itself we should be concerned about: it’s also our attitudes towards privacy that are important.
When we stop caring about our digital privacy, we witness surveillance apathy.
And it’s something that may be particularly significant for marginalised communities, who feel they hold no power to navigate or negotiate fair use of digital technologies.

Serious concerns as businesses prepare for the mandatory data breach notification

Some businesses appear ill-prepared for the Notifiable Data Breaches regime, which begins in February
In February of this year, the Notifiable Data Breaches (NDB) legislation was passed, with the new regime coming into effect on 22 February 2018. This means businesses need to start preparing now to comply with this amendment to the Privacy Act.
The NDB scheme requires businesses to notify both the Office of the Australian Information Commissioner (OAIC) and any affected individuals if the company experiences any unauthorised access, disclosure, or loss of personal information, if a reasonable person would conclude that this access, disclosure, or loss would be likely to result in serious harm.
The act makes it clear that serious harm isn’t necessarily only related to financial losses but could also include the public disclosure of private information such as a medical condition, for example.
6 November 2017

How data democracy will reshape healthcare

Posted by Julie Lambert
Australia will need to make “a dramatic shift” in thinking on digital health to maintain its world-leading quality of healthcare, according to a new report from Harvard Business Review (HBR) Analytic Services.  
The HBR briefing paper, sponsored by Microsoft, stemmed from an international survey of 783 business decision makers on digital transformation, including 9% employed in the health sector, as well as qualitative interviews with Australian digital health experts.  
In Australia, an unsustainable spending trajectory, the rise of digitally literate consumers, the burden of chronic disease and demographic factors made the take-up digital technologies a crucial need, it said. 

Wearable sensor technologies to help revolutionise personalised medicine

3 November 2017
Video of Grand Challenge: Your health in your hands
This is an outstanding project that will help doctors treat disease earlier and more effectively with precision therapies.
A research project, which aims to revolutionise personalised medicine through wearable sensor technologies such as bracelets, will receive up to $10 million as the inaugural winner of The Australian National University (ANU) Grand Challenge Scheme.
The five-year project promises to help clinicians detect diseases in people much earlier than is currently possible, and better manage their conditions.

6 November 2017

Genetic privacy v duty to disclose: who wins?

Authored by Jane McCredie
AS WE delve ever further into the human genome, ethical and legal frameworks are struggling to keep up.
Given the potential of genetic information to affect people’s employment prospects, or ability to get insurance, there’s been an understandable focus on protecting genetic privacy.
But what of situations where a patient refuses to share information that might give relatives the opportunity to identify their own genetic risk and seek early prevention or treatment?

Smartphones a friend for G Medical

  • The Australian
  • 12:00AM November 7, 2017

Supratim Adhikari

ASX-listed mobile health outfit G Medical Innovations’ bet on turning your smartphone into a bona fide health monitor looks set to play out, one way or the other in 2018, as the company edges closer to a couple of crucial milestones.
The first big one is winning approval for its product, Prizma — a medical-grade smartphone sleeve — from Chinese regulators, a move that will open the door to the biggest smartphone market in the world.
The second is to start ramping up production on Prizma and get the products into the hands of consumers.
Prizma’s goal, according to G Medical chief executive Yacov Geva, is to put a “doctor in the pocket” of everyday smartphone users. In practical terms, the Prizma sleeve fits over a smartphone and once there continuously collects, consolidates and analyses medical data. It’s powered by an independent battery that only becomes active when needed and ­allows patients to share the data with medical specialists.

G Medical Innovations Holdings expands into India and Taiwan

10:53 06 Nov 2017
The halt will remain in place until Wednesday 8th November 2017.
The company's shares are in pre-open
G Medical Innovations Holdings Ltd (ASX:GMV) has two binding Memorandum of Understanding's on the table for distribution of G Medical Devices in both India and Taiwan.
The company specialises in next generation mobile and e-health solutions.

Enabling Iconic Figures in Australia’s Treatment of Cancer

June 1, 2017
Categorized: Health | Watson
Written by Terry Sweeney, IBM Watson Health, Asia Pacific
One in two Australians will be diagnosed with cancer in their lifetime[1]. That’s the latest alarming cancer statistic from the Australian Institute of Health and Welfare. Its findings show a sharp increase in incidence from previous reports. It’s our nation’s leading cause of death, and has touched the lives of almost everyone in some way.
Cancer is a global challenge, driving researchers and oncologists in their quest for a cure. In fact, 8,000 medical research papers are published every single day with new treatment options, genetic factors and patient studies, opening new possibilities in the fight against this terrible disease. That sheer volume of information is simply too much for one doctor to digest, and it’s only going to increase.

Sydney start-up EpiSoft closes $1m capital raising

  • The Australian
  • 12:00AM November 7, 2017

David Swan

Sydney medtech start-up EpiSoft has closed a $1 million capital raising, backed by four private investors, as the Springboard Enterprises alumnus looks to scale-up its offering.
EpiSoft is a cloud-based medical record SaaS business, catering to hospitals and clinics with software that supports care co-ordination, management and treatment planning.
Company founder Jenny O’Neill, a health IT executive and the first female president of the Medical Software Industry Association, told The Australian she believed there was a gap in the investment market in Australia. She also felt there was a reluctance from investors to pour money into the digital health space, given a lack of knowledge.

EpiSoft raises $1 million to fund global expansion

Australian start-up EpiSoft has closed a $1 million capital raising as it prepares to further develop its digital health platform and expand globally.
The capital raising was backed by private investors and is EpiSoft’s first investor raise, and follows a previous $250,000 government grant in 2013.
Founder of EpiSoft, Jenny O’Neill, a health IT executive with 20-plus years’ experience in senior roles and the first female president of the Medical Software Industry Association, says she believes there is a gap in the current investment market in Australia, and investors have an appetite for companies raising $500,000 or $3 million.
  • Updated Nov 6 2017 at 11:05 AM

GP tech platform HealthKit raises $2.5 million to take on Europe

A tech start-up founded by two former ANZ bank employees claims it has become the most popular health practice management software in Australia, as it closes a $2.5 million capital raising before international expansion.
HealthKit founders Alison Hardacre and Lachlan Wheeler say the company has more than doubled its market size this year, going from 10,000 practitioners using its platform to more than 22,000 worldwide, 19,000 of which are in Australia.  
The company plans to use the funds it has raised to set up a European headquarters in Ireland. It would not reveal who had led the $2.5 million raise, beyond saying it came from existing investors. 

Learning to live with, and control, intelligent machines

  • The Australian
  • 12:00AM November 7, 2017

Supratim Adhikari

Artificial intelligence and automation may or may not be the death knell of society as we know it, but there’s a growing chorus of voices calling for us to re-evaluate our relationship with technology.
It’s pretty hard to deny the profound benefits delivered by technology over the course of the past decade; however, they haven’t come without consequences.
Some of the benefits have come at the expense of traditional business models and have laid down the foundation for new ­hegemons.

How Ancient Romans would build the national broadband network

Clive Williams
Published: November 7 2017 - 12:15AM
Australian leaders could learn much from this 2000-year-old approach to management.
Australian governments in general seem to have problems managing major infrastructure projects. This seems particularly the case with the federal government and the 10-year-old national broadband network. (That is not to say the opposition, in government, would do any better.)
I recently had reason to consider the Roman approach to management, and there are a few lessons that can still be learned from what worked for them for several hundred years.
One of their major projects was building Hadrian's Wall in northern England, starting in AD122. At the time, it would have compared in scale to today's NBN project. The Romans completed the massive task in six years.

Tweet longer: Twitter officially moves to a 280 character limit

Tim Biggs
Published: November 8 2017 - 8:00AM
Twitter's iconic 140 character limit for tweets is no more. In a move that could affect which ideas you can express on the platform, the amount of scrolling you have to do on your Twitter app and the political policies set by the President of the United States, the company has today announced that 280 characters is the new standard for all users.
The change, which will roll out to all users tweeting in English and most other languages, doubles the maximum length of every tweet, but Twitter says a recent test of the new limit showed the platform will maintain its brevity.
"We — and many of you — were concerned that timelines may fill up with 280 character Tweets, and people with the new limit would always use up the whole space", said Twitter product manager Aliza Rosen in a blog post. "But that didn't happen".


Bernard Robertson-Dunn said...

This article David found is well worth a read.

"How the Australian Digital Health Agency is helping create a seamlessly-connected digital healthcare system for Australia"


The half truths and conflation of MyHR and interoperability are wondrous.

For example:

"My Health Record is a standout priority for all of us. It offers such clear, clinical benefits. There is widespread consensus to develop a digital health service, which allows data to flow circularly and seamlessly across borders. Not just political borders, but also the institutional borders of healthcare in a way that doesn’t currently happen."

I have never seen any evidence that there are benefits - I've seen claims, but never evidence.

I certainly agree about improving the flow of information, but I haven't seen any evidence that this flow should include giving the data to the government.

And in case you think my claim that government gets and keeps the data is is an exaggeration, you only need to read the next sentence:

"However, My Health Record is not an EMR[1](Electronic Medical Record). It is not intended to become a comprehensive resource."

It's the reference that is key:

"[1]When asked to clarify, Mr. Kelsey said that My Health Record takes copies of records from other systems, EMR systems included, from hospitals, from GP software systems, from pathology and radiology systems. It takes those copies (not original documents) and makes them easily visible to clinicians, keeping in account reports such as pathology and digital imaging display only the report itself, not the visual image."

And if anyone thinks that MyHR is being used for anything useful, have a look at this document from the October board meeting:

Item 8.1 - Attachment A - Performance Report (PDF, 1.02MB)

Charts 3 and 12-17 are most illuminating.

Chart 3. "Consumers who have had their record viewed by 2 or more healthcare provider organisations" shows fewer than 300 views per month

And Chart 14. "Number of VIEWS viewed by provider organisations each month" shows that the number of views of Health Record Overviews per month by providers is so low it is almost indistinguishable from zero.

And these are from over 5 MILLION registrations.

And Tim has the gall to talk about evidence!

Anonymous said...

What an excellent article Bernard

Your insightful comments make me wonder - surely to goodness the ADHA Board cannot be so blind as to not see that they are presiding over a huge civilian IT project which is failing at a great rate of knots. Is this Board incapable of asking the really hard question? The last release of Board documents and the above article points in no uncertain terms to a Titanic Project with water pouring in below the waterline. (pardon the mixed metaphors)