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, March 05, 2018

Weekly Australian Health IT Links – 5th March, 2018.

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

Another quiet week with Senate Estimates (Reported yesterday) and the report into WA Health being the highlights.
The opioid epidemic is also prompting some action in a couple of capitals. Enjoy the browse!

WA Health in dire need of better IT investment: review

By Allie Coyne on Feb 27, 2018 5:00PM

Progress towards digital health system "critical".

Technology projects in the Western Australian health system have swallowed up large amounts of money for little benefit, creating a "culture of distrust" in the management of IT, a report into the state's health system has found.
The 'sustainable health review' interim report [pdf] painted a bleak picture of the state of IT within WA's health network.
The report - which was commissioned by the state government last June - found a track record of IT projects that had spent lots of money "in areas that have not necessarily supported the system or improved health outcomes more generally".
WA's health IT investments have shown an "inability" to deliver what has been required, the report found.

WA Health’s “poor” IT delivery has created “culture of distrust,” report finds

Lynne Minion | 28 Feb 2018
The creation of a statewide digital health strategy, improved data sharing and closer ties to My Health Record are among the recommendations of a scathing report into Western Australia’s health system that criticised budget blowouts and bungled implementations in the state’s transformation to digital health.
Past ICT delivery has been “poor”, according to the Sustainable Health Review interim report to the WA government, creating a “culture of distrust” in the management of projects.
“ICT investments across the WA health system have been beset with challenges and issues that have had a significant impact on delivery and created a culture of distrust in the management of ICT,” the report found.

Qld Health nears delivery of new ERP system

By Justin Hendry on Feb 27, 2018 6:00AM

Asks KPMG to mitigate risks.

Queensland Health expects to have its new SAP ERP system up and running by August this year, but will spend several months transitioning staff across to mitigate potential risks.
The $105 million financial system renewal project (FSR), which the agency has been working on since December 2016, will replace a heavily customised, 20-year-old SAP R/3 4.6B ERP suite known as the finance and materials management information system (FAMMIS).
FAMMIS has been out of support for a decade, forcing the agency to “put in place mitigating action to maintain system performance and stability until the financial system is replaced”, according to a recent financial audit by the Queensland Audit Office [pdf].
The project will see Health and all hospital and health services across the state move to a new on-premise version of SAP's S/4HANA solution, which will interface into the agency’s now-stable SAP payroll system.
28 February 2018

ACT ramps up push for real-time monitoring

Posted by Julie Lambert
ACT Health Minister Meegan Fitzharris has vowed to push for national real-time prescription monitoring, while rolling out a system to stop “doctor shopping”, in her jurisdiction this year.
Minister Fitzharris said she would use her role as 2018 chair of the Council of Australian Governments health ministers’ council to widen scrutiny of controlled pharmaceutical drugs.
By March 2019, doctors and pharmacists in the ACT would have access to real-time information to curb the illicit or excessive use of Schedule-8 medicines and possibly some S-4 drugs, she said.
But she wants to see a nationally consistent set of rules, as called for repeatedly by coroners.

Tasmanians to track low-dose codeine

Tasmania is leading the way as it sets up real time monitoring of formerly-OTC codeine, pharmacy stakeholders say

The island state has announced that it plans to implement Drugs and Poisons Information System Online Remote Access (DORA) for a number of Prescription Only drugs of concern, in addition to the Schedule 8 drugs it already tracks.
PSA president Dr Shane Jackson told the AJP that Tasmania has been “well ahead” on real time monitoring for some years.
“Essentially what they’ve done now is what they said they were going to do from the middle of last year, so it’s not just codeine, it’s other high-risk drugs: benzodiazepines, Tramadol and so on,” he says.
“Codeine will be part of that. So they’re making sure they have the information in real time, not just for S8s but other opioids and high-risk drugs, so pharmacist and doctors will have access to that and Tasmania has led the way here.

How technology is helping Australia tackle youth mental health

Posted on March 2, 2018

Did you know that research has shown that the speed of typing on your mobile phone can be a predictor of depression?

As more young Australians deal with mental health issues, technology is playing a greater role in helping parents keep a close eye on their child’s state of mind.
The Telstra Foundation is a proud partner of Orygen, the National Centre of Excellence in Youth Mental Health, which is developing technology to revolutionise therapy for young people with mental health conditions as well as supporting those caring for them.
For Orygen, treatments are not just about traditional psychology and delivering services face-to-face, but reinventing youth mental health services, so patients are not only relieved of the symptoms of mental ill-health but can use technology and interventions to live happier, more fulfilling, connected and purposeful lives.

Another GP policy fail as PIP revamp is shelved

The overhaul will be put on ice for at least a year
1st March 2018
The biggest ever revamp of the $300 million Practice Incentives Program will be shelved for at least a year amid fears it would have triggered mass closures of GP practices.
The reforms, designed to set the foundations for pay-for-performance in general practice, have instead become the latest GP policy flop for the Federal Government, coming in the wake of the delayed Health Care Homes trial and the botched roll-out of the cervical screening register.
From May, a number of the current PIP incentives — covering asthma, quality prescribing, diabetes and aged care — were to have been scrapped and replaced by a new quality improvement incentive.

Can we deliver high value care with one eye on the clock and the other on the screen?

Given longer consultations are associated with better health outcomes, the Medicare Benefits Schedule should be restructured to incentivise appropriate consultation time in general practice.

It is estimated that doctors are making an incorrect diagnosis in up to 20% of cases, and up to 30% of investigations may be unnecessary. It is often thought that medical knowledge and skills are the culprit, but there is another reason for the majority of medial mistakes.
Doctors need time to listen and think. General practice’s inherent time pressures, interruptions and the need to record information on computers can be distracting and cause cognitive errors. Our thinking process is also influenced by our emotions; for example, as a result of work stress or running late.

RACP left waiting for system failure report by IT supplier

By Allie Coyne on Feb 23, 2018 12:59PM

As Pearson Vue blames failure on system set-up.

The Royal Australian College of Physicians has been left waiting for a root cause analysis report on the failure of a critical online exam for trainee doctors that was meant to arrive two days ago.
The medical college had been promised by the system's provider, Pearson Vue, that a report on the failure would be provided by Wednesday.
However the report is yet to arrive, and the RACP has been given no indication of when it might appear.

IT supplier refunds student fees for botched doctor exam

By Allie Coyne on Feb 27, 2018 1:40PM

Human error caused system failure.

Education testing software vendor Pearson Vue has agreed to refund the fee students paid to sit a botched online exam after finding "human error" was behind the failure.
Last Monday a number of trainee doctors found themselves locked out of the crucial computer-based 'basic divisional written exam' and unable to complete the second part of the test.
The exam, administered by the Royal Australian College of Physicians, is the gateway for trainee doctors to enter a specialist practice in either adult internal medicine or paediatrics and child health at the end of their first four years of training.

Junior doctors to get $2m refund for troubled tester's botched exam

By Aisha Dow
27 February 2018 — 2:47pm
Troubled multinational testing company Pearson Vue will refund more than $2 million to distressed junior doctors after an IT bungle halted a major exam last week.
About 1200 doctors were sitting the basic training exam last Monday when it was abruptly cancelled due to a technical fault.
The crucial test, which can take up to two years to prepare for, determines whether doctors are ready for advanced specialist training.

Digital health leaders explore new worlds at inaugural symposium

26 Feb 2018
UNSW Media
Digital health experts have gathered at UNSW to discuss the future of healthcare technology and the use of big data in health systems around the world at the first International Digital Health Symposium.
Digital health leaders from around the globe have met at UNSW Sydney for the inaugural International Digital Health Symposium to learn from different global approaches to digital innovation that are inclusive, evidence-based, and support sustainable, high-quality health and care.
The leaders discussed the global advancement of digital health policy, how digital health can support clinical quality and safety, challenges in healthcare interoperability, data sharing for health systems improvement and building the evidence base for digital health benefits. The management of global public health priorities, new approaches to disease prevention, and maximising the benefits of precision medicine were also discussed.
Australian Digital Health Agency CEO Tim Kelsey said that Australia and its international partners can learn from each other and share information about what has worked in their health settings to support best use of digital technology in modern healthcare.

Global Digital Health Partnership launched in Australia with participants from 13 countries, Hong Kong SAR and WHO

By: Priyankar Bhunia
26 Feb 2018
Over the coming year, the Global Digital Health Partnership will collaborate on: 1) connected and interoperable health care; 2) cyber security; 3) policies that support digital health outcomes; 4) clinician and consumer engagement; and 5) evidence and evaluation of digital health.
International participants from thirteen countries, Hong Kong SAR, and the World Health Organization (WHO) kicked off a new global network to support the use of digital technology in modern healthcare.
The thirteen countries involved in the Global Digital Health Partnership (GDHP) are Austria, Australia, Canada, India, Indonesia, Italy, New Zealand, Saudi Arabia, Singapore, South Korea, Sweden, the United States and the United Kingdom.
The GDHP is an international collaboration between governments, public agencies, and multinational organisations responsible for policy, funding, and delivery of health services to their citizens.  

PHNs build My Health Record expansion readiness

My Health Record Training and Strategic Engagement event lays the foundations for communications and provider readiness.
The two-day My Health Record Training and Strategic Engagement event took place in Melbourne on 13-14 February, bringing together members of the My Health Record Expansion program team and 150 PHN colleagues.
All the PHN attendees are key delivery partners in both provider readiness and communications for the expansion program.
Attendees were provided updates on some of the clinical benefits of using the My Health Record system, as well as progress in tactical communication implementation, after which they collectively workshopped strategies to promote My Health Record with providers and consumers alike.

Australian FHIR innovation a frontrunner as the US government looks to standardise health data exchange

Lynne Minion | 27 Feb 2018
Australian-developed open source technology FHIR could soon be standardised for health information exchange by the US Government in a move that would propel the giant EHR companies and healthcare providers towards data sharing.
Following Apple’s January announcement that it was adopting the FHIR API in its new Apple Health app, the fast-tracked democratisation of data exchange could vanquish siloes and place information in the hands of individuals, according to Bruce Greenstein, Chief Technology Officer of the US Department of Health and Human Services.
“We've made some progress on health information networks but not at the level that we really want. So I think that what you'll see come out of HHS this year with regard to the Trusted Exchange Network and work on interoperability that will move all the EHR and other health information companies in the right direction,” Greenstein told Healthcare IT News Australia.

Is your vendor being honest about AI?

Some vendors who claim their products use artificial intelligence or machine learning technology are really using rules-based engines. Here's how to spot the lie.
Roger A. Grimes (CSO (US)) 27 February, 2018 22:00
New technologies generate new buzzwords. Cloud, fabric, bitcoin, blockchain, containers, microservices, and so on. Artificial intelligence (AI) as a technology and term has been around for decades, but only recently seems buzzworthy. Unfortunately, some vendors are associating the buzzword with their products without having any real AI. Or to be charitable, they stretch the limits of what can be considered AI. Maybe they don’t really understand what AI is, or maybe the marketing team cajoled them into it. Either way, buyers need to be aware that many of the products claiming to have AI don’t.
I’ve been reviewing more vendors than I usually do, and it appears they all think if they have the word AI in their product description, they will sell more of their product or service. When I ask them how they are using AI, I get gaps of silence or descriptions that sound a whole lot more like rules engines.
Vendors who claim to have AI when they clearly don’t is confusing customers. This is frustrating all the vendors that have done all the hard work to have real AI in their products. If you are a consumer or purchaser of computer security products, it can only help you to understand what AI really means.

Microsoft founder Paul Allen wants to teach machines common sense

Updated1 March 2018 — 9:42am first published at 9:39am
Microsoft's co-founder Paul Allen said Wednesday that he was pumping an additional $US125 million ($161 million) into his nonprofit computer research lab for an ambitious new effort to teach machines "common sense."
The money for the Allen Institute for Artificial Intelligence will about double the lab's budget over the next three years, helping to fund existing research as well as the new effort, called Project Alexandria. In the years and decades to come, the lab hopes to create a database of fundamental knowledge that humans take for granted but machines have always lacked.
Nearly 200 companies have gathered in Tokyo to showcase the latest in robotic industry technology.
26 February 2018

How can GPs stay up to date with rapid changes in medical knowledge?

It’s a problem as old as the profession. Harvard University Professor Nicholas Christakis said it in 1910: ‘there has always been and will always be too much to know. Medical knowledge is theoretically and practically limitless.’
However, the current rates of expansion of medical knowledge far exceed what Christakis could have imagined. A doctor practising in 1950 would have seen medical knowledge double every 50 years. In 2010, the rate was at 3.5 years, and by 2020, it will only take 73 days1 for existing medical knowledge to double in size.
While a GP is expected to continue their own education and professional development, given the rapidly expanding landscape of medical knowledge, this process is not what it used to be.

How companies scour our digital lives for clues to our health

26 February 2018 — 12:34pm
Your digital footprint — how often you post on social media, how quickly you scroll through your contacts, how frequently you check your phone late at night — could hold clues to your physical and mental health.
That at least is the theory behind an emerging field, digital phenotyping, that is trying to assess people's well-being based on their interactions with digital devices. Researchers and tech companies are tracking users' social media posts, calls, scrolls and clicks in search of behaviour changes that could correlate with disease symptoms. Some of these services are opt-in. At least one is not.
People typically touch their phones 2617 per day, according to one study — leaving a particularly enticing trail of data to mine.
"Our interactions with the digital world could actually unlock secrets of disease," said Dr Sachin H. Jain, chief executive of CareMore Health, a health system, who has helped study Twitter posts for signs of sleep problems. Similar approaches, he said, might someday help gauge whether patients' medicines are working.

The car of the future will sell your data

26 February 2018 — 9:46am
Picture this: You're driving home from work, contemplating what to make for dinner, and as you idle at a red light near your neighbourhood pizzeria, an ad offering $US5 off a pepperoni pizza pops up on your dashboard screen.
Are you annoyed that your car's trying to sell you something, or pleasantly persuaded? Telenav , a company developing in-car advertising software, is betting you won't mind much. Car companies-looking to earn some extra money-hope so, too.
Automakers have been installing wireless connections in vehicles and collecting data for decades. But the sheer volume of software and sensors in new vehicles, combined with artificial intelligence that can sift through data at ever-quickening speeds, means new services and revenue streams are quickly emerging. The big question for automakers now is whether they can profit off all the driver data they're capable of collecting without alienating consumers or risking backlash from Washington.

Notifiable data breaches amendment a good step

  • Tim Wellsmore
  • The Australian
  • 12:00AM February 27, 2018
We now have our notifiable data breaches amendment to the Privacy Act 1988 enacted in Australia. In the face of the risks posed by the numerous and relentless cyber threats that cross our borders every day, this legislation is, without doubt, a step in the right direction.
But the legislation, in its current form, is far from perfect and should be considered just a first step. We haven’t gotten it right yet.
For one, the amendment is only mandatory for some businesses, and only when they think they need to report a breach. No one is mandated to report anything when a bank is breached and vast sums of money are stolen, nor when an industrial company is breached and its intellectual property is stolen, nor when an electricity company is compromised by rogue nation-states or their proxies.

Technology set to change the way we manage pigmented skin lesions

25th February 2018
Industry Message
This content is produced by Heine.
Diagnosis and documentation of pigmented skin lesions has become easier for doctors with new cutting-edge technology that allows the capturing, storage and review of digital dermoscopic images from anywhere in a practice.
Using technology developed by HEINE, a German manufacturer of innovative diagnostic equipment, doctors can now avoid the cumbersome process of downloading images from a camera into a computer and then into a patient file. 
The powerful wireless software allows real-time data transfer that ensures data security by matching the images with the right patient.

A nifty ECG device for patients

28 February 2018
PRODUCT Kardia Mobile ECG
PRICE $199 (including postage) 
PROS Small, well built, simple to use
CONS Detects only AF, sometimes has difficulties getting a signal from patient
1=useless   2=at own risk   3=maybe   4=should have   5=must have now
I am happy to inform you that no-one at my family’s Christmas lunch had atrial fibrillation (AF). How do I know? Because I tested them all with the new Kardia Mobile ECG device.

Compumedics confirms sustainable profitability with contract win and continued eHealth growth forecast

One of Australia’s leading medical device companies, Compumedics (ASX: CMP), announced this week, record sales orders of $18.5 million for first half year having secured its largest system contract in the company’s history worth $4.93 million.
The contract, which will see Compumedics’ supplying its magnetoencephalography (MEG) imaging system to the world-renowned Barrow Neurological Institute (BNI) in the second half of 2018, has opened up a pathway to the multi-billion dollar brain imaging market for Compumedics.
Compumedics’ sustainable profitability comes off the back of the company receiving sales orders worth $6.5 million within the half year that were yet to be shipped and invoiced, thus guaranteeing income for the second half of 2018.

Network expert says govt NBN paper 'seriously flawed'

A network expert who was associated with the initial stages of the national broadband network rollout has described the working paper issued by the Department of Communications and the Arts on network speeds as "seriously flawed".
Rod Tucker, Laureate Emeritus Professor at the University of Melbourne and a member of Labor's Expert Panel that advised on the NBN, said: "By itself, the figure of 49Mbps rings alarm bells, being just below the 50Mbps maximum bandwidth of the speed range that NBN Co is currently pushing. It looks awfully like a justification of the FttN network."
The paper claimed that the NBN rollout should provide enough bandwidth for Australian households through to 2026, adding that peak bandwidth demand for households with the highest usage was forecast to increase from between 11Mbps to 20Mbps in 2016 to between 20Mbps to 49Mbps in 2026.

NBN Co pushes back crucial HFC status update

By Ry Crozier on Feb 27, 2018 10:29AM

As numbers released on HFC recommendations.

NBN Co has delayed a planned update on the state of its HFC network by a few more weeks, denting hopes for the 700,000 users whose connections were pulled back for remediation late last year.
Since its decision in late November to freeze sales and remediate existing connections, NBN Co has promised a major update through its map that was timed “February 2018”.
With month-end fast approaching, users had been in internet forums in greater numbers speculating when the update might come through.

NBN puts new HFC rollout timetable on hold

By Adam Turner
27 February 2018 — 10:11am
Millions of Australians waiting for the NBN over HFC cable have been put on further hold as NBN Co pushes back the release of its updated rollout timetable.
New Hybrid Fibre Coaxial (HFC) broadband connections were suspended in December, after NBN Co chief Bill Morrow halted the rollout to address dropouts and other connection issues plaguing the cable network.
The rollout was delayed six to nine months, with the online NBN rollout map instructing affected Australians to check back for an update in "February 2018". Only days away from this deadline, the rollout map has quietly changed to read "new information will be available over the coming weeks".

Telstra puts total 5G broadband reach at 1m premises

By Ry Crozier on Feb 26, 2018 11:13AM

About 9 percent of NBN’s coverage.

Telstra is expecting the entire telco industry to serve around one million premises with 5G-based broadband, less than one-tenth of the reach of the NBN.
The telco used its annual presence at the Mobile World Congress in Barcelona to announce a “5G network roadmap”, though it was short on details other than a planned start for 5G in 2019.
What the announcement did put plainly, however, is the limited reach of 5G and how much traffic will still be transported over existing (albeit enhanced) 4G networks once 5G enters the fray.

More than 850,000 homes to get NBN speed upgrade

By Jennifer Duke
Updated 26 February 2018 — 9:09amfirst published at 12:05am
Telstra has been quietly increasing customers’ National Broadband Network speeds, with 850,000 households and businesses to get an upgrade.
The telecommunications company is moving households and businesses from 25Mbps plans to 50Mbps plans, after the NBN Co discounted wholesale prices in December amid spiralling concerns about broadband speeds.
The network hoped telcos would pass on the savings to customers and encourage Australians to choose higher speed plans.


Bernard Robertson-Dunn said...

I see that executive general manager for Innovation and Development Rachel de Sain is moving on.

She has been in charge of overseeing the redesign of the consumer and provider portals for myhr

If that is the extent of innovation at ADHA, I'm not surprised she's moving on. It's rather like putting lipstick on a pig - it does nothing for the fundamental problems myhr has and will face.

And when it come to Digital Health innovation, I have seen nothing I would call innovation coming out of this government bureaucracy. Which isn't surprising, government bureaucracies are not renowned for innovation.

Adding a second, government owned, health database to GP's already stressful lives is unlikely to deliver much in the way of benefits - as opposed to cost and risk.

Anonymous said...

Should at least bring down the travel budget for a bit

Anonymous said...

"I see that executive general manager for Innovation and Development Rachel de Sain is moving on. She has been in charge of overseeing the redesign of the consumer and provider portals for myhr."

She has seen the writing on the wall.

Anonymous said...

Bloody marvellous isn't it how Mr Stephen Moo, Chief Information Officer, Department of Health and Families is still a Member of the ADHA Jurisdictional Advisory Committee (JAC).

Anonymous said...

Even more bloody marvellous is the way Tim Kelsey mentions Rachel's departure in PulseIT in the same breath as he announces that "ADHA is working on two new releases of the My Health Record, one scheduled for April and one for June."

I'm surprised she didn't elect to hang around for all the accolades!

Anonymous said...

Mt Moo is now a private consultant and would not qualify for the jurisdiction advisory committee. The fact his name is still there is probably more a reflection of how sloppy the ADHA is. They obviously cannot manage web content so I am wondering if they are fit to manage personal health information. It certainly raises questions regarding readiness

Anonymous said...

I think it is the responsibility of the Board to ensure their committee membership is current n the web.

Anonymous said...

The Board would be accountable to ensure the organisation operates to a high standard and would commission policy, process and procedures. The CEO is responsible to ensure day to day operations are working properly

I do lean towards 8:06 PM in that this poor management of a simple content management system does not exactly give confidence in the management of the MHR. I wonder how many opt out requests will be simply lost or forgotten?