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"


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

Monday, June 25, 2018

Weekly Australian Health IT Links – 25th June, 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

Other than the much ballyhooed ‘Death of the Fax’ a quiet week I believe.
The first article is the pick of the bunch!

Think you're busy now? More work uploading e-health summaries is on the cards

Department of Health expected to 'lift the bar' for e-PIP qualification, adviser says
20th June 2018
GPs could be forced to upload more shared health summaries to qualify for the Practice Incentives Program eHealth Incentive when My Health Record becomes opt-out in December. 
Dr Steve Hambleton, a Brisbane GP and adviser at the Australian Digital Health Agency, says he expects the Department of Health to “lift the bar” for the so-called e-PIP. 
When the requirement to upload summaries for at least 0.5 per cent of patients was added to the e-PIP in 2016, almost one-third of practices did not meet the target.

My Health Record replatforming talks begin

By Justin Hendry on Jun 20, 2018 6:58AM

Ahead of early market approach.

The Australian Digital Health Agency has begun talks to replatform the My Health Record system ahead of the 2020 expiry of its multi-million deal with national infrastructure provider Accenture.
Accenture has held the deal for the design, build and integration of the system since 2011, when it was known as the personally controlled electronic health record (PCEHR).
Leading a consortium of suppliers, including Oracle and Orion Health, it has built the system’s core IT infrastructure and operations centre from the ground up.
It has also been responsible for the portals used by healthcare suppliers and consumers to access the record.
18 June 2018

There’s something in the AIR (just not much)

Posted by Felicity Nelson
The government had little to say in response to awkward questions from GPs about the Australian Immunisation Register (AIR) at a conference in Adelaide this month. 
“How is the AIR going to support us in transferring this data to you?” one GP asked Hope Peisley, the director of the Immunisation Policy Section at the federal Department of Health.
“It is not compulsory and, for most GPs, it’s time consuming and sometimes we don’t want to transfer because there is no funding for us,” the GP said.
GP clinics currently receive $6 every time they notify the AIR that they have vaccinated a child up to the age of seven, and an additional $6 to report catch-up vaccinations for children who are more than two months overdue.

Australia's first digital public health service

By Dr Stephen Ayre
Tuesday, 19 June, 2018
Queensland’s Metro South Health recently completed an ambitious project to replace paper-based medical records with integrated electronic medical records across five facilities. Clinician input helped guarantee the project’s success.
Health care is changing and so are our hospitals. Innovation and the introduction of digital platforms are shaping the way we build and plan our hospitals.
In 2014, Brisbane’s Princess Alexandra Hospital (PAH) became the first large-scale public hospital in Australia to replace paper-based medical records with integrated electronic medical records (ieMR). An ieMR means a patient’s medical information is documented and accessed via a secure electronic medical record, across all services including acute medical, surgical, mental health, cancer, rehabilitation and allied health services. The ieMR automatically uploads observations and vital signs from patient monitoring devices; allows efficient electronic ordering of radiology and pathology tests; and provides decision support for clinicians in prescribing, verifying and administering medicines to our patients.

Why prescriptions should state patient’s disease

Key findings and suggestions from health and welfare report
20th June 2018
Adding the condition or disease being treated to prescriptions could help prevent over-prescribing, according to the Australian Institute of Health and Welfare (AIHW).
The AIHW has released its latest report on Australia’s health but says the snapshot is missing information linking diseases to prescriptions.
Recording the condition being treated on PBS scripts would “greatly help” assess how much money is spent on each disease group.

Health to build national data exchange for prescription tracking

By Justin Hendry on Jun 21, 2018 6:54AM

For real-time monitoring system.

The Department of Health will establish a national data exchange for transferring prescription information between states and territories in real-time.
The exchange is the first piece of work for the national prescription monitoring system, which was funded with $16.4 million last year to target the misuse of certain prescription drugs.
The system will be used to instantly alert pharmacists and doctors if a patient has previously been supplied with prescription-only medicines that contain morphine, oxycodone, dexamphetamine and alprazolam.

Dept of Health hunts for provider to build national data exchange

A component of the Real Time Prescription Monitoring system
Samira Sarraf (ARN) 21 June, 2018 11:35
The Department of Health has put out a request for tender (RFT) seeking a provider to build the National Data Exchange component of the Real Time Prescription Monitoring (RTPM) system.
The RTPM system was announced in July 2017 with Government pledging to invest $16 million in a system to monitor dangerous prescription drugs.
The system will provide an instant alert to doctors and pharmacists, through their clinician software, if patients have previously been supplied with target drugs. This information will assist in clinical decision making, according to the RFT documents.

Tamworth company develops app for men's health

14 June 2018
Men of all ages will be reminded to take regular health check-ups to stay healthy and out of hospital with the assistance of a new app developed by a Tamworth company with the backing of the NSW Government.
Member for Tamworth Kevin Anderson helped launch the 'PromptMate' app in the lead-up to Men’s Health Week next week.
The app has been developed by ManageHealth with the support of a Minimum Viable Product (MVP) grant from the NSW Government-backed Jobs for NSW.
'This app PromptMate will be like a tap on the shoulder for men to touch base with their GP or specialist on a regular basis to maintain a healthy balance of life,' Mr Anderson said.

Avoidable complications to cost public hospitals funding

  • The Australian
  • 12:00AM June 19, 2018

Sean Parnell

Public hospitals would be stripped of taxpayer funding if patients were discharged only to suffer avoidable complications that required them to be readmitted to hospital.
Under a proposal being developed by the Independent Hospital Pricing Authority, in the third wave of its quality-based funding reforms, several new funding models for avoidable readmissions would be tested across the public system from July next year. Quality and safety experts have compiled 11 categories of ­diagnoses warranting closer ­attention, including multi-resistant infections within two days of discharge, unexpected surgical pain within 14 days, gastrointestinal infections within 28 days and any venous thromboembolism within 90 days.
“The objective of interventions targeting avoidable re­admissions is to provide incentives for hospitals and clinicians to identify areas for quality ­improvement,” the IHPA has told stakeholders in a consultation document.
“This can include tackling ­issues such as the rate of complications and other adverse events arising during the index ­admission, as well as improving discharge planning, care co-­ordination and the provision of health and other support services in the community.”

Robotics roadmap for Australia launches

To make sure Australian industry and society benefits from robotics and automation technologies
George Nott (Computerworld) 18 June, 2018 12:00
Robots are hard at work all over Australia. They are pulling tonnes of iron ore hundreds of kilometres across the Pilbara. They are swimming around the Great Barrier Reef killing environment damaging starfish. They are surfing Australian waters collecting scientific data and replacing maintenance workers on hazardous oil rigs.
Despite its size, Australia has been a relative leader in the use of robotics and autonomous systems. It was the first country in the world to automate a port, with autonomous stevedores in action at Port Brisbane since 2007. Its mines were among the first globally to operate driverless trucks. Australia-written autopilot code keeps more than one million Unmanned Aerial Vehicles from crashing to the ground.
Meanwhile it’s robotics, computer vision and AI researchers are respected around the world, with the International Conference on Robotics and Automation held for the first time in the southern hemisphere in Brisbane earlier this year. Last year a team of 27 roboticists from Queensland University of Technology, The University of Adelaide and the Australian National University won the global Amazon Robotics Challenge.

NSW’s record-breaking “people’s budget” injects $25 billion into high-tech health system and new Liverpool health precinct

Lynne Minion | 20 Jun 2018
The NSW Government has announced a $2.3 billion budget boost for world-class hospitals and health services in the state in 2018-19, with a new Liverpool health precinct and a $25 billion total health budget taking NSW towards the 2019 election.
It is a record-busting “people’s budget”, according to Treasurer Dominic Perrottet, with the government investing in an extra 300 doctors, an additional 950 nurses and midwives, and 120 more allied health professionals, taking the frontline clinical and clinical support staff numbers to over 105,000, while $8 billion over the next four years will be plunged into 40 new facilities, upgrades and redevelopments. 
“Our government is committed to providing state-of-the-art health facilities for all of NSW,” Perrottet said.

Nursing informatics position paper launches at NIA

Nurses have a unique leadership role in ensuring a digitally enabled health system delivers on the promise of better health for all Australians. A joint position paper released today by Australia’s peak bodies for nursing and digital health says as the largest single profession in the healthcare workforce, nurses need to be recognised and acknowledged for their enabling role in the digital health movement. The paper says nurses have the potential to deliver better patient outcomes as well as facilitate a better consumer and clinician experience.
Produced collaboratively by the Australian College of Nursing (ACN), HISA and its special interest group Nursing Informatics Australia (NIA) following sector consultation, the paper is the first national statement to affirm the role of nurses in digital healthcare at all levels and in all health settings. With seven key actions, it urges nurses and midwives to lead in decision-making as well as to partner; to obtain the knowledge and experience to act as knowledge brokers and to transform services and empower patients in self-care.

A waiting game

Hold off on My Health Record registration till a new process comes into place, accredited pharmacists are told 

Accredited pharmacists should hold off for registering for access to the My Health Record program till 1 July when a new, streamlined registration process kicks off, PSA national president Dr Shane Jackson says.
Speaking at the Australian Association of Consultant Pharmacists conference – ConPharm – in Brisbane last weekend, Dr Jackson said there were currently 2974 pharmacies registered for the MHR project, but it was currently a more difficult process for accredited consultant pharmacists to access the system through the provider portal. 
“However, I’ve been assured that there will be a much more streamlined and effective system of registration that will be in place from 1 July to allow individual accredited pharmacists to register for access,” he said.

Media release - Industry collaborates to end the era of the fax machine

Out of date and unsecure fax machines are being used to share patient information between healthcare providers, despite other sectors discarding them over a decade ago. Not only do fax machines cause frustration for healthcare providers trying to communicate with each other, they can also cause patient harm.
In May 2018, a coroner’s report revealed that Hodgkin’s lymphoma patient Mettaloka Halwala died alone following chemotherapy complications. His medical test results were faxed to the wrong number, which meant his treating haematologist did not receive information that could have saved his life.
Coroner Rosemary Carlin called for the hospital involved to phase out fax transmission of imaging results as a matter of urgency. She said it was difficult to understand why such an antiquated and unreliable means of communication exists at all in the medical profession.

‘Antiquated and unreliable’ tech must go

They’re out of date and insecure, says the Australian Digital Health Agency: so it’s time to stop using fax machines to share patient information

The Agency, with the Medical Software Industry Association, ran a secure messaging industry collaboration workshop this month to make decisions about secure messaging and interoperability across the health sector.
Key industry players have agreed to improve secure messaging of patient records between healthcare providers using clinical software.
In a statement the Digital Health Agency said that while other sectors discarded fax machines a decade ago, healthcare providers are still using them, causing frustration between healthcare professionals and also patient harm – up to and including death.

Australia’s National Digital Health Strategy promotes interoperable and secure communication

By: Teresa Umali
Published: 20 Jun 2018
Relying on fax machines as a form of communication among healthcare providers, professionals and patients can be fatal. Australia’s National Digital Health Strategy answers the need for interoperability and a secure form of communication that would provide timely, reliable and safe information.
An announcement by the Australian Digital Health Agency highlighted on Australia’s National Digital Health Strategy and how it will be able to solve problems concerning interoperability and secure communication. This strategy will also end dependence on fax machines and paper-based correspondence.
In order to address the issue of interoperability and secured communication among healthcare providers, professionals and patients and support the uptake of digital health services, the Council of Australian Governments (COAG) Health Council approved Australia’s National Digital Health Strategy. They described the strategy as Safe, Seamless and Secure.
The urgency to do so was brought about by an incident with a fax machine. Outdated and unsecure fax machines are still being used to share patient information between healthcare providers. It has become a source of frustration for healthcare providers. Plus, it can cause harm to a patient.

COORDINARE – My Health Records

June 19, 2018
Batemans Bay resident, Brad Rossiter sees the benefits of sharing and accessing information on My Health Record, providing a convenient snapshot of his health.

Brad has had Type 1 diabetes since 1970, and in 2000 was diagnosed legally blind and with end-stage renal failure requiring dialysis. Within eight years, he received a kidney and pancreas organ transplant, and became a double leg amputee.

Brad found out about My Health Record though the Eurobodalla Health Service Community Consultation Committee and Canberra Hospital Renal Advisory Meeting (RAM).

“After reading over the information on the website and talking to my GP, I decided to register – with my medical history it really was a no brainer,” said Brad.

Medical software sector, docs and govt on mission to kill the fax

Standards meetings and proof of concepts underway to find consensus on interoperable messaging of health data
George Nott (Computerworld) 21 June, 2018 11:28
In November 2015, Mettaloka Halwala, a Sri Lanka-born father of two, went for a PET scan at Goulburn Valley Hospital near Shepparton, Victoria.
Halwala, who had moved from his home in New Zealand to work as a civil engineer for Goulburn Murray Water, had been receiving chemotherapy for Hodgkin’s lymphoma, but his latest PET results suggested he may be suffering toxicity as a result.
Two days later he received another dose of chemotherapy, which only happened “because the haematologist…was unaware of the results”.
Days later, having called his doctor to say he was feeling unwell the night before, Halwala was found dead in his hotel room.

Telstra called out on cancer registry fail

21 June 2018


Missed deadlines for the National Cancer Screening Register are affecting more than just Telstra's hip pocket, writes Antony Scholefield
Poor Telstra. Fresh from apologising for two outages in its phone network, including one affecting the triple-0 emergency line, the telecom’s failings are under the spotlight again.
A recent Senate estimates hearing asked health officials to explain exactly what was happening with the National Cancer Screening Register, for which Telstra was awarded a $200 million contract to establish.
The launch of the register was delayed by six months last year, finally rolling out on 1 December. And because the changes to cervical ​screening – which replaced Pap smears with five-yearly HPV screening – were linked to the register, this revamp was delayed too.

ALP help to outlaw Mediscare messages

  • The Australian
  • 12:00AM June 19, 2018

Rachel Baxendale

Labor has voted to pass laws that would criminalise the “Mediscare” text message sent out by the Queensland branch of the party during the 2016 federal election campaign.
The laws, dubbed the “Medi­scare bill” by the Coalition, make it a criminal offence to impersonate a federal entity company or service, such as a government agency or department.
In 2016 the Queensland branch of the ALP took responsibility for a text message sent to voters reading: “Mr Turnbull’s plans to privatise Medicare will take us down the road of no return. Time is running out to Save Medicare”.

Major German research project chooses openEHR

Posted on by wolandscat
I just returned from Heidelberg, where another very successful ‘openEHR day’ was held, this time by the HiGHmed research consortium, with 100 attendees. HiGHmed is funded with 20m€ by the German Federal Ministry of Education and Research (BMBF) under the “Medical Informatics” funding scheme, and has as its goal (my bolding):
.. to develop and use innovative information infrastructures to increase the efficiency of clinical research and to swiftly translate research results into validated improvements of patient care. These aims are tightly connected with challenges to integrate and further develop solutions of innovative, internationally interoperable data integration and methods, with the aim to demonstrate their added value for health research and patient care. The concepts must be designed in a way that will help to develop sustainable structures and with the perspective for an easy roll-out to other hospitals.
The slide in the image above is from Wouter Zanen, who presented on EuroTransplant, an 8-country network that facilitates patient-oriented allocation and cross-border exchange of deceased donor organs, now using openEHR. But the reasons for HiGHmed’s choice are pretty close I think. A number of other presentations on openEHR deployments and projects say very similar things.

Want to know when you might die? So does Google

WHEN a sick woman went into hospital doctor’s gave her a 90.7 per cent chance of surviving her visit. Google was less optimistic.
news.com.au June 20, 20182:44pm
GOOGLE is getting into healthcare and is touting the power of its artificial intelligence systems to determine the likely fate of patients.
With the enough data, the company thinks it can predict when a patient will die with up to 95 per cent accuracy.
In May, Google scientists published the account of a woman who came to hospital with late stage breast cancer and fluid building in her lungs. After the hospital equipment and computers took the woman’s vital signs, it estimated that she had a 9.3 per cent chance of dying during her stay at the hospital.
Then it was Google’s turn. Its neural network, a type of artificial intelligence that can analyse huge reams of data and automatically learn and improve, was fed 175,639 data points on the woman including past health records and her current vital signs. It delivered a decidedly more grim prediction, calculating the woman had a 19.9 per cent chance of dying during her stay.
  • Jun 18 2018 at 11:00 AM

HealthMatch raises $1.3m as it seeks to become the global platform for clinical trials

HealthMatch, an Australian start-up aiming to become the go-to platform linking sick patients with clinical trials of potential treatment, is targeting US expansion after a $1.3 million capital raising from Australian venture capital and US industry insiders.
The early stage start-up first rose to prominence late last year, when it won the inaugural Australian version of popular US pitching competition TechCrunch Startup Battlefield, and will now begin hiring more staff to capitalise on progress it has made in establishing its product.
The company has created an online platform which uses machine learning to sort through the thousands of clinical trials being run by contract research organisations (CROs) in Australia and matches relevant registered patients. Its co-founders Manuri Gunawardena and Arran Schlosberg needed funding to hire software engineers and some marketing and operations staff as the company starts to grow in earnest.

Why we cannot allow machines to take over

19 June 2018


The digitisation of medicine is having a negative impact by eclipsing the human side of medicine, writes Professor Stephen Leeder.
"There are times when the diagnosis announces itself as the patient walks in, because the body is, among other things, a text,” says Professor Abraham Verghese, professor for the theory and practice of medicine at Stanford University Medical School, California.
Writing in the New York Times (16 May), he adds: “I’m thinking of the icy hand, coarse dry skin, hoarse voice, puffy face, sluggish demeanour and hourglass swelling in the neck — signs of a thyroid that’s running out of gas. This afternoon the person before me in my office isn’t a patient but a young physician; still, the clinical gaze doesn’t turn off and I diagnose existential despair.”
The state of the US healthcare system, which means doctors no longer care for real patients, is the root cause of this young doctor’s despair, Professor Verghese says.
  • Updated Jun 19 2018 at 11:00 PM

Australia poised for a boom in robotic surgery

by Jill Margo
Australia is poised for a boom in robotic surgery and while this might make many shudder, it's likely to make surgery more efficient and to speed recovery.
While some fear this steely technology will crowd out compassion and leave no space for the ancient art of medicine, in reality the two can happily co-exist.
Today, when a patient with cancer at the base of his tongue is wheeled into a contemporary operating theatre, the large, looming pieces of robotic technology probably don't look too friendly.
But they will likely prevent enormous suffering. Until recently, his jaw would have been cut in half and spread open so surgeons could reach the tumour.

Fixing fake health news: will Google and Facebook help?

Authored by Jane McCredie
WHEN the Collins Dictionary anointed “fake news” its 2017 word of the year, it was presumably because the publishers deemed the term so important it didn’t really matter that it wasn’t actually a single word.
Misinformation is hardly new, but the platforms it spreads on these days certainly are. Google, Facebook and friends provide an unprecedented capacity for the misleading, or downright dishonest, to be disseminated and amplified.
In April 2018, Facebook CEO Mark Zuckerberg acknowledged to the US Congress that his organisation had, among other things, been “too slow to spot and respond to Russian interference” in the 2016 US presidential election using the social media site.

It's a matter of digital life and death

By Caitlin Fitzsimmons
Updated17 June 2018 — 1:51pmfirst published at 12:00am
I fully intend to live to 100 and with one grandmother aged 89 and the other about to turn 94, the odds are on my side.
But with death it’s a case of planning for the worst and hoping for the best. While I don’t like thinking about death and how my loved ones would cope without me, for their sake I’ve done the basic preparation any responsible adult should do.
My husband and I have simple matching wills, death nominations in our super, and sufficient life insurance to allow the surviving partner to pay off our mortgage were the unthinkable to happen.

NEC loses national biometrics database project

By Justin Hendry on Jun 15, 2018 3:30PM

Over ongoing delays and cost overruns.

The Australian Criminal Intelligence Commission has terminated its contract with NEC Australia for a new national biometrics database after walking staff off the project earlier this month.
In a statement, the agency said it made the decision to “discontinue” the biometric identification services (BIS) project in “light of project delays”.
“The contract with NEC Australia to deliver the BIS project has today been terminated,” ACIC CEO Michael Phelan said.
  • Updated Jun 21 2018 at 12:15 AM

Bankers look for break-up benefits in Telstra restructure

For bankers it's manna from heaven.
Telstra didn't just deliver the prospect of a demerger bigger than Wesfarmers' $18 billion Coles spin-off but also a handy $2 billion in asset sales for investment banks to crawl over.
Insiders believe InfraCo, the business Andy Penn wants to package up for a potential demerger (or to attract a strategic investor), has been overlooked by a market fixated on its retail business. 
Plans to hive off the infrastructure assets were foreshadowed by Street Talk in May 
One (very) bullish analysis puts the value of InfraCo at between $30 billion and $36 billion, or roughly Telstra's entire market value on Wednesday. In other words, investors could buy Telstra shares today and effectively get the mobile business for nothing.  

Take-up of faster NBN plans increasing, company claims

More customers are switching to faster broadband plans, NBN Co, the company rolling out Australia's national broadband network, claims.
In a statement, the company said 70% of new plans being taken up were either 50Mbps or higher.
Orders for the higher speed plans had almost tripled, from 16% to 44%, NBN Co said, without specifying the figure on which these percentages were based.
It also claimed that "average bandwidth network congestion reduced from more than five hours to less than 30 minutes per service, per week compared to this time last year (excluding Sky Muster satellite)".

ACMA unveils NBN standard to keep customers online

By Ry Crozier on Jun 22, 2018 11:51AM

During any messy transition.

New protections will kick in from September 21 that are aimed at preventing customers that switch to an NBN service being left without functional internet for an extended period.
The service continuity standard is one of a batch of protections being worked on by the Australian Communications and Media Authority (ACMA) at the direction of the government.
ACMA chair Nerida O’Loughlin said in a statement that the authority’s own research showed that “about 16 per cent of households reported being left without their home internet and/or phone service for more than a week when moving to services provided over the NBN”.

Will 5G really finish the NBN? Not so fast

  • David Kennedy
  • The Australian
  • 8:46AM June 20, 2018
There has been a huge amount of recent speculation about the looming impact of 5G on the Australian fixed broadband market — with some even predicting the nbn will be rendered obsolete.
But the death of fixed broadband is much exaggerated, for three main reasons. First, the rollout of 5G is going to be slower than some people expect. Second, consumer data demand is growing fast and cannot be serviced by mobile alone. Finally, fixed broadband is developing too and is well placed to absorb the impact of much higher data usage.
5G is an evolution of 4G technology that adds some new and powerful features. 5G is designed to support the “internet of things” (IoT) that is increasingly being used to automate and manage industries from manufacturing to agriculture to transport. But for now, these new and potentially lucrative 5G services lack a clear operating model and business case. Conventional mobile broadband — like the existing 4G service — is the only established use case for 5G that we have at present. 5G can be used to carry data traffic in areas where 4G is under strain, such as CBDs, sporting venue and the like. But telcos will get no additional revenue out of this, because they are just serving existing demand.

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