This Is A Must Not Miss Contribution To The Discussion Of The Value of Health IT.

The following appeared a little while ago:

The Trillion Dollar Conundrum

By David Dranove

In Tuesday’s Wall Street Journal Op-Ed pages, physicians from Harvard and University Pennsylvania Medical Schools criticize subsidies for expanding the use of health information technology (HIT). The physicians cite a recent review article that failed to find consistent evidence of cost savings associated with HIT adoption. If true, this is bad news for the health economy, as supporters claim that HIT could cut health spending by as much as $1 trillion over the next decade.

How can something that is so avidly supported by most health policy analysts have such a poor track record in practice? In a new NBER working paper by myself, Avi Goldfarb, Chris Forman, and Shane Greenstein, we label this the “Trillion Dollar Conundrum.” One explanation may be that most HIT studies examine basic technologies such as clinical data repositories, while most of the buzz about HIT focuses on advanced technologies such as Computerized Physician Order Entry. In our paper, we offer a rather different explanation for the conundrum, one that would have eluded physicians and other health services researchers who failed to consider the management side of HIT.

My coauthors on this paper are experts on business information technology. They are not health services researchers. When I approached them to work on this topic, they insisted on viewing HIT much as one would view any business process innovation. As I have learned, this is by far the best way to study most any issue in healthcare management. Those who advocate that “healthcare is unique” – usually by ignoring broadly applicable theories and methodologies—often strain to explain data that are easily understood using more general frameworks. Such is the case with HIT.

Health services researchers have analyzed HIT much as they would analyze a new medical intervention. Some patients receive the treatment, others receive a placebo, and the treatment is deemed “successful” if the treatment group fares better than the control group and the difference passes statistical muster. While this methodology inspires a certain level of confidence in medicine, it has a critical shortcoming that has only recently been addressed through “personalized medicine.” The intervention might be effective for only some of the treatment group, and might be harmful to others. The typical research design masks these heterogeneous effects.

Lots more (and some really great comments) are found here:

http://thehealthcareblog.com/blog/2012/09/20/the-trillion-dollar%C2%A0conundru/

Re the Author:

David Dranove, PhD, is the Walter McNerney Distinguished Professor of Health Industry Management at Northwestern University’s Kellogg Graduate School of Management, where he is also Professor of Management and Strategy and Director of the Health Enterprise Management Program. He has published over 80 research articles and book chapters and written five books, including “The Economic Evolution of American Healthcare and Code Red.” This post first appeared at Code Red.

This all needs careful reading as we are seeing a range of perspectives on many aspects of the “value of Health IT” debate and balance and careful logical thought is vital!

Here is coverage from the Wall St Journal of the trigger article:

• OPINION
• September 17, 2012, 7:25 p.m. ET

A Major Glitch for Digitized Health-Care Records

Savings promised by the government and vendors of information technology are little more than hype.

By STEPHEN SOUMERAI And ROSS KOPPEL

In two years, hundreds of thousands of American physicians and thousands of hospitals that fail to buy and install costly health-care information technologies—such as digital records for prescriptions and patient histories—will face penalties through reduced Medicare and Medicaid payments. At the same time, the government expects to pay out tens of billions of dollars in subsidies and incentives to providers who install these technology programs.

The mandate, part of the 2009 stimulus legislation, was a major goal of health-care information technology lobbyists and their allies in Congress and the White House. The lobbyists promised that these technologies would make medical administration more efficient and lower medical costs by up to $100 billion annually. Many doctors and health-care administrators are wary of such claims—a wariness based on their own experience. An extensive new study indicates that the caution is justified: The savings turn out to be chimerical.

Since 2009, almost a third of health providers, a group that ranges from small private practices to huge hospitals—have installed at least some "health IT" technology. It wasn't cheap. For a major hospital, a full suite of technology products can cost $150 million to $200 million. Implementation—linking and integrating systems, training, data entry and the like—can raise the total bill to $1 billion.

But the software—sold by hundreds of health IT firms—is generally clunky, frustrating, user-unfriendly and inefficient. For instance, a doctor looking for a patient's current medications might have to click and scroll through many different screens to find that essential information. Depending on where and when information on a patient's prescriptions were entered, the complete list of medications may only be found across five different screens.

Now, a comprehensive evaluation of the scientific literature has confirmed what many researchers suspected: The savings claimed by government agencies and vendors of health IT are little more than hype.

Lots more here:

http://online.wsj.com/article/SB10000872396390443847404577627041964831020.html

As I said - a contested space. Careful reading is vital!

David.

I Am Struggling To Know Just Why This Article Was Commissioned by The MJA. Hardly By A Recognised E-Health Expert And Contains No Real News.

This appeared a week or so ago (behind a paywall sadly - hardly a way to get views into the public domain!)

e-Health records: beware of assumed benefit

Ray N Moynihan

Med J Aust 2012; 197 (6): 319.

doi: 10.5694/mja12.11282

Ray Moynihan rings some notes of caution coming from experiences elsewhere

Change is perennial in health care, but some changes are more significant than others, like the personally controlled electronic health record (PCEHR) currently being rolled out across Australia. An ambitious reform, its much-touted benefits are safer and more effective care, less duplication of unnecessary tests — and, of course, enhanced datasets for researchers. As with most things medical, potential adverse consequences can attract less attention than promises, so it may be timely to explore a few experiences elsewhere.

In 2007, the United Kingdom rolled out the Summary Care Record as part of the much bigger National Health Service National Programme for IT overhaul. Within the broader reform, a personal electronic health record system called HealthSpace was introduced, allowing people to view their record and record information like blood pressure readings. However, an independent evaluation of the system in 2010 was scathing.1

Of those invited to open an “advanced” HealthSpace account (which allows access to the summary record and opportunity to interact with health professionals, on top of the “basic” account containing an individual’s data), only one in a thousand registered, compared with predictions of 5%–10% uptake. Many people found it “neither useful nor easy to use”, and its “functionality aligned poorly with their expectations and self management practices”.1 Stressing the limitations of their evaluation — informed by experiences of very few patients — the researchers identified a fundamental flaw in the concept. HealthSpace was envisaged primarily as a “data container” to be “deployed”, rather than part of a dynamic and interactive “sociotechnical” network.

Led by Trisha Greenhalgh from the Healthcare Innovation and Policy Unit at Barts and the London School of Medicine and Dentistry, the evaluation team argued that unless the e-records “align closely with people’s attitudes, self management practices, identified information needs, and the wider care package ... the risk that they will be abandoned or not adopted at all is substantial”.1 Early in 2012, Greenhalgh and colleagues published a wider evaluation of the experiences across England, Scotland and Wales,2 explicitly offering lessons in introducing electronic health record systems. A key finding was that implementation had “rarely gone as planned”.

Lots more here:

https://www.mja.com.au/journal/2012/197/6/e-health-records-beware-assumed-benefit

There are 5 references provided.

I have described the NEHRS / PCEHR as an ‘evidence free’ initiative (especially in terms of proven utility and benefit) regularly for years so the title hardly tells us something we did not know.

See here:

http://aushealthit.blogspot.com.au/2011/03/current-literature-shows-that-health-it.html

and here:

http://aushealthit.blogspot.com.au/2011/11/some-commentary-on-parliamentary.html

Additionally it is not made clear what is being done in Australia is different to what has been done overseas and so did not offer not much utility.
There is no news at all here to anyone who follows the field. It also struck me to ask just why wasn’t Prof. Enrico Coiera (who is cited in the article and is an expert) or another e-Health expert, asked to provide this review if one was needed?

Indeed, I would also argue a lack of analysis and discussion, in context, of just what is going on now with the NEHRS / PCEHR leaves this article rather incomplete.

Interestingly Professor Greenhalgh’s (also cited) analysis of large national programs, such as the NPfiIT and successors, and failure to learn the lessons available is quite devastating. While similar in some aspects of course the NEHRS is fundamentally different and it is hard to know just how much transfers usefully - but certainly some generalities do!

I have written a blog on this paper:

http://aushealthit.blogspot.com.au/2012/01/from-this-we-can-really-grasp-just-how.html

The full paper is found here now:

http://www.milbank.org/publications/the-milbank-quarterly/featured-articles/article/3497/why-national-ehealth-programs-need-dead-philosophers-wittgensteinian-reflections-on-policymakers-reluctance-to-learn-from-history

The best bit is this two sentence quote from the abstract:

“Findings: National eHealth programs unfold as they do partly because no one fully understands what is going on. They fail when this lack of understanding becomes critical to the programs’ mission.”

How true!

Of course, as I mentioned above, there is also an College (ACHI) which has 30 or 40 Fellows who know a fair bit about this topic as well. There are plenty of experts around if you bother to look!

It’s all a little odd that none of them were asked - or if they were that they declined.

What is needed from the MJA - if they must commission articles - is commentary and insight from established Health IT experts who are recognised by the clinical community as such. Mr Moynihan has done some good and useful work in a range of areas in seeking to keep 'the establishment' honest, but, to my knowledge, has not been active for any significant period in the e-Health space. Others are better equipped to respond to such commissions in this space I believe.
Bottom line - we need authoritative commentary on e-Health in our leading medical journal and it should also be peer reviewed given the mess we now see. This really is not good enough. Pity about the accesses restrictions also!

David.

Senator Sue Boyce Announces Agreement To Recommend Improvements To The Public Scrutiny of NEHTA. A Good Thing!

The following was sent to me today by her office.

MEDIA RELEASE

September 26 2012

E-HEALTH SHOULD BE ACCOUNTABLE

The Senate Community Affairs Committee had taken the unusual step of recommending that a Government agency, the National E-Health Transitional Authority, be required to report annually to Parliament, Queensland LNP Senator Sue Boyce said today.

At present NEHTA is not required to provide an annual report because of its corporate structure, despite the fact that it has already spent up to $1 billion dollars of taxpayers' money on the attempted introduction of a national E-Health system.

The authority is "owned" by the Federal and State Governments with the secretaries of all Health Departments as directors.

NEHTA has attended a number of Senate Estimates hearings, at the request of the Committee, and has received a significant number of questions on notice arising from those hearings, including questions around the issues of funding, expenditure and governance.

“It has also been the subject of on-going questions and criticisms about its performance and the delivery of products and outcomes that work and further the roll out of a national E-health system," Senator Sue said.

“I believe it would be fair to say both the Government and the Coalition have reservations about the performance of NEHTA.

“In its regular review of annual reports supplied by Government departments and agencies the all-party Senate Community Affairs Committee, of which I am a member, has recommended: 'Given NEHTA's significant public funding and responsibilities that go to Commonwealth policy and funding, the committee asks the government to consider whether, as a principal shareholder in NEHTA, it should make arrangements for the report to be presented to Parliament'.

“I've tried to ensure NEHTA is accountable so I really welcome this recommendation. The Gillard government must surely take it up in the interests of transparency and accountability,” Senator Sue said.

“NEHTA was to launch the cornerstone of the E-Health system, the Personally Controlled E-Health Record (PCEHR), on July 1 this year after five years of work but all they launched was a toll free number that didn’t work.

“Taxpayers should be able to scrutinise how Government bodies spend their money and making NEHTA supply a detailed annual report will greatly assist that process in regard to E-Health,” Senator Boyce said.

The link is to the relevant committee page:

http://www.aph.gov.au/Parliamentary_Business/Committees/Senate_Committees?url=clac_ctte/index.htm

The italics are the important part of the release.

I asked Senator Boyce’s office about the possibility of the ANAO conducting an audit of all this. The answer was just wonderful.

“Auditor has replied to our entreaties by saying

a. They have it on a list of future possibles

b. They believe that they need outcomes before an audit would have value!!!!

(We have expressed the view that expenditure=no outcomes =need for urgent audit)”

Catch 22 in alive and thriving in Canberra!

Amazing and horrifying stuff!

David.

At Least The Financial Review Is Keeping An Eye on The ‘Non-Progress’ of the NEHRS. The Snails Are Way Out In Front So Far In the Race!

The following appeared today.

Progress slow in electronic health push

25/09/2012

Emma Connors

Some 10,070 people now have a personal electronic health record as the government makes slow progress in addressing the concerns of consumers and doctors.

About 3240 signed up in the last month, joining the 6830 who were registered in late August.

However, obstacles remain. No GP practise is using clinical software directly linked to the new records system because the software is still not available. On the patient side, the Consumers Health Forum believes take-up would be faster if more people knew about the system, and if concerns about audit trails and governance were addressed.

Some teething problems have been addressed. Immunisations records and donor registration details have migrated to the new system as have Medicare and pharmaceutical benefit scheme records.

The government has also reached an uneasy truce with the Australian Medical Association after extending a cut-off date for technology allowances for surgeries and agreeing time spent updating e-records can be billed through the Medicare Benefits Scheme.

GPs will have to wait for software upgrades to link into the new system, but at least they now have some idea of how to charge for time spent on the new records, Australian Medical Association president Steve Hambleton said.

“We would have preferred separate item numbers but at least doctors won’t fall foul of the professional services review if they do itemise their accounts in this way,” he said.

Dr Hambleton hopes ease of use considerations will sit alongside security when access to the new health records becomes widespread.

“A big issue at the practise level is everyone will require a piece of hardware to prove who they are when they log into the new records system.

“I’m not sure how that will work with hot desking; we would prefer for that authentication process to take place through a mobile phone.”

Lots more here with discussion of Audit Trails etc.

http://afr.com/p/technology/progress_slow_in_electronic_health_B6IOIgi5IYFejg5kyCPEMK

All I can say is it is good that Emma Connors from the AFR is still on the case!

It is also useful to know that the total registration is still about 10,000 - which means we still a really tiny percentage involved (4.545 * 10^-4 of the population).

We are now essentially at ‘go-live’ + 3 months and it is fair to say that what has been delivered so far confirms the stupidity on the part of DoHA on responding to clearly absurd political deadlines - rather than just commencing operations when they were properly ready. The system ups and downs since really emphasises the validity of that view.

The Consumer Health Forum concerns also are really valid - especially the governance ones - which I have to say are nowhere near good enough as far as I am concerned.

Well worth a full read if you have access or can find a copy of the paper.

David.

Weekly Australian Health IT Links – 24th September, 2012.

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 much more interesting week, with a lot of reporting on all sorts of initiatives from the developer and private sector - in the absence of much from the Government.

It is clear that ‘under the radar’ there is a lot going on. I hope some of this leads to some really useful outcomes over time.

-----

http://www.itnews.com.au/News/316321,doctors-could-reject-e-health-records.aspx

Doctors could reject e-health records

By John Hilvert on Sep 20, 2012 4:59 PM

Consumer power restricted.

Consumers who customise their personally controlled electronic health record could miss out on its intended benefits, a Parliamentary committee into cybersafety was told.

Consumers Health Forum chief executive Carol Bennett told a committee hearing that doctors could refuse to use a patient's e-health record if that patient declined access to certain medical documents associated with the record.

The Federal Government's PCEHR initiative, launched on July 1, allows consumers to opt-in into the record and determine which clinicians or doctors can view records and health summary information associated with the record.

-----

https://www.mja.com.au/journal/2012/197/6/e-health-records-beware-assumed-benefit

e-Health records: beware of assumed benefit

Ray N Moynihan

Med J Aust 2012; 197 (6): 319.

doi: 10.5694/mja12.11282

Ray Moynihan rings some notes of caution coming from experiences elsewhere

Change is perennial in health care, but some changes are more significant than others, like the personally controlled electronic health record (PCEHR) currently being rolled out across Australia. An ambitious reform, its much-touted benefits are safer and more effective care, less duplication of unnecessary tests — and, of course, enhanced datasets for researchers. As with most things medical, potential adverse consequences can attract less attention than promises, so it may be timely to explore a few experiences elsewhere.

-----

http://www.cmd.act.gov.au/open_government/inform/act_government_media_releases/gallagher/2012/new_electronic_health_records_for_patients

New electronic health records for patients

Released 10/09/2012

The ACT Chief Minister and Minister for Health Katy Gallagher MLA today launched a pilot of a new secure system for Canberrans to access their health information online.

My eHealth enables patients to access personal information relating to their health care.

"My eHealth is a secure, online service which improves patients' access to their health information, and helps them keep track of their appointments," the Chief Minister said.

-----

http://www.6minutes.com.au/news/latest-news/medical-apps-lack-medical-input

Medical apps lack medical input

17 September, 2012 Michael Woodhead

Patients are increasingly relying on smartphone health apps for medical guidance, but many apps are lacking in evidence or may be used inappropriately, doctors have warned.

Paediatricians in the UK say they are seeing an increasing number of parents turning to health apps for medical advice and as a guide to what is ‘normal’ for their children.

In some cases the apps can promote ‘best practice’ and early recognition of medical problems, they say, but there is also the potential for mishaps, they write in the Archives of Diseases in Childhood.

-----

http://www.medicalobserver.com.au/news/online-cognitive-behaviour-therapy-cuts-suicidal-ideation

Online cognitive behaviour therapy cuts suicidal ideation

19th Sep 2012

Neil Bramwell

PATIENTS with suicidal ideation should not be excluded from internet cognitive behaviour therapy (iCBT), results from a new Australian study suggest.

Research on nearly 300 patients prescribed an iCBT program by primary care clinicians showed that suicidal ideation dropped from 54% to 30% after the six-lesson online course, regardless of sex and age.

The course covers psycho-education, behavioural activation, cognitive restructuring, problem-solving, graded exposure and relapse prevention, with content presented in the form of an illustrated story in which the character gains mastery over their depressive symptoms.

www.thiswayup.org.au

-----

http://ehealthspace.org/news/skin-cancer-receives-tele-treatment

Skin cancer receives tele-treatment

Posted Thu, 20/09/2012 - 16:41 by Will Turner

An Australian led team has developed a new camera to more accurately detect melanoma as part of an innovative technological system to combat the scourge of sun-loving Australians.

The camera is the work of MoleMap by Dermatologists, a melanoma surveillance and diagnosis service which sees nearly 30,000 patients a year across Australia, New Zealand and the United States.

Known as tele-dermatology, MoleMap’s system involves a patient’s skin abnormality being photographed by a doctor or nurse. The images are sent electronically to a patient database and are reviewed remotely by a dermatologist who reports anything significant back to the GP.

-----

http://www.medtechglobal.com/news/446/185/Medtech-Launching-eRx-eScripts.html

Medtech Launching eRx eScripts

Australian GP users of popular clinical software Medtech32 will have improved medication management at their fingertips with the launch of eRx eScripts in version 9 of the software this month.

Beta testing was successfully completed in June.

-----

http://www.medtechglobal.com/news/445/185/Medtech-Global-to-launch-Patient-Portal-PCEHR-functionality-in-v9.html

Medtech Global to launch Patient Portal, PCEHR functionality in v9

Medtech Global is in beta testing for a major upgrade of its Medtech32 clinical information system, which will feature the company's ManageMyHealth patient portal along with new PCEHR capabilities.

The ManageMyHealth portal is one of the company's flagship products, chief technology officer Rama Kumble said, allowing patients to book appointments online, receive email or SMS reminders from their doctor about tasks such as monitoring blood glucose levels or taking medications, as well as request repeat prescriptions or enquire about pathology results.

-----

http://www.healthintersections.com.au/?p=1149

Standards – we’re doing so well…

Posted on September 17, 2012 by Grahame Grieve

Vince MacCauley has written an article about standards development in Healthcare IT in Pulse IT. He starts with an interesting claim:

Software standards in general and eHealth software standards in particular provide a methodology and governance framework to encapsulate community agreed best practice in a readily accessible and stable specification.

-----

http://business.scoop.co.nz/2012/09/21/orion-health-opens-singapore-office/

Orion Health opens Singapore office

16:04 September 21, 2012 

Press Release – Orion Health

Orion Health Solidifies its Place in the Asian Healthcare Market Expands Regional Presence with Opening of Singapore Office

News release

Orion Health Solidifies its Place in the Asian Healthcare Market
Expands Regional Presence with Opening of Singapore Office
Singapore, 21 September 2012– To support its burgeoning success in Asia Pacific, Orion Health, New Zealand’s largest privately owned software exporter and a global leader in eHealth technology, today announced the official opening of its new Singapore office. This new facility provides a new home for the company’s Singapore-based services, development and technical support teams.

-----

http://www.mjainsight.com.au/view?post=ED+performance+data+biased&post_id=10805&cat=news-and-research

ED performance data biased

THE validity of the emergency department waiting time performance data published on the MyHospitals website has been called into question by a study that shows hospitals with higher proportions of urgent cases are disadvantaged by the reporting methods.

The study of 158 Australian emergency departments (EDs), published in the latest MJA, presented an analysis of waiting times reported on the website according to the proportion of patients in each of five triage categories — resuscitation, emergency, urgent, semi-urgent and non-urgent. (1)

Correlating the data this way showed that hospitals with a higher proportion of patients in the “emergency” category had poorer waiting time performance, indicating that performance data was biased in favour of EDs that reported fewer urgent patients.

-----

http://www.cio.com.au/article/436812/medibank_health_solutions_deploy_video_access_medical_specialists/

Medibank Health Solutions to deploy video access to medical specialists

Telehealth services organisation to enable patients to access video consultations with its offsite specialists

• Byron Connolly (CIO)
• 19 September, 2012 14:13

Medibank Health Solutions is gearing up to extend its online consultation service – Anywhere Healthcare – to enable patients in regional Queensland to connect with selected medical specialists over a video link provided at their GP’s office.

Next month, Medibank is rolling out the service to around 20 GPs under the first phase of the program. The organisation is targeting medical practices in rural areas where individuals don’t necessarily have easy access to medical specialists such as psychiatrics and clinicians trained in chronic disease management.

Medibank delivered the Anywhere Healthcare service using online medical consultation software from American Well, which it purchased in mid-2011. The software is hosted at Medibank’s data centres in Melbourne and Sydney.

-----

http://blog.healthlink.net/2012/09/clinical-messaging-electronic-lifeblood-new-zealand-australian-health-sectors/?utm_source=rss&utm_medium=rss&utm_campaign=clinical-messaging-electronic-lifeblood-new-zealand-australian-health-sectors

Clinical Messaging – the Electronic Lifeblood of the New Zealand & Australian Health Sectors

by Tom Bowden on September 20, 2012

The New Zealand health sector has one of the highest levels of clinical messaging in the world – by my estimation we are second behind Denmark.  Clinical messaging has a wide range of uses, predominantly it is used for the exchange of pathology and radiology reports, specialist letters, discharge summaries and to send information to and from a range of databases.

-----

http://www.itnews.com.au/News/315786,us-patient-records-stolen-by-staff-possibly-sold.aspx

US patient records stolen by staff, possibly sold

By Danielle Walker on Sep 17, 2012 11:43 AM

Miami hospital hit by second breach this year.

The University of Miami Hospital has fired two employees suspected of stealing and possibly selling the personally identifiable information of patients.

The health system announced the breach last week — the second to occur there this year — and began notifying those affected. A website detailing the incident also was set up. 

A hospital spokeswoman declined to provide the number of patients impacted by the theft, in which employees accessed “face sheets” — documents that include the names, addresses, dates of birth, insurance policy numbers, the reason for the hospital visit, and the last four digits of patients' Social Security numbers, according to a letter sent to affected individuals.

-----

http://www.mjainsight.com.au/view?post=Johanna+Westbrook%3A+Cost+of+archaic+care+&post_id=10821&cat=comment

Johanna Westbrook: Cost of archaic care

FOR vulnerable residents in aged care facilities, a missed page at the end of a fax can lead to a medication mix-up with potentially devastating consequences.

It was shocking enough to see the recent report on the ABC’s Lateline that thousands of dementia patients may be dying prematurely due to the routine prescription of antipsychotic drugs. But, sadly, our work at the Centre for Health Systems and Safety Research, at the University of NSW, shows that this may be just the tip of the iceberg in terms of poor medication practices in aged care homes.

We have been undertaking research in a number of residential aged care facilities to look at the challenges they face in being able to safely deliver all types of medications to residents.

-----

http://www.theaustralian.com.au/australian-it/government/committee-recommends-bill-containing-new-penalties-after-serious-privacy-breaches/story-fn4htb9o-1226476026016

Committee recommends bill containing new penalties after serious privacy breaches

• by: Andrew Colley
• From: The Australian
• September 18, 2012 12:00AM

AUSTRALIAN companies are a step closer to fines of up to $1.1 million for severe or repeated breaches of privacy regulations.

A parliamentary committee yesterday recommended passing a bill containing the new penalties in a report tabled in the lower house. It became the first of two parliamentary committees examining the bill to deliver its findings. A Senate committee is also due to report to parliament this month.

The bill was a response to the Australian Law Reform Commission's 2008 report on privacy and attempts to update current privacy laws for the digital age.

-----

http://www.medicalobserver.com.au/news/new-ehealth-record-privacy-penalties-may-be-broadened

New e-health record privacy penalties may be broadened

18th Sep 2012

Byron Kayne and Danielle Cesta

THE federal government is considering broadening tough new mandatory reporting laws for e-health records, including fines for those who fail to report breaches, beyond the realm of health care, MO can reveal.

The personally controlled electronic health record (PCEHR) will be subject to Australia’s first privacy mandatory reporting laws after the Office of the Australian Information Commissioner (OAIC) released draft guidelines with fines of up to $55,000 for failure to notify.

Last week, Attorney General Nicola Roxon’s office confirmed that while the PCEHR would be the only area without “voluntary” reporting laws, “the government… is considering whether to introduce a mandatory data breach notification requirement more broadly”.

-----

http://www.medicalobserver.com.au/news/draft-social-media-policy-stifling-and-costly-critics

Draft social media policy 'stifling' and costly: critics

17th Sep 2012

Byron Kayne and Danielle Cesta

GPRA has raised concerns about AHPRA’s new draft social media policy, arguing that GPs need to “embrace” communication advances rather than “stifle” the progress and discussion that is possible using these platforms.

In a letter to the regulator GPRA said it supported moves to help educate doctors navigate the online world “but we fear it may be counterproductive to stifle the progress and discussion that is possible using social media.”

GPRA also asked why a separate policy was required when doctors were already bound by a code of conduct.

-----

http://www.theaustralian.com.au/australian-it/government/up-to-15-per-cent-of-vic-human-services-tech-roles-could-go/story-fn4htb9o-1226473440881

Up to 15 per cent of Vic Human Services tech roles could go

• by: Fran Foo
• From: Australian IT
• September 13, 2012 4:50PM

THE Victorian Human Services Department could slash up to 15 per cent of technology roles as part of the Baillieu government's workforce reduction program.

The department's IT division employs 300 workers, including contractors. Its chief information officer Grahame Coles said between 30 to 40 people could go as part of a state-wide voluntary redundancy scheme.

Human Services is set to lose 500 positions from its 1100-strong workforce.

-----

http://www.smh.com.au/technology/sci-tech/a-robot-with-a-reassuring-touch-20120919-265ae.html

A robot with a reassuring touch

Date September 19, 2012 - 10:09AM

John Markoff

If you grab the hand of a two-armed robot named Baxter, it will turn its head and a pair of cartoon eyes - displayed on a tablet-size computer-screen "face" - will peer at you with interest.

The sensation that Baxter conveys is not creepy, but benign, perhaps even disarmingly friendly. And that is intentional.

It feels like a true Macintosh moment for the robot world. 

-----

http://www.smh.com.au/technology/sci-tech/a-chip-to-repair-the-brain-20120916-25ztk.html

A chip to repair the brain

Date September 16, 2012

Researchers are working on an implant to restore lost mental capacity, writes Benedict Carey.

Scientists have designed a brain implant that sharpened decision making and restored lost mental capacity in monkeys, providing the first demonstration in primates of the sort of brain prosthesis that could eventually help people with damage from dementia, strokes or other brain injuries.

The device, though years away from commercial development, gives researchers a model for how to support and enhance fairly advanced mental skills in the frontal cortex of the brain, the seat of thinking and planning.

The new report appeared on Thursday in the Journal of Neural Engineering.

-----

http://www.theaustralian.com.au/australian-it/government/australian-engineers-write-quantum-computer-qubit-in-global-breakthrough/story-fn4htb9o-1226477592578

Australian engineers write quantum computer 'qubit' in global breakthrough

• by: Chris Griffith
• From: The Australian
• September 19, 2012 8:56PM

AUSTRALIAN researchers say the world's first quantum computer is just 5 to10 years away, after announcing a global breakthrough that makes manufacture of its memory building blocks possible.

A research team led by Australian engineers has created the first working "quantum bit" based on a single atom in silicon, invoking the same technological platform that forms the building blocks of modern day computers, laptops and phones.

It opens up the real prospects of new quantum computers performing calculations billions of times faster than now within a decade.

-----

http://www.smh.com.au/technology/sci-tech/space-shuttle-endeavour-makes-final-flight-20120922-26dcf.html

Space shuttle Endeavour makes final flight

Date  September 22, 2012 - 1:50PM

The US space shuttle Endeavour took its final flight on Friday, making a spectacular series of flypasts over California before landing in Los Angeles where it will retire near its birthplace.

Piggy backed by a specially fitted Boeing 747, the shuttle flew over San Francisco's Golden Gate Bridge before heading south to take in the Hollywood sign and Disneyland, later landing at LA International Airport (LAX).

"It's so cool, and so sad," said Todd Unger, 28, who was among thousands who camped out from the early hours at the Griffith Observatory overlooking the city and the nearby iconic hilltop Tinseltown sign.

-----

Enjoy!

David.

AusHealthIT Poll Number 137 – Results – 24th September, 2012.

The question was:

Will The Huge Cuts We Are Seeing In State Health Systems Have A Major Impact On Progress In e-Health Going Forward?

No - All Will Be Well 10%   (5)

Possibly 12%   (6)

Probably 18%   (9)

Yes - E-Health Will Be Hard Hit 52%   (26)

I Have No Idea 8%   (4)

Total votes: 50

Very interesting response. Essentially about 70% think there will be at least some impact. One really has to wonder about the 8% who admit an absence of idea about the issue!

Again, many thanks to those that voted!

David.

There Is A Lot Going On In E-Health Which Is Just Not Being Reported. Why Is This Do You Think?

Has anyone else noticed just how quiet things have become in the reporting of the E-Health Sector.

I guess because I pay close attention I have noticed it more than most.

Also I have the sense that things that are newsworthy are also not being reported in the mainstream or even technical media.

Take this as an example these outages in the test environment being used by Vendors to set up their software to interact with the NEHRS.

From: PCEHR.SVT.SUPPORT@accenture.com

Sent: Thursday, September 20, 2012 11:50 AM

To: PCEHR.SVT.SUPPORT@accenture.com

Subject: PCEHR SVT UNPLANNED OUTAGE 11:45AM 20/09/2012

Outage Notification PCEHR SVT Environment Outage ─ Unplanned
Environment	PCEHR Software Vendor Testing
Start Date & Time (AEST)	20/09/2012 11:45:00
Reason for Change	PCEHR SVT Environment is unavailable - cause still to be ascertained.  PCEHR SVT support apologises for any inconvenience this may cause.
Outage Contacts	mailto:pcehr.otshelpdesk@humanservices.gov.au
Impacts	PCEHR SVT Environment is unavailable.

Followed by:

 From: PCEHR.SVT.SUPPORT@accenture.com

Sent: Thursday, September 20, 2012 2:43 PM

To: PCEHR.SVT.SUPPORT@accenture.com

Subject: *** UPDATE *** PCEHR SVT UNPLANNED OUTAGE 11:45AM 20/09/2012 *** UPDATE ***

Dear Stakeholders,

 A high severity incident has been raised with infrastructure team to restore service in the PCEHR SVT environment.

 We are working towards restoring service, this may take up to 4:00PM 20/09/2012.

 We apologize for any inconvenience this may cause.

----- End Messages.

I have a whole lot of these and am assured it is a sadly much more than regular occurrence. It seems that the system is just going up and down like a ‘yo-yo’. How can vendors deliver with a test environment that is so unstable in the very limited time available as recounted last week?

See here:

http://www.aushealthit.blogspot.com.au/2012/09/a-totally-unrealistic-email-came-out.html

I find it hard to know just why this is not being reported anywhere. I can assure you there are some more than frustrated Vendors.

Maybe the silence is all to do with the wider press environment. We have Fairfax and News Ltd hacking staff (two reporters with a major interest lost with this) and we also have places like ZDNet somehow dropping the e-health topic.

The Government is running dead on any news in the area (just hoping for something good to happen) and most of the other sources have scaled back their NEHRS coverage and are often doing little more than re-hashing press releases (of which we see very few from the NEHRS program.)

Additionally we have seen our favourite attack blog being defunded if the disappearance of the NEHTA sponsorship logo and lack of posting is anything to go by (only one post since July 30, 2012). So much for professional independent journalistic interest being driven by altruism. The blog was always a paid mouthpiece and what has happened just goes to pretty much confirm that view. Bit of a pity really as there was occasionally some semi-official feedback and reaction posted which was interesting.

My view is that this is a serious betrayal of the public interest as it is clear from the number of comments on the blog there is continuing interest and concern regarding this program.

We need to topic covered so we can all form a view as to what is happening and what it means.

David.
p.s. By way of more news this afternoon the NEHRS seems to be up and working as expected. My meds have even been updated to the 5th of August. Of course after a year or two this might become a rather annoying repeated list!
D.