Here Is A Big Picture Discussion Of the Place Of Technology In Health Care. All Articles Worth A Look.

This appeared a few days ago.

Why Medicine Will Be More Like Walmart

What health care will look like after the information technology revolution.

• By David M. Cutler on September 20, 2013

• View full report

Why It Matters

Information technology can cut costs by driving the consolidation of health care.

The idea that technology will change medicine is as old as the electronic computer itself. Actually, even older. In 1945, Vannevar Bush, the man with the vision for the National Institutes of Health, foresaw a Memex computer program that would allow access to past books and records. A lone physician searching for a diagnosis in far-flung case histories was one of the applications Bush imagined.

Medicine is an information intensive industry. Yet there’s still no medical Memex. Even though the Internet teems with health information, study after study shows that medical care often differs greatly from what the guidelines say—when there are guidelines. Doctors frequently rely on their own experience, rather than the experience of millions of patients who have seen thousands of doctors. Not only is the past lost, the present is missing. How many times has a patient received a drug that causes an allergic reaction, just because that information is not available at the time it is needed?

Bit by bit, this situation is changing. The 2009 American Recovery and Reinvestment Act (aka the stimulus bill), created the HiTech program, which allocates billions of dollars for doctors and hospitals to buy electronic health records systems. Since the program was enacted, rates of ownership of such systems have tripled among hospitals and quadrupled among physicians. In just a few years, it is reasonable to think that the entire medical system will be wired.

What will happen then? The introduction of information technology into the core operations of hospitals and doctors’ offices is likely to make health care much more like the retail sector or financial services. Health care will be provided by big institutions, in a more standardized fashion, with less overall cost, but less of a personal touch.

Health care today looks a lot like the retail sector did in the early 1980s, when clothes and household products were sold by many local stores and small chains. Quality was haphazard, prices were higher, and buyers’ experiences were mixed. Consumers had only the information they could see in the store or the Sunday paper.

Retail firms got larger when information technology became widespread. Walmart replaced the corner drug store and Amazon put the local book shop out of business because large firms can use information technology better than small ones—to manage inventories, create consistency, automate routine activities, and lower prices. Output per worker grew over 4 percent annually in the retail sector since 1995. Output per worker has fallen in health care over the same time period.

When the medical Memex finally arrives, look for health care to follow the retail track. The solo practitioner is likely to be the first to go. He or she will have to decide whether to try to become an IT manager as well as a doctor, or join a larger group of doctors. For most, the choice will be easy. The chance that a doctor over 65 works alone or in a two-person practice is about 40 percent. For young doctors, it’s less than 5 percent.

Lots more here:

http://www.technologyreview.com/news/518906/why-medicine-will-be-more-like-walmart/

The whole series is well worth a browse and from a group of people who know what they are talking about.

Enjoy.

David.

Here Is A Health IT Debate We Probably Need To Have. What Do You Think?

This appeared a few days ago.

http://www.healthdatamanagement.com/blogs/physician-computer-usage-46586-1.html

Do Physicians Spend Too Much Time With Computers?

By William Hersh, M.D.

SEP 17, 2013 9:35am ET

A recent study of work hours of medical interns in the new era of duty hour regulations produced an interesting side finding, which is that modern medical interns spend about 40% of their time at a computer [1]. To some, this prompted concern that computers were drawing medical trainees away from patients and their care.

A finding like this certainly warrants attention. However, I wonder whether many expressing concern are asking the wrong question. The proper question is not whether this is too much time at a computer, but rather if this amount of time compromises the interns' care of their patients or of their learning experience.

Implicit among those who raise the question of too much time with computers is the assumption that computers are taking physicians away from patients. It is instructive, however, to consider historic data of how much time physicians spend in direct vs. indirect care of patients. It turns out that physicians have historically spent most of their working time in activities other than in the presence of their patients.

Time studies of hospital [2-6] and emergency [7] physicians show physicians spend about 15-38% of their time in direct patient care versus 50-67% of their time in indirect patient care, divided among reviewing results, performing documentation, and engaging in communication. Likewise, studies of outpatient physicians find that 14-39% of work takes place outside the exam room [8-9]. In addition, work related to patients when they are not even present at the hospital or office consumes 15-23% of the physician work day [9-11].

Therefore, this new study does not necessarily indicate the computers are drawing physicians away from patients.

…..

By William Hersh, M.D., professor and chair, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University. Dr. Hersh blogs as the Informatics Professor.

This is quite an interesting issue.

In the past there has been concern about how the use of a computer while providing patient care might interfere with the doctor-patient communication and relationship and some have made some good suggestions about how to minimise the impact.

There is a useful very recent article here:

Doctors Need More Training on How To Use EHRs During Patient Encounters

by Ken Terry, iHealthBeat Contributing Reporter Monday, July 1, 2013

The use of electronic health records in the exam room need not harm the doctor-patient relationship if physicians use EHRs properly, according to a recent report from the American Medical Association Board of Trustees. But observers raise some serious questions about how EHRs may be changing doctor-patient interaction and about whether physicians are trained well enough to know what they're doing.

William Ventres -- an Oregon family physician who coauthored a Family Practice Management piece on the subject -- said that many physicians are too absorbed in their computers to pay adequate attention to their patients during office visits. A major reason for this, he said, is insufficient training.

"Most people starting out with EHRs get very little training on how to use them in terms of the doctor-patient relationship," he noted. "The computer is put down in front of them and they're told to 'use it.' And there are many different ways of using it, but people don't get that education."

Lots more here:

http://www.ihealthbeat.org/insight/2013/doctors-need-more-training-on-how-to-use-ehrs-during-patient-encounters

I think any concerns with all this should be balanced by the benefits received by both clinician and patient if the clinician has access to accurate records and other relevant information (lab results and the like).

Clearly there is also benefit to be had if we ensure the patient can see what is being recorded, correct if necessary, and develop a better understanding of what is happening to them.

There is a useful blog discussing this issue here:

http://aushealthit.blogspot.com.au/2010/07/another-issue-for-ehr-planners-to.html

Overall, as long as systems provide good workflow support, I think there is considerable upside and limited downside with computer use. What do others think?

David.

It Has Been A Big Week For News On Major Project Failures. Lots Of Lessons Still Not Learnt.

In Australia we have had an excellent review of the mess the deeply underperforming NBN has become.

What went wrong with the NBN?

September 21, 2013

David Ramli and James Hutchinson

The National Broadband Network Company was to be the Labor government’s crowning achievement in the vein of Medicare and the Snowy River Dam Project.

Where high speed broadband was traditionally restricted to corporate networks and international links, Labor would connect it to 93 per cent of homes and businesses, from the sandstone manors of Bellevue Hill to the valleys of Tasmania and everywhere in between.

But four years on the reality is murkier. Its founding chief executive has been pushed out the back door while the entire telecommunications industry is despondent.

The current chairman Siobhan McKenna – despite attempts to confront the company’s mismanagement – has been earmarked for replacement.

And Telstra, the one company NBN Co sought to sideline in its efforts to rewire Australia, has found itself with the whiphand; poised to get the very contracts it was denied.

How did things go so wrong and who is to blame?

According to those who claim to know , many of the problems can be traced to a single shock decision in 2011.

After a year of hard-fought negotiations between Australia’s 14 biggest construction firms the tender to build the national broadband number for $12-14 billion had been thrown out the window amid claims of mass price-gouging.

“We weren’t going to get to a fair price, and the only way to achieve that was to sit down opposite a credible company and work through the detail,” NBN Co head of corporate services Kevin Brown said later.

To the bidders involved, it sounded like a gut-churning April Fools’ joke. The decision to cancel tenders, approved by NBN Co’s inaugural chief executive Mike Quigley, led to the immediate departure of Patrick Flannigan, NBN Co’s first head of construction, just days after the announcement.

“It was obviously a shot across the bows and showed they were very determined to get the best value for money,” says Graeme Sumners, a former managing director of telecommunications services firm, Service Stream. It was one of the main companies responsible for building the NBN. Together with Lend Lease it formed a 50-50 joint venture named Syntheo that won contracts worth up to $315 million.

NBN Co eventually sat down with a select group of contractors and began to squeeze every cent of discount from the players at the table. Eventually four companies agreed to final contracts worth $1.1 billion.

Lots more of the gruesome facts here.

http://www.afr.com/p/national/what_went_wrong_with_the_nbn_OOFd2s5eB4KLuceU4Cp9QO

And in the UK we have had a damning report on the UK Health IT Program.

Why big IT projects crash

By Henry Mance

There are several ways the US Air Force could have wasted $1.1bn. It could have poured tomato ketchup into 250m gallons of jet fuel or bought a sizeable stake in Bear Stearns.

Instead it upgraded its IT systems. Work began in 2007 to reconfigure how the force managed its logistics, with the aim of replacing 200 dated networks with a single piece of Oracle software. By the time the project was abandoned last November, it was at least four years behind schedule and would have required an additional $1.1bn to become usable.

Dead projects

Yet in making such mistakes, the Air Force is not flying solo.

This week a UK parliamentary watchdog described a failed National Health Service patient IT programme – the cost of which has spiralled to £9.8bn – as “one of the worst and most expensive contracting fiascos in the history of the public sector”. Earlier this month the Department for Work and Pensions admitted that it had written off £34m of IT costs, incurred in an attempt to overhaul how social security benefits are paid. A week earlier Co-operative Bank said it had written off the £148m cost of a new IT system that would no longer be implemented.

“It is quite scary,” says Ralf Dreischmeier, the global head of Boston Consulting Group’s IT practice. “From my experience, 20 per cent of projects fail, and 40-50 per cent have a cost overrun, time overrun or don’t meet requirements. Only a third could be described as good projects.”

Why are companies and governments still suffering such embarrassing failures?

In a 2011 study, Bent Flyvbjerg and Alexander Budzier at Oxford university’s Saïd Business School examined 1,471 IT projects against their forecast costs and overruns. They found that the projects exceeded their budgets by an average of one-quarter.

“Over the past decade there have been no improvements even though a lot of things have been tried,” says Mr Budzier. The researchers posited that planners consistently underestimated the costs and overestimated the benefits of IT projects. They also failed to appreciate the “black swan” scenario – that is, the chance that something will go really wrong.

Citing Nicholas Nassim Taleb, author of the book The Black Swan, the researchers argue that “the high over-incidence of black swans underlines that ICT projects are a very important source of uncertainty in an organisation”. In one in six projects examined by Prof Flyvbjerg and Mr Budzier, the cost was at least triple what had been estimated. When Hershey’s, the chocolate maker, implemented a new ordering system, it ended up missing out on a whole Halloween of sweet sales, worth $100m.

What have we learnt from past mistakes?

Make realistic estimates

“People always underestimate the cost of software development. Suppliers always push their prices,” says John Fotheringham, a partner at Deloitte.

Keep it short

Longer projects tend to see a higher turnover of personnel and a greater likelihood of a change in objectives. “A reasonable recommendation would be to try to complete a project within 18 months,” says Alexander Budzier of Oxford university’s Saïd Business School. The state of South Australia recently proposed only commissioning IT projects lasting less than 90 days. Yet Mr Budzier adds that there is no statistical correlation between the value of an IT project and its success.

Everyone loves ‘agile’

Up to four-fifths of new IT projects are now implemented using agile methods, whereby pieces of the project are implemented quickly then improved if necessary. This can, however, require more active management.

Your project is not different

“If the project manager thinks this is a unique project, then it’s going to explode,” says Mr Budzier. “And there’s a clear reason – they don’t benchmark themselves.”

Although much criticism has been directed at civil servants, IT overruns are present in both the private and public sector.

“The private sector is just much better at hiding these things,” says Mr Budzier. He points out that large blue-chip companies continue to operate failing IT systems because they are unwilling to write down the expense.

Lots more here:

http://www.ft.com/intl/cms/s/2/794bbb56-1f8e-11e3-8861-00144feab7de.html

Both there long articles are well worth a careful read. There are lessons here - as usual - that we all need to be reminded of regularly.

I loved the comment regarding the private sector being better as hiding things!

David.

Telehealth Looks To Be On A Bit Of A Roll At Present - Especially With Evidence Being Provided Of Some Success.

All sorts of interesting things have appeared this week. First we had.

http://www.medicalobserver.com.au/news/telehealth-can-cut-costs-for-cancer-patients

Telehealth can cut costs for cancer patients

17th Sep 2013

Andrew Bracey

TELEHEALTH consultations for cancer patients significantly reduce travel and accommodation costs, an analysis of a Queensland model has found.

Researchers led by the director of the department of medical oncology at the Townsville Hospital, Associate Professor Sabe Sabesan, reviewed 605 teleoncology consultations conducted with 147 patients.

They compared the cost of providing the services with estimated expenses associated with face-to-face care.

Projected costs included anticipated aeromedical retrievals as well as the likely travel and accommodation required for patients, specialists and patient escorts.

These figures were matched against the cost of setting up the model of care, including the purchase and maintenance of equipment and staff costs.

The results, published last week by the MJA, revealed a total net saving of more than $320,000.

…..

MJA 2013; 199(6):414-17

More here

http://www.medicalobserver.com.au/news/telehealth-can-cut-costs-for-cancer-patients

Then we had a US report covering another Australian study.

Telehealth reduces healthcare use, but produces too many alerts

September 20, 2013 | By Susan D. Hall

Self-monitoring along with nurse oversight helped reduce care costs by $2,931 per person among patients with chronic obstructive pulmonary disease (COPD) in an Australian study published in Telemedicine and e-Health.

Participants were taught to measure their blood pressure, weight, temperature, pulse, and oxygen saturation levels daily and transmit that information by telephone to a secure website, monitored by a nurse. There were fewer emergency room visits and hospital admissions among the telehealth group--nearly half as many--vs. a control group, though not at a statistically significant level. However, the cost savings added up from the use of fewer resources, according to the paper.

In addition, the telehealth participants reported increased confidence in their ability to manage their condition and less anxiety.

However, a review of health failure patients treated by a Massachusetts home health agency monitoring similar data found only three percent of alerts were associated with ED visits and hospitalizations. Because the nurses had to follow up on every alert, that meant they spent a lot of time trying not to miss the few meaningful alerts, according to a second study at Telemedicine and e-Health.

Many of the false alarms were generated when patients did a poor job of taking their vitals. Meanwhile, 22 percent of cardiac-related ED visits and hospitalizations had no alerts associated with them. The study points to anxiety as a key predictor of ED visits and hospitalizations among heart-failure patients, a factor that must be addressed, the authors said.

More here:

http://www.fiercehealthit.com/story/telehealth-reduces-healthcare-use-one-study-produces-too-many-alerts-anothe/2013-09-20

We also have this:

Mental-health help goes online

Mystrength.com is there to help those who can’t wait to see a therapist

Sep 13, 2013, 4:00am MDT

Ed Sealover

Reporter- Denver Business Journal

The digital revolution let people with physical ailments visit websites such as WebMD and diagnose their own conditions for the past 10 years. But Scott Cousino saw what it couldn’t do — help Americans with mental-health ailments aid themselves without a therapist.

In 2010, Cousino — an online-education professional who had overcome a bout of severe depression in his 20s — began working on myStrength.com. The website provides mental-health checks, affirmations and other supplemental help to people whose therapists aren’t available.

Three years later, eight community behavioral-health networks in Colorado use the website, it’s expanded to six other states and officials from the National Council for Community Behavioral Healthcare have created an exclusive relationship with the Denver company to advance the use of technology as a mental-health treatment extender.

“It’s like taking your therapist home with you. It empowers consumers to take charge of their treatment,” said Rick Doucet, CEO of Community Reach Center, which serves about 13,000 people in Adams County. “We haven’t seen the end of what technology can do to help us.”

Mental health is the No. 1 disability in the United States, affecting 25 percent of Americans at some point in their lives. Nearly 20 percent of employer health costs are tied to it, and untreated symptoms can hurt productivity and lead to many missed work days.

MyStrength.com takes evidence-based resources and turns them into interactive tools. Users are asked to tell the site about their energy levels, can complete e-learning curriculum about depression, can track their mental-health state, and post inspirational and spiritual photos or messages that help them.

More here:

http://www.bizjournals.com/denver/print-edition/2013/09/13/mental-health-help-goes-online.html?page=all

Last for now we come back to Australia.

Push to expand telehealth MBS items

13 September, 2013 Paul Smith

The Federal Government is under pressure from a state health minister to extend Medicare rebates to GPs for telehealth consultations with public hospital specialists.

Under current rules, MBS items for GPs to sit in on telehealth consultations can only be claimed when the specialist is in private practice.

However Queensland Health Minister Lawrence Springborg says the arrangement is unfair -- both to GPs and public hospital patients -- and is calling for the system to be revamped.

"Medicare funds are for consultations with doctors with a right of private practice," Mr Springborg said.

"It excludes patients under the care of public hospital specialists which is unfair given that, if you are a private hospital patient under the care of the same GP, maybe the same specialist, you get access [to the telehealth rebates]."

Following the introduction of the telehealth items two years ago, GPs have sat in on more than 32,000 video conferencing consultations with specialists.

More here:

http://www.6minutes.com.au/news/latest-news/push-to-expand-telehealth-mbs-items

Really quite a busy week in the telehealth area and nice to see there is a lot of reporting of actual clinical and benefits trials.

David.

Weekly Australian Health IT Links – 23rd September, 2013.

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 surprisingly interesting week with e-Health getting some attention - in part due to the e-Health heir apparent being left out of the ministry and the senior health minister being so relaxed that he has been given Sport as well as Health and the Assistant Minister - Senator Nash - appearing to need a lot of briefing since having not apparently been all that involved in Health to date.

It is interesting to note that as of Sunday we still do not have an updated website for the Health Minister. I wonder when that will happen?

Now remember DoHA does not exist - it is now just DoHS or DoHaS!

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http://www.theaustralian.com.au/technology/sector-calls-for-transparency-and-end-to-mistakes-in-pcehr/story-fn4htb9o-1226720434416

Sector calls for transparency and end to mistakes in PCEHR

• Fran Foo
• The Australian
• September 17, 2013 12:00AM

MEDICAL experts and industry players have urged Tony Abbott to rectify the national e-health record system's "significant mistakes and missed opportunities" and ensure transparency is a key plank in its delivery.

In the lead-up to the election, Mr Abbott vowed to overhaul the cumbersome personally controlled e-health record (PCEHR) program, calling for a review.

Details on who will conduct the review and its parameters are still scant as Mr Abbott only yesterday announced his frontbench, to be sworn in tomorrow.

Peter Dutton has been appointed health minister, as expected, while Nationals NSW senator Fiona Nash is assistant health minister.

Andrew Southcott, previously opposition parliamentary secretary for primary healthcare and the Coalition's e-health spokesman, missed the cut.

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http://www.news.com.au/lifestyle/health/billion-ehealth-system-rejected-by-doctors-as-8216shambolic8217/story-fneuz9ev-1226722256752

$1 billion e-health system rejected by doctors as 'shambolic'

September 19, 2013

Sue Dunlevy National Health Correspondent

AUSTRALIA'S billion-dollar e-health system is in danger of becoming an expensive white elephant with doctors refusing to use it.

A key clinical adviser to the government who quit in frustration last month has described the system as "shambolic".

And the medical software industry says the body running the system, the National E-Health Transition Authority, lacks the skills to do the job and warns patient safety could be at risk.

Dr Mukesh Haikerwal who resigned in frustration from work on the e-health record says he's uploaded 150 patient records on to the system but "no-one can read it".

Patients who want a hospital or specialist to see their e-health record have to take their own ipad to the consultation to show the record because hospitals and specialists don't have the software to read it.

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http://www.medicalobserver.com.au/news/im-still-an-advocate-for-pcehr-haikerwal

I’m still an advocate for PCEHR: Haikerwal

19th Sep 2013

Andrew Bracey

DR MUKESH Haikerwal remains an advocate for the government’s personally controlled e-health records (PCEHR) system despite serious concerns about the accuracy of clinical records and the system’s useability.

Dr Haikerwal, who recently quit his post as NEHTA’s chief clinical lead, told MO the system was still “some time off” being a reliable, useful and widely accessible resource for doctors, and there remained much to be gained from the work already completed.

“We all know there are issues with the program and project that need to be fixed up but the positive side is that there is something to be worked from and built on,” he said.

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http://www.medicalobserver.com.au/news/new-health-minister-abbott-announces-changes

New health minister: Abbott announces changes

16th Sep 2013

Andrew Bracey

OUR new health minister is announced while the news is not so good for doctor frontbenchers as Tony Abbott names his new ministry.

Peter Dutton will be officially sworn in as Australia’s new health minister this week after Prime Minister-elect Tony Abbott confirmed this afternoon that the bulk of his Opposition front bench would be retained in the cabinet.

Mr Dutton had been widely anticipated to hold on to health, having served as shadow health minister for the last six years but in an unexpected move he will also hold the portfolio of minister for sport.

However, there will be some change to the management of the health portfolio, with shadow parliamentary secretary for primary healthcare and former surgical registrar, Dr Andrew Southcott, among the few Opposition frontbenchers to be dropped.

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http://www.medicalobserver.com.au/news/optimism-over-coalitions-ministry

Optimism over Coalition’s ministry

17th Sep 2013

Andrew Bracey

HEALTH groups remain optimistic about the prospects of the Coalition ministry, despite criticism of the lack of standalone portfolios for mental health and science

The Mental Health Council of Australia (MCHA) has called on Prime Minister-elect Tony Abbott to ensure mental health remained a priority “despite removing it as a dedicated portfolio”

“We hope that the new Abbott government recognises that mental health cuts across traditional portfolio boundaries,” MHCA CEO Frank Quinlan said.

“The urgent establishment of the promised review by the National Mental Health Commission will provide an important opportunity to bring true reform to this complex area of public policy.”
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http://www.abc.net.au/news/2013-09-17/man-sent-someone-elses-ehealth-details/4963268

Man sent someone else's eHealth details

September 17, 2013

An Adelaide man who was mistakenly sent another person's confidential eHealth login details says he is concerned about the apparent privacy breach.

The man, who wishes not to be identified publicly, says he got an email from the National eHealth Record System operator about having successfully registered.

But he says he had made no such application.

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http://www.zdnet.com/au/aussie-ehealth-record-data-mishap-defended-by-department-of-health-7000020818/

Aussie eHealth record data mishap defended by Department of Health

Summary: A report claiming that data is being leaked from the government's eHealth records system is being denied by the Department of Health on the basis that it never sends out passwords, and certainly never in plain text.

By Michael Lee | September 18, 2013 -- 07:17 GMT (17:17 AEST)

The Australian Department of Health has moved to allay concerns over the alleged leak of confidential eHealth login details, stating that even if it had mistakenly sent login details to the wrong person, they are useless without further details.

On Wednesday morning, an unnamed Adelaide source told ABC News that he had mistakenly been sent an email from the National eHealth Record System Operator that appeared to be intended for someone else with the same last name.

The unnamed man claimed to have been sent a "private login password", leading to speculation that the eHealth system was securing patient records using plain text passwords. Such practices are deemed insecure by modern standards for a number of reasons, including the fact that most email communications are insecure, and that passwords are often reused by users across several services.

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http://www.cio.com.au/article/527034/national_e-health_still_has_future_despite_problems_cios/

National e-health still has a future despite problems: CIOs

Under fire national program lacking the right policy framework for broad adoption

• Byron Connolly (CIO)
• 20 September, 2013 11:40

Technology heads in the healthcare sector continue to back the federal government’s controversial and slow moving national e-health record program, saying it has a future despite lacking the critical mass it needs to succeed.

As of July 31, 612,391 Australians had registered for an e-health record, according to a recent National E-Health Transition Authority (NEHTA) report. A further 4500 organisations had registered in the personally controlled e-health record (PCEHR) system and 4585 shared health summaries had been uploaded as of 22 May.

The scheme has come under fire in recent months. In July, Australian Doctor polled 514 general practitioners with two-thirds indicating they will not take part. Earlier this week, a man was accidentally sent another person’s e-health details.

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http://www.afr.com/p/australia2-0/tough_times_continue_for_pharmacists_G85LBeCZ2Ww82Z3f6P81bK

Tough times continue for pharmacists

17 Sep 2013 12:30:00 | UPDATED: 18 Sep 2013 07:37:46

E-health

Jessica Gardner

Outgoing Pharmacy Guild of Australia president Kos Sclavos has called on the new Coalition government to support a national e-health record system that would allow pharmacists to play a greater role in the management of medications and improve patient outcomes.

Mr Sclavos, who will step down from the Guild presidency in October after eight years at the helm, said the current maintaining of e-health records was an opt-in system. For the prescription of certain drugs, he supported an opt-out program that would allow pharmacists to identify if drugs were being inadvertently or deliberately misused.

“Pharmacists are the medication experts,” he said. “A more interventionist approach to some parts of the health system could generate big savings.”

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http://www.6minutes.com.au/news/latest-news/heft-privacy-fines-on-way-gps-warned

Hefty privacy fines on way, GPs warned

16 September, 2013 Antonio Bradley

GPs are being warned to review the way they handle patient information ahead of a law change next year that brings with it potential fines of $340,000 per practitioner.

The large fines, which can reach $1.7 million per practice, are the pointy end of a new privacy law which comes into effect in March and applies to all businesses and their staff.

Though GPs are not expected to be fined, the potential is still there, particularly for those practices that send patient data overseas for transcription or storage.

The new law for the first time requires all practices to have a privacy policy that describes how information is collected and used, and that gives details on how patients can complain about a breach of privacy.

Currently, general practices are only required to have a privacy policy if they wish to be accredited.

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http://www.medicalobserver.com.au/news/labors-legacy

Labor’s legacy

17th Sep 2013

Byron Kaye

AS THE curtains close on one of Labor’s most difficult periods in government, Byron Kaye looks back over six years of health programs, promises and problems.

A week before the Australian electorate ended Labor’s tumultuous six-year reign, Tanya Plibersek did something out of character. The normally unflappable health minister showed signs of frustration. The woman who would have marked two years in the portfolio in December was spruiking her party’s health record when she all but admitted that the bad feeling towards her party’s policies was starting to bite. “It just drives me crazy,” she said.

Ms Plibersek was being asked by MO about the $600 million-plus GP Super Clinics program and its favoured status among Coalition and doctor ranks as a symbol of Labor’s big promises, flawed delivery and inadequate consultation with industry. The pink batts scheme. The rort-friendly school halls program. GP super clinics...

Not as far as Ms Plibersek was concerned.

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http://ehealthspace.org/news/setting-health-data-connectivity-fhir

Setting health data connectivity on FHIR

Posted Tue, 17/09/2013 - 17:12 by Fran Molloy

As eHealth is adopted around the globe and a multiplicity of eHealth software programs proliferates, the adoption of health data interchange standards has become more and more important.

Australian health technology expert Graham Grieve has been deeply involved in the development of healthcare standards for over a decade, and in 2009 was awarded the HISA Don Watson Award for Effectiveness in Health Informatics in 2009 in recognition of his work.

Grieve is one of the architects of a new health information standards framework called FHIR (Fast Health Interoperable Resources) which will be released for trial in coming months, with one of the first large-scale tests to be performed in Sydney in October at a ‘connectathon,’ where developers and health information professionals attending will trial the new system.

The Connectathon will be on Sunday October 27, just before the annual International HL7 Interoperability Conference 2013 (IHIC 2013) which will be held on Oct 28th and 29th at the North Sydney Harbourview Hotel.

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http://www.6minutes.com.au/news/latest-news/push-to-expand-telehealth-mbs-items

Push to expand telehealth MBS items

13 September, 2013 Paul Smith

The Federal Government is under pressure from a state health minister to extend Medicare rebates to GPs for telehealth consultations with public hospital specialists.

Under current rules, MBS items for GPs to sit in on telehealth consultations can only be claimed when the specialist is in private practice.

However Queensland Health Minister Lawrence Springborg says the arrangement is unfair -- both to GPs and public hospital patients -- and is calling for the system to be revamped.

"Medicare funds are for consultations with doctors with a right of private practice," Mr Springborg said.

"It excludes patients under the care of public hospital specialists which is unfair given that, if you are a private hospital patient under the care of the same GP, maybe the same specialist, you get access [to the telehealth rebates]."

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http://www.medicalobserver.com.au/news/telehealth-can-cut-costs-for-cancer-patients

Telehealth can cut costs for cancer patients

17th Sep 2013

Andrew Bracey

TELEHEALTH consultations for cancer patients significantly reduce travel and accommodation costs, an analysis of a Queensland model has found.

Researchers led by the director of the department of medical oncology at the Townsville Hospital, Associate Professor Sabe Sabesan, reviewed 605 teleoncology consultations conducted with 147 patients.

They compared the cost of providing the services with estimated expenses associated with face-to-face care.

Projected costs included anticipated aeromedical retrievals as well as the likely travel and accommodation required for patients, specialists and patient escorts.

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http://www.fiercehealthit.com/story/telehealth-reduces-healthcare-use-one-study-produces-too-many-alerts-anothe/2013-09-20

Telehealth reduces healthcare use, but produces too many alerts

September 20, 2013 | By Susan D. Hall

Self-monitoring along with nurse oversight helped reduce care costs by $2,931 per person among patients with chronic obstructive pulmonary disease (COPD) in an Australian study published in Telemedicine and e-Health.

Participants were taught to measure their blood pressure, weight, temperature, pulse, and oxygen saturation levels daily and transmit that information by telephone to a secure website, monitored by a nurse. There were fewer emergency room visits and hospital admissions among the telehealth group--nearly half as many--vs. a control group, though not at a statistically significant level. However, the cost savings added up from the use of fewer resources, according to the paper.

In addition, the telehealth participants reported increased confidence in their ability to manage their condition and less anxiety.

However, a review of health failure patients treated by a Massachusetts home health agency monitoring similar data found only three percent of alerts were associated with ED visits and hospitalizations. Because the nurses had to follow up on every alert, that meant they spent a lot of time trying not to miss the few meaningful alerts, according to a second study at Telemedicine and e-Health.

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http://www.psnews.com.au/Page_psn3793.html

New health recall portal launched

GS1 Recallnet Healthcare, an electronic product recall notification management system for therapeutic goods, has been launched with the support of the National E-Health Transition Authority (NEHTA).

GS1 Recallnet Healthcare is an online portal designed to improve patient safety by streamlining the management of product recall and non-recall notifications.

GS1 Australia’s CEO, Maria Palazzolo said it was designed to provide an electronic product recall notification management system in the Australian healthcare sector to improve patient safety by enhancing the speed, efficiency and accuracy of the recall process for therapeutic goods.

“Therapeutic product recalls always present a significant challenge to the Australian healthcare industry and this portal will improve the therapeutic product recall notification process for the benefit and safety of all Australians,” she said.

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http://www.theage.com.au/technology/sci-tech/robots-starting-to-feel-the-love-20130918-2tzey.html

Robots starting to feel the love

Date September 19, 2013

Mark White

Machines have been used to help dementia sufferers with some amazing results.

• Finding a partner a virtual reality

Thomas would sit still all day at his aged-care home. The 82-year-old had not spoken for two years. Staff would serve him coffee and leave him be.

One day, a group of researchers led by Wendy Moyle, from Queensland's Griffith University, were running a test involving a Paro robot seal called Millie. They had been used in Japan to help children with developmental disorders, and to comfort victims of the 2011 tsunami. Professor Moyle wondered if a Paro could improve the quality of life for dementia sufferers by making them less anxious - the seals are covered in antibacterial plush fur and sensors, and squirm and squeal when stroked.

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http://www.computerworld.com.au/article/527026/more_australian_privacy_principles_released_consultation_/

More Australian Privacy Principles released for consultation

Deadline for replies is 21 October

• Hamish Barwick (Computerworld)
• 20 September, 2013 10:36

The next set of draft Australian Privacy Principle (APP) guidelines have been released for public feedback by the Office of the Australian Information Commissioner (OAIC).

APPs 1 to 5 were published in August. This covered new requirements for agencies and enterprises about how they manage personal information, including the requirement to have a clearly expressed and up-to-date privacy policy.

Australian Information Commissioner Professor John McMillan said the guidelines outline how the OAIC will interpret and apply the APPs which come into law on 12 March 2014.

Australian Privacy Commissioner Timothy Pilgrim said the second stage of these draft guidelines gives guidance about new requirements for agencies in how they use or disclose personal information, undertake direct marketing activities and send data off-shore.

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http://www.theaustralian.com.au/technology/octfolio-software-to-help-manage-asbestos/story-e6frgakx-1226720432894

Octfolio software to help manage asbestos

• Stuart Kennedy
• The Australian
• September 17, 2013 12:00AM

A NEW software platform aims to help map, manage and eradicate asbestos, the deadly building material.

Octfolio's asbestos information management software launches this week along with a supplementary website.

The platform has been in development for three years and beta versions are already in use with Ergon Energy, Byron Shire Council and the Department of Finance and Deregulation.

Octfolio is owned by investment outfit Tulla Group, founded by one-time Elders Resources chief executive Kevin Maloney who is also Tulla chairman.

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http://www.smh.com.au/digital-life/games/gaming-may-improve-older-players-memory-20130913-2tpja.html

Gaming may improve older player's memory

Date September 15, 2013

Elizabeth Lopatto

Video games, largely considered the province of the young, may help the elderly, according to a study looking to boost memory among those ages 60 and older.

A car-racing game played for 12 hours helped 60- to 85- year-old players improve their memory and attention span, and the effects lasted for six months, according to research published in the journal Nature.

Nintendo, the Kyoto, Japan-based maker of the Wii console, and closely held Posit Science of San Francisco, are among companies that have targeted the elderly and baby boomers with video games meant to improve their minds. Video games may offer the same memory benefits that games such as Sudoku have shown in population studies, said Maria Carrillo, the vice president of medical and scientific relations at the Chicago-based Alzheimer's Association.

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http://www.australiandoctor.com.au/news/latest-news/digital-charts-slower-than-pen-and-paper

Digital charts slower than pen and paper

13 September, 2013 Dr Elizabeth Lord

Electronic hospital charts might look snazzy, but they are "significantly more time-consuming" than old-fashioned paper-based systems, Canadian researchers say.

An Ottawa Hospital study found doctors who completed their patient's record electronically took 40 minutes longer on average than those who used the time-honoured paper and pen.

Surveys confirmed doctors were unconvinced the electronic records had done anything to streamline their documentation processes.

"Physicians participating in the study were not satisfied with the electronic medical record and they did not see more patients by using it," the researchers wrote in the Emergency Medicine Journal.

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http://www.afr.com/p/national/what_went_wrong_with_the_nbn_OOFd2s5eB4KLuceU4Cp9QO

What went wrong with the NBN

September 21, 2013

David Ramli and James Hutchinson

The National Broadband Network Company was to be the Labor government’s crowning achievement in the vein of Medicare and the Snowy River Dam Project.

Where high speed broadband was traditionally restricted to corporate networks and international links, Labor would connect it to 93 per cent of homes and businesses, from the sandstone manors of Bellevue Hill to the valleys of Tasmania and everywhere in between.

But four years on the reality is murkier. Its founding chief executive has been pushed out the back door while the entire telecommunications industry is despondent.

The current chairman Siobhan McKenna – despite attempts to confront the company’s mismanagement – has been earmarked for replacement.

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http://www.smh.com.au/technology/sci-tech/bionic-eye-shines-light-on-darkness-20130915-2tswl.html

Bionic eye shines light on darkness

Date September 16, 2013

Bridie Smith

Science Editor, The Age

For the first time since they lost their sight, Australian patients given a bionic eye have been able to see their environment.

The three patients trialling early prototype devices have been able to locate shapes on a screen after the device's camera was connected with a stimulator to produce an image using 20 electrodes.

Previously, Dianne Ashworth, Murray Rowland and Maurice Skehan had seen only flashes or spots of light as each of the 20 electrodes in their 24-electrode bionic eye were activated for testing.

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http://www.theaustralian.com.au/technology/google-promises-new-thinking-for-health-company-calico/story-e6frgakx-1226722880449

Google promises new thinking for health company, Calico

• AFP
• September 19, 2013 3:00PM

GOOGLE is launching a new company focused on health and well-being, and hinted at cooperation with long-time rival Apple in the venture.

A Google statement said the company, Calico, would put a particular focus on "the challenge of aging and associated diseases."

Arthur Levinson, chairman and former chief executive of the biotech firm Genentech and chairman of Apple, will be Calico's chief executive and a founding investor.

Announcing the new investment, Google CEO Larry Page said: "Illness and aging affect all our families. With some longer term, moonshot thinking around healthcare and biotechnology, I believe we can improve millions of lives."

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http://www.smh.com.au/it-pro/business-it/coming-soon-to-you-the-information-you-need-20130917-hv1r9.html

Coming soon to you: the information you need

Date September 18, 2013 - 6:53AM

Drew Turney

The day when your hat can extrapolate your mood from your brain activity and make a spa appointment on your behalf may not be far away.

The next big thing in the digital world won't be a better way for you to find something. If a confluence of capabilities now on the horizon bears fruit, the next big thing is that information will find you.

Welcome to contextual search, a world where devices from your phone to your appliances will join forces in the background to make your life easier automatically.

Contextual, or predictive search, started with the now-humble recommendations pioneered by companies such as Amazon – where metadata applied behind the scenes led you to products with similar attributes via pages that made helpful suggestions such as "customer who bought this also bought...".

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Enjoy!

David.