Weekly Overseas Health IT Links 15-12-2009

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article.

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http://www.smartplanet.com/technology/blog/rethinking-healthcare/why-open-source-may-win-the-electronic-health-record-market/684/

Why open source may win the electronic health record market

By Dana Blankenhorn | Dec 11, 2009

Electronic Health Records (EHRs) are the trend of the day.

Starting with its stimulus package, the Obama Administration has been pushing EHRs as the solution to all that ails health care. The idea is that the data they collect can drive change, change can drive efficiency, and efficiency can reduce costs.

There are literally dozens of EHRs to choose from. The vast majority are proprietary.

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http://www.healthcareitnews.com/news/white-paper-outlines-healthcare-interoperability-goals

White paper outlines healthcare interoperability goals

December 09, 2009 | Kyle Hardy, Community Editor

SAN FRANCISCO – 
A new white paper outlines national healthcare goals on healthcare information exchange, regional health information organizations and leveraging stimulus money to achieve “meaningful use” of electronic health records.

“Fulfilling ARRA: A Collaborative Approach to Connected Health,” a white paper released by San Jose, Calif.-based Axolotl as part of the Healthcare Stimulus Exchange National Roadshow 2010, outlines efforts to educate healthcare organizations on how to optimize the use of healthcare IT to receive stimulus money allocated by the American Recovery and Reinvestment Act.


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http://www.nytimes.com/2009/12/08/business/media/08adco.html?_r=3

Groups Far Apart on Online Privacy Oversight

By STEPHANIE CLIFFORD

Washington

IF online privacy was once an obscure policy subject, it has come front and center. That much was apparent at the standing-room-only roundtable on privacy and technology that the Federal Trade Commission held here on Monday.

The commission had brought in academics, consumer advocates and executives from Google, Microsoft and Wal-Mart to debate what needs to change to address privacy issues online.

It was not just a theoretical question. The commission has been examining whether online privacy should be regulated. The debate has grown louder as technology companies are tracking and profiling people in new ways, Congress is showing an interest in the subject, and companies are trying to avoid government intervention.

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http://www.modernhealthcare.com/article/20091211/REG/312119987

Facebook privacy revisions ‘sign post' for healthcare

By Joseph Conn / HITS staff writer

Posted: December 11, 2009 - 11:00 am EDT

Part one of a two-part series:

Facebook, the global phenomenon in Web-based social media, rolled out a massive overhaul of its privacy protection policies and technology this week—and in so doing may have drawn up a playbook for healthcare as well, industry experts say.

The privacy upgrade gives its 350 million worldwide users increased control over who has access to some of, but not all, the information on their personal pages. These new, so-called “granular” controls—specifically those embedded in the site's “publisher” function, which enables a user to post new material to his or her Facebook pages—reach down to the level of discrete data elements. The new controls, for example, allow a user to restrict who gets to see each newly posted photo or typed comment.

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http://www.fortherecordmag.com/archives/120709p10.shtml

December 7, 2009

Never Say Good-Bye?

By Greg Goth

For The Record

Vol. 21 No. 23 P. 10

A proposal to create a 10-year nationwide records retention policy has produced differing opinions on the merits of such a plan. Should healthcare organizations hold on to what they’ve got?

The retention and preservation of paper- and film-based medical records isn’t the sexiest topic, especially as so much emphasis across the healthcare industry is currently being placed on selecting and implementing EHR systems. However, the fate of decades’ worth of records on paper and film is receiving increased scrutiny precisely because the healthcare delivery system has reached a critical transition point between storing patient information on paper and in digital formats.

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http://www.healthimaging.com/index.php?option=com_articles&view=article&id=19870&division=hiit

RSNA: Visage Imaging introduces all-inclusive workstation

Visage Imaging promoted its new diagnostic imaging solution, the unified viewer Visage 7 platform at the Radiological Society of North America (RSNA) annual conference in Chicago last week.

“[The Visage 7] allows the end-user to view 2D, 3D and 4D images all on one screen and all on a thin client,” explained Diane Clifford, director of global marketing for Visage.

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http://www.eweek.com/c/a/Health-Care-IT/Obama-Dedicates-88M-More-for-Health-IT-368534/

Obama Dedicates $88M More for Health IT

By: Roy Mark

2009-12-10

As part of the new Recovery Act funding, President Obama pushes health information technology systems for community health care centers.

President Obama is seeding the health care industry with another $88 million in funding for health care centers to adopt new health information technology systems to manage their administrative and financial matters and transfer old paper files to electronic medical records. The initiative is part of $600 million in stimulus money that will go toward improving community health centers across the country.

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http://www.modernhealthcare.com/article/20091210/REG/312109987

Security, privacy breaches plague healthcare in '09

By Joseph Conn / HITS staff writer

Posted: December 10, 2009 - 11:00 am EDT

It has been a bad past couple of months for healthcare information security.

In October and November, multiple healthcare organizations announced patient data losses that made headlines in their communities, and national news in a few of the most egregious instances in which of breaches involved hundreds of thousands of records.

Healthcare security experts, however, say the breaches, while shocking to some, come as no surprise to industry security cognoscenti. These experts attribute the heightened publicity to federal breach notification provisions in the American Recovery and Reinvestment Act of 2009 that went into effect in September.

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http://www.infoway-inforoute.ca/lang-en/about-infoway/news/news-releases/517-design-implementation-of-manitobas-secure-health-record-now-underway-oswald

Design, implementation of Manitoba's secure health record now underway: Oswald

December 9, 2009 (Winnipeg, MB) - The province’s electronic health record (EHR) project continues to move forward with the design and implementation of a system that will offer authorized health care providers immediate access to selected patient information, Health Minister Theresa Oswald announced today.

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http://license.icopyright.net/user/webEprint.act?id=3.8425-43432

December 4, 2009

Health-care tip: Investing in information technology saves lives

By Robert Bell

Special to Globe and Mail Update

Manitoba, Newfoundland and Ontario are working together to create a tele-pathology system

In the long history of medicine, innovations in technology - from antibiotics and vaccines to X-rays and MRIs - have steadily improved our ability to save lives, preserve health and improve the quality of life for patients. But not every life-saving innovation can be seen in doctors' offices or operating theatres. Some of the most important technological advances in health care are only found behind the scenes.

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http://www.fierceemr.com/story/survey-those-emrs-more-likely-report-drug-errors/2009-12-10?utm_medium=nl&utm_source=internal

Survey: Those with EMRs more likely to report drug errors

December 10, 2009 — 11:55am ET | By Neil Versel

We've heard, at least anecdotally, how EMRs make it so much easier for physicians to report on compliance with quality measures, so this news was probably inevitable: those with EMRs are more likely to report adverse drug events. That is the finding of an Ipsos survey of 300 primary-care physicians, commissioned by pharmaceutical giant Pfizer.

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http://news.cnet.com/8301-1001_3-10413086-92.html

December 10, 2009 7:48 AM PST

Microsoft to buy Sentillion for health care software

by Lance Whitney

Microsoft is adding another player to its portfolio of health care offerings.

The software powerhouse said Thursday that it plans to buy Sentillion, a privately held company that supplies software to health care professionals. Microsoft hopes to combine Sentillion's technologies with its own Amalga Unified Intelligence System (UIS). The goal is to offer integrated technology that can help health care providers more easily access patient data from across multiple sources.

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http://www.ihealthbeat.org/features/2009/plan-launched-to-bring-health-it-academics-to-ground-level.aspx

Thursday, December 10, 2009

Plan Launched To Bring Health IT Academics to Ground Level

by George Lauer, iHealthBeat Features Editor

Until now, the academic emphasis in health IT and medical informatics has been largely at the post-graduate and research level. A new plan fueled by stimulus funding hopes to quickly take it to the community college level to train a new work force for the country's evolution toward a digital health system.

Put very simply, this is a tightly choreographed, high-speed effort to extend health IT academics beyond the theoretical realm to the everyday, hands-on realm.

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http://members.sg2.com/content-detail-standard/default.aspx?contentid=6485785487182123892

Electronic Medical Records: The Good, the Bad, and the Ugly [Expert Insight]

• By Pitud Rangsithienchai, MD, Consultant, Sg2
• December 7, 2009 at 08:40 AM

Earlier this year, President Barack Obama signed the American Recovery and Reinvestment Act of 2009 (the stimulus bill), which provided payment incentives to encourage all hospitals and physicians to adopt electronic medical records (EMRs) by 2015. As a practicing internist who "grew up" using EMRs, this goal excites me. I cannot imagine practicing medicine without an EMR. In my career, I have been fortunate enough to use 3 different systems: Epic (EpicCare Inpatient and Ambulatory), Cerner (PowerChart), and VistA (the Department of Veterans Affairs Computerized Patient Record System, or CPRS). Having experienced similar issues with each of them, I want to focus here on EMR use in general and discuss both the benefits (the good) and the pitfalls (the bad and ugly) from a physician's standpoint.

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http://www.ehealtheurope.net/news/5461/isoft_signs_first_pacs_deal_in_germany

iSoft signs first PACS deal in Germany

10 Dec 2009

ISoft has announced that it has taken the first order for its new Picture Archiving and Communications System in Germany.

The Diagnostische Zentrum am Vincentinum in Southern Germany has signed a €130,000 agreement to implement the system at its specialist diagnostic centre in Augsburg.

The deal is worth €70,000 in licence and implementation fees and €60,000 for services over five years, and for the first time provides the application as a service

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http://www.washingtonpost.com/wp-dyn/content/article/2009/12/07/AR2009120703279.html

Report: Health strategy could save W.Va. $1B

By TOM BREEN

The Associated Press

Monday, December 7, 2009 6:57 PM

CHARLESTON, W.Va. -- West Virginia's health care system could save over $1.1 billion by going digital and centralizing patient care, according to a first-of-its-kind report presented to lawmakers Monday.

Those savings would be seen not just by government agencies, but by private insurers and policyholders, who could benefit directly in the form of lower premiums.

The report should lend urgency to some initiatives that have already begun, like electronic medical records and prescriptions, according to the groups behind its creation.

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http://www.modernhealthcare.com/article/20091209/REG/312099985

Loma Linda opens health ‘geoinformatics' laboratory

By Joseph Conn / HITS staff writer

Posted: December 9, 2009 - 11:00 am EDT

Students interested in public health and wanting to learn how computerized mapmaking and data analysis software can be used to improve the health of populations around the world will be able to take training at the newly opened Health Geoinformatics Laboratory at Loma Linda (Calif.) University.

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http://www.modernhealthcare.com/article/20091209/REG/312099987

Problems exist in keeping health data secure: experts

By Joseph Conn / HITS staff writer

Posted: December 9, 2009 - 11:00 am EDT

A new federal privacy breach law has revealed flaws in the healthcare industry's ability to keep healthcare data private.

The American Recovery and Reinvestment Act of 2009, which is expected to allocate $34 billion in health information technology spending, requires the government to create a national IT plan that includes security protections for health information exchange and “specifying technologies or methodologies for rendering health information unusable, unreadable or indecipherable.”

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http://www.healthdatamanagement.com/news/standards_HL7_ISO_EHR-39482-1.html?ET=healthdatamanagement:e1108:100325a:&st=email

EHR Standard Goes International

HDM Breaking News, December 9, 2009

The International Organization for Standardization has published as an international standard the Electronic Health Record System Functional Model, Release 1.1. The standard was developed by Health Level Seven, a standards development organization in Ann Arbor, Mich.

The functional model is designed to provide guidance to EHR software developers and purchasers about the features any such product should have. The model contains about 1,000 criteria covering more than 150 functions in such areas as medication history, problem lists, orders, clinical decision support, and privacy and security.

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http://govhealthit.com/newsitem.aspx?nid=72691

Military to test lifetime EHR in six local communities

By Peter Buxbaum

Tuesday, December 08, 2009

The Department of Veteran Affairs is seeking community coordinators to head up as many as six localized health information exchange projects designed to advance the VA and Department of Defense joint virtual lifetime electronic record project (VLER).

"The Virtual Lifetime Electronic Record Health Communities Initiative is the first necessary step for the implementation and refinement of VLER," said an online business notice posted yesterday by VA.

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http://www.healthcareitnews.com/news/it-helps-drive-232b-personalized-medicine-market

IT helps drive $232B personalized medicine market

December 08, 2009 | Bernie Monegain, Editor

NEW YORK – Information technology and telemedicine are helping to boost the market for personalized medicine in the United States and also benefiting from it.

The $232 billion market is projected to grow 11 percent annually, according to a report published Tuesday by PricewaterhouseCoopers.

PricewaterhouseCoopers projects that the market for a more personalized approach to health and wellness will grow to as much as $452 billion by 2015. Its estimates are based on a broad view of the market opportunity beyond drugs and devices, including demand for high-tech storage and data-sharing as well as low-tech products and services aimed at consumers' heightened awareness of their own health risks.

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http://www.informationweek.com/news/healthcare/clinical-systems/showArticle.jhtml?articleID=222000954

McKesson Unveils Pharmacy Automation System

The system is designed to improve dosage accuracy and patient safety while saving pharmacists' time.

By Mitch Wagner InformationWeek

December 8, 2009 12:25 PM

McKesson introduced a system to allow hospitals to automate dispensing tablets, capsules, and other oral solid medications that come pre-packaged from drug manufacturers.

By retaining original manufacturer packaging, PROmanager-Rx helps hospital pharmacies increase accuracy and improve safety. The system also frees pharmacists from packaging and dispensing, so they can play more integral roles on the clinical care team, McKesson said. The system dispenses medications in unit-dose barcoded form.

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http://health-care-it.advanceweb.com/editorial/content/editorial.aspx?cc=211710

The Tipping Point for ePrescriptions

The use of ePrescribing is on the rise, but more must be done to encourage adoption of the technology.

By Sumit Dutta, MD

Electronic prescribing will soon become a standard medical practice in the United States. Initiatives promoting clinicians' use of ePrescribing are achieving remarkable results. Starting this year, Medicare is increasing reimbursements to doctors using ePrescribing. By 2012, physicians not using this technology will be penalized with lower Medicare reimbursements.

Key medical organizations have endorsed a timely transition to ePrescribing, and a growing number of health plan sponsors are supporting ePrescribing programs that put the technology into physicians' offices. Finally, the merger between major networks SureScripts and RxHub is setting the foundation for uniform ePrescribing standards. As a result of these and other efforts, an estimated 100 million ePrescriptions were "written" in 2008, a 300 percent increase from 2007.

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http://www.wellcome.ac.uk/News/2009/News/WTX057811.htm

e-Health initiative generates first published research

9 December 2009

The Wellcome Trust and Research Councils Joint Initiative in Electronic Patient Records and Databases in Research, supporting the use of electronic resources in health research, has generated its first published research.

The papers provide insight into the use of antibiotics to treat respiratory tract infections and the methodology of stroke research. They illustrate the potential of electronic patient databases to deliver key analyses that can help improve health care and public health, as well as analysing methodological questions facing researchers using large datasets from electronic records.

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http://www.ihealthbeat.org/perspectives/2009/celebrating-the-small-wins-respite-from-a-feast-of-grand-visions.aspx

Tuesday, December 08, 2009

Celebrating the Small Wins: Respite From a Feast of Grand Visions

by Thomas H. Lee M.D.

As the turkey makes its way into sandwiches, casseroles and tetrazzini, and as the family slowly revives itself from food coma, it's perhaps a good time to digest and reflect upon the year.

And what a year it has been. Economic crisis. Multi-billion dollar stimulus for health IT. The contentious battle over health care reform. And the persistent rhetoric proclaiming that health IT will save the day.

Lost among the grand and hopeful visions for health care reform and health IT subsidies, however, have also been the small victories that occur daily on the ground. Accomplishments unheralded. Challenges overcome.

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http://www.irishtimes.com/newspaper/finance/2009/1120/1224259174134.html

Technology 'could save HSE millions'

JOHN COLLINS

THE HSE could save €79 million a year by introducing electronic patient records and €195 million a year by treating chronic illness in the home, according to a report prepared by a coalition of 17 telecoms and technology firms.

The report, presented to Minister for Health Mary Harney, also found there would be 106,000 fewer prescription errors in the primary care sector and 292 fewer diabetic deaths per year if Ireland “radically improved” the use of and investment in technology in the health sector.

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http://www.nj.com/business/index.ssf/2009/12/att_develops_household_items_t.html

AT&T sets its sights on the 'telehealth' industry

By Venuri Siriwardane/The Star-Ledger

December 06, 2009, 6:00AM

A laser micro projector adjunct.The device works with a smartphone to illustrate diagrams, x-rays and MRIs on any surface.

The doctor will see you now. Or at least in the few seconds it takes AT&T to relay your vital signs over its broadband network.

The telecommunications giant has big plans to establish a foothold in the "telehealth" industry, an emerging field that links patients and physicians across the country via video and medical-information technology.

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http://www.healthleadersmedia.com/content/242969/topic/WS_HLM2_TEC/10-Most-Hazardous-Technologies-in-Healthcare.html

10 Most Hazardous Technologies in Healthcare

Cheryl Clark, for HealthLeaders Media, December 3, 2009

The ECRI Institute, an independent nonprofit company that evaluates medical devices and processes, has published its list of the 10 most dangerous technological hazards in healthcare.

The organization made its choice and prioritized the order "based on the likelihood and severity of the reports we've received over the past year, the recalls and other actions we've reviewed, and our continuing examination of the published literature," ECRI authors wrote in their introduction.

These 10 are "problems that we believe are the most crucial right now, and that hospitals should consider putting at the top of their to-do lists for keeping patients safe from technology-related risks."

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http://www.ehiprimarycare.com/news/5452/dh_mandates_incident_reporting

DH mandates incident reporting

08 Dec 2009

The Department of Health has confirmed that it will end the voluntary system for reporting patient safety incidents to the National Patient Safety Agency.

Instead, it will make it mandatory for all NHS trusts in England, including hospitals, primary care trusts, mental health services and ambulance services to report instances of harm or death to the NPSA.

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http://www.itbusiness.ca/it/client/en/home/News.asp?id=55653

IT can improve health care and streamline health processes

Decision makers need to think about how digital data can help improve processes, Microsoft executive says

12/7/2009 4:32:00 PM By: Rafael Ruffolo

The best way to prevent wasteful spending and actually improve health care, according to Microsoft Corp.'s (NASDAQ: MSFT) global e-health czar, is to think about technology as a way to streamline health processes.

“Health care organizations are getting so caught up, and in many ways distracted, by the (electronic health records) discussion and are not thinking about the ways in which technologies can be used to transform medical practice,” said Bill Crounse, a medical doctor who is Microsoft's worldwide health senior director.

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http://www.e-health-insider.com/news/5449/turmoil_grips_nhs_it_programme

Turmoil grips NHS IT programme

07 Dec 2009

The future of the National Programme for IT in the NHS has been plunged into doubt after the Chancellor of the Exchequer singled it out as a suitable candidate for cuts.

Speaking ahead of the Pre-Budget Report, Alistair Darling made it clear that he believed there were savings to be made, and bluntly stated that he viewed the programme as expensive and unnecessary. NPfIT “isn't essential to the frontline”, the Chancellor told the Andrew Marr show.

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http://www.modernhealthcare.com/article/20091207/REG/312079987

Nurses group to open quality database to researchers

By Joe Carlson / HITS staff writer

Posted: December 7, 2009 - 11:00 am EDT

The American Nurses Association is opening up its database of nursing and quality measures to scientific inquiries in the hopes that the large data set will enable researchers to draw more parallels between nursing and patient outcomes.

The proprietary National Database of Nursing Quality Indicators, or NDNQI, was established 11 years ago and today includes data submitted quarterly by more than 1,500 hospitals. ANA officials said the data are broken down into more than 12,000 individual nursing units, which enables researchers to find specific patterns that would otherwise be obscured by hospital-specific data.

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http://www.modernhealthcare.com/article/20091207/REG/312089979

Gov't won't always rule HIT, Blumenthal says

By Jennifer Lubell

Posted: December 7, 2009 - 11:00 am EDT

Private industry, not the federal government, will eventually drive health information technology initiatives, said David Blumenthal, national coordinator for health information technology at HHS, at a policy conference sponsored by the National Committee for Quality Assurance in Washington.

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http://www.healthcareitnews.com/news/new-center-duke-universtiy-focus-healthcare-it

New center at Duke University to focus on healthcare IT

December 04, 2009 | Kyle Hardy, Community Editor

DURHAM, NC – In response to the growing need for specialists in healthcare information technology, Duke University has created the Duke Center for Health Informatics.

The new center will be dedicated to overseeing an interdisciplinary approach to education in healthcare informatics gearing up a new generation of nurses, physicians and healthcare administrators, said Duke officials.

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http://www.fiercehealthit.com/story/uk-group-facebook-flirting-wholly-inappropriate-doctors/2009-12-07?utm_medium=nl&utm_source=internal

UK group: Facebook flirting 'wholly inappropriate' for doctors

December 7, 2009 — 12:20pm ET | By Neil Versel

It's well known that many physicians are among the 350 million-strong Facebook community, and that more than a few doctors have "friended" patients. It's been documented that physicians can embarrass themselves in such online social forums. We've also heard of patients attempting to discuss clinical information with their doctors via Facebook. So it seems inevitable that some people would use the world's most popular networking site to flirt with their physicians.

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http://www.fiercehealthit.com/story/medical-imaging-moves-cloud/2009-12-07?utm_medium=nl&utm_source=internal

Medical imaging moves to the cloud

December 7, 2009 — 2:10pm ET | By Neil Versel

Editor’s Corner

Call it coincidence, or perhaps confirmation of a trend. HealthLeaders Media published a story about web-based PACS just as the massive, annual Radiological Society of North America expo got underway in Chicago.

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http://community.zdnet.co.uk/blog/0,1000000567,10014580o-2000673651b,00.htm

Monday 7 December 2009, 7:43 PM

NHS spend on IT - How would you make savings?

Posted by Fat Pop Do Wop

So chancellor Alistair Darling may cut back or even scrap the National Program for IT, NPfIT, saying that the expensive system isn't needed right now. A spokesperson for the BMA said that this system is already being used in frontline care, and their comments seemed to show a worrying possibility that removing the NPfIT system could impact on care of patients. The spokesperson went on to add that the Government ought to examine the use of private sector external management consultants before cutting IT systems. The BMA's statement said that it's crucial that clinicians have the tools they need for the job.

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Enjoy!

David.

The Press Release You Put Out When You Have Essentially Nothing to Say.

This arrived via the NEHTA RSS yesterday.

Northern Territory pushes the button on new e-health messaging system

15 December 2009. A new e-health messaging system is now in operation in the Northern Territory.
A national consortium of health organisations this week pushed the button on an innovative secure messaging delivery system in the Northern Territory which aligns with emerging national e-health standards.

The system, known as the Web Services Messaging Application or WSMA, uses new web-services technologies to send health information between different clinical software systems. It is based on a first generation messaging specification, drafted by NEHTA earlier this year, which is the front-runner to a national specification for secure messaging delivery currently pending release.

Sponsored by the Northern Territory Department of Health and Families (DHF), with software developed by local IT firm Diverse Systems Consulting, the project has been a joint initiative of the National E-Health Transition Authority (NEHTA), General Practice Network NT, and commercial software vendors Communicare Systems Pty Ltd and PEN Computer Systems Pty Ltd. The new system is part of the Northern Territory’s ongoing program of e-health innovation aimed at improving clinical information exchange and service delivery, particularly for patients in remote areas.

The WSMA application is designed to securely and efficiently transfer thousands of electronic messages a day containing critical healthcare information used to update the records of approximately 40,000 people who have already registered for the Northern Territory’s eHealthNT Shared Electronic Health Record service.

Under a self-assessment process a Declaration of Conformance was issued to affirm WSMA’s compliance with NEHTA draft specifications. Future WSMA releases are expected to undergo formal testing under a new national software conformance assessment scheme, specifications for which will shortly be released by NEHTA for industry comment.

Integrated within the established clinical software packages offered by PEN and Communicare, WSMA will be used in most of the Territory’s Aboriginal community controlled health clinics, public hospitals and a growing number of urban general practices.

NT DHF Chief Information Officer Stephen Moo said that, through its eHealthNT program, the Territory was committed to building state-of-the-art e-health solutions in line with NEHTA standards.

Design work has already commenced for the next generation of WSMA to be commissioned once the final NEHTA specification has been released. Future plans include developing NEHTA compliant eReferrals and eDischarge Summaries, enabling clinical information exchange between healthcare providers in the Northern Territory and providers in South Australia and Western Australia.

Test messages have already been successfully sent from SA Health systems to NT DHF systems demonstrating the e-health vision in action with information flowing seamlessly between interoperable systems in conformance with a national standard.

Read the full release (with contact details) at the NEHTA site:

http://www.nehta.gov.au/media-centre/nehta-news/576-nt

This release is really a classic ‘red rag’ to a tired old bull!

What it tells us is that the NT Health Department have had some vendors build a system based on what is thought will be NEHTA Standards (Those are not yet done.) and that this has been given a great new acronym (WSMA).

We are then told WSMA has been designed to do something – not that it is not actually doing it yet.

Also we are told that this trial implementation has been integrated with some community service software providers and that WMSA will be used within them.

We are then told further design work is underway for the actual working and standardised WMSA.

We are then delighted to be told that with test messages already sent (content totally un-specified) they are “demonstrating the e-health vision in action with information flowing seamlessly between interoperable systems in conformance with a national standard”. Now that is grand and wonderful is it not?

The obvious thing that is required here is that this release should have happened when there were some actual runs on the board and that attached to the release were some concrete technical details as to what has actually been achieved, how well it is working, what issues and leanings etc have been achieved.

To date not one of the 40,000 souls mentioned seem to have benefited from all this. When that happens is the time for the release!

The bottom line is to ‘toot you horn’ when you actually have something real to toot about!

This blatant chase after good PR is both transparent and unseemly. Note this is not to at all diminish or discourage what NT, Health and its partners are trying to do, but rather to condemn the publicity seeking nonsense coming from NEHTA.

David.

Weekly Australian Health IT Links - 14-12-2009

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article.

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http://www.zdnet.com.au/news/hardware/soa/WA-Health-issues-4-million-Cisco-contract/0,130061702,339299989,00.htm

WA Health issues $4 million Cisco contract

By Josh Mehlman, ZDNet.com.au

10 December 2009 05:17 PM

The Western Australian Department of Health is upgrading its networks and has issued a two-year, $4 million tender for Cisco switches and systems integration services.

The request for tender seeks a single company to supply Cisco switch infrastructure and associated management systems, and systems integration services for the equipment supplied. The equipment supplied must be from Cisco for "interoperability and Standard Operating Environment reasons".

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http://www.itwire.com/content/view/29980/127/

NBN to drive critical mass for new apps: Conroy

by James Riley

Friday, 11 December 2009

Australia does not have the critical mass of connections that would allow for the natural development of emerging applications in areas like e-health, education and business productivity and required Government intervention, Communications Minister Stephen Conroy said.

The massive Government investment in the National Broadband Network was an enabling investment in the broader economy, and in social service delivery, Senator Conroy said.
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http://www.australiandoctor.com.au/articles/4F/0C06624F.asp

E-health system still short on detail

8-Dec-2009

By Sarah Colyer

FRUSTRATION is mounting at the Federal Government’s lack of detail on how an e-health system will work, after a vague announcement at yesterday’s Council of Australian Governments meeting.

In a communiqué from yesterday’s meeting, COAG “affirm[ed] its commitment to the introduction in 2010 of national healthcare identifier numbers”.

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http://www.theaustralian.com.au/australian-it/nbn-co-down-the-wrong-path-cisco/story-e6frgakx-1225809283038

NBN Co down the wrong path: Cisco

• Andrew Colley
• From: Australian IT
• December 11, 2009 8:50AM

NETWORKING experts have discussed concerns that the national broadband network will put the nation on a $43 billion path "back to the future" by returning incumbent telcos to dominant market positions.

Cisco Australia chief technology officer Kevin Bloch said that the NBN Co's minimalist approach to building the network would place an additional investment burden on access seekers that only dominant market players could bear.

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http://www.zdnet.com.au/news/software/soa/iSoft-looking-to-create-500-Aussie-jobs/0,130061733,339299986,00.htm

iSoft looking to create 500 Aussie jobs

By Suzanne Tindal, ZDNet.com.au

10 December 2009 05:43 PM

Australian-listed e-health company iSoft is considering upping its headcount in Australia by 500 people, hoping to increase the percentage of research and development workers it fields down under.

"We are looking for investment and I've asked for a significant amount of investment to put back into Australia," iSoft managing director Australia and New Zealand Denis Tebbutt said today at an Australian Information Industry Association event in Sydney.

-----

http://www.theaustralian.com.au/australian-it/regional-it-projects-get-265m-boost/story-e6frgakx-1225808993365

Regional IT projects get $26.5m boost

• Fran Foo
• From: Australian IT
• December 10, 2009 11:54AM

PRIME Minister Kevin Rudd today unveiled seven projects that would receive a total of $26.5m as part of the $60m Digital Regions initiative.

The purpose of the program is to deliver better health, education and emergency services to regional, rural and remote communities.

-----

http://www.news.com.au/breaking-news/bionic-fingers-lending-a-helping-hand/story-e6frfku0-1225808800904

Bionic fingers lending a helping hand

• From correspondents in London
• From: AAP
• December 09, 2009 8:39PM

THE world's first set of bionic fingers have been unveiled by scientists in Britain.

The lightweight motorised fingers, which cost up to STG45,000 ($80,585), are made out of plastic and give people with damaged hands the ability to pick up objects, write, grip and point.

-----

http://www.computerworld.com.au/article/329008/tony_who_budde

Tony who?: Budde

New shadow communications minister needs to engage with the industry, then get some policies

Tim Lohman 08 December, 2009 13:09

The first priority of the new shadow communications ministers, Tony Smith, should be to consult with industry and develop positive, constructive policies on the National Broadband Network (NBN), according to telecommunications analyst, Paul Budde.

Speaking to Computerworld, Budde said that former shadow communications minister Nick Minchin term had been characterised by politicking and a lack of engagement with the industry.

----

http://abnnewswire.net/press/en/61905/iSOFT_Group_Limited_ASX:ISF_Launches_New_Aged_And_Community_Care_IT_Solution.html

iSOFT Group Limited (ASX:ISF) Launches New Aged And Community Care IT Solution

Sydney, Dec 9, 2009 (ABN Newswire) - iSOFT Group Limited (ASX:ISF) today announced the launch of iSOFT Aged Care - Enterprise Wide Health (EWH), an integrated management solution for aged and community care organisations.

iSOFT Aged Care is designed to support organisations of any size, including residential, long-term and community care, and retirement living. Enabling the delivery of improved and more efficient health care, the solution includes residential aged care and retirement components that manage care records, billing and financials, eBusiness and reporting requirements.

-----

http://www.computerworld.com.au/article/329210/isoft_won_t_take_hit_from_uk_contracts_ceo

iSoft won't take a hit from UK contracts: CEO

iSoft executive chairman and CEO Gary Cohen says little chance of NHS National Program for IT being scrapped

Trevor Clarke 09 December, 2009 16:49

ASX-listed healthcare software provider iSoft (ASX:ISF) has down played the possibility of taking a hit from possible changes to its lucrative UK contract for the NHS National Program for IT.

Comments from chancellor Alistair Darling ahead of the UK government's pre-Budget report this week suggested the 12.7 billion pound program could be scrapped.

Speaking to Boardroom Radio Australia iSoft executive chairman and CEO Gary Cohen, said the government had since clarified the chancellor's statements and that there was little chance of the program being binned.

-----

http://www.theaustralian.com.au/australian-it/three-way-struggle-for-bionic-eye-development/story-e6frgakx-1225807909793

Three-way struggle for bionic eye development

• Andrew Colley
• From: The Australian
• December 08, 2009 12:00AM

COMPETITION for a $50.7 million fund to develop a bionic eye has become a three-way tussle between Bionic Vision Australia, Swinburne University of Technology and a mystery suitor.

It is understood the Australian Research Council has short-listed a joint bid by Swinburne University and La Trobe University's Graeme Clark Hearing and Neuroscience Unit, and a second bid by Bionic Vision Australia backed by National ICT Australia and the University of Melbourne.

-----

http://www.computerworld.com.au/article/328860/consensus_reached_e-health_software_standards?eid=-255

Consensus reached on e-health software standards

National E-Health Transition Authority announces standards agreement

Georgina Swan 07 December, 2009 17:50

The move towards e-health standards has taken a significant step forward as industry groups join with the National E-health Transition Authority (NEHTA) to develop an approach for the standard assessment of medical software.

The four industry groups — the Medical Software Industry Association (MSIA), the Australian Information Industry Association (AIIA), the National Association of Testing Authorities (NATA) and the Joint Accreditation Scheme of Australia and New Zealand (JAS-ANZ) — have been working with NEHTA to define how software will be certified and the principles around compliance and conformance.

Note: Covered in earlier blog.

-----

http://www.newsmaker.com.au/news/2013

Australia’s Fragmented E-Health System in Limbo

Monday, December 07, 2009 - IQPC Australia

Sydney, Australia – Australia’s fragmented e-Health system has hit another barrier with reports claiming the governments have ‘changed direction’ on a national e-Health scheme.

NEHTA’s Chief Executive Peter Flemming said the original vision of having a single e-health record for each Australian had been abandoned by the Council of Australian Governments in favour of a ‘more commercial approach’.

-----

http://www.media.tas.gov.au/release.php?id=28578

Lara Giddings, MP

Minister for Health

Tuesday, 1 December 2009

NW Patients Linked to New Medical Records System

North West patients will soon be able to access health services across Tasmania without the need to repeat personal details every step of the way.

The North West Area Health Service has replaced its 20-year-old patient administration system with an up-to-date integrated statewide system.

The new system, launched at the Mersey Community Hospital today by Health Minister Lara Giddings, allocates each patient a single identification number which will apply across the State and lays the foundation for the introduction of the electronic patient record.

Note: iSoft are the software provider.

-----

http://www.nehta.gov.au/media-centre/nehta-news/571-snomed-ct

Health terminology for the Australian health sector launched

7 December 2009. NEHTA today launched the first release of SNOMED CT-AU^®* to Australian licence holders.

SNOMED CT-AU is the Australian release of SNOMED CT (Systematized Nomenclature of Medicine-Clinical Terms) with additional customised content for the Australian healthcare market.

-----

http://www.theaustralian.com.au/australian-it/warning-on-self-diagnosis-via-the-net/story-e6frgakx-1225807584107

Warning on self-diagnosis via the net

• Stephen Lunn
• From: The Australian
• December 07, 2009 1:00AM

RESEARCHERS have warned Australians risk becoming a "nation of cyberchondriacs", as doctors urge consumers against using the internet to diagnose and treat themselves rather than consulting a health professional.

According to a new study, more than one in four Australians who search online for health information believe they can use it to diagnose and treat themselves without the need for a doctor.

-----

http://www.theaustralian.com.au/australian-it/gov-20-unveils-draft-report/story-e6frgakx-1225807627091

Gov 2.0 unveils draft report

• Fran Foo
• From: Australian IT
• December 07, 2009 10:01AM

THE public has been invited to comment on how federal government departments and agencies can utilise web 2.0 to their benefit.

They will have until December 16 to air their views on a 129-page draft report on web 2.0, including social networking tools and websites like Facebook and Twitter.

Also here:

http://www.smh.com.au/national/challenge-is-for-public-servants-to-shrug-off-their-instinct-for-secrecy-20091207-kffh.html

Challenge is for public servants to shrug off their instinct for secrecy

MATTHEW MOORE

December 8, 2009

THERE are two main recommendations in this report on how government should adapt to the internet era and one obstacle threatens both of them: public service culture.

Unless that culture changes, the report says, secrecy will remain the default position of government.

-----

http://www.smh.com.au/digital-life/mobiles/no-tumour-link-to-mobile-phones-says-study-20091204-kaqs.html

No tumour link to mobile phones, says study

December 4, 2009

A very large, 30-year study of just about everyone in Scandinavia shows no link between mobile phone use and brain tumours, researchers reported on Thursday.

Even though mobile telephone use soared in the 1990s and afterward, brain tumours did not become any more common during this time, the researchers reported in the Journal of the National Cancer Institute.

-----

http://www.smh.com.au/technology/technology-news/the-future-before-your-eyes-20091205-kc04.html

The future before your eyes

KELSEY MUNRO

December 6, 2009

IMAGINE a world where your contact lenses double as a personal computer display, superimposing information in front of you.

That virtual-reality dream, a staple of sci-fi movies, is a step closer thanks to the work of Seattle scientists who have been developing a prototype to generate images inside a contact lens. The information would appear about 50 centimetres from the user's eye.

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http://www.zdnet.com.au/news/business/soa/NSW-Health-CIO-leaves-role/0,139023166,339299849,00.htm

NSW Health CIO leaves role

By Suzanne Tindal, ZDNet.com.au

04 December 2009 12:58 PM

in brief: NSW Health chief information officer Mike Rillstone has made permanent his secondment as the chief executive of NSW Health's shared services area.

A spokesperson for NSW Health told ZDNet.com.au that Rillstone has now been appointed to the role of CEO Health Support Services. He stepped into that role in June as a six-month secondment while the department sought an executive to fill the position, which was vacant after the former chief executive John Roach became NSW Health's chief financial officer.

------

http://www.techworld.com.au/article/329227/mozilla_thunderbird_e-mail_client_comes_tabs

Mozilla's Thunderbird e-mail client comes with tabs

Mozilla hopes to lure users away from Outlook with new search features

Mikael Ricknäs (IDG News Service) 10/12/2009 06:25:00

Mozilla Thunderbird 3 now has message archiving

Mozilla Messaging on Tuesday released version 3 of its Thunderbird e-mail client, which comes with a tabbed user interface and improved search features.

The support for tabs is inspired by the same tabs that have become a standard feature in web browsers and function in the same manner. For example, hitting enter or double-clicking a message opens it in a new tab.

-----

Enjoy!

David.

Medicare and Centrelink are to be Merged. Health Information Said Not to Be Involved.

The following, as a result of a National Press Club Speech today, was reported a few hours ago.

Medicare, Centrelink to be merged

By Online parliamentary correspondent Emma Rodgers

Agencies that have direct contact with the public, such as Medicare and Centrelink, will be merged into a "one-stop" shop under changes to the sector announced by the Government today.

In a major overhaul to the way health rebates and welfare payments are delivered, the Government will begin establishing offices around the country that will incorporate Medicare, Centrelink, the Child Support Agency and disability service organisation CRS Australia under the one roof.

Medicare and Centrelink will also be moved into the Human Services portfolio.

Announcing the reforms at the National Press Club today, Human Services Minister Chris Bowen said the changes will improve service delivery and reduce bureaucratic processes and duplication.

"The time has come to reassess whether we, the Government and the nation, are getting enough out of the Department of Human Services," he said.

"There is not enough coordination between our service delivery agencies.

.....

Mr Bowen has also been quick to reassure people that the changes are not about the collection of personal information in one central location.

"It is not a central database," he said.

"We will not house an individual's personal, sensitive information in one place, vesting all control with one body or one card."

The Department will work with the Privacy Commissioner over the reforms and Mr Bowen says health information will not be included in the shake up.

.....

Read the full report here:

http://www.abc.net.au/news/stories/2009/12/16/2773480.htm

If ever there was a set of changes where the devil will be in the detail this is it! Inevitably in a merged organisation there will be information flows that no one is aware of – some of which may, or may not, be seen as appropriate by those who are subjects of that information

I am sure these changes will suit some, but I wonder just how those with some of the more stigmatizing health issues will feel about Centre link employees also being in the same loop. Time will tell I guess.

David.

If This is True, And One Would Hope Not, I Wonder Does NEHTA Know About It?

The following appeared today in the West Australian.

ID plan to curb welfare cheats

ANDREW PROBYN and SHANE WRIGHT, EXCLUSIVE, The West Australian December 15, 2009, 2:45 am

The private details of every Australian will be held on a giant national database under a Federal Government plan for "virtual" national identity cards designed to crack down on welfare and medical fraud.

The West Australian understands Human Services Minister Chris Bowen will use a speech tomorrow to claim the idea will save Australians from the paperwork involved in applying for employment benefits, seeing a doctor or collecting child support payments.

But the concept, expected to anger privacy advocates, is effectively a re-birth of the Howard Government's controversial Access Card proposal that was killed by the Rudd Government as a $1.2 billion saving measure in its first weeks of taking office.

However, instead of issuing all Australians with new identity cards - as envisaged under the trouble-plagued Access Card and its earlier incarnation, the Australia Card - the Government will create "virtual" ID cards by centralising vast amounts of information already held by various human services agencies.

These include Medicare, Centrelink, the Child Support Agency, Australian Hearing and CRS Australia, which coordinates rehabilitation services for people with disabilities, injuries or other health conditions.

.....

Coupled with the proposed national electronic health records, which would allow the sharing of patient details between healthcare providers, the new e-identity database will be a powerful Government tool to track down welfare cheats and deadbeat parents attempting to avoid child support payments.

Consolidating Government information would also aid the fight against so-called "doctor shoppers" who move between bulk-billing GPs to get multiple prescriptions for pain-killers and other addictive drugs.

.....

Full Article Here:

http://au.news.yahoo.com/thewest/a/-/newshome/6585637/id-plan-to-curb-welfare-cheats/

There is some more coverage here:

Bowen to announce Government data reforms

By Brett Winterford

Dec 15, 2009 12:18 PM

Feds deny plans for another Access Card.

The Federal Minister for Human Services, Chris Bowen, will tomorrow make a speech that outlines reforms to Australia's welfare system expected to be underpinned by a major IT refresh.

While details are still scant, it is widely expected to include an announcement of some level of data sharing between Human Services departments - which includes Centrelink, Medicare, the Child Support Agency, Australian Hearing and CRS Australia.

An article in the West Australian today linked the pending announcement to scuttlebutt suggesting that the Rudd Government plans to implement a "virtual ID" card by centralising the databases across these departments.

.....

"That [West Australian] article is incorrect," the spokesman said. "There will be no Virtual ID card. The Government has no plans to create one central database across Government or store all data in one location."

The spokesman did not deny, however, that the announcement will involve some sharing of data between departments within the Human Services portfolio.

More here:

http://www.itnews.com.au/News/162925,bowen-to-announce-government-data-reforms.aspx

The possibilities are I think quite high there is the plan to use some sort of data matching approaches to improve services and reduce fraud – and that this will be without a card. It will be all “virtual”.

Amazingly one of the key systems – Medicare Australia’s Customer Data System is one of the 4 systems targeted and also the source of NEHTA’s IHI.

Of course the IHI is meant to have legislated protection – but the source for its information and for updates etc is now to be used for more general ID management – hardly a good look – and all too cute as well! I have a feeling this is a very bad case of the right and left hand not having a clue about what the other is up to.

Confusion about what is going on with all this has the real potential to derail the HI Service plans I suspect and someone needs – real quickly – to start getting a coherent overall plan together.

This has all the feel of the same sort of silliness and lack of communication that derailed the Access Card and the Australia Card.

The truth of the general thrust of these reports is somewhat confirmed by the fact that a 3AW host in Melbourne sought comments on what all this means from a colleague.

I await the speech tomorrow with considerable curiosity.

David.

Response From CeH to Blog Comments

I write in response to the blog comments following release of the letter to the PM.

In regard to whether or not to make the letter to the PM public – We certainly were of two minds. The BCA letter had been made public and it was the view of the last meeting of the CeH (referred to in the letter) that our support for the BCA position should be made widely known. We did delay its release and sought advice from participants prior to release. The view was that it must be made known to the members of the organisations involved. With so many of those we thought it was tantamount to being made public and so we did that. If there had been some indication from the PM’s office that they would prefer to enter into private discussions then we certainly would have respected that and in any event meant no disrespect by its release. We believe it is about building political support from the broader community which surely is helpful for such an important issue and when so much money is involved.

In regard to the reference to NEHTA: There is now a published NEHTA plan with measureable milestones. This is what has been asked for by David and contributors to the blog for a long time. There is also evidence of the Jurisdictions talking together and aligning better than they have in the past. These are worthy steps forward which deserve recognition – which is what the letter did. I do accept there is a level of frustration around the pace of progress.

In response to questions about the constitution and authority of the Coalition: As described in the letter to the PM, the Coalition formed to improve the strength and coherence of the health system’s voice on e-health issues. It is a loose coalition and is not legally constituted. To do so would have precluded a number of the organisations from participating. There is no elected spokesperson that can speak on behalf of all those organisations. More information is provided at www.ceh.net.au

What happened in relation to the letter was that at the last meeting of the Coalition (held 1^st December) which was convened by HISA and well attended, there was consensus that a letter should be sent to the PM prior to the COAG meeting which was to be held on the 7^th of December. A small group undertook to write the letter based on the discussions that had taken place at the meeting, to distribute it for comment and then to allow organisations to withdraw from the list for the letter if they felt they were not in a position to support it for whatever reason (one did).

This is what was done and why the letter talks about the consensus at the meeting. Because of the time frame there was not a lot of time for a different approach. It should be said however that there was strong support for both the action and the letter from the many that did respond on behalf of their organisations.

Michael Legg,

President HISA

Specific Disclaimer of CeH Views on NEHTA.

On Sunday I posted a blog suggesting the CeH letter to the Prime Minister was an unalloyed good.

I have learnt a lesson here. I had seen a range of circulated drafts but had not actually seen, and carefully reviewed, the final letter before posting.

This paragraph appeared late in the drafting and I did not notice it before I put the file up for downloading.

“We believe that the National E-Health Transition Authority (NEHTA) has shaped a coherent vision and roadmap and has defined several “Foundation Projects” that must be funded and implemented to provide a shared basis for success. The States and Territories are also progressively aligning with the NEHTA roadmap and its foundation projects. We also note growing support of the private sector; the Business Council of Australia has strongly supported action on e-health in their letter to you dated 21 October 2009, the content of which we endorse. Finally, there is widespread consumer acceptance of and desire for a health system transformed by e-health – an independent public opinion poll commissioned by NEHTA found that 82% of consumers say they would use an e-health record.”

For the record I totally support the CeH thrust in getting more attention on e-Health and supporting the funded implementation of the National E-Health Strategy.

I do not believe NEHTA has shaped a ‘coherent vision’ and I do not believe they understand what their role is in supporting health system reform and improvement. I have no idea just how many of the CeH members agree with this sentiment. As far as I can tell I was not asked but I could have missed it!

My view is that NEHTA is a dysfunctional disaster that has slowed e-Health progress in Australia a great deal – but all regular readers know that and the reasons why I feel this way.

I have posted earlier on the issue of NEHTA’s claim of total public support. See here:

http://aushealthit.blogspot.com/2009/12/more-evidence-regarding-silliness-of.html

I am sorry I did not check more carefully before putting this final version up for download. Excluding that paragraph the letter is good – with it – not so!

Sorry again! Running a blog like this is a learning experience!

David.

The NEHTA / Medicare Australia Health Identifiers Still have A Few Serious Issues To Address.

Late last week we had the release of the draft legislation for the National Health Identifier Service.

I have provided the links here to the documentation.

http://aushealthit.blogspot.com/2009/12/e-health-news-from-doha-new-draft.html

First of let me say that if what is proposed actually provides a robust, reliable and trustworthy, privacy protective identifier to permit the correct linkage of the various information components that may make up a lifelong patient electronic record and provide clinicians and consumers with certainty as to the provenance and ownership of the health documentation they are authorised appropriately to access, and essentially nothing else, then that outcome is almost certainly a very good thing.

Indeed right at the beginning the proposed legislation says (as its objective):

“3. Purpose of this Act

(1) The purpose of this Act is to provide a way of ensuring that a person who provides or receives healthcare is correctly matched to health information that is created when healthcare is provided.

(2) This purpose is to be achieved by assigning a unique identifying number to each healthcare provider and healthcare recipient.

The essence is that all this is to ensure ‘correct’ matching of records by allocation of a unique identification number.”

This, of course, brings us to the first set of issues.

First where is the practical evidence that the approach being adopted will work ‘correctly’? I assume by the use of the word correct we are talking of vanishingly small error levels.

Well, we all know the Medicare Australia databases have measurable error rates and we also know there are more Medicare Numbers out there than there are people entitled to have them so how can we know the system will be essentially error free?

My view is that we can’t. Without a large scale pilot of say 500,000 people we are only guessing. How many mismatched records does it take to cause a problem? I don’t know but it is not many.

Second to conduct a pilot of this scale all the systems that may need to embed the identifier will need to be modified, tested and operational so exchange accuracy can be confirmed. It’s a bit late to discover we have used a ‘trusted’ data source which turns out not to be quite trustworthy enough after the event!

Put bluntly this is a potentially expensive leap of faith that may turn out to not be quite ‘good enough’.

In the COAG explanatory document we have the following (Building the Foundations – Page 7):

“A Healthcare Identifiers Service (HI Service) is being designed and developed by the National E-Health Transition Authority (NEHTA) on behalf of all governments.

The HI Service will provide a national capability to consistently identify individuals and healthcare providers to facilitate reliable healthcare-related communication.

In 2007, NEHTA contracted Medicare Australia to scope, design, build and test the HI Service. The design of the HI Service draws on existing elements of Medicare Australia infrastructure including trusted personal information about individuals, consumer Medicare cards, information policies, and customer services such as shop front and online services. For these reasons it is proposed that Medicare Australia will be the initial operator for the HI Service for the first two years of operation.”

I can’t find a single word that suggests a feasibility study has proven all this will actually work as intended. It seems just to be assumed.

The planned time lines are explained in this article

NEHTA to test health ID this year

By Suzanne Tindal, ZDNet.com.au

02 October 2009 04:54 PM

The National E-Health and Transition Authority (NEHTA) has today released its strategy for 2009 to 2012, listing priorities and timelines to enable e-health, including developing an "office" model for health identifiers by December.

The strategy was formed considering the National E-Health Strategy written by Deloitte last year and the recent National Health and Hospital Reform Commission recommendations. NEHTA admitted that there had been a gap between what stakeholders expected of it and where the authority was heading. "As the organisation evolves it is important to ensure a foundation exists for 'what' the organisation has been put in place to deliver," it said.

There are four parts to the strategy: "urgently" developing the foundations to enable e-health, coordinating the progress of priority e-health solutions and progresses, accelerating adoption, and leading the progression of e-health in Australia.

The strategy will see an "office model" for the healthcare identifiers released by December this year. An early adopters release will follow in April 2010, followed by a later adopters release in July 2010.

NEHTA CEO said earlier this year that legislation to enable the use of individual health identifiers was unlikely to be passed until next year.

Lots more here

http://www.zdnet.com.au/news/software/soa/NEHTA-to-test-health-ID-this-year/0,130061733,339298878,00.htm

I don’t see any large scale validation or software modification phases – I wonder why?

This must also be a worry

COAG commits to health IDs in 2010

By Suzanne Tindal, ZDNet.com.au

08 December 2009 03:43 PM

The Council of Australian Governments yesterday confirmed the goal of introducing individual healthcare identifiers within the next year and vowed to put draft legislation on the table for consultation.

.....

However, the overall framework for e-health records remains unfunded. NEHTA's business case for the combination of the health identifiers into personally owned individual electronic health records was again not considered by COAG. NEHTA has been trying to get its business case considered since October last year.

Estimates say that the spend needs to be between $1.2 billion to $1.9 million to create a functioning e-health system.

More here:

http://www.zdnet.com.au/news/software/soa/COAG-commits-to-health-IDs-in-2010/0,130061733,339299911,00.htm

We might be creating all this and the big picture does not get proceeded with!

See here:

http://aushealthit.blogspot.com/2009/12/coalition-for-e-health-wrote-to-prime.html

The comments by experts reported here are also very interesting:

E-health identifiers ready

10-Dec-2009

By Sarah Colyer

BASIC privacy rules for Australia’s future e-health system have been laid out in draft legislation, but privacy experts are worried the Bill is too narrow in scope.

.....

Australian Doctor understands the identifiers are technically ready, and could come into use as soon as the Bill is passed.

But David Vaile, executive director of the University of NSW’s Cyberspace Law and Policy Centre, said the Bill was “contextless” and a “complete governance failure”.

“It’s almost as if they have deliberately tried to make the Bill impossible to comment on, because you can’t see the system it is a part of,” he told Australian Doctor.

The Bill did not answer whether the identifier could be used for financial monitoring, research or auditing, he said -– “things way beyond clinical care”.

He was also concerned that the legislation left some complaints to be dealt with in the Privacy Act, “which is encyclopaedic”.

Dr Juanita Fernando, chair of the health sub-committee of the Australian Privacy Foundation, raised concern that the Bill does not address incidental breaches of privacy; for instance, when doctors fail to log out of the e-health record properly.

More here (registration required):

http://www.australiandoctor.com.au/articles/3d/0c06633d.asp

The National Partnership for e-Health certainly is not reflective is quality governance in my view. See here:

http://www.coag.gov.au/coag_meeting_outcomes/2009-12-07/docs/npa_e-health.pdf

Lastly for interesting takes on the matter we have this:

Govt wants to establish e-health system

December 11, 2009 - 12:09AM

AAP

Every Australian should be assigned their own electronic health record number by the middle of next year, with the federal government releasing the draft legislation establishing the system.

Introducing personal e-health records will slash $627 million off the health budget every year, according to the Australian Institute of Health and Welfare.

Federal Health Minister Nicola Roxon says a national e-health system will allow health providers to share patient records and improve care.

"Mismatching of patient information has been an acknowledged problem in the health system," she said in a statement on Thursday.

More here:

http://news.smh.com.au/breaking-news-national/govt-wants-to-establish-ehealth-system-20091211-kmi2.html

One can only be glad that someone knows exactly how much personal records will save. I am sure the AIHW would be surprised at the apparent precision of the estimate!

Note this link provides a very useful summary of what is planned:

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr09-nr-nr230.htm

Even if the HI Service does deliver something that is fit for purpose, scales as needed and so on there are still some major issues to be sorted I believe.

These seem to me to fall into the categories of Implementation and Cost Issues.

Among the implementation issues are things like:

1. Addressing the education of public and providers as to what all this is about, what it means and so on.

2. Addressing the present lack of clarity as to who does what in the maintenance and updating of the HI Service. With 20+ million souls enrolled and 300,000 new ones a year being added this is a major task.

3. The issuance of the NASH provided smartcards for provider identification to the 600,000 or so health providers. (The cost in materials and effort of this will be non-trivial).

4. The lack or a ‘real’ implementation plan – 22 million people are not going to be using this service come July 1, 2010 take it from me!

Cost issues also exist I think.

1. NEHTA has a total of $218M to spend on this and all its other operations until June 2012 (from July 2009). Given NEHTA’s base running costs are about $35M p.a. (excluding consultants) that does not leave all that much to get all this going and then operate!

2. Who will pay the software developers to modify their systems to suit these identifiers or is it just something they have to do.

3. How is the work done in practices around the country for initial and confirmatory look ups of HI’s the be compensated?

I am sure there are all sorts of other issues – like just how likely is the legislation when passed going to suit what has been built – and guess what I now see the whole student sector is about to get an identifier to – approved at the last COAG!. We are all going to be numbered to death!

I will leave it to the lawyers and privacy experts to assure us all this is all OK but I have a feeling – from Prof. David Vailes comments – which I agree with on my reading – there are some problems here also.

I am not at all comfortable with the use of identifiers for such areas as research, management and disease surveillance without some actual consent from the patient involved. As for the old ‘and whatever the law requires’ should just not be there.

I also wonder how making provider details available without specific consent (say as is done in Skype) might not be a better idea.

I really don’t have a good feeling about all this. Too secretive, too un-consultative and too unproven are my takes for openers.

David.

Health Department Secretary Feels the Heat of e-Health Inaction. About Time!

There was a Government sponsored conference on the National Broadband Network last week for 2 days.

The meeting web site is here:

http://www.broadbandfuture.gov.au/index.html

You can catch up with all the action - in a landmark for Australian Government openness - here:

http://www.broadbandfuture.gov.au/conference-program.html

Links are there to audio and video of all the sessions.

There is a just wonderful report of one of the four e-Health sessions.

E-health future on NBN derailed by lack of basics

Ry Crozier | Dec 11, 2009 9:32 AM

Passions spill over at broadband futures forum.

Frustration at perceived delays in implementing a national e-health agenda boiled over at the Government’s broadband future forum yesterday where a discussion on NBN possibilities could not get past basic issues like funding availability.

In a session where imaginations were supposed to run wild and free on the e-health applications made possible by the National Broadband Network, the whiteboard and butcher’s paper went unused.

Dialogue instead took for granted applications made possible by the NBN, such as human genome mapping, as issues of financial sustainability and scalability of more basic e-health proposals currently on the table took centre stage.

That prompted at least two delegates - including a representative of the CSIRO e-Health Research Centre - to pass comments that they “thought the purpose of this session was to look into the future of what we could do with the NBN.

“We seem to be having a discussion on what the issues are today. We need to challenge ourselves a little bit more,” the representative said.

The observation drew support from some delegates and defensive responses from some of the assembled panel of experts.

“The reason this group is about barriers is because there’s an element of frustration from a technology point of view,” said Adam Powick, a Deloitte partner and primary author of the national e-health strategy.

“Now that the technology is available, how do we break through? Right now we can’t share information between a hospital and GP [general practitioner] 100 metres away for God’s sake. We have to put in place the basic building blocks.”

Powick was supported by Department of Health and Ageing secretary and National E-Health Transition Authority (NEHTA) board member Jane Halton.

“We have to deal with some of the barriers in a way that respects they are real,” she said. “We have to work through [them].”

Dr Mukesh Haikerwal, a GP and professor at Flinders University’s school of medicine, stopped short of labelling the attitude of the room as “negativity”. But he recognised there was “more we can do."

He believed initiatives such as the future forum were a positive. “[By] pulling together people I think we can make this happen,” he said.

Budde’s burst

Tensions were raised from the first opportunity for audience participation as telecommunications analyst Paul Budde criticised the Government over what he saw as a lack of “high-level strategic policy” and frameworks on their part to drive the e-health agenda forward.

“Jane, let’s be honest. The problem is we don’t have good Government policy on e-health going forward,” Budde said.

“We [need to] start with a high-level strategic policy on what we’re going to do with e-health and set a framework so individual silo's point in the same direction. I think we need some leadership from the Government in setting some high-level policy.”

The suggestion immediately appeared to put the panelists on the defensive.

Dr Haikerwal pointed Budde to the national e-health strategy released by the Federal Government last week, while Halton told the packed room, “I think you’ve seen a significant level of leadership from the Government on this.

“NEHTA has been relentlessly swotting away, with some controversy I acknowledge,” she said.

“The bottom line is we do have a strategy. You can’t expect a revolution on this in 20 seconds.

“It does require a bunch of software [and funding] which we don’t have. We all acknowledge we could do more which is why we’re here.”

Powick acknowledged the “absolutely critical” importance of policy but believed the “bigger issue has been the readiness of the [health] sector to take it up.

“The current situation is diabolical,” Powick said, referring to issues of care professionals not being able to share records such as x-rays between facilities.

Heaps more fun here:

http://www.securecomputing.net.au/News/162575,ehealth-future-on-nbn-derailed-by-lack-of-basics.aspx

Of course Paul Budde is right! (Thanks Paul!) All we have officially is an unfunded 20 page summary National e-Health Strategy and a lot of people who are sick and tired of the obfuscation and delay! As I keep reminding people NEHTA has now been in operation over 5 years and really should have got more done, that makes a difference, before now. Hence the frustration.

Remember it is August 2008 when the National E-Health Strategy was finalised! (16 months ago – not 20 seconds)

If you want some real amusement watch the wrap up session given by the NEHTA CEO with the purpose of dragging together the 2 days of e-Health discussions.

The direct link is here:

http://webcast.viostream.com/?viocast=2251&auth=2e531774-16c7-4122-8bc5-84f09c057b0d

I heard the same platitudes and excuses, and the same list of issues and claims of progress, as I have been hearing for the last decade. Just absolute ‘baby steps’ forward and what progress there has been made has been almost in spite of Government policy on many occasions.

It really is time to stop the excuses. If the NBN is going to justify itself an upfront and serious investment is required in the leadership, policy and governance of e-Health in this country. Remember the NBN is said to be an 8 year program – I hope we can make some serious progress well before then. (I am not likely to last that long!)

David.

The Coalition for E-Health Wrote to the Prime Minister A Week or So Ago. Letter Now Released.

Here is the release e-mail.

-----

Dear Colleagues,

There was only limited response from COAG around e-health and no feedback other than acknowledgement of receipt from the PM, despite the opportunity presented by being in the same place (broadband forum) last week and so it would seem sensible to make our letter public.

Although the PM did say supportive things in his speech and interestingly Jane Halton came out in the forum saying there were only two things she wanted to get up in her current tenure they were improvement in Aboriginal health and e-health! This is the strongest statement I have heard from the Department.

Please use whatever channels at your disposal to make the contents of the letter known (attached for convenience).

Regards,

Michael

-----

Dr Michael Legg, PhD FAICD FAIM FACHI MACS(PCP) ARCPA

President, Health Informatics Society of Australia

End e-mail

The letter can be downloaded from here:

http://moreassoc.com.au/downloads/CeH%20Letter%20to%20PM%20re%20COAG%207Dec09%20v1.0.pdf

Of course, Ms Halton then went on to say there was no money and she would have to rob Peter to pay Paul.

That perspective just reveals how 'detached from reality' Ms Halton and her Minister and PM are. Has no on pointed out to them investments in Health IT actually make money and improve quality and efficiency over the longer term.

Investment of this sort is a core Government function in my view! That's what her e-Health Strategy (that she has been spruiking) says at least!

The CeH letter is a good one and should be taken notice of.

The CeH can be found here:

http://www.ceh.net.au/

Bah Humbug! And so close to Christmas.

David.

Why the US is Doing Health Information Technology – in Two Pages – Must Read!

For those who wonder why the US is spending near to $US40 Billion on E-Health, from the man who is doing it!

The Evidence for HIT

Monday, November 30th, 2009 | Posted by: Dr. David Blumenthal | Category: ONC

In February 2009, President Obama and the Congress launched a vast, ambitious program to improve the health of Americans, and the performance of their health system, by building a nationwide, interoperable, private and secure, electronic health information system. This vision – of health care empowered by a modern information system, serving each and every American according to their needs and preferences – reflects decades of study and thinking by health care experts, health professionals, and average citizens. Typical of the consensus underlying the nation’s new health information technology (HIT) program is this recommendation by the Institute of Medicine from its seminal 2001 report, Crossing the Quality Chasm:

“Congress, the executive branch, leaders of health care organizations, public and private purchasers…should make a renewed national commitment to building an information infrastructure to support health care delivery, consumer health, quality measurement and improvement, public accountability, clinical and health services research, and clinical education. This commitment should lead to the elimination of most handwritten clinical data by the end of the decade.”

Similar recommendations have come from many other non-partisan, independent authoritative sources such as the Commonwealth Fund, the Markle Foundation, and the Robert Wood Johnson Foundation. These recommendations reflect not only academic studies showing the benefits of HIT, but also experience and common sense. We live in a digital age. We have seen technology improve virtually every facet of our lives. But medicine still relies on cumbersome paper charts. We manage information the same way Hippocrates did 2400 years ago. It’s time to move medicine into the 21^st century.

Many health care organizations, big and small, public and private, have installed electronic health record systems and are reaping their benefits daily. Examples include not only national systems like the Veterans Administration and Kaiser Permanente, but regional groups like Geisinger Health System, and individual hospitals like the Beth Israel Deaconess Hospital in Boston, and Lakeland Hospital, a 77-bed facility outside of Omaha Nebraska. These organizations show that the vision is feasible – health care can be made higher in quality and lower in cost through the best existing HIT.

From a common sense perspective, it is impossible to imagine a 21^st century American health system deprived of the electronic methods of collecting, managing, and moving data that have revolutionized virtually every other area of human endeavor. Information is the lifeblood of medicine. HIT is its circulatory system. A health care system without an electronic health information system simply cannot achieve its potential, anymore than an Olympic athlete could compete with a failing heart. This is the vision that President Obama and the Congress embraced in February 2009.

Nevertheless, any bold new goal has to be reduced to practice, and skeptics are now asking appropriately whether the HIT program can succeed. A few recent studies have raised questions about whether health care organizations that have installed electronic health records are actually realizing the expected benefits. Perhaps existing examples of success are atypical, and can’t be reproduced in the rest of our health system? Perhaps we are moving too fast? Perhaps the risks are too great?

As a scientist myself, I take the academic literature very seriously. I believe that policy should be based on the best available information, carefully analyzed and considered. However, recent studies raising questions about the benefits of EHRs are informative, but limited in their applicability to our HIT program. To the extent that they accurately capture past experience with EHRs, these studies illustrate something that the Congress and the President understand and have allowed for: namely, that having an EHR alone is not sufficient. Doctors and hospitals have to use this technology effectively, have to employ its extraordinary power to improve clinical decisions, in order to achieve its potential benefits. The federal government’s new programs of incentives and penalties are totally focused on encouraging the meaningful use of EHRs. The resources set aside by the Congress to encourage the adoption of EHRs will go only to physicians, hospitals, and other providers who meet carefully designed new requirements for the use of EHRs that will translate into health improvements and cost reductions for the American people. And the plan passed by Congress includes new resources and support that will help make it possible for providers and hospitals to meet these requirements. We have already announced the availability of grants that will help providers adopt and use EHRs, and we will be making additional announcements in the weeks and months ahead.

Sometimes bold steps are required to improve the human condition. Among the most successful health and social programs in American history are Social Security, Medicare, Medicaid, the Community Health Center Program, and the State Children’s Health Insurance Program. It would have been a tragic mistake, costing untold thousands of lives and enormous suffering, if we had foregone or delayed these programs. I believe the HIT initiative will rank with these huge successes in the value it will bring to the American people over the years to come.

– David Blumenthal, M.D., M.P.P. – National Coordinator for Health Information Technology

Link to original is here:

http://healthit.hhs.gov/blog/onc/index.php/2009/11/30/the-evidence-for-hit/

Lots of comments follow the post.

As they say I could not have put it better myself! The central point that Dr Blumenthal makes is crucial – having an EHR is not of much use – actually having clinicians using it to deliver care in a better, more evidence based and safer way is!

The clumsy implementation efforts of Australian State and Commonwealth Governments, Medicare and the production of endless paper specifications by NEHTA is not the way we can actually make a difference. Following the US and thinking how we can incentivise ‘meaningful use’ of e-Health is a much better way I believe.

We deserve way better leadership in this space – as even the CEO of NEHTA said a few days ago at the NBN talkfest!

David.