This Blog and A History of Getting it Close To Right. We Notice Disasters Looming Pretty Well!

It is always fun to go back and look at what was happening on the blog a year or so ago and see how we are going at getting things right and wrong. Note dates of articles in bold.

I was prompted by the following to have a bit of a look round and see by this.

Timing ‘unrealistic’ for rollout of e-health patient ID scheme

16th Oct 2009

Elizabeth McIntosh

GPs face a long wait to see the promised rollout of an electronic patient identification system, an e-health expert claims, despite the National E-Health Transition Authority (NEHTA) saying that it will be in place by mid-2010.

Unique healthcare identification (UHI) numbers are a key plank of the e-health program, and are expected to improve patient safety by reliably identifying patients, providers and care facilities.

According to the recently released NEHTA strategic plan, UHI numbers will be rolled out to all stakeholders by July 2010.

However, health IT consultant Dr David More was sceptical of the 10-month time frame listed in the 46-page document, arguing it was unclear and unrealistic.

“Look at all the other [e-health initiatives] that they’ve attempted to introduce to help – even the ones that have been successful have taken years to be adopted,” Dr More said.

“2012 – that is reasonable – but pretending that 2009/10 is the year of delivery is not going to happen. They’re not going to have the majority of GPs signed up.”

More here

http://www.medicalobserver.com.au/index.php/news/timing-unrealistic-for-rollout-of-ehealth-patient-id-scheme

In retrospect I suspect I was being overly optimistic.

The following is a good one:

Tuesday, March 21, 2006

The Slow Demise of Health-E-Link

It’s been another bad day for e-Health In Australia.

Today we learned that the NSW HealthConnect Trial for NSW - the Health-E-Link project is coming apart for the most basic of reasons - the lack of proper involvement and consultation of healthcare providers and consumers.

More here:

http://aushealthit.blogspot.com/2006/03/slow-demise-of-health-e-link.html

We are now 4 years into this trial and what has been the outcome.

The evaluation report (a summary) appeared in December, 2008 and the whole thing has been such a success it has not been expanded some 15 months later and the web site has stopped reporting additions to the data base. If ever there was a project the NSW Department of Health hopes would just go away this has to be it!

Indeed it may just have:

See here:

http://ehealthinfo.gov.au/what-is-e-health/case-studies/

We find the statement:

“At the time of its conclusion in June 2009, Healthelink electronic health records had been produced for some 45,000 people.”

Did we all miss the announcement of it being canned?

More evidence here:

https://records.healthelink.nsw.gov.au/concerto/Login.htm

Seems the certificate for the secure log in died a week ago!

While on the HealthConnect topic, it seems the Tasmanian money wasting clone has finally vanished.

The domain www.healthconnecttasmiania.net.au has just died.

This was the link:

http://www.healthconnecttasmania.net.au/index.php

As far as South Australia – also pretty dead and empty!

http://www.healthconnectsa.org.au/Home/tabid/36/Default.aspx

Other than the excellent Primary Care Software developed by Pen Computing.

See here:

http://www.healthconnectsa.org.au/Default.aspx?tabid=85

I said it was mostly a waste of money and that is how this all turned out!

This was also a good one!

Sunday, February 25, 2007

Its Really Nice to Know You Were Right!

Well the chickens have come home to roost! Even allowing for a fifty percent margin of error E-Health in Australia is only moving forward very slowly and is certainly not progressing with the urgency hoped for by Minister Abbott!

The goal was set in June 2005. A report, from that time, of the Minister’s remarks is as follows:

See http://www.computerworld.com.au/index.php?id=1737192765&eid=-6787 for the full article.

Here as an extract:

“Health Minister Tony Abbott has put federal health IT bureaucrats on notice saying he expects tangible results within a year, specifically functioning electronic health records and accompanying smartcard system - or heads would start to roll.

"I am sick of trials and studies and working groups," Abbott said.

"I want patients to see a difference in 12 months. If patients do not see a difference, we will have failed," Abbot said, adding he was not prepared to be "held hostage" by a never-ending chase for the latest and greatest IT solutions.”

As we know it never happened as even worse it was the now Opposition Leader Mr Abbot who defunded the effort! I pointed this out in an article in 2005 that can be found here:

http://www.computerworld.com.au/article/135541/academic_says_healthconnect_will_meet_abbott_timeframe/

Of course we also have this saga outlined here which more than justified scepticism of the so called “year of delivery”

http://aushealthit.blogspot.com/2009/11/this-is-really-sad-take-careful-read-of.html

Lastly:

Thursday, February 11, 2010

NEHTA Fantasises About What it Will Deliver with the HI Service.

The following lobbed today. Comments in italics in the text.

Healthcare Identifiers Bill 2010 marks e-health progress

10 February 2010.

A major step towards the implementation of a national e-health system occurred today with the introduction of the Healthcare Identifiers Bill 2010 into the House of Representatives.

The Governments Bill represents the culmination of more than a decades work in developing a framework for the introduction of e-health in Australia across different jurisdictions and with the assistance of professional bodies.

Comment: What do we think NEHTA means by the introduction of e-Health? NEHTA has been around for 5 years and what are the changes they have delivered? And what exactly is the “e-Health System” they are talking about? Would be good to see the end state that is planned so we can all decide what we think about it. Is an IEHR involved and how is this to work?

The legislation provides for the introduction of a unique identifier which will allow all Australians to have their confidential medical information transferred electronically between health providers.

End Extract of NEHTA Press Release.

Other comments in the rest of the text in the blog.

Then my comment was:

Even now there is no clear discussion as to why any single provider or software provider would adopt all this, given the cost in time and inconvenience.

I believe this project will be DOA without careful piloting and evaluation – and then modification on the basis of the findings. This assumes NEHTA will not review a range of alternatives we know exist to solve the problem without a ‘great big’ centralised ID database.

Fantastic thinking is alive and well at NEHTA if they think this can all roll out and work nationally over the next 6 months! If this is not the plan, maybe they could tell us what the plan actually is?

---- End Extract

And now we all know, if it happens at all, it will be over years, and may have an initial evaluation in 2013 when even NEHTA now admits implementation will probably not be complete by then! This detail just did not seem to quite make it into the Press Release.

Bah, humbug and spin. It seems it takes a Senate inquiry to blast away the spin and get at the truth.

Enough, I think most of us have these bureaucrats pretty much sussed. I would love to hear examples of where NEHTA’s efforts have yet been properly evaluated and found to make any real difference clinically?

Isn’t that what they are meant to exist for?

Just so I am not accused of being excessively negative I have to say that I see all this as reflecting a ‘bunker mentality’ on the part of NEHTA’s leadership group. If they would only be more open about what is going on and actually listen to those in the Health IT Community, who have a clue or two, they could be doing a vastly better job and I could stop typing.

A really good example of this is the HI Service. Who has seen the contract with Medicare Australia and actually knows what they were asked to deliver so we can know if they have done it, or not? It’s not the dollars I am interested in but rather what was to be delivered, how it was to work, how deployed and how used by the e-Health community. I don’t think we know pretty much any of that, and there is a sense out there NEHTA has been making it up as they go along.

I really feel very sad seeing so much that is just not actually delivering what is possible. How long should we persist with trying to build these national foundations before we have a really hardnosed review and make sure there is not a better way? I believe we need to work out how to get the value out of what has been done, where possible, and that really requires a strategic review of the sort undertaken by the Boston Consulting Group three years ago. This time we also need the recommendations to be actioned and not shelved.

David.

Talk About a Waste of A Bit Over an Hour!

Well, we have had the Great Health Debate.

The most interesting thing was the worm and the complete lack of genuine clarity, from both sides, as to what was planned.

There seems to be agreement as to the need for more local management of hospitals, but how this fits with and integrates with primary care, aged care and so on - no joy!

Neither side explained how they were actually going to fix the 'Blame Game' in a credible way.

The whole 75 minutes was an 'e-Health Free Zone'.

I hope we get another chance at this when both sides have their complete health plans out. What we had today was great theatre but no real substance.

The ability of these guys to simply just not answer a straightforward question just beggars belief!

David.

This Report Will be a Worry to iSoft Shareholders – Of Which I am One!

The following has just appeared in the UK Guardian newspaper on-line.

Delays with £12.7bn NHS software program bring it close to collapse

• Simon Bowers
• guardian.co.uk, Sunday 21 March 2010 18.47 GMT

Department of Health locked in frantic talks to save Lorenzo, the IT package meant to revolutionise patient records

The government's programme to introduce software to revolutionise the way patient records are kept has lost the confidence of many NHS staff Photograph: Christopher Furlong/Getty Images

The government's ailing £12.7bn IT programme to overhaul paper-based NHS patient records in England is close to imploding, potentially triggering a deluge of legal claims against the taxpayer running into billions of pounds, which could start to emerge weeks before a general election.

The Guardian has discovered that mounting chaos and delays in installing core care records systems across the country is reaching a tipping point, with intense political pressure from Whitehall now falling on Morecambe Bay NHS Trust and a software "go-live" deadline set for the end of this month.

Morecambe Bay is intended to be the first acute trust to take a new patient administration software package called Lorenzo, which has been delayed for four years. After a string of missed deadlines, the Department of Health set a deadline of March 2010 for Lorenzo last April. "If we don't see significant progress... then we will move to a new plan for delivering infomatics in healthcare," Christine Connelly, the Department of Health's director general of IT, said at the time.

Preparatory testing at Morecambe Bay is believed to have failed some weeks ago, though iSoft, the firm behind Lorenzo, last week insisted testing was "on track" and dismissed as "media speculation" suggestions that the deadline was in jeopardy.

If Lorenzo is not running smoothly at Morecambe Bay in the next two weeks it will send financial shockwaves throughout Labour's National Programme for IT, potentially forcing profits warnings from iSoft and others. It will also be devastating for the Department of Health, which is locked in frantic contract renegotiations with contractors to keep the project alive.

Lots more here:

http://www.guardian.co.uk/business/2010/mar/21/nhs-software-system-close-to-imploding

and also here – which provides some background.

http://www.guardian.co.uk/business/2010/mar/21/nhs-national-program-problems

I find this all a bit worrying since we have had a firm denial of any major problems as recently as Friday, 19^th March 2010.

Interview with iSOFT Executive Chairman & CEO Gary Cohen

Sydney – Friday, 19 March 2010 – iSOFT Group Limited (ASX: ISF) – Australia's largest listed health information

technology company, today provides the opportunity to listen to an audio broadcast with Executive Chairman & CEO

Gary Cohen in a presentation titled "iSOFT reaffirms FY10 guidance".

To listen, please copy the following details into your web browser:

www.brr.com.au/event/64877

The presentation details are as follows:

• iSOFT reaffirms FY10 guidance - Gary Cohen, Executive Chairman & CEO
• Presented by Gary Cohen, Executive Chairman & CEO
• Thu, 18 Mar 2010 9:45am AEST

The release to the Australian Stock Exchange (ASX) is here:

http://newsstore.fairfax.com.au/apps/previewDocument.ac?sy=smh&ss=SMH&docID=GCA01048468ISF&backTo%3Dhttp%3A%2F%2Fmarkets.smh.com.au%2Fapps%2Fqt%2Fquote.ac%3Fcode%3DISF%26submit%3DSearch%26securityType%3D0%26section%3Dsummary%26sortBy%3D0%26descContains%3D0

One can only hope that it is the imminent election in the UK that is flushing all this material out and that, in reality, all is going reasonably well.

The previous blog might give one some cause for pause. For the sake of my rather trivial superannuation I hope that is the case! I also happen to think it would be good if we could have an indigenous Health IT industry with one or two decent sized and successful players.

David.

An Australian E-Health Prophet Being Noticed Overseas. Is He Ignored at Home?

Last week there was a major global conference on E-Health. Links to some material will be included in the International News for this week.

It seems a keynote from Prof. Enrico Coiera, of UNSW in Sydney has stirred up some significant comment.

There is reporting here:

WoHIT keynoter warns of healthcare IT disaster

March 17, 2010 | Jack Beaudoin, VP, Content

In a sobering keynote address at the 2010 World of Health IT Conference and Exhibition, eHealth researcher Enrico Coiera of University of New South Wales, Australia said industry enthusiasts who back, uncritically, national-scale HIT systems need to prepare themselves for some very bad news.

"We've yet to experience our first health IT plane crash, a health IT failure that claims many lives," Coiera said Wednesday. "But I think that will happen... I think it's unavoidable given what we're doing. We need to do our best to mitigate that."

Coiera titled his talk "The Dangerous Decade," because while he predicts unprecedented growth in healthcare information technology in the immediate future, that proliferation will come with some unwanted side effects -- especially when deployed on a national scale.

"I think over the next 10 years we will build more health IT than we have ever built before," he said. "These systems will be bigger and more complex. The costs and benefits are so large that they will significantly impact national GDP -- people are going to notice it.

"We have no choice but to do this," Coiera continued. "The danger is that health IT is still in its infancy. We are doing things we have never done before."

To date, Coiera said, national HIT projects typically have come in two flavors: a top-down, single system implementation exemplified by England's NHS National Programme for IT; and a decentralized, bottom-up federated system best characterized the United States approach. Neither had been an unqualified success, and in fact both approaches have faced significant criticism.

.....

Given the complexity of the healthcare IT needed to address patient safety and rising costs, Coiera said there were three risks to watch: the safety of IT systems, unrealistic expectations about those systems, and addressing the wrong problem.

"We're still focused on the technology," he said. "I worry that a focus on the electronic health record dominates the thinking of most people. We are missing the easy wins," such as decision support and e-prescribing.

More here:

http://www.healthcareitnews.com/news/wohit-keynoter-warns-healthcare-it-disaster

There is also additional comment here:

Is there an HIT disaster waiting to happen?

By Jeff Rowe, Editor

A few months ago, we applauded ONC’s effort to prepare for the future by re-configuring its internal staff responsibilities.

But while federal HIT policymakers have been working on several fronts to anticipate and encourage greater use of HIT across the healthcare sector, a presentation delivered at the 2010 World of Health IT Conference and Exhibition leads us to wonder if ONC is also anticipating the possibility of something going terribly wrong.

In a presentation he pointedly called “The Dangerous Decade,” eHealth researcher Enrico Coiera of University of New South Wales, Australia, claimed that HIT “industry enthusiasts . . .need to prepare themselves for some very bad news.”

In his view, “we've yet to experience our first health IT plane crash, a health IT failure that claims many lives . But I think that will happen... I think it's unavoidable given what we're doing. We need to do our best to mitigate that."

We won’t bother to speculate about what a disaster might look like, but, at the very least, the recent incident at the Veterans Administration demonstrates the capacity for a single error to shut down an entire system.

.....

But there are potential downsides, as well, and when the health or lives of patients are involved, those downsides can be terribly serious.

More here:

http://ehr.healthcareitnews.com/blog/there-hit-disaster-waiting-happen

You can see the original paper here:

http://www3.chi.unsw.edu.au/pubs/Coiera%20E.%20Building%20a%20national%20health%20IT%20system%20from%20the%20middle%20out.pdf

and last week’s presentation here:

http://moreassoc.com.au/downloads/Barcelona2010-NHIT.pdf

(Prof Coiera provided the file)

In general I think he has a point but I also think that we need to be careful to avoid the ‘throwing out the baby with the bathwater problem”.

There is no doubt there have been some major projects that have struggled and which have cost a good deal more than was initially planned.

However we now are also seeing some real successes come through.

Key examples are:

Kaiser Permanente.

See here:

Kaiser Permanente Honored for Electronic Health Record Implementation

HIMSS Analytics Awards Another 12 Kaiser Permanente Hospitals Highest Recognition

OAKLAND, Calif., March 2 /PRNewswire/ -- Kaiser Permanente, the nation's leading health care provider and not-for-profit health plan, received 12 Stage 7 Awards from the Healthcare Information and Management Systems Society. The Stage 7 Award honors hospitals that have achieved the highest level electronic health record implementation. The 12 awards were presented at the HIMSS 2010 annual conference in Atlanta, Georgia.

Kaiser Permanente is known for leadership in the use of health information technology and its groundbreaking electronic health record, Kaiser Permanente HealthConnect®. Last year, Kaiser Permanente also received 12 Stage 7 Awards, meaning that two-thirds of the system's 36 hospitals have now received these premier awards. Only 39 American hospitals have achieved this status; 24 of those are Kaiser Permanente hospitals.

More here:

http://www.prnewswire.com/news-releases/kaiser-permanente-honored-for-electronic-health-record-implementation-85948822.html

Additionally Kaiser have just announced the completion of implementation of advanced systems in all their 39 or so hospitals.

Indiana Health Information Exchange

Indiana Health Info Exchange hits critical mass

By Heather B. Hayes

Wednesday, March 17, 2010

Indiana Health Information Exchange (IHIE) officials have made good on a long-term goal to expand the Indiana Network for Patient Care (INPC), its data exchange platform, to the far edges of the state’s healthcare market. At present, 62 of 114 medical facilities in Indiana have signed contracts to exchange information via the INPC, and 41 of those are now up and running.

Last week, Good Samaritan Hospital in Vincennes, Ind., became the most recent medical facility to start exchanging patient data over the INPC. The hospital, a 232-bed community health care facility, serves patients that reside in both southeastern Illinois and southwestern Indiana.

The INPC is one of the highest volume HIEs in the U.S., handling more than 2.5 million transactions a day and containing the health records of more than 10.3 million patients. It was created in 1994 by the Regenstrief Institute, an informatics and healthcare research organization in Indianapolis, but has been taken over recently by IHIE, which also offers a clinical messaging system and a quality improvement reporting initiative.

More here:

http://govhealthit.com/newsitem.aspx?nid=73318

We also need to see how a planned incremental approach has really worked in both Denmark and Holland. (More on this later in the week).

I would argue that key factors that lead to success are:

· Clinician Leadership

· Consumer Involvement with Attention to Privacy and Security Concerns and the Ability to Opt Out.

· An Incremental Phased and Planned Approach

· Really Robust Governance and Leadership

· Frequent Evaluation and Preparedness to Make Mid-Course Corrections.

· Adequate Funding

· A Bottom Up / Middle Out Style of Approach of the Right Size

· Pursuit of the Low Hanging Fruit (Clinical Messaging, Ubiquitous Basic EHR Functionality etc)

· Technologically Conservative and Proven Solution Approaches and Proper Conformance with Global Standards

· Recognition that this is a 10 year Journey.

Enrico is right to warn, in my view, that overarching top down approaches have a very bad track record.

I hope the powers that be are listening.

David.

Obama Passes Health Reform in the USA

The bills have just passed the US House of Representatives by a tiny margin 219-212.

This is all that is needed given the Democrat Majority in the Senate passed the same bill late last year.

The Bills now go the the President for signature.

This is a major step forward for the US with another 30 million now getting healthcare coverage.

Mr Rudd must be hoping he can follow suit!

David.

The Silliest Press Release We Have Ever Seen from NEHTA.

The following was released by NEHTA a few days ago.

Australia launches leading edge e-health supply chain location directory

17 March 2010.The first electronic location directory, connecting healthcare purchasers and suppliers around Australia, was officially unveiled in Melbourne and Sydney this week. The central registry, known as GS1Locatenet GLN Directory for Healthcare, will improve the speed and accuracy of supply transactions helping to reduce hospital operating costs and save lives.

The service is the result of an ongoing partnership between the National E-Health Transition Authority (NEHTA), which built the National Product Catalogue (NPC) with support from public sector health authorities, and GS1 Australia (www.gs1au.org), a member of an international not-for-profit standards and services organisation. GS1 Australia hosts the NPC.

.....

At the launch in Melbourne on 17 March 2010, NEHTA’s Head of Strategy Andrew Howard said GS1Locatenet was a major breakthrough in the development of Australia’s national e-health system replacing current manual processes with a quicker, more accurate method of transacting with suppliers.

“Receiving the right products, at the right time and in the right location has enormous safety benefits for patients, as well as massive savings for the healthcare businesses involved,” he said.

“Every year, a number of patient deaths result from incorrect prescribing. Correct ordering and timely delivery can significantly reduce this risk.”

“The electronic system also has major benefits inside a hospital making inventory management and distribution easier and improving traceability and recall procedures for sensitive goods, such as drugs.”

ENDS

Read the full release here:

http://www.nehta.gov.au/media-centre/nehta-news/618-supply-chain

You can down load an absurdly large 3 page glossy brochure from here:

http://www.gs1au.org/assets/documents/services/locatenet/s_gs1locatenet.pdf

or you can read all about it here:

http://www.gs1au.org/services/locatenet/

Let me say the actual system sounds like a very good idea and well worth implementing as it will uniquely identify (where have we heard that lately?) locations where supplies are to be delivered from a central directory.

Of course, given it seems to cost, to the organisation for each location you allocate a GLN to, one wonders just how rapid adoption will be. I guess that is why they are free unil June 2011 so you can try before you buy!

But the last four paragraphs (and especially paragraph three) of the release are arrant nonsense and reveal either a totally brain dead Head of Strategy or much more likely a very over-excitable NEHTA Communications Person.

I am at a total loss, as I am sure you are, to work out how accurate delivery of supplies will reduce incorrect prescribing! Are inventory men and store-men prescribing these days and I was not told? This is just fantastic drivel and someone should be ‘taken out and shot’ for making such ludicrous claims. E-Health needs to be delivered on the basis of fact not absurd spin. Talk about working hard to dispose of any remaining credibility!

Can someone get NEHTA back to planet earth please?

David.

COAG Meeting Deferred Until April, 19 2010

I have just heard on the ABC the Council of Australian Governments Meeting to approve the Rudd / Roxon Plan for Health Reform will happen on April, 19 2010.

I hope we have heard about the plans for e-Health long before this date. I fear however it will not happen as we all might hope!

David.

Weekly Australian Health IT Links - 21-03-2010.

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. Note also that full access to some links may require site registration or payment.

General Comment:

The early part of the week was clearly dominated by the Health Identifiers Bill Inquiry and the report that was produced and tabled in what must have been in near record time. It looks like debate in the Senate will happen in early May – during the Budget Session. It is not clear how it will all work out at this point.

Now that we have seen the outcome of the Tasmanian and SA elections it does seem Mr Rudd’s proposals are going to meet continuing scrutiny. It also seems the COAG meeting, due on April 11, might also be delayed a little.

Also this week we see continuing issues with just how the NBN and Telstra will work together (or not). No doubt we would all like to see this just sorted out so that the infrastructure is in place for e-Health applications to use when they are ready.

-----

http://www.infosecurity-us.com/view/8179/iso-issues-new-guidelines-for-safeguarding-electronic-medical-data-/

ISO issues new guidelines for safeguarding electronic medical data

18 March 2010

ISO has published two new documents outlining principles and guidelines for secure archiving of electronic medical record data.

The Switzerland-based International Organization for Standardization, more commonly known as ISO, has just released two new briefs that address the complex nature of securing electronic medical record data. The organization concluded that documents outlining both data protection principles and guidelines were necessary to provide harmonized international standards for this industry, where information is quite sensitive and regulations regarding data transfer and storage abound.

Although the use of electronic medical records has proliferated throughout the globe as of late, its use is “exacerbating issues such as confidentiality, integrity, availability, and accountability” of the data, according to the Pekka Ruotsalainen, who led the project to develop the standards.

Ruotsalainen’s group produced two documents: Health Informatics – Security requirements for archiving of electronic health records – Principles, and Health Informatics – Security requirements for archiving of electronic health records — Guidelines. Each is available for purchase from the ISO website.

-----

http://www.theaustralian.com.au/news/health-science/medical-dividend-from-biosecurity-network/story-e6frg8y6-1225842567635

Medical dividend from biosecurity network

Leigh Dayton, Science writer

From: The Australian

March 20, 2010 12:00AM

THIS week's launch of the Australian Biosecurity Intelligence Network promises spin-offs for public health as well as improved preparedness for biological threats to plants and animals.

Based in Canberra and headed by geneticist, immunologist and counter-terrorism expert Joanne Banyer, the network will provide secured communications and information technology infrastructure to enable experts and officials to tackle emerging biosecurity threats.

"We think of it as providing the collaboration infrastructure," explains Stephen Prowse, an expert in immunology, infectious diseases and diagnostics with the University of Queensland and an ABIN board member.

-----

http://www.medicalobserver.com.au/index.php/news/nehta-set-to-miss-deadline-for-identifier-numbers?hash=0f4c9790d7a85b5ee7acc95ba1b597bd-41f78717d591531fca1ca679682ca2f3

NEHTA set to miss deadline for identifier numbers

19th Mar 2010

Shannon McKenzie

THE National e-Health Transition Authority is almost certain to miss its 1 July deadline to begin the national rollout of its healthcare identifier numbers, after the necessary legislation was delayed in Federal Parliament.

Senate debate on the Healthcare Identifiers Bill 2010 has now been pushed back to 11 May. However, given this is scheduled to be a short parliamentary session ahead of the federal Budget, there is no guarantee the legislation will be passed on this date.

National e-Health Transition Authority (NEHTA) clinical lead Dr Mukesh Haikerwal said this would “absolutely cause a delay” in the program, but one that could present opportunities.

------

http://www.geelongadvertiser.com.au/article/2010/03/20/156531_news.html

Top doc praises our e-health uptake

Joel Cresswell

March 20th, 2010

GEELONG is a leader in Australia's movement to electronic health, according to one of the nation's top GP's.

The clinical head of the National E-Health Transition Authority, Mukesh Haikerwal, said Geelong's hospital and GP network had embraced electronic data collection and communication, well ahead of the remainder of the technologically "backward" sector.

He said the changes had streamlined drug prescriptions, diagnosis and reduced double handling between the hospital and GPs.

-----

http://www.healthtechwire.com/The-Industry-s-News-unb.146+M570d0560a7c.0.html

Chronic disease and demographic development to drive eHealth adoption

BARCELONA, SPAIN - (HealthTech Wire / News) – At The World of Health IT, iSoft, one of the largest eHealth companies in the world with more than 13,000 customers, launched its Health Information Exchange (HIE) platform, which connects all stakeholders in healthcare – including the patient. Andrea Fiumicelli, Chief Operating Officer at iSoft, spoke to HealthTech Wire about the factors that will drive eHealth adoption in Europe and how his company is advancing ICT in healthcare.

According to Fiumicelli, the major challenges in European eHealth are the actual processes.

“The industry has been ready to establish a single European eHealth market for the past 5 to 8 years. The technology is no longer a limiting factor. However, the processes are and we would welcome a simplification, e.g. with regards to reimbursement,” Fiumicelli said. This would ease innovations and lead to more efficient research and development.

-----

http://www.medicalobserver.com.au/index.php/news/software-vendors-urge-ehealth-subsidies-for-gps

Software vendors urge e-health subsidies for GPs

19th Mar 2010

SOFTWARE vendors have argued that GPs should be subsidised to upgrade computer software that will enable the rollout of a national e-health system.

Shannon McKenzie

SOFTWARE vendors have argued that GPs should be subsidised to upgrade computer software that will enable the rollout of a national e-health system.

Addressing a Senate inquiry into proposed legislation that will enable the rollout of the unique health identifiers (UHI) scheme, Dr Vincent McCauley, treasurer of the Medical Software Industry Association, said while GPs would be required to invest in new software, they would not necessarily reap the benefits.

-----

http://www.theaustralian.com.au/australian-it/health-identifier-bill-delayed/story-e6frgakx-1225841967151

Health identifier bill delayed

• Karen Dearne
• From: Australian IT
• March 17, 2010 4:25PM

SENATE consideration of the Rudd Government's controversial Healthcare Identifiers Bill will not take place until budget day on May 11.

This follows a tumultuous week of testimony and a rushed report recommending adoption despite Coalition concerns and calls for amendments.

The Healthcare Identifier service, to be run initially by Medicare Australia, is due to commence on July 1.

Medical software specialists, privacy advocates and the e-health community had been seeking more details on how the scheme would work.

Late last Friday, Health Minister Nicola Roxon finally released draft regulations underlying the proposed legislation, and invited public comments by April 9.

-----

http://www.smh.com.au/technology/this-brainless-patient-is-no-dummy-20100320-qn7n.html

This brainless patient is no dummy

RACHEL BROWNE

March 21, 2010

MEET the new high-tech robot suffering from a multitude of health problems helping to save lives around Australia.

SimMan 3G might look like a dummy but he is surprisingly smart. He talks, cries and bleeds as well as replicates conditions ranging from anaphylaxis to cardiac arrest.

Costing $100,000, the wireless robot is being used by hospitals, universities, the Defence Force and ambulance services.

-----

http://www.theage.com.au/victoria/hospitals-caught-out-on-data-says-doctor-20100318-qicu.html

Hospitals caught out on data, says doctor

JULIA MEDEW

March 19, 2010

VICTORIANS should expect the performances reported by most hospitals to drop this year as a result of a crackdown on data rorting, a Melborne doctor says.

Dr Peter Lazzari - who was dropped by Angliss Hospital last year after he spoke about waiting-list manipulation - said that if hospitals reported waiting times honestly this year, their performance on paper could look much worse.

Last year, Victoria's Auditor-General Des Pearson found that at least three Victorian hospitals inappropriately removed patients from waiting lists and one had ''admitted'' them to fictitious wards.

-----

http://www.6minutes.com.au/articles/z1/view.asp?id=513539

Senate wary of health identity numbers

by Michael Woodhead

Concerns about privacy and 'function creep' have dominated Senate discussions over the introduction of unique health identifier numbers for all Australians.

Last week’s Senate hearings into the proposed July introduction of health identifiers saw Senators asking pointed questions about whether Medicare and other agencies could guarantee privacy of patients’ medical records under such a scheme.

Medicare representatives rejected media claims that Medicare staff were routinely gaining unauthorised access to on personal medical files, saying that compliance programs had reduced the instances of snooping from 270 in the first year of e-health programs to just 16 the last six months.

-----

Crikey, March 16, 2010

http://www.crikey.com.au/2010/03/16/health-id-cards-unleash-scary-little-brothers/

17. Health ID cards unleash 'scary' Little Brothers

Stilgherrian writes:

AUSTRALIAN HEALTH CARE, ID CARDS, IDENTITY THEFT, NATIONAL IDENTITY CARD

Comparing the proposed Healthcare Identifier to the doomed 1980s Australia Card is a cliche, I know, but it’s spot on. The Healthcare Identifiers Bill introduced last Wednesday is sketchy at best, and health minister Nicola Roxon has already been forced into releasing an equally sketchy draft of the accompanying regulations on Friday.

The legislation authorises Medicare to issue a new 16-digit healthcare ID number, central to the government’s eHealth strategy, to every Australian and every healthcare provider from July 1. But that’s about all it does. It fails to address in any real detail what protections will be implemented when this one identifier provides the key to everything from an appointment with your masseur or your dentist to your s-xual or mental health records.

-----

http://www.smh.com.au/national/gps-angry-about-bypass-program-on-web-20100315-q9og.html

GPs angry about 'bypass' program on web

KATE BENSON HEALTH

March 16, 2010

AUSTRALIAN researchers have developed a world-first program that allows people to bypass GPs and be assessed, diagnosed and treated by psychologists over the internet.

About 1000 people have already been treated for anxiety disorders, including obsessive compulsive disorder and agoraphobia, and developers, from Swinburne University in Melbourne, want to start treating depressives, bulimics and gamblers next month.

The program, designed to tackle the nation's crippling shortage of mental health services, has drawn the ire of doctors, concerned that patients could be dangerously misdiagnosed.

-----

http://www.theaustralian.com.au/australian-it/medicare-data-breaches-increase-privacy-fears/story-e6frgakx-1225841101367

Medicare data breaches increase privacy fears

• Karen Dearne
• From: The Australian
• March 16, 2010 12:00AM

MEDICARE Australia dealt with 234 serious data privacy breaches by employees in 2007-08, but 160 of these resulted in only an emailed warning or counselling.

In the three years from November 2006 until December last year, 569 staff were identified as having "unauthorised access" to client records held by the agency.

Contrary to recent Medicare claims that most of the unauthorised access related to staff accessing their own records, only 171 out of the 569 investigated were in that category.

Medicare was yesterday forced to produce data breach statistics and details of sanctions to a senate inquiry, after disputing revelations in The Australian of staff snooping.

-----

http://www.theaustralian.com.au/australian-it/heath-identifier-function-creep-threatens-data-privacy-says-coalition/story-e6frgakx-1225841103224

Heath identifier function creep threatens data privacy says Coalition

Karen Dearne

From: The Australian

March 16, 2010 12:00AM

THE Senate Community Affairs committee has recommended passage of the controversial Healthcare Identifiers Bill, despite the minority Coalition members calling for amendments to ensure patient privacy and prevent personal identifiers being turned into a national identity regime.

Last night, the committee recommended developing a plan to introduce the scheme over the next two years, opening it to public comment before finalisation.

"The National E-Health Transition Authority in partnership with the Health Department and Medicare should more effectively engage all stakeholders in establishing the HI service," it said.

-----

http://www.theaustralian.com.au/australian-it/reject-e-health-identifier-bill-says-law-professor/story-e6frgakx-1225841104102

Reject e-health identifier bill, says law professor

• Karen Dearne
• From: The Australian
• March 16, 2010 12:00AM

THE Healthcare Identifiers Bill should be rejected until the Rudd government provides the full suite of legislation intended to support new national electronic health initiatives, a Senate inquiry has been told.

Law professor Graham Greenleaf, co-director of the Cyberspace Law and Policy Centre at the University of NSW, said the fundamental problem was that the bill was incomplete, covering only a "small but central element of a much broader health identification and surveillance system", including future personal e-health records.

"When seen in its entirety, this system shares a very large number of common elements with the discredited and rejected Australia Card (in 1986-87) and the Access Card (2006-07) proposals put forward by governments from both parties," he said.

-----

http://www.zdnet.com.au/blogs/patch-monday/soa/Can-privacy-and-health-identifiers-mix-/0,2001107879,339301777,00.htm

Can privacy and health identifiers mix?

Posted by Stilgherrian @ 17:32

A new 16-digit healthcare identifier for all Australians is a centrepiece of the Rudd Government's e-health strategy. The numbers are scheduled to be issued from 1 July, but have the privacy issues been properly thought out?

The Healthcare Identifiers Bill (PDF) is currently making its way through parliament, but many key details have been left to be defined in regulations. After pressure in a Senate committee, Health Minister Nicola Roxon was forced to release draft regulations (PDF) on Friday, but they're still short on details.

http://media.cnetnetworks.com.au/audio/musiccentre/patch_monday/patch_monday_ep34_01.mp3

-----

http://www.zdnet.com.au/news/software/soa/Senators-split-over-e-health-Bill/0,130061733,339301800,00.htm

Senators split over e-health Bill

By Ben Grubb, ZDNet.com.au

16 March 2010 03:14 PM

Senators looking into the Federal Government's Health Identifier Bill as part of a Senate inquiry have not been able to reach a consensus over whether they recommend the new law be passed.

The Bill — due for debate as the third item on the Senate's orders of the day on 11 May — is required to be passed in order for Australians to be issued a 16-digit national healthcare identifier. The Federal Government intends to have the Bill passed before 1 July, when the roll-out is due to begin.

Health Minister Nicola Roxon referred the Bill to a Senate Committee late February due to high levels of community interest. The report from the committee's inquiry has shown in its corresponding report that Coalition and Labor senators are split over privacy concerns and evidence raised in submissions.

-----

http://www.e-health-insider.com/news/5737/isoft_makes_move_on_consumer_healthcare

ISoft makes move on consumer healthcare

16 Mar 2010

ISoft has formed a partnership with Switzerland-based telehealth device company Medic4all. The two companies are showcasing integrated telehealth products at the World of Health IT conference in Barcelona.

These include a monitoring operations centre that manages patient data and a home care platform that allows healthcare professionals to remotely monitor, diagnose and care for patients.

According to iSoft, one of key differentiators between its "end to end" solution and what other companies are offering is the look and appeal of each of the devices.

-----

http://www.computerworld.com.au/article/339598/isoft_reaffirms_revenue_guidance/?eid=-255

iSoft reaffirms revenue guidance

Says work under the UK’s National Programme for IT (NPfIT) remains on track

• Tim Lohman (Computerworld)
• 15 March, 2010 17:52

iSoft (ASX:ISF) has moved to reassure investors that its FY10 financial guidance and work on the UK’s National Programme for IT (NPfIT) remains on track.

In an ASX statement today the e-health provider said it was on track to achieving the agreed data for the roll out of its Lorenzo application at Cumbria's University Hospitals of Morecambe Bay NHS Trust under the NPfIT. This was contrary to recent speculation in media reports.

“iSoft expects the milestone at Morecambe Bay to be met according to the timetable agreed between its partner Computer Sciences Corporation [CSC] and the National Health Service [NHS], and expects this achievement to trigger a cash payment to the company,” the statement said.

-----

http://abnnewswire.net/press/en/62442/iSOFT_Group_Limited_%28ASX:ISF%29_Reaffirms_FY10_Guidance_and_Says_NPfIT_Commitments_on_Track.html

iSOFT Group Limited (ASX:ISF) Reaffirms FY10 Guidance and Says NPfIT Commitments on Track

Sydney, Mar 15, 2010 (ABN Newswire) - iSOFT Group Limited, Australia's largest listed health information technology company, today reaffirmed its guidance for fiscal 2010 and said it is on track to achieve the agreed date for the rollout of Lorenzo at University Hospitals of Morecambe Bay NHS Trust under the UK's National Programme for IT (NPfIT).

Morecambe Bay "go-live"

iSOFT remains on track for the "go-live" of Lorenzo Regional Healthcare Release 1.9 at Morecambe Bay in accordance with the agreed schedule, contrary to recent speculation in media reports. iSOFT expects the milestone at Morecambe Bay to be met according to the timetable agreed between its partner Computer Sciences Corporation (CSC) and the NHS, and expects this achievement to trigger a cash payment to the company.

-----

http://www.e-health-insider.com/news/5741/isoft_says_it_is_%27on_track%27_at_morecambe

iSoft says it is 'on track' at Morecambe

16 Mar 2010

Australian health IT firm iSoft yesterday said it was “on track” to implement Lorenzo across University Hospitals of Morecambe Bay NHS Trust by the end of March.

In a statement to the Australian Stock Exchange, the company said it would meet its promised revenues and added: “iSoft remains on track for the ‘go-live’ of Lorenzo Regional Healthcare Release 1.9 at Morecambe Bay in accordance with the agreed schedule, contrary to recent speculation in media reports.”

Last week, E-Health Insider reported that local service provider CSC and iSoft look set to miss the 31 March deadline for the go-live across the trust.

-----

http://www.theaustralian.com.au/news/opinion/broadband-network-will-be-43bn-white-elephant/story-e6frg6zo-1225841083908

Broadband network will be $43bn white elephant

Malcolm Colless

From: The Australian

March 16, 2010 12:00AM

THE present federal budget describes the Rudd government's $43 billion national broadband network as the single largest building infrastructure project in Australian history.

But it could end up as one of Australia's biggest and costliest infrastructure debacles. And that's saying something when you look at the financial disaster that has engulfed the home insulation program and the amount of taxpayers' money wasted on the mismanagement of the primary school building revolution.

What has emerged from these multi-billion-dollar spending splurges is an absence of good governance. Political rhetoric and spin have taken precedence over economic common sense.

The NBN is no exception. It is just that the financial cost of failure is so much higher. The project's operating body, NBN Co, is flying by the seat of its pants on a mission from Kevin Rudd to deliver a national high-speed fibre-optic broadband network at the cutting-edge of world standards.

-----

http://www.theaustralian.com.au/australian-it/conroy-set-for-clash-over-nbn/story-e6frgakx-1225841689131

Conroy set for clash over NBN

Mitchell Bingemann

From: The Australian

March 17, 2010 12:00AM

THE Rudd government will today defy a Senate order by not releasing the study into the costs, structure and financial viability of the $43 billion national broadband network.

Last week, Greens senator Scott Ludlam lodged a Senate order for Communications Minister Stephen Conroy to release the $25 million KPMG and McKinsey study by 10am today.

It is understood the government will ignore the request.

"It's extremely politically dangerous for the government to not table the study because they have been referring all the unanswered questions about the information vacuum surrounding the NBN to this particular study," Senator Ludlam said.

-----

http://news.smh.com.au/breaking-news-national/broadband-network-hangs-in-balance-20100318-qg66.html

Broadband network hangs in balance

March 18, 2010 - 7:59AM

AAP

The federal government has until 10am (AEDT) on Thursday to produce a report that might determine whether the Senate approves Labor's planned national broadband network strategy.

But the Australian Greens, who are threatening to withdraw their support for key legislation paving the way for the break-up of Telstra, are not holding out much hope the government will agree to the upper house demand.

-----

http://www.smh.com.au/technology/enterprise/word-excel-powerpoint--free-on-the-web-20100315-q7g7.html

Word, Excel, Powerpoint - free on the web

LIA TIMSON

March 15, 2010 - 3:43PM

Microsoft is rising to the challenge of Google Docs, offering free Office applications on the web as it releases Office 2010.

New paid versions of the ubiquitous office suite will be available to businesses in May and consumers in June, but its Office Web Apps component is already available in beta through Microsoft Office Live.

Anyone with a Windows Live account can create, modify or share Word, Excel and PowerPoint documents for free. They do not need Microsoft software installed on their machines.

------

Enjoy!

David.

A Couple of Interesting White Papers from CSC’s Healthcare Group.

The following appeared a few days ago.

Insights

Technology Cornerstones Supporting Tomorrow's Healthcare

Author:

Michael Garzone, Fran Turisco, Jared Rhoads

Summary:

New technologies are helping to deliver critical health information to authorized end users regardless of time, place or device. These technologies are broadening the reach of health information across care settings as they improve data access and data interoperability, enable personalized interactions, and provide ubiquitous computing. Care communities, patients, care givers and consumers need to develop a vision of how care delivery practices and processes should fit together, which data are shared and how, and which are the most suitable supporting infrastructure technologies. In this paper, we discuss the technology cornerstones that support the healthcare system of tomorrow. We identify the cornerstones and discuss what new technologies are available to fill those needs.

Download "Technology Cornerstones Supporting Tomorrow's Healthcare"

Contact Details are here:

http://www.csc.com/health_services/insights/40262-technology_cornerstones_supporting_tomorrow_s_healthcare

This paper was published in February, 2010 and builds on this paper from late last year.

Insights

Tomorrow's Healthcare System Using Today's Technology

Author:

Fran Turisco, Erica Drazen

Summary:

Tomorrow's healthcare system can be achieved with today's technologies. Patient-Centric care, directed by a team of professional care givers and family members, supported by commonly-used IT technologies and integrated medical devices, improves medication, care plan and health goals adherence and allows patients to remain independent longer. By removing the current barriers of health reforms and reimbursement issues, and lack of widespread connectivity and EHR adoption, this paper allows the reader to imagine a truly efficient and effective healthcare system from the perspectives of a patient, nurse, physician and care mentor/coach.

The proliferation of today's communication and Internet-based technologies, plug-and-play medical devices for the home, and a growing number of health and wellness applications provide the infrastructure to bring tomorrow's healthcare system within reach.

Download "Tomorrow's Healthcare System Using Today's Technology"

Again the contact information is here:

http://www.csc.com/health_services/insights/36297-tomorrow_s_healthcare_system_using_today_s_technology

Both are worth a download and read. The vision of what is more than possible today is great fun.

David.