It Seems Someone Is Running an e-Health Spruiking Campaign! I Wonder Who?

All of a sudden there seems to be a great deal of publicity to foster excitement around e-Health.

First we have a little NEHTA puff piece which demonstrates that better communication – manual or electronic – can save everyone lots of hassles. Of course the electronic version assumes an e-Health infrastructure we will all be lucky to see in the next decade or two!

Making a Difference with E-Health

E-health is about ensuring Australians get the right treatment and the right medication in the right place and time. Here, one of NEHTAs Clinical Leads, Dr Ashley Bennett, a radiologist shows the difference e-health will make to patients and healthcare providers. Here is Dr Bennett's story.

Dr Ashley Bennett

Mr Tran is a 54 year old non-English speaking man who recently visited his GP with acute-on-chronic back pain and sciatica. The condition was not severe enough to require a visit to the emergency department, but it kept him awake at night and interfered with daily activities. His GP gave him a hand-written referral saying “Please review previous films and inject level indicated as per report’s recommendations”.

.....

As an estimate, the total time from patient presentation until the conclusion of the procedure was 16 hours. In addition, Mr Tran and his daughter, myself and the GP were inconvenienced by the lack of information available and the inability to treat Mr Tran.

The difference e-health will make to this real life scenario is significant.

The GP will be able to submit the request electronically and the Radiology reception staff will be able to retrieve Mr Trans’ electronic health record instantaneously, including the previous lumbar MRI report. Seeing the ambiguity of the request, I would be asked to contact the GP straight away (before he went on leave) to clarify the procedure required. When Mr Tran arrived for his procedure, his previous images will be available for online review. After confirmation of the symptoms with Mr Tran and his daughter, a nerve root sleeve injection would have been performed. As an estimate, the total time from patient presentation until the conclusion of the procedure would be approximately 20 minutes.

Read the full saga here:

http://www.nehta.gov.au/media-centre/feature-story/624-making-a-difference-with-e-health

Then we have the RACGP out there spruiking NEHTA as part of their ‘being best mates’ sponsorship!

College's E-health Futures Leads The Way, Australia

09 Apr 2010

The Royal Australian College of General Practitioners (RACGP) is very pleased to announce that its latest e-health initiative, e-health Futures, will officially be launched today at College House in South Melbourne.

e-health Futures is an innovative and interactive e-health display, which involves a walkthrough experience of how e-health information will work among health care professionals.

RACGP President Dr Chris Mitchell, who will open e-health Futures in Melbourne today, said that this initiative is very important to position general practice at the centre of the e-health revolution.

"General practice is in an ideal position to be at the forefront of e-health. There are now around 115 million GP consultations taking place annually and computers are now used by 98 per cent of GPs for clinical purposes.

"Without improvements in e-health and medical information management systems, we will continue to expose patients to unnecessary risks, including adverse events and medication errors.

The college has worked closely with the National E-Health Transition Authority (NEHTA) to incorporate their Model Healthcare Community into e-health Futures.

The model provides an opportunity to learn more about the policy and implementation of Australia 's future Healthcare Identifiers Service and also to see other innovations in e-health such as the RACGP's data aggregation tool Oxygen and the Pen Clinical Audit Tool (CAT).

Dr Chris Mitchell said that the college will be adding to the e-health projects available as the resources are being developed to assist and support GPs as e-health continues to evolve.

"This project is a unique opportunity for general practice teams, other health professionals, health industry associations, consumer groups, privacy advocates, universities, information industry associations, vendors and media representatives to learn more about e-health and find out how they can utilise the model.

"With more e-health government announcements to be expected soon, e-health Futures provides a timely opportunity for everyone to get ready and experience and direct the future of electronic health," concluded Dr Mitchell.

Source

Royal Australian College of General Practitioners

The release is here:

http://www.medicalnewstoday.com/articles/184965.php

And finally we have the Brumby Government spruiking e-Health!

Vic wants COAG decision on e-health

By Suzanne Tindal and Ben Grubb, ZDNet.com.au on April 9th, 2010 (1 day ago)

The Victorian Government yesterday called for an updated business case for the roll-out of a national individual electronic health record (IEHR) to be approved at the Council of Australian Governments (COAG) meeting this month.

"A business case for IEHRs for every Australian is ready for consideration by COAG," the state government said in its Putting Patients First proposal. "Victoria strongly supports COAG endorsing the business case as part of the overall health reform package, and the Commonwealth funding it from the Health and Hospitals Fund, with additional support from states."

The idea is that individual health records will allow Australians to easily access and share information such as test results, prescriptions and hospital discharge information with all of their healthcare providers.

The business case for the IEHR scheme, created by the National E-health Transition Authority (NEHTA), was first submitted to COAG in October 2008, but the financial crisis intervened and e-health was pushed off COAG's list of issues to consider. At subsequent COAG meetings, the business plan was not considered urgent enough to merit immediate attention.

The Victorian Government feels that now is the time for the business case to get a hearing.

More here:

http://www.zdnet.com.au/vic-wants-coag-decision-on-e-health-339302303.htm

Funny that the Victorians are on about the NEHTA IEHR plan and the Commonwealth is on about Personally Controlled EHRs – whatever each of those actually is?

Once is happenstance, twice is coincidence and three times is enemy action. Given NEHTA seems to be the common thread one just wonders what is going on behind the scenes. If this is the NEHTA push to get Victoria signed up to the Commonwealth version of Health Reform to assist NEHTA in getting some via some funds for NEHTA for an IEHR or whatever we should all be pretty alarmed I believe!

David.

Senator Sue Boyce Slams Rudd Government Efforts on E-Health. Game On for Progress in E-Health I Hope!

At last it seems we are now going to get some serious debate on just what is happening with e-Health with the Opposition firing the first salvo!

Here is a release from an few hours ago.

GOVERNMENT BUNGLING ON E-HEALTH INTRODUCTION: SENATOR SUE BOYCE

The Rudd Government's electronic health system had a snowball's chance in hell of being ready by its announced introduction date of July 1, Liberal Senator Sue Boyce, said today.

"This system which is supposed to be a state-of-the-art nationally integrated system to provide all Australians with their own identifier number is crippled by inept management, hopeless dithering and a complete lack of any political leadership," Senator Boyce said.

The system is also supposed to provide identifier numbers to all health care providers (and consumers).

Senator Boyce, a member of the Senate Community Affairs Legislation Committee, said evidence she had been provided on February 10 during Estimates about the state of the e-health network had been wildly and falsely optimistic.

"I was assured then by a senior Health Department bureaucrat that trials of the e-health system were already underway yet only days ago a Health Department spokeswoman was quoted as saying that work is yet to begin on the system," Senator Boyce said.

"I have written to the Health Minister, Nicola Roxon, asking her to explain why what I was told on February 10 in the Senate hearings appears in retrospect to have been so wrong and so utterly misleading, given the statement by the Health Department spokeswoman published recently," she said.

Senator Boyce said the hopeless management of the e-health system by the Rudd Government was underlined by the fact that the legislation to establish the system had not even been introduced to the Senate.

"The fact that we are only ten weeks or so away from the July 1 implementation date and the Rudd Government hasn't even got around to having the legislation required to establish the system introduced, speaks volumes about how badly the whole process has been mismanaged," Senator Boyce said.

"This is another example of how the Rudd Government handles the implementation of its grand schemes – big promises, massive spin and then hopeless bungling. Clearly, there is a pattern of failure across the board," Senator Boyce said.

"I would not be surprised, given how long it will take to get the system eventually bedded down, that we will go to the election with – at best – a patched-together and incomplete system," she said.

April 14, 2010-04-14

MEDIA CONTACT: RUSSELL GRENNING 0448 193 903

----- End Release.

Here is a copy of the letter which Senator Boyce has sent to the Health Minister.

April 14, 2010

Hon Nicola Roxon MP

Minister for Health and Ageing

Parliament House

Canberra ACT 2600

Dear Minister

On February 10, 2010, as a member of the Senate Community Affairs Legislation Committee, I asked several questions during the Additional Budget process Estimates hearing of your Departmental staff about progress on the implementation of the e-health project.

The following exchange, as recorded by Hansard, occurred between myself and Ms Liz Forman, Assistant Secretary, eHealth Branch, after I had asked about who in the primary care sector NEHTA had been working with in terms of developing an implementation pathway:

Senator Boyce: When did the work on implementation with each of these organisations in the primary care sector and the primary care software vendors begin?

Ms Forman: That work and that collaboration is still very much at the discussion stage I think.

Senator Boyce: So has the work actually commenced or are they talking about working?

Ms Forman: They are talking about working. They also have a working group relating to secure messaging where quite a significant amount of work has been done with the vendors.

Senator Boyce: Is secure messaging being undertaken or is talk about secure messaging happening?

Ms Forman: Talk and development of software so the vendors are able to work towards bringing their software in line with the NEHTA specifications and then testing that.

Senator Boyce: So that is being trialled?

Ms Forman: That is underway.

Senator Boyce: Are there actual trials happening? Is software that has been developed to meet the NEHTA specifications actually being trialled right now?

Ms Forman: It is being developed and we are expecting there to be a testing workshop in April.

Subsequently, I was advised in response to a Question on Notice (Question: E10-423) that; "NEHTA is working with a significant number of vendors on implementation matters across both the primary care and jurisdictional environment" and a lengthy list of companies was attached. I had asked specifically for "a list of who are the primary care sector vendors that NEHTA has been working with in terms of developing an implementation pathway."

In response to Question on Notice E10-424, I was advised that; "the Integrating the Healthcare Enterprise (IHE) Secure Messaging Connectathon will take place in Canberra from the 19-23 April, 2010". That response provided details about how the testing workshop would be conducted.

Given all of these confident predictions, I was surprised to read in The Australian (April 13, 2010) an article; "E-Health ID work yet to start" by Karen Dearne.

In that article, Ms Dearne wrote that; "six months after assuring a Senate committee that the National E-Health Transition Authority was working with primary care software firms over the proposed national Healthcare Identifier system, the federal Health Department has conceded work is yet to begin."

A spokeswoman for your Department was quoted as saying; "Currently there are no implementation projects within primary care being funded" and that your Department was "unable to supply a list of medical practice vendors previously said to be working with Nehta on an 'implementation pathway'."

Now, I learn from this story that the lengthy list that I was provided when I asked specifically for the list of "primary care sector vendors that NEHTA has been working with in terms of developing an implementation pathway" is, in fact, a list of "eligible suppliers".

I refer you specifically to the evidence of Ms Forman, quoted earlier, when she said that trials were already underway and ask how you can reconcile this evidence with the published statement by a Departmental spokeswoman in The Australian that there were no implementation projects being funded.

I also refer you to the information provided to me in response to Question on Notice E10-424 about the testing workshop expected to commence within days. Will that workshop still take place and, if not, why it has been delayed and when it might take place?

I also ask for your categorical assurance that this system will operate flawlessly and smoothly from July 1, 2010, as the government and your Department have always asserted.

Yours sincerely

Sue Boyce

Senator for Queensland.

---- End Letter.

All I can say is that this intervention is an unequivocally good thing as what is needed now is serious political engagement, from both sides, with all aspects of e-Health to see if some sensible, properly managed, planned and funded e-Health approach can be finally delivered.

Sweeping e-Health under the carpet was a very bad idea and we can now see.

All power to the Opposition for at least starting the Debate for real!

David.

This Anonymous Comment Needs More Exposure and for Lots of Reasons.

Anonymous said...

David, not sure that this sort of "national enquirer" commentary really helps your status as a noted member of the e-health community.

Although I share your concerns, I simply don't believe that it is possible to divine the internal machinations of government by just looking at what is publicly released. There is SO much more happening behind the scenes that punters never get to see.

The tar-drip speed of progress can be mind-bending, but I am sure that the staff in government (including ALL of the people at DoHA and NEHTA who live and breathe this too) want to get it going. And they haven't stopped working yet. Nothing at COAG is final until the meeting is over.

Think more broadly for a moment: health identifiers are *really* close, national health reform is the dominant government story in the news right now, every health department is working at local e-health projects, PIP messaging vendors are making great progress, and the big defence e-health tender has just asked the open market to build a real implementation of almost all the technical elements outlined in the national e-health strategy.

There has never been a better set of circumstances to get the fire started. Don't let the smoke get in your eyes...

Tuesday, April 13, 2010 10:27:00 PM

----- End Comment.

Let us think what is being said here.

1. Anything useful that is happening is happening behind the scenes and no one other than the ‘in crowd’ can know.

2. The fact that the progress has been minimal for the last 5 years does not mean that great things are not close.

3. NEHTA and DoHA are toiling away on this and we should all trust that they will sort it out – and they don’t need anyone’s help.

4. You and the readers do not know what is going on and apparently nor should you.

5. Lie back, enjoy and trust us – and all will be well.

Now all this may be true, but the evidence we have from the press:

See here:

http://aushealthit.blogspot.com/2010/04/and-this-lot-think-they-can-implement.html

and from Senate Estimates seems to suggest it is just not true.

If you accept this stuff you must also believe in fairies in my view. I must be a ‘doubting Thomas’ who wants evidence, and after all these years I am one who has totally lost trust in the sort of person who thinks it is useful to post this material – but is so scared of their bosses they can’t use their name.

I am really rather ashamed of a country where this secrecy would be seen as normal behaviour – but maybe things have changed now we have Mr Rudd and Ms Roxon in charge.

It is now a decade since serious plans were outlined for a National E-Health approach with Health Online and we have hardly moved in terms of practical national delivery – accepting that some projects are seemingly making headway – but at a really ‘tar-drip’ speed - other than the essentially private initiatives around GP computing and messaging supported by some quite limited funds.

I also find it really silly that the details of any NEHTA / DoHA proposal to COAG or following meetings are not being discussed and reviewed openly. Perfect wisdom these people do not have – trust me on this small point! Let us be also totally clear the IEHR and Personally Controlled EHR proposals are both very bad and ill considered ideas that should not be funded.

Manifest leadership, strategy, governance, co-ordination, support, planning and so on are just absent - and in this environment we all know little of value is ever achieved.

Everyone knows who I am. Anonymous who are you to tell us you know better and that we should just relax and enjoy?

David.

We Are Led by Clueless Incompetent Nitwits. They Just Can’t Work Out What to Do – Pathetic!

The final offer for the COAG Health Reform Plan was released yesterday.

It was entitled:

A National Health And Hospitals Network: Further Investments In Australia’s Health

You can find the document here:

http://www.health.gov.au/internet/main/publishing.nsf/Content/nhhn-report-2

On page 92 of the document we find the sole mention of e-Health

Next Steps

The Government will continue to make further investments in the National Health and Hospitals Network, in both the priority areas discussed in this document, and in additional important areas such as mental health, dental care and preventive health.

In mental health, while some progress has been made in recent years in providing more services to people with common conditions such as depression and anxiety, the system is not currently meeting the needs of certain groups of people with mental illness. In particular, young people with or at risk of mental illness are not accessing the timely care they need.

In dental health, many Australians experience poor access to dental care – often because there are not enough dentists and dental professionals. Current estimates project there will be a shortfall of 2.3 million dental services in 2020. People who are socially and economically disadvantaged are much more likely to have poor dental health. The Government is committed to expanding access to dental care in Australia, for example through the establishment of the Medicare Teen Dental Plan.

The Government recognises there is much more to be done to improve access to mental health services and dental care.

Obesity, tobacco and alcohol misuse are the key common risk factors for a range of chronic diseases, including diabetes, cancer and cardiovascular disease. Since 2007 the Commonwealth Government has made unprecedented investments in prevention, committing $872 million through COAG for preventive health programs to be rolled out in schools, workplaces and communities to help individuals modify their lifestyles to reduce the risk of chronic diseases. Nonetheless, the Government recognises there is scope for targeted further action to build on these important measures.

In addition, e-Health reforms will work to provide additional foundations to support improvements to the quality and efficiency of care across the National Health and Hospitals Network. The Government will be making further announcements on these reforms over the coming weeks and months.

Can you believe it? Weeks and months as Dr Oliver Frank, who sent me the document exclaimed! How long do we have to wait given we have known this is an issue since even Minister Abbott admitted he was struggling with the whole area in 2006-7!

Both sides of politics seem to be just utterly clueless and stupid.

What is going on is now utterly clear.

The work on E-Health done by NEHTA and DoHA is so hopeless that the Government was not even prepared to put it to COAG – for fear of being laughed out of the room!

I hope they can find someone who has a clue to help them and soon – or the overall quality of any Health Reform is doomed in my view.

The credibility of Mr Rudd and Ms Roxon in Health is basically shot as far as I am concerned. It is frankly terrifying that these people and their highly paid bureaucrats are in charge of what now looks like rendering terrible harm to a health system which, while stressed. does not need an axe taken to it - without real confidence some good will result.

Has someone told them there is actually a quite reasonable National E-Health Strategy they could get started with?

David.

AusHealthIT Man Poll Number 15 – Results - 13 April, 2010.

The question was:

Should NEHTA Be Attempting To Displace The Current Secure Messaging Providers?

Absolutely

- 7 (17%)

If There Is a Major Benefit to Clincians

- 10 (25%)

If There Will Be Savings Long Term

- 2 (5%)

They Should Let the Market Decide

- 13 (33%)

Absolutely No Way

- 7 (17%)

Total Votes: 39.

Comment:

I will leave the interpretation of the results to the reader. For me it seems clear that a significant number do not want NEHTA just using its Government mandate to disrupt already satisfactorily operating e-Health Infrastructure without some very good reason.

Thanks again to all who voted.

David.

And This Lot Think They Can Implement Health Reform? Not a Snowflake’s Chance in Hell.

The following appeared in the Australian today – April 13, 2010.

Work yet to start on e-health identifier

• Karen Dearne
• From: The Australian
• April 13, 2010 12:00AM

SIX months after assuring a Senate committee that the National E-Health Transition Authority was working with primary care software firms over the proposed national Healthcare Identifier system, the federal Health Department has conceded work is yet to begin.

"Currently there are no implementation projects within primary care being funded," a Health spokeswoman said last week.

The department was unable to supply a list of medical practice vendors previously said to be working with Nehta on an "implementation pathway" -- originally requested by Queensland Liberal Senator Sue Boyce in February amid questions about Nehta's activities.

.....

The Australian queried the list provided to the Senate, as many of the firms are not involved in the primary care software sector.

"As the work is still in its early stages, there is no list of primary care vendors currently available, other than those involved in the secure messaging work," the departmental spokeswoman said.

"The information is not incorrect.”

More here:

http://www.theaustralian.com.au/australian-it/work-yet-to-start-on-e-health-identifier/story-e6frgakx-1225852940454

Well sometimes the small articles are the really important ones!

The Orwellian quote "The information is not incorrect” just leaps from page and leaves one gasping!

After all the nonsense from DoHA and NEHTA about implementation dates and timetables for the HI Service the actual activity seems to be essentially a big fat zero.

This can’t be much less that systematic deception of the Senate, Ministers and the public can it?

No wonder, they are struggling to agree an approach to e-Health under the Rudd / Roxon health reform plan with this dazzling level of competence.

As an e-mail correspondent put it. ‘Off with their heads – the lot of them’!

Wanders off into the night sadly shaking head in disbelief!

David.

This Really Can’t Be Seen as a Full Package – What is Going On?

From the SMH this morning.

http://www.smh.com.au/national/elective-surgery-when-you-need-it-rudds-bold-pledge-20100412-s442.html

Elective surgery when you need it: Rudd's bold pledge

MARK METHERELL HEALTH CORRESPONDENT

April 13, 2010

THE Prime Minister has set his government the ambitious goal of ensuring that virtually all Australians needing elective surgery will get their operations in clinically recommended times.

Kevin Rudd last night released the final section of his of health reform proposals, a $650 million boost over four years to finance his promise that 95 per cent of patients get timely treatment.

But the government is holding back on declaring plans for four big problem areas previously targeted for reform: mental health, dental health, preventive health measures for obesity and alcohol abuse, and ''E-health'' or electronic health records.

This is despite the National Health and Hospitals Reform Commission's ''Denticare'' recommendation to ensure dental care for all Australians and its call for patient-controlled electronic health records to enable safer and more efficient care.

More here:

http://www.smh.com.au/national/elective-surgery-when-you-need-it-rudds-bold-pledge-20100412-s442.html

Does anyone understand why after all the reviews and discussion, all the reports and consultation we find ourselves in this mess – with grumpy Premiers and a determined PM just storming on?

I sure don’t.

David.

Yup - E-Health is Being Ignored! - Really Sad News.

Just listening to ABC's PM.

It seems the last roll of the dice is more funding for elective surgery ($600M over 4 years).

It will fund 90,000 surgeries over 4 years.

No money if the States do not sign on!

This is apparently the last offer for the COAG Meeting to be held on April 16, 2010.

The Premiers are chatting over the phone tonight to consider the final offer.

Mental Health and e-Health are totally left out it would seem.

Sad news and a reflection that NEHTA / DoHA can't put any convincing case for e-Health to Government.

Just pathetic!

David.

We Must Be the Next Cab off the Rank - Or Will E-Health Again be Ignored?

Think back a little over a month ago and we had the following from the Health Reform Team (Rudd / Swan / Roxon et al).

A National Health and Hospitals Network for Australia’s Future

Joint Release

Prime Minister

Treasurer

Minister for Health and Ageing

3 March 2010

The Rudd Government today announced major structural reforms to Australia’s health and hospital system.

The Government will deliver better health services and better hospitals by establishing a National Health and Hospitals Network.

This new national network will be funded nationally and run locally.

These reforms represent the biggest changes to Australia’s health and hospital system since the introduction of Medicare, and one of the most significant reforms to the federation in its history.

• A National Network: to bring together eight disparate State run systems with one set of tough national standards to drive and deliver better hospital services.
• Funded nationally: by taking the dominant funding role in the entire public hospital system the Australian Government will end the blame game, eliminate waste and shoulder the burden of funding to meet rapidly rising health costs.
• Run locally: through Local Hospital Networks bringing together small groups of hospitals, where local professionals with local knowledge are given the necessary powers to deliver hospital services to their community.

..... Lots left out from the middle or release.

On the basis of these reforms, over the coming weeks and months, the Government will announce critical additional investments to:

• train more doctors and nurses;
• increase the availability of hospital beds;
• improve GP services; and
• introduce personally-controlled electronic health records.

The establishment of the National Health and Hospitals Network builds on record investments in health and hospitals made by the Rudd Government over the last two years.

----- End Release.

The full release is here:

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr10-nr-nr038.htm

Now of that list of additional announcements that we were told were coming we have now had (over the last 2-3 weeks) the following:

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr10-nr-nr046.htm

Building a National Health and Hospitals Network - Training a Record Number of Doctors

and

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr10-je-je027.htm

Building an Australian Aged Care System: Commonwealth to Take Complete Responsibility for Aged Care

and

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr10-nr-nr064.htm

Strengthening Primary Care in Local Communities

The primary care area is important and is explained in more detail here:

Divisions will become primary health care organisations

by Michael Woodhead

Regional primary health care organisations will be built from the existing network of Divisions of GPs “so that they don’t create additional bureaucracy” the Prime Minister Kevin Rudd has announced today.

In an statement made in conjunction with health minister Nicola Roxon, the PM confirmed that a network of primary health care organisations will be set up as recommended in the National Health and Hospitals Reform Commission

He said the first primary health care organisations will be established by mid 2011, with funding to be confirmed in the May Budget.

The function of the new PHCOs will be to work with proposed Local Health and Hospital Networks to improve the delivery of integrated care, particularly for people with chronic diseases, he said.

More here:

http://www.6minutes.com.au/articles/z1/view.asp?id=515208

and here:

Govt reveals plans for division-primary care evolution

12th Apr 2010

Shannon McKenzie

THE landscape of primary care is set to be overhauled with the Federal Government today unveiling plans to transform divisions of general practice into primary health care organisations.

The move has long been expected following its recommended by two independent think tanks – the National Health and Hospitals Reform Commission and the Primary Health Care Strategy External Reference Group – last year.

According to plans announced by Prime Minister Kevin Rudd and Health Minister Nicola Roxon the primary health care organisations (PHCOs) will ensure better collaboration between primary health care, allied health and hospital services.

PHCOs will also work to identify groups that are unable to access primary care services, and will have a particularly focus in securing services for patients with chronic conditions.

The Government also flagged a larger role for the PHCOs down the track.

More here:

http://www.medicalobserver.com.au/news/govt-reveals-plans-for-divisionprimary-care-evolution

In addition we have had announcements on regional cancer centres, diabetic care and indeed a pretty big one on emergency care over the last weekend.

See here:

Rudd's emergency ward funds welcomed

April 11, 2010

Prime Minister Kevin Rudd has put another sweetener on the table to help get the states and territories to agree to his health reform package.

He has offered $500 million in funding to help cut waiting times in public hospital emergency wards.

Under the plan, hospitals will be given $150 million to help improve services in emergency departments from July this year.

Federal Health Minister Nicola Roxon says another $350 million will be allocated to hospitals that meet targets to cut waiting times.

More here:

http://www.abc.net.au/news/stories/2010/04/11/2869586.htm

As Peter Cundall was prone to saying this now – after the rush of releases on today – April 12, 2010 – looks like ‘your bloomin’ lot’, except for e-Health.

Both ends of the hospital system are now at least partially de-stressed, more docs and other staff and more primary and preventive care – all we need is some decent co-ordination as E-Health could help provide.

One gets the sense that with a good number of Premiers seemingly not all that happy and a number of expert commentators coming out and saying the Brumby Plan needs a close look – the ground might be moving to a rather more consultative approach as to how reform is to get done.

One thing that must change is that we are told – and soon – what the e-Health plans are – so that if they are as absurd as we seem to be hearing from both Melbourne (IEHR’s) and Canberra ( personally-controlled electronic health records) there will be some comment time available to push for more sensible and strategic first steps.

We have waited for a long time for some sensible funds to back up implementing the National E-Health Strategy. This has the feel that the last roll of the dice is very near indeed!

David.

Formal Blog Policy Change - Comment Rejection Policy

Over the last few weeks I have noticed an increase in the number of Anonymous comments that are personally rather than content and ideas directed.

As of now, these comments will simply be rejected at my total discretion. Any comment related to the content of and ideas contained in the blog - other than those fussing about punctuation, grammar and the like - will, of course, be published.

If there is an error in these areas - e-mail works fine and I will do my best to fix the issue if I can work out what it is!

I simply will not tolerate Anonymous personal abuse and will not publish same here. On the other had the free flow of ideas and discussion is greatly valued by both myself and the readers I believe. Be assured I will do nothing to censor the free flow of ideas - cookey, wrong headed or not!

Anonymous posting serves a useful function here, but life is just too short to put up with Anonymous and abusive smart asses - most of whom are pushing paid agendas.

If you don't like the policy set up your own blog and go for it!

David.

p.s. My policy of simply rejecting comments trying to insert commercial links to potency pills, fraudulent offers and the like will also remain.

D.

Weekly Australian Health IT Links - 12-04-2010.

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:

It seems that the Federal Health Team are pushing with all their weight to get their version of health reform through. We have another announcement today – this time on Emergency Departments.

http://www.smh.com.au/national/rudd-promises-to-halve-waiting-times-20100410-rzs2.html

Rudd promises to halve waiting times

STEPHANIE PEATLING POLITICAL CORRESPONDENT

April 11, 2010

AUSTRALIANS would wait no more than four hours for medical attention in hospital emergency departments in an ambitious bid by the federal government to halve existing waiting periods.

Prime Minister Kevin Rudd will today announce a $500 million injection for emergency departments but only if the states sign up to his health reform plan.

And in a boost for Queensland the government announced yesterday it would spend $22 million on clinical training to entice graduates to take up jobs in the cities and towns in which they have studied.

Under the new target, public hospitals will be required to ensure people are admitted to hospital, referred for follow-up treatment or treated and discharged within four hours.

---- End extract.

Three things occur to me about all this.

The first is to ask the question just why is it that the vague, partially defined plan put up by the Commonwealth is to brook no discussion, debate or fine tuning? Compare this with what happened in the US where there was a full on public and political debate with lots of tweaking of the final package that made it to the President’s desk. I thought we lived in a democracy where the best ideas should be accepted. Not much sign of this here. ‘My way or the highway’ seems to be the mantra.

Second just why do we have to be drip fed the plans? Being made up on the run feels about right to me!

Third, you won’t fix emergency department treatment times until you fix the hospitals that they are the front door for.

I really do not like how this is being done at all, and I suspect people who think like me are rising in number. The results of the recent poll make this clear.

See here:

http://aushealthit.blogspot.com/2010/04/aushealthit-man-poll-number-14-results.html

Can I also say I don’t much like these ‘behind closed door’ discussions that seem to be going on. Just what is it that the Government is offering that the public can’t know about?

See here:

http://www.smh.com.au/national/emergency-funding-welcome-but-extra-hospital-beds-key-doctors-20100411-s0gd.html

Emergency funding welcome, but extra hospital beds key: doctors

April 11, 2010 - 1:28PM

Doctors say federal Labor's promise of an extra $500 million to cut waiting times in emergency departments will only work if there is also a boost in hospital beds.

In order to receive the extra cash public hospitals will have to treat and discharge emergency patients, refer them for follow-up care or admit them, within four hours.

"The funding will assist emergency departments to deal more efficiently with patients who are treated and discharged and those who are referred for follow-up treatment," Australian Medical Association president Andrew Pesce said in a statement.

"(But) there will need to be additional reforms to ensure that patients who must be admitted to hospital have a bed to go to in a safe and appropriate timeframe."

---- End extract.

And as a last point, watch the tricks that go on to ensure patients are treated etc in the 4 hour window. Put a bucket of money in front of any Health Bureaucrat and watch them meet the target 100% - statistical fudging will be rife I suspect – just as it is now!

-----

http://www.theaustralian.com.au/australian-it/data-breach-costs-2m-per-incident/story-e6frgakx-1225851401246

Data breach costs $2m per incident

• Karen Dearne
• From: Australian IT
• April 08, 2010 1:19PM

ONE of the first comprehensive local surveys of data breach costs shows organisations sustained financial losses of almost $2 million on average per incident, with an average $123 spent to deal with each compromised record.

The 2009 Australian Cost of a Data Breach study, conducted by US-based Ponemon Institute on behalf of data encryption specialist PGP, examined the actual financial losses incurred by 16 organisations from different industry sectors following a data loss, with breaches ranging from around 3300 to 65,000 lost or stolen records.

In the most expensive incident, one organisation spent more than $4m to resolve a single event.

-----

http://www.australiandoctor.com.au/articles/80/0c068880.asp

Mind the glitch

8-Apr-2010

COMPUTERS: Software problems could result in a medicolegal disaster for GPs. By Noel Stewart

ACCURATE clinical records -- preferably electronic -- and robust recall management systems can go a long way in protecting GPs and their medical clinics from adverse legal actions.

Yet inaccurate or incomplete clinical notes can at times result from a glitch in the software system. I have heard many horror stories of clinical data being lost, often during software upgrades or in the migration process. Sometimes these issues were slow to be resolved.

So who is at fault if a doctor is sued for negligence based on a glitch in the computer system?

-----

http://www.computerworld.com.au/article/342392/casa_upgrade_medical_records_system/?eid=-6787

CASA to upgrade medical records system

Will streramline business processes at the aviation safety agency

• Computerworld Staff (Computerworld)
• 08 April, 2010 12:00

The Civil Aviation Safety Authority (CASA) is to overhaul its medical records system (MRS) in a bid to streamline the government agency’s business processes.

The current MRS supports the processing of regular medical examinations required to be undertaken by pilots, flight crew and air traffic controllers to obtain and keep their licences, according to CASA documents.

As a result of overhauling the MRS, CASA expects that it will realise significant efficiencies by improving the user environment and avoiding unnecessary multiplication of effort, and improve safety effectiveness by having a single, robust system with consistent data.

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http://www.futuregov.net/articles/2010/mar/30/australian-healthcare-provider-migrates-clinical-s/

Australian healthcare provider migrates clinical system online

30 March 2010

St Vincent’s & Mater Health Sydney implemented a web-based clinical support system which reduced cost without compromising user experience. Chief Information Officer David Roffe tells FutureGov the benefits of migrating its clinical system online.

The application development tool used to develop the previous system at St Vincent & Mather Health (SV&MHS) went out of support in 2000. Although the system was still usable, it was difficult and expensive to find programmers who are skilled in such an outdated computer programme. Roffe needed to decide whether to buy a new system off-the-shelf or redevelop the current system in-house, and what technology to use.

-----

http://www.e-health-insider.com/news/5810/cohen:_morecambe_bay_go-live_%27early_may%27

Cohen: Morecambe Bay go-live 'early May'

08 Apr 2010

Gary Cohen has predicted that the latest version of Lorenzo will go live at University Hopsitals of Morecambe Bay NHS Trust in May 2010.

The executive chairman and chief executive of iSoft told the Financial Times "we are confident that we have a go-live in early May."

He made his comments the day after NHS chief information officer Christine Connelly confirmed that the trust had not gone live with Lorenzo Regional Care Release 1.9 by the 31 March deadline she set last year.

-----

http://www.couriermail.com.au/news/queensland/bosses-held-party-while-queensland-health-staff-went-without-pay/story-e6freoof-1225852012703

Bosses held party while Queensland Health staff went without pay

• Matthew Condon
• From: The Courier-Mail
• April 09, 2010 11:00PM

THE introduction of Queensland Health's payroll system was celebrated with a roof-top party while thousands of staff went without their fortnightly pay.

Senior executives and bureaucrats involved in the $40 million project were treated to beers, cheese platters and a barbecue just days after the troubled payroll system went live.

The Tuesday afternoon shindig was held on March 30 on the roof of the Department of Public Works in George St, with guests enticed by an invitation featuring a cheesy play on the poem Click Go The Shears.

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http://www.theaustralian.com.au/australian-it/medibank-private-acquires-mckesson-asia-pacific/story-e6frgakx-1225851849432

Medibank Private acquires McKesson Asia-Pacific

• Correspondents in Melbourne
• From: AAP
• April 09, 2010 1:47PM

PRIVATE health insurer Medibank Private has agreed to acquire phone and web-based healthcare services provider McKesson Asia-Pacific from McKesson Corp for an undisclosed sum.

McKesson Asia-Pacific, McKesson New Zealand and Fitness2live will become a part of Medibank.

Medibank Private managing director George Savvides said McKesson delivered healthcare services and programs to state and national governments, area health services, corporations and health insurers, including Medibank Private.

-----

http://www.theaustralian.com.au/in-depth/aboriginal-australia/gps-to-ask-all-patients-if-theyre-aboriginal/story-e6frgd9f-1225851120249

GPs to ask all patients if they're Aboriginal

• Adam Cresswell
• From: The Australian
• April 08, 2010 12:00AM

DOCTORS and health workers will be expected to ask all their patients if they are of Aboriginal origin regardless of their appearance or country of birth as part of the push to lift standards in indigenous health.

New guidelines issued by the Australian Institute of Health and Welfare today say all patients in hospitals, clinics and GP surgeries should be asked whether they are "of Aboriginal or Torres Strait Islander origin" even if staff already know the patient or the family background.

The move is intended to provide a more accurate measure of indigenous health disadvantage by counting people whose status has previously been unrecorded -- in some cases because they were not asked.

-----

http://www.computerworld.com.au/article/342180/pirate_party_philip_nitschke_teach_seniors_hack_filter/?eid=-255

Pirate Party and Philip Nitschke teach seniors to hack filter

Newcastle techie preaches proxies to the grey army

• Darren Pauli (Computerworld)
• 07 April, 2010 07:16

Pro-euthanasia group Exit International is holding national hacking crash-courses in how to bypass the Federal Government's planned ISP-level Internet content filter with help from the Australian Pirate Party.

The first of eight “Hacking Masterclasses” was held in Chatswood NSW on Thursday last week, and drew about 50 elderly people — some bearing laptops. Exit International director and controversial Australian physician, Philip Nitschke, created the class to help the elderly access euthanasia-assistance material online, following fears that the Internet filter will block access to the information.

A leaked copy of the filter blacklist revealed Exit International websites, the UK publisher of the Peaceful Pill eHandbook, and three YouTube videos were on the list of banned materials.

-----

http://www.smh.com.au/business/telstra-on-brink-of-deal-or-no-deal-20100408-rv85.html

Telstra on brink of deal or no deal

LUCY BATTERSBY

April 9, 2010

AN END to the tussle between the government and Telstra on the value of Telstra's telecommunications infrastructure is in sight, with Communications Minister Stephen Conroy saying the parties will soon reach a conclusion or break off negotiations.

''It won't be long before there will be either a deal or no deal in the discussion between the government and Telstra,'' Senator Conroy told 3AW yesterday.

''I can assure Telstra shareholders that David Thodey and Catherine Livingstone have been representing their interests,'' he said, referring to Telstra's chief executive and chairman.

-----

http://www.theaustralian.com.au/business/industry-sectors/optus-sides-with-telstra-in-national-broadband-controversy/story-e6frg9hx-1225851118825

Optus sides with Telstra in national broadband controversy

• Mitchell Bingemann
• From: The Australian
• April 08, 2010 12:00AM

OPTUS has joined Telstra in baulking at a deal with the government over the national broadband network, with the No 2 carrier saying drastic changes were needed to draft legislation before it will sign up to the $43 billion project.

In its submission to the senate select committee on the national broadband network, Optus warned that the project could be sunk unless clauses that allowed the government-owned network to compete in retail markets -- specifically in the supply of telco services to government agencies -- were removed from the draft legislation.

Optus, until now, has been happy to negotiate with the government about its involvement in the NBN and had even gone so far as to consider selling its east-coast hybrid fibre-coaxial (HFC) cable network into the project.

-----

http://www.theaustralian.com.au/australian-it/medicare-extends-its-long-standing-contract-with-ibm-for-another-year/story-e6frgakx-1225850070857

Medicare extends its long-standing contract with IBM for another year

• Karen Dearne
• From: The Australian
• April 06, 2010 12:00AM

MEDICARE Australia will pay IBM $189 million for a one-year extension to its longstanding technology infrastructure services contract, along with a disengagement arrangement for up to 24 months.

This disengagement period will begin on January 1, three months before the services contract is due to end, on March 31 next year.

It covers provision of business-as-usual services including computing hardware and software in midrange, mainframe and data warehouse environments, desktops, a gateway and cross-platform services.

-----

http://www.theaustralian.com.au/australian-it/medicare-pours-8m-into-advertising-blitz-for-online-claims/story-e6frgakx-1225850080813

Medicare pours $8m into advertising blitz for online claims

• Karen Dearne
• From: The Australian
• April 06, 2010 12:00AM

MEDICARE spent $8 million spruiking the benefits of electronic claiming in doctors' offices in a two-month advertising blitz last May and June, on top of $42m in financial incentives and $6m to fix a "design flaw" inhibiting uptake of the troubled Easyclaim system.

The media campaign promoted the use of Easyclaim, Medicare Online and (in-hospital claiming service) Eclipse in a bid to reduce attendance at Medicare offices for cash rebates.

A direct mailout to 7.2 million Medicare cardholders cost $4.1m, $2m was spent on print and radio advertisements, while $1.8m was spent on creative and market research consultants", public relations firms and "champion" events.

-----

http://www.smh.com.au/nsw/nsw-health-admits-its-patient-satisfaction-figures-are-rubbery-20100404-rlsd.html

NSW Health admits its patient satisfaction figures are rubbery

JULIE ROBOTHAM HEALTH EDITOR

April 5, 2010

NSW Health has overstated the proportion of patients satisfied with how long they have to wait for an operation, after an error compiling the statistics, the department has admitted.

In its latest patient survey, released in November, it claimed 85 per cent of patients thought their operation had been scheduled within a reasonable period. But the actual figure was 80 per cent, a departmental spokesman confirmed to the Herald.

The original satisfaction figure was compiled from the responses of the 59 per cent of patients who had undergone medical tests before admission, while other patients' answers were not included.

-----

And from a year ago.

http://www.computerworld.com.au/article/301824/nsw_health_spend_100m_electronic_medical_records/

NSW Health to spend $100m on electronic medical records

Patient information to be shared between health facilities

• Rodney Gedda (Techworld Australia)
• 04 May, 2009 14:3

After many promises and trials, NSW Health has committed $100 million over the next two years to replace existing paper-based health records in public hospitals with a state-wide electronic system aimed at improving patient care.

NSW Health anticipates the new electronic medical record (eMR) technology will make it easier for doctors and nurses to track the condition of patients through the health system as hospital information will be linked between facilities electronically.

Minister for Health, John Della Bosca, said the $100 million project will be rolled out to 188 hospitals across the state by the end of 2010.

-----

I wonder how this project is going. We do now have a new Health Minister in NSW.

It looks like there has been some progress in the West of the state.

http://www.health.nsw.gov.au/news/2009/20091028_00.html

28 October 2009

Electronic Medical Record providing safer care in our public hospitals

The Deputy Premier and Minister for Health, Carmel Tebbutt, today announced that hospitals in the Greater Western Area Health Service (AHS) were preparing to roll out an Electronic Medical Record (eMR) system to assist clinicians and provide safer care for patients.

"There are many advantages in the switch to electronic records," Ms Tebbutt said.

"An eMR system will allow clinicians fast access to patient information, notify them of alerts and whether a patient has an allergy and will reduce paperwork to give nurses and doctors more time with patients.

-----

And for a serious sense of déjà vu!

http://www.misaustralia.com/viewer.aspx?EDP://1270767702634&section=news&xmlSource=/news/feed.xml&title=Gershon+reforms+too+slow%2c+say+IT+companies

Gershon reforms too slow, say IT companies

Brian Corrigan

Showdown talks with senior information technology industry executives will kick off a review of the federal government's implementation of plans to reduce IT spending by $1 billion over four years.

The former head of the National E-Health Transition Authority, Ian Reinecke, was appointed by the Finance Minister, Lindsay Tanner, last month to conduct an independent review of the ICT Reform Program embarked upon following the Gershon Review of 2008.

And also in the AFR:

Review of IT cuts begins with talks

09 Apr 2010

Ian Reinecke will meet senior representatives of the information technology industry next week as part of a review of the federal government’s plans to wipe $1 billion from IT spending over four years.

Oh dear, oh dear!

-----

Enjoy!

David.

Crikey’s Health Blog Finds a Great Little Story! Spin Alert On!

The following appeared a few days ago.

Come in spinner…DOHA needs you

April 7, 2010 – 9:53 pm, by Croakey

The Department of Health and Ageing has put out a tender for “media liaison and issues management services”. It’s worth reading because it says quite a lot about how the Department views this role.

I saw no emphasis on or even mention of concepts like promoting greater transparency or fostering a more open and informed health debate. But of course it was probably naive to even search for such a thing; this job is all about keeping the lid on. Control, control, control – isn’t that what “issues management” is all about?

It could be fun to have a go at re-writing the evaluation criteria – what if DOHA asked for feedback from journalists or those who have been promoting more open government? We could provide comment on not only the consultant’s performance but related processes and the broader departmental culture around media engagement. Or perhaps even on the writing of the tender document…

Presumably the contract – due to commence on October 6, just a day after the final date for its awarding – will be worth a small fortune as it involves masses of work, including being the first point of contact for all media enquiries, handling media inquiries referred by the Ministers’/Parliamentary Secretary’s offices, supporting the Secretary and Departmental Executive, and serving as the Chief Medical Officer’s primary media adviser.

The full blog and some responses can be browsed here:

http://blogs.crikey.com.au/croakey/2010/04/07/come-in-spinner-doha-needs-you/

A quick visit to the DoHA site finds the following:

Provision of media liaison and issues management services.

Reference Number

RFT 277/0910

Title

Provision of media liaison and issues management services.

Description

The Department of Health and Ageing is seeking tenders from capable and experienced individuals or organisations to provide media management including critical issues across a range of matters for the Department. The successful tenderer will be the first point of contact for all media enquiries and issues for the Department. Tendering organisations will need to provide evidence of previous experience in journalism and management of sensitive media issues; and an understanding and appreciation of, and experience with, health, ageing, and sport (in the context of sport and health) media issues.

Full specification is found here:

http://www.health.gov.au/internet/main/publishing.nsf/Content/2770910

So here we have the DoHA tender for help in ‘issues management’ – read spin and public disinformation service.

Of course they will have to work very hard to do better than the equivalent team at NEHTA!

I hope some enterprising soul with an ABN Registration will download a copy and send it along. I would love to browse the detail of the requirements!

David.