A Really Important Review of European Health Information Sharing I Initially Missed.

The study cited here seems to me to be of considerable importance to all of us here in Australia as well.

Across the Pond

Should HIE leaders in the U.S. look to European progress for clues going forward? Yes, with caveats, says one international IT expert

by Mark Hagland

Health information exchange (HIE) development experiences in a number of European nations should give HIE innovators in the United States both some hope and some cause for concern, as they consider the many hurdles facing HIE progress in this country. Indeed, says one expert on international healthcare IT development, lessons learned from Europe offer the classic “glass half-full or half-empty” conceptual quandary. For CIOs helping to lead their organizations and communities along the first steps of inter-organizational connectivity, the message is clear: we've got a very long way to go to resolve some basic issues.

The experiences of the U.K., the Netherlands, and Denmark in HIE speak to some of the challenges that American HIE leaders face in the future.

Among the issues that some European countries have taken on - head-on - include the creation of a national patient identifier and nationwide patient identification; privacy and security of patient data; governance and communications around patient data sharing, and the technical architecture, standards, and certification needed to establish and broaden nationwide health information exchanges. It has taken several years to work out some of these issues in the Netherlands, Denmark, and the United Kingdom, which were special countries of focus in a study co-authored by Fran Turisco, principal researcher in the Waltham, Mass.-based Emerging Practices division of the Falls Church, Va.-based CSC. The study, entitled “Accomplishing EHR/HIE (eHealth): Lessons from Europe,” was published in late 2009.

For example, Turisco says, “In researching this topic, I found that the fundamental issue around patient data ownership and privacy issues is around communication, in terms of letting patients and healthcare consumers know ahead of time what the parameters are, giving them choices, and setting the right expectations.” One big issue, she says, is the question of opting in or opting out” of whatever protocols are created in terms of the sharing of patient-identifiable data.

So, for example, when the government of the Netherlands created a nationwide HIE, “They sort of forgot about communicating the terms of opt-in/opt-out to patients, and realized after the fact that they needed to establish patient consent to share data, and that delayed communication freaked people out,” Turisco notes. Two lessons learned are important in that context, she says. First, of course, sets of rules on patient consent, on release of information have to be established in advance. And second, whatever protocols are envisioned have to be incorporated into the building of the infrastructure itself.

Furthermore, Turisco says, it's far easier and more useful to create “opt-out”-based permissions systems, rather than “opt-in”-based ones. But, according to Turisco, even in opt-out-based permissions systems, architecting and implementing the systems has required years of optimization in European countries.

Another issue that has been resolved, over time, in some European countries, is that of a national patient identifier number. In the Netherlands, for example, Turisco notes, it took several years to get a national patient identifier approved in the nation's parliament, primarily because of considerable turnover in parliament members. Meanwhile, in the U.K., a national patient identifier was put in place, but it wasn't being correctly captured across the various health systems, called trusts, nationwide; and considerable work had to be done to establish consistency and reliability of identification across the nationwide system.

Much more is found here:

http://healthcare-informatics.com/ME2/dirmod.asp?sid=&nm=&type=Publishing&mod=Publications%3A%3AArticle&mid=8F3A7027421841978F18BE895F87F791&tier=4&id=9D84FDCEC90540119B23589C7472D1D8

The source article reference is:

Healthcare Informatics 2010 April;27(4):32-34

The original source is here:

http://www.csc.com/health_services/insights/29433-accomplishing_ehr_hie_ehealth_lessons_from_europe

Insights

Accomplishing EHR/HIE (eHealth): Lessons from Europe

Author:

Dr. Harald Deutsch, Fran Turisco

Summary:

Health reform, a top priority for the Obama administration, requires EHR and HIE technology solutions to be successful. The recently enacted Health Information Technology for Economic and Clinical Health (HITECH) Act is re-invigorating discussion activities surrounding state and regional eHealth efforts by addressing a number of the current obstacles - interoperability, privacy and sustainability.

Understanding the risks and issues from similar efforts can help the U.S. to avoid making the same mistakes. Fortunately, comparable efforts do exist. Our first-hand experience in Europe (Denmark, the Netherlands, and three regions in the UK) has enabled us to identify major decision points, best (exemplary) practices, and lessons learned that are transferrable to U.S. projects. While the size of the European efforts is far smaller than the U.S., they are comparable to our state efforts and often have encountered many of the same issues under discussion at the national level.

Download "Accomplishing EHR_HIE (eHealth)_Lessons from Europe"

I mentioned this report once before on the blog last year but having now browsed it closely it is clear it needs careful review, and the lessons need to be carefully considered.

I hope NEHTA as taken all the lessons on board – they are pretty important!

David.

Senator Boyce Accuses Medicare Australia of An Attempted Cover Up of Issues that Might Have Caused Patient Harm.

The following letter was sent to the Minister for Human Services today – April 28, 2010.

April 28, 2010

Hon Chris Bowen MP

Minister for Human Services

Parliament House

Canberra ACT 2600

Dear Minister

I refer to the serious glitch that affected Medicare's systems in early February and, specifically, your reported statements about it in an article in The Australian of April 22, "Minister not told of Medicare record glitch".

I was surprised that you reportedly confirmed that you had not had this matter brought to your attention by Medicare Australia until Friday, April 16.

I draw your attention to a letter dated April 1, 2010, and signed by Ms Sheila Bird PSM, General Manager, eBusiness Division, of Medicare Australia which was sent to 70 Medicare software vendors.

In that letter, Ms Bird states: "Medicare Australia implemented a maintenance change to patient verification at 10pm on Saturday, 6 February 2010. There was no need for Medicare Australia to close down the system to undertake the maintenance. Following concern from a small number of software vendors as to the way as to the way patient verification was functioning, the maintenance change was withdrawn at approximately 9:00 pm on Tuesday, 9 February 2010, and the system functionality was restored to pre 6 February 2010 operations."

Ms Bird continued: "During the above period, an area of functionality within the OPV, PVM and EPV facilities was changed. Software vendors or sites may have actioned the information supplied in the return patient verification messages in different ways. How this was done may have resulted in some records being incorrectly updated."

After stating that Medicare Australia would arrange for a "suitable time and method to work with each (software vendor) to determine the best way of resolving any potential impacts on your clients", Ms Bird sought to assure the software vendors that she was "putting in place robust procedures to ensure that you will receive prompt notification should there be any problems in the future."

Given the timeline of events, I'm sure you agree that it is an appalling situation that 70 Medicare software vendors were not given any official notification of this event in a timely manner or advised that arrangements would be made to resolve any problems until 8 weeks after the event.

If these software vendors were treated in a cavalier way, the fact that you were not advised until – on your own admission – April 16, speaks volumes about Medicare Australia's corporate culture.

I am advised by people in the medical software industry that one of Medicare's software vendors, McCauley Software, informed Medicare's Online Vendor help desk around midday on February 8 and that the Medicare Online vendor help desk confirmed it as a Medicare problem at about 4pm that day.

My advice is that subsequently, Medicare tried to assert that it was a vendor-related issue.

Further I understand that during February and March, some software vendors pleaded with Medicare to advise all affected vendors and peak medical bodies that there had been a problem. These vendors became so frustrated by what appeared to them to be a lack of concern, inertia or – even worse – an attempt to sweep the matter under the carpet - that they threatened to take the matter to you.

It was only after these threats were made that Medicare Australia issued the letter on April 1, to which I have referred.

I was particularly concerned by the statement in The Australian of April 22 by a Medicare spokesman that: "Medicare will inform (doctors and other health providers) about the issue, and provide details of their practice records where a verification check was undertaken (before the error was fixed). Practices will be asked to check their records and correct any that were incorrectly updated."

The use of the present tense suggested to me that this process had not yet begun by April 21 when the statement would have been provided to The Australian. This was confirmed when I became aware of another letter dated April 27, 2010, by Ms Sheila Bird.

In that letter to Medicare's software vendors, Ms Bird stated: "The Medical Software Industry Association and the Australian Medical Association have advised that the unintended change to patient verification on February 6 may have resulted in clinical records being incorrectly updated with incorrect patient names."

The fact is that there was no "may" about it – records were corrupted.

The letter continued: "As a result of this advice Medicare Australia wrote to approximately 2700 practice sites that were impacted by this issue on 23 April 2010."

I would be glad if you could inform me why Medicare Australia waited from February 9 when the glitch was discovered to April 23 – about 2 and a half months – to write to the 2700 medical practices.

That date was, incidentally, a week after Medicare Australia got around to advising you as Minister.

When you issued your statement after that briefing, you said you had requested "regular updates" about progress on record checking so did those early "regular updates" alert you to the fact that 2700 medical practices hadn't been advised by Medicare Australia of the glitch? Did you, at the time of the initial Medicare Australia briefing, actually ask if any medical practices affected by the glitch had been promptly advised of the possible consequences?

Your advice about why Medicare Australia was so demonstrably slow in advising software vendors, the medical profession and you is requested.

However desultory this unhappy history has proven Medicare Australia to have been, of most concern is this paragraph in Ms Bird's letter of April 27: "This issue has revealed complex issues with how software systems use the information obtained through patient verification. It has highlighted for Medicare Australia that information can be used in a way that wasn't intended. Specifically, the information provided as part of patient verification was only intended for use in claiming purposes and not clinical purposes."

It is astounding that Medicare Australia, almost on the eve of the implementation of the scheduled national e-health scheme on July 1, has discovered this major fault in its software. What guarantees can you give that any other major failures of this nature will not occur in the future?

I noted that your statement to The Australian contained the reassurance that would "not hesitate to take further actions to ensure patient safety" which is welcomed and I would be glad to receive your further advice about what action that is or might be.

Yours sincerely

Sue Boyce

Senator for Queensland

----- End Letter.

Accepting the truth of the quotations provided here, and I have seen the source Medicare Australia letter sent to Software providers, the delay and the failure to recognise the need for rapid action, and the attempt to blame the Software Vendors for the problems are really the most troubling of a range of issues raised by Senator Boyce.

Again we have a situation where non-clinically orientated bureaucrats and technical people are failing to make good judgements about the importance of system failures that could impact the quality and safety of patient care – something the Software Vendors understand very well.

The time for improved governance of the whole e-Health space is well and truly upon us – as is the need for much improved co-operation between government and the industry in delivering safe and workable solutions.

The fact that Medicare Australia initially just implemented a change to their systems with no notification speaks volumes about the e-Health governance we do not have!

David.

Condemnation of Federal Government E-Health Policy is Mushrooming - And For Very Good Reason!

As I indicated in my introductory notes to the Australian Health IT Links yesterday – see here for details:

http://aushealthit.blogspot.com/2010/04/weekly-australian-health-it-links-26-04.html

We have hit an absolute wall in terms of the level of confidence and trust placed in the present Federal Government by many in the e-Health Community.

First published today we have Dr Andrew McIntyre of Medical Objects.

eHealth – Where is the duty of care?

After watching the failure of the Government Home Insulation Scheme and the Payroll issues with Queensland Health unfold its clear that the eHealth issues in Australia are part of a much bigger problem.

There is enormous potential for eHealth to cause damage and there is a duty of care to make sure the risks are minimised. Currently the push to roll out parts of the eHealth agenda is just as flawed as the home insulation scheme and the payroll system. We need to get some basic quality controls in place first or the consequences will be worse than what we have seen with these programs. Poor, missing or incorrect patient data can be just as deadly as Foil insulation in the hands of untrained installers.

Nehta, I am sure, has some great talent in its ranks, but I don’t see anyone with an overall understanding of the issues that face eHealth or how to fix them. They are unwilling to listen to the practical concerns of people with experience and now it seems they are under political pressure to deliver and just like these other rushed programs the risks are very high.

I have multiple levels of concern, but chief amongst them is to try and steamroll connectivity in a physical sense when in a practical sense it is badly broken. The quality of the data being moved is low and very non-compliant with standards and this is well known. There appears to be a block on the idea of a quality program for the messages, despite the machinery to do this at a basic level existing for over 5 years. Applications fall over importing good data and often fail to display it correctly and in many cases can’t support HL7 (Health Level 7) at all. Blindly sending data around, even with shiny New Health Care identifiers is a recipe for disaster.

Read the rest of the blog here:

http://blog.medical-objects.com.au/?p=52

Just before this appeared we had the following appear in Tuesday’s Australian.

E-health is Kevin Rudd's little orphan Annie

• Karen Dearne
• From: The Australian
• April 27, 2010 12:00AM

THE glaring omission of e-health in the Rudd government's long-awaited national health and hospitals reform package has stunned and dismayed the IT industry.

"The missing link is health IT," said Health Informatics Society of Australia president Michael Legg.

"There was every expectation e-health would be addressed in the Council of Australian Governments agreement, as the National Health and Hospitals Reform Commission made it clear the reforms had to be underpinned by a robust IT infrastructure.

"But e-health is notable for its absence in these announcements."

Deloitte partner and lead author of the National E-Health Strategy, Adam Powick, said that while disappointing, the outcome was "hardly surprising, given the political nature of the negotiations".

"Spending on hospital beds, doctors and waiting lists has always taken precedence over health IT," he said.

"But I observe the Prime Minister promised these reforms would lead to a better integrated, better co-ordinated healthcare system, and the only way you can do that is by improving the flow of information across geographic and private-public boundaries.

"And that requires investment so we can electronically connect healthcare systems."

While Kevin Rudd said in his National Press Club speech last month that the national structural reforms would build a health system for the 21st century, Mr Powick said: "We are now a decade into the new century, and many parts of the healthcare system are still reliant on bits of paper, human memory and patients lugging their X-rays around."

Mr Powick said it was critical for the government to make a "meaningful investment and commitment" to e-health as part of the budget process.

"If we do not get that, our chances of working towards a co-ordinated national e-health agenda will be seriously jeopardised," he said. "E-health is going to happen. You're not going to stop it, particularly with the explosion of mobile solutions we've seen with the iPhone and will soon see here with the iPad.

"The question is whether we can deliver e-health in a co-ordinated, aligned fashion, or is it going to be fragmented and extremely difficult to integrate across healthcare boundaries."

The views of many other, very unhappy, heavy hitters are found here:

http://www.theaustralian.com.au/australian-it/e-health-is-kevin-rudds-little-orphan-annie/story-e6frgakx-1225858544370

The sole response from the usual Department of Health Spokesperson is to remind us of the funds COAG provided, a year or two back, to fund that paragon of successful delivery, transparency and effectiveness NEHTA.

We can only be grateful that there is beginning to be some political glare shone on the way all this has been handled.

The simple fact is that what the Government wants to do with its really rather less than ideal Health Reform package is just not deliverable without a substantial, well planned and well delivered upgrade to the Nation’s E-Health Infrastructure.

To pretend this is not true is just arrant nonsense – something we seem to be seeing more and more from this Government sadly. The sudden decision to just bale out of attempting to address climate change following on the policy weaknesses in so many other areas becomes a source of serious concern for me.

I suspect we will be seeing cartoons like the one linked here more and more often.

http://newmatilda.com/sendstudio/display.php?M=15105&C=1270b3fd039b30a06d4629443c17afca&L=9&N=685

Bluntly to me is what we have is e-Health ignored in the context of Health Reform that is hardly worth the name and that has all the hallmarks of being an overly complex, poorly conceived implementation disaster!

We are seeing the first serious hints of this already.

POLL: Most GPs will snub diabetes scheme

30th Apr 2010

Andrew Bracey

GPs are set to reject the Rudd Government’s contentious plan to overhaul the management of patients with diabetes.

A Medical Observer poll has revealed that just one in five GPs plans to adopt the new model, which is set to begin in 2012.

Under the controversial $436 million scheme, practices will receive block-funding worth up to $1200 for each patient they enrol, plus annual payments worth an average of $10,800, which will be based, in part, on GPs’ performance in keeping patients healthy and out of hospital.

Additional upfront payments of $1500 per practice were also offered to sweeten the deal.

Announcing the scheme earlier this month, Federal Health Minister Nicola Roxon anticipated 60% of practices would sign up within the first year.

More here:

http://www.medicalobserver.com.au/news/poll-most-gps-will-snub-diabetes-scheme

Proper planning for policy implementation requires road testing of policies carefully before rushing in. Seems like not much of this happened here!

Pretty sad that.

David.

Australia’s National Prescribing Service Reviews e-Prescribing Software.

The following press release has just appeared.

Study identifies key prescribing software features that impact patient safety

A study by the National Prescribing Service (NPS) into how electronic software can impact prescribing practice has identified a list of key features that contribute to safe medicines use and patient safety.

Published in the online journal, BMC Medical Informatics & Decision Making, the study discusses the importance of appropriate features in electronic prescribing software and offers a list of key features to guide vendors.  

“Most GPs in Australia use electronic prescribing software however there are no standards or guidelines for features of these systems. This makes it difficult for vendors to know what should be included and can have a big impact on the safe and effective use of medicines,” NPS CEO Dr Lynn Weekes said.

This study builds on past research conducted by NPS into decision support alerts and contributes a valuable body of knowledge to the e-health sector.

“If implemented across all software programs, the key features identified in the study are likely to increase patient safety and improve prescribing practice. In the absence of national standards we believe this list could be used as a basis for software standards and guidance for software vendors,” Dr Weekes said.

The study was done with input from NEHTA, the Australian Commission on Safety and Quality in Health Care (ACSQHC), the Medical Software Industry Association (MSIA), RACGP, software vendors and a number of prescribers, health informaticians and consumers.

To determine the most important features, a review panel rated 114 different software features by expected impact across four domains - patient safety, quality of care, usefulness to the clinician and usefulness to the patient. While all 114 features were rated as having a positive impact on at least one domain, 27 features were found to have a high impact on three or all domains.

“The key features identified range from warnings when a medicine is prescribed and the patient has a contraindication to that medicine, to clearer designs, and automatic medicines lists that can be printed for each patient with clear instructions and dose information,” Dr Weekes said.

“Most of these functions seem simple but when you consider the potential impact they can have they become very important.”

The second stage of this study, which includes an analysis of the features of individual software systems used in Australia, will be published later this year.

ENDS

Media enquiries to Katie Butt, NPS Media Adviser on 02 8217 8667 or email kbutt@nps.org.au

The National Prescribing Service Limited (NPS) is an independent, not-for-profit organisation for quality use of medicines funded by the Australian Government Department of Health and Ageing.

This is a very useful study that involved genuine contributions from a really useful number of stakeholders and experts.

Those interested are encouraged to download and browse.

Disclosure: I was one of the many who contributed to the work.

David.

Weekly Australian Health IT Links - 26-04-2010.

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:

I have the feeling that we have entered some sort of e-Health dark hole. We have a collection of mess-ups and stuff-ups just everywhere.

From Medicare Australia messing up record management, to Qld Health messing up payroll processing, to COAG ‘prioritizing’ e-health to the garbage tin, to NEHTA inventing identification systems it seems the planned users will reject and so it goes.

With a recent track record like this what next can go wrong can be the only question.

The only bright spot on the horizon is that the Federal Opposition seems now to be ‘on the case’ and maybe we will see some improved accountability and performance.

It is really hard to see how it can get much worse!

This article really takes the biscuit for reporting honestly the pathetic spin being served up by the Government.

http://www.zdnet.com.au/coag-to-prioritise-e-health-record-339302592.htm

COAG to 'prioritise' e-health record

By Ben Grubb, ZDNet.com.au on April 21st, 2010 (4 hours ago)

After two days of discussions in the Council of Australian Governments (COAG), the state and territory governments have not committed to a date to implement a national individual electronic health record, although the issue now seems to have become a priority.

"COAG noted the importance of continuing to work towards a national Individual Electronic Health Record system and agreed to prioritise discussions over the coming months to move towards the implementation phase," COAG's communiqué (PDF) said.”

It seems to me that if NEHTA had anything is vaguely credible in the way of a proposal – busy agenda and all - COAG would have given more than three lines.

If they were at all accountable their leaders would resign for having let the Australian public down so comprehensively!

Even their clinical lead is frustrated – being polite about it!

http://www.theaustralian.com.au/politics/electronics-upgrade-urgent/story-e6frgczf-1225856610677

E-health upgrade 'urgent'

• Adam Cresswell, Health editor
• From: The Australian
• April 22, 2010 12:00AM

THE lack of action on improving electronic health systems is emerging as an Achilles heel of the federal plans, with experts warning that the entire reform agenda will stall without an urgent commitment to upgrade IT networks.

E-health, as it is known, earned a single sentence in the 30-page COAG communique released on Tuesday, with state and federal governments saying they "noted the importance of continuing to work towards" a national electronic health record system, and had "agreed to prioritise discussions" on the issue.

But IT advocate and GP Mukesh Haikerwal -- one of the 10 members of the National Health and Hospitals Reform Commission, whose final report formed the basis for the reform plans -- said inadequate computer systems, software or differences in data-gathering practices meant many of the measures would face serious delays.

-----

http://www.theaustralian.com.au/australian-it/patient-id-system-may-be-set-to-fail-e-health/story-e6frgakx-1225855712342

Patient ID system may be set to fail: e-health

• Karen Dearne
• From: The Australian
• April 20, 2010 12:00AM

A LACK of identity management capability within medical offices may bring the compulsory national patient identity numbering scheme unstuck, with doctors unwilling to risk heavy fines for breaches under the proposed Healthcare Identifiers legislation.

And the new rules could shut down existing e-health programs such as shared care for patients with chronic diseases, clinical trials, secure messaging services and e-prescribing because software and third-party service providers would not be treated as eligible organisations.

The federal government's controversial bill to establish an HI service and assign a unique 16-digit health identifier to every Australian, as well as medical professionals and health organisations, is due for debate in the Senate during the brief budget session next month.

-----

http://www.6minutes.com.au/articles/z1/view.asp?id=515788

Health identifiers: more paperwork and fines

by Jared Reed

Medical groups say heavy fines for practices that breach regulations for the new unique health identifier legislation are unnecessary and will stop doctors using them in the first place.

Contravening a minor regulation exposes practices of fines of up to $5,500 a time.

The legislation, due for debate in the Senate next month, will propose a two-year transition period for users to become familiar with the new system and rules. But consumer groups are insisting on immediate enforcement to preserve privacy and to track who might have unnecessarily accessed an identifier.

-----

http://www.theaustralian.com.au/australian-it/medicare-glitch-affects-records/story-e6frgakx-1225855706275

Medicare glitch affects records

• Karen Dearne
• From: The Australian
• April 20, 2010 12:00AM

A SOFTWARE glitch in Medicare's systems in February has caused a major safety alert, with the agency set to notify thousands of doctors that some patient records may have been incorrectly updated during a three-day period.

Medicare told The Australian yesterday that changes to its online patient verification system after maintenance on February 6 could have resulted in an adverse test result not being matched to the right person.

While the agency believes there is little risk to patient safety, it will contact affected medical practices so doctors can check their records and make corrections if necessary.

-----

http://www.smh.com.au/national/medicare-slow-to-fix-record-bungle-20100420-sru6.html

Medicare slow to fix record bungle

MARK METHERELL

April 21, 2010

MEDICARE Australia has taken 10 weeks to alert 2700 medical practices of a bungle in the agency's computer system, which could have linked patients to the wrong diagnosis.

The problem has emerged at a sensitive time for the government, which is struggling to get agreement from doctors and others for regulations for the first steps of its national e-health scheme, the introduction of unique patient identifier numbers that are supposed to be introduced in July.

-----

http://www.theaustralian.com.au/australian-it/medicare-it-bungle-deepens/story-e6frgakx-1225856720488

Medicare IT bungle deepens

• Karen Dearne
• From: Australian IT
• April 22, 2010 9:08AM

A GLITCH of Medicare's online verification system affected nearly 30,000 patient records - not 1300 - over a three-day period in February, seriously risking the health of thousands of people, Queensland Liberal Senator Sue Boyce claims.

"I understand the fault meant that some pathology test results would not have made it back to the patient's GP, or could have been attached to the medical history of another family member," she said.

"The glitch meant that only the first name appearing on a family Medicare card was recognised, and all pathology results for persons on that card were recorded under the first name.

-----

http://www.theaustralian.com.au/australian-it/minister-not-told-of-medicare-record-glitch/story-e6frgakx-1225857063300

Minister not told of Medicare record glitch

• Karen Dearne
• From: Australian IT
• April 22, 2010 4:56PM

HUMAN Services Minister Chris Bowen was not informed of a serious glitch in Medicare's systems involving the potential incorrect updating of up to 30,000 patient records - and nor were affected doctors - until 10 weeks after the error occurred.

Medicare is writing to 2700 medical practices to warn that 22,000 patient records will need to be checked as a result of flawed data return messages from the agency's online patient verification service during a three-day period in February.

"Medicare will inform (doctors and other health providers) about the issue, and provide details of their practice records where a verification check was undertaken (before the error was fixed)," a Medicare spokesman said.

-----

http://www.theaustralian.com.au/australian-it/auditor-slams-document-verification-service/story-e6frgakx-1225856571730

Auditor slams document verification service

• Karen Dearne
• From: Australian IT
• April 21, 2010 6:45PM

A NATIONAL document verification service intended to clamp down on fake IDs and rising identity theft has been slammed as a failure by the Auditor-General.

More than 18 months past its four-year project deadline, the $25 million IT hub intended to allow authorities to authenticate a vast range of commonly used ID documents issued by legions of federal and state agencies is yet to enrol many of the expected users and is nowhere near fully operational.

The national Document Verification Service (nDVS) has been handling fewer than 10 transactions a day instead of the expected one million daily, while no fraudulent documents were identified in more than 50,000 transactions to the end of November 2009.

-----

http://www.smh.com.au/technology/antiid-theft-computer-system-flops-20100422-tg2h.html

Anti-ID theft computer system flops

MARK DAVIS

April 23, 2010

A $28 million Howard government plan to create a high-tech system to address identity crime has been plagued by technical difficulties and failed to achieve its aims, the Australian National Audit Office says.

The National Document Verification Service, announced by the Coalition in 2006, is a computer network which is supposed to link federal and state government agencies responsible for key identity documents such as birth certificates, passports and drivers' licences.

-----

http://www.computerworld.com.au/article/344248/aged_carers_could_get_cut-rate_mobile_e-health/

Aged carers could get cut-rate mobile e-health

Non-profit builds clinical records app, throws into the cloud

• Darren Pauli (Computerworld)
• 24 April, 2010 17:37

A Perth-based not-for-profit will offer its enterprise in-house built e-health smartphone application for cost-price to hundreds of aged care facilities.

The platform means nurses can build detailed patient records on medical treatments, symptoms, and pain, fatigue and nausea levels. Aged care providers can use the application for reporting and finance services.

The system, dubbed ComCare, is used by more than 1000 Silver Chain mobile nurses using Ericsson smartphones. The WA health care provider has up to 700 nurses using the system at any given time who service more than 40,000 patients a year.

-----

http://www.racgp.org.au/media2010/36930

PCS Clinical Audit Tool™ now available for all SA GPs

15 April 2010

SA Health has announced that, until 30 June 2014, all general practitioners in the state will now have access to the PCS Clinical Audit Tool™ (CAT) with the take up of a state-wide license.

CAT is a population reporting tool, which aggregates data, enabling general practice teams to view their practice population as a whole. This information can be used in a variety of ways, from simply getting to know the demographics of your population through to identifying areas for attention or targeting consumer information. It can also be used to streamline practice accreditation processes.

Professor Nigel Stocks, Chair of the Royal Australian College of General Practitioners (RACGP) SA/NT Faculty, congratulated SA Health for its support of general practice and for its commitment to better health outcomes for patients, especially those with chronic disease.

“Using CAT allows general practice staff to review and analyse demographic and clinical data held within their practice to identify patients at risk (of developing diabetes, for example) and implement improved prevention and management strategies.

-----

http://www.australiandoctor.com.au/articles/4c/0c068d4c.asp

EXCLUSIVE: GPs to pay $650 rego from July

20-Apr-2010

By Sarah Colyer

New fee hikes for national medical registration have been leaked to the press and are set to spark outrage among GPs.

GPs can expect to pay $650 for annual registration with the new Medical Board of Australia, a GP source has told Australian Doctor.

The GP, who asked not to be named, said the fee rise — which is more than double the $270 paid by NSW GPs — was “absolutely scandalous”.

Comment – so much for technology reducing costs and improving efficiency!

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http://www.theaustralian.com.au/politics/more-money-but-no-wages/story-e6frgczf-1225856603730

Qld Health payroll debacle worsens

• Rosanne Barrett
• From: The Australian
• April 22, 2010 12:00AM

PITFALLS in Kevin Rudd's new deal for hospitals were exposed in his home state yesterday with the Queensland government in damage control mode over payroll bungling that has left health workers without their pay.

Hopes that the month-long problem would be fixed yesterday were dashed as thousands of health workers failed to receive their full wages or were not paid at all.

The Prime Minister yesterday confirmed the payroll management of hospitals would remain state-based under the much-touted National Health and Hospitals Network Intergovernmental Agreement.

Mr Rudd downplayed the role of the states yesterday, saying: "It's just a payment authority."

The payroll problems for state health workers in Queensland erupted when the $40 million WorkBrain/SAP system was introduced to replace the ageing LATTICE system.

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http://www.news.com.au/breaking-news/health-workers-prepare-for-pay-bungles/story-e6frfku0-1225856185136

Health workers prepare for pay bungles

• From: AAP
• April 21, 2010 4:27AM

QUEENSLAND'S health workers will begin discovering today whether they've again been underpaid - or even paid.

Tens of thousands of Queensland Health (QH) staff have been underpaid, overpaid, or not paid at all since a payroll system was rolled out last month.

The Australian Services Union (ASU), which represents QH's 650 payroll staff, believes problems could stretch into the next financial year.

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http://www.abc.net.au/news/stories/2010/04/20/2877226.htm?section=justin

Government braces for more health payroll problems

By Chris O'Brien and Melinda Howells

Deputy Premier Paul Lucas will lead a Cabinet meeting today as he also keeps an eye on Queensland Health's pay problems.

Health salaries go into bank accounts tonight for tomorrow's pay day, but the State Government is not expecting a perfect payroll run.

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http://www.couriermail.com.au/news/queensland/d-day-for-queensland-health-pay-system/story-e6freoof-1225856130595

D-Day for Queensland Health pay system - and it looks like it's failed again

• by Anna Caldwell
• From: The Courier-Mail
• April 21, 2010 11:26AM

UNHAPPY Queensland Health employees are reporting more payroll problems today as the beleaguered system comes under further attacks.

Today is D-day for Queensland Health's beleaguered payroll system, but the department's top brass have no idea how many workers will be underpaid.

But judging by comments posted on couriermail.com.au Queensland Health employees have again failed to receive their correct pay.

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http://www.zdnet.co.uk/news/it-at-work/2010/04/22/doh-offers-npfit-patient-admin-system-alternative-40088723/

DoH offers NPfIT patient admin system alternative

By Kable, 22 April, 2010 10:39

NEWS

A contract for the supply of a patient administration system has indicated a further revision of plans for England's NHS National Programme for IT.

The Department of Health (DoH) has confirmed that a new deal will enable some trusts in the north of England to use an alternative software to the suite to which they had been committed by their local service provider.

It has said that a £36m, four-year contract signed with McKesson would cover some trusts in the North, Midlands and East of England (NME) area, which have previously been due to take iSoft's Lorenzo suite.

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http://www.bjhcim.co.uk/news/2010/n1004024.htm

iSOFT partners Gateway Computing to deliver document management solution

20 April 2010

Scott Wilce, Sales Director, Gateway Computing said: “With iSOFT’s experience in the NHS clinical arena and Gateway’s knowledge of the NHS built up over 16 years, we believe that the EDMS offering now available via iSOFT offers an extremely good value for money solution and provides a trust-wide comprehensive solution to all areas of the NHS.”

Adrian Stevens, Managing Director of iSOFT’s UK and Ireland business, said: “With increased pressure on the NHS to meet efficiency targets, document management is becoming increasingly important. WinDIP Enterprise can retrieve any document within seconds, so finding that needle in the haystack will become a reality. iSOFT sees a great opportunity in the market place for this product.”

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http://www.abnnewswire.net/press/en/62661/iSOFT_Group_Limited_%28ASX:ISF%29_Agrees_On_UK_Deals_Worth_A8M.html

iSOFT Group Limited (ASX:ISF) Agrees On UK Deals Worth A$8M

Sydney, April 20, 2010 (ABN Newswire) - iSOFT Group Limited (ASX:ISF) - Australia's largest listed health information technology company, today said it signed two deals in the UK totaling GBP4.8 million (A$8 million) for a hospital system and an e-commerce and logistics hosting application.

Sussex Partnership NHS Foundation Trust in the South of England, one of the country's largest mental health trusts, chose to continue using iSOFT's Patient Management (formerly i.Patient Manager) solution in a deal that includes an option to become an early adopter of Lorenzo within six months. The agreement includes an initial license fee for the latest version of iSOFT Patient Management, and support services for up to five years.

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http://www.e-health-insider.com/news/5841/sussex_partnership_may_move_to_lorenzo

Sussex Partnership may move to Lorenzo

20 Apr 2010

Sussex Partnership NHS Foundation Trust has signed a five-year deal with iSoft that includes an option for it to become an early adopter of Lorenzo.

The trust has renewed its deal for iSoft Patient Management (formerly known as iPatient Manager or iPM). As part of the deal, iSoft will install the latest version of the application and support it for up to five years.

It will also “consider the option in the next six months of becoming iSoft’s first UK-based Lorenzo early adopter outside the National Programme for IT in the NHS.”

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http://www.e-health-insider.com/news/5848/morecambe%27s_lorenzo_go-live_shifts_again

Morecambe's Lorenzo go-live shifts again

21 Apr 2010

E-Health Insider understands that the go-live of Lorenzo at University Hospitals of Morecambe Bay NHS Trust is likely to be shifted from the start to the end of May.

The trust failed to hit an end of March deadline to go live with the latest version of the iSoft electronic patient record, set by Department of Health chief information officer Christine Connelly.

The failure to hit the deadline cost CSC a revised local service provider deal with NHS Connecting for Health.

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http://www.sbpost.ie/news/ireland/hses-60-million-it-firm-misses-nhs-system-deadline-48689.html

HSE’s €60 million IT firm misses NHS system deadline

18 April 2010 By John Burke and Ian Kehoe

The IT firm working on a €60 million upgrade of the Health Service Executive (HSE) patient records systems has missed a deadline in the rollout of a similar £1 billion patient record system for the NHS in Britain.

iSoft has been contracted by the HSE to install its patient records software in hospitals and clinics in Ireland, but the system has been plagued with problems. The firm is also the main software supplier to three of Britain’s five health regions on a similar programme.

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http://www.e-health-insider.com/news/5849/nhs_bury_experiences_issues_with_lorenzo

NHS Bury experiences issues with Lorenzo

22 Apr 2010

NHS Bury, the first trust to go-live with Lorenzo Regional Care Release 1.9, is experiencing continual issues with the system’s reporting functionality.

Documents on the PCT’s website make references to problems with the iSoft electronic patient record, with which it went live at the start of November.

The documents indicate the PCT is having difficulties monitoring performance and the 18 week referral to treatment time target.

They also indicate the problems have delayed the creation of a business management centre for its provider services and the deployment of further functionality.

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http://www.theaustralian.com.au/business/nbn-co-chief-tries-to-clear-record/story-e6frg8zx-1225856132609

NBN Co chief tries to clear record

• Mitchell Bingemann
• From: The Australian
• April 21, 2010 12:00AM

THE head of the $43 billion national broadband network has tried to quell concerns the project will not generate a commercial return, but a network veteran has dubbed his claims "bullshit".

Speaking at the Commsday summit in Sydney yesterday, NBN Co chief Mike Quigley denied reports last week that quoted him saying the government would not make a financial return on the NBN for up to 30 years.

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http://www.smh.com.au/technology/technology-news/if-we-win-well-scrap-network-coalition-20100421-t0mn.html

If we win we'll scrap network: Coalition

ARI SHARP

April 22, 2010

THE Coalition is likely to scrap the $43 billion national broadband network if it wins office this year, a position one industry expert labelled ''a total disaster''.

The government said it would be a return to the Howard era.

The Opposition spokesman on communications, Tony Smith, said it would instead seek to attract private investment to broadband and be able to deliver improved speeds - faster than the eight years proposed by the Rudd government.

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http://www.zdnet.com.au/australia-still-waiting-for-google-health-339302517.htm

Australia still waiting for Google Health

By Ben Grubb, ZDNet.com.au on April 19th, 2010

As state and territory governments meet to talk health reform at the Council of Australian Governments (COAG) meeting in Canberra today, Google said it had "no time frame" for the deployment of Google Health in Australia, despite its CEO formerly saying he hoped to have the service available in Australia by late 2008.

Google Health allows users to volunteer their health records either manually or by logging into their accounts at partnered health service providers. The service is only available in the US.

On 18 March 2008, Google CEO Eric Schmidt was in Sydney talking up e-health. At the time, he acknowledged tough regulatory hurdles would need to be overcome first, but said he hoped to bring the Google Health service to Australia by the end of that year.

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http://www.computerworld.com.au/article/343526/paradise_lost_decade_data_breaches/?eid=-6787

Paradise lost: a decade of data breaches

Australia no island of security

• Darren Pauli (Computerworld)
• 19 April, 2010 08:47

Do you think the moat around Australia extends around your business and hackers won’t target you? It doesn’t, and research says data breaches will be the elephant-in-the-conference-room at your next IT meet.

Australia has to date been sheltered from much of the painful data breach disclosure laws sweeping the world, and organisations here appear to have avoided the high-profile hacks that have plagued others over the last decade. But are we as lucky as it would appear?

No. For starters, the seas that girt Australia offer illusionary security, according to Gartner. Research vice-president, Rich Mogull said Australian organisations are being hacked and losing data. “It’s just hidden,” Mogull said. Moreover, he said, we are in a worse position than others because of our close proximity to Asian countries where data breaches are rife.

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http://www.smh.com.au/technology/security/fake-security-software-is-enemy-no1-20100421-ss9g.html

Fake security software is enemy No.1

April 21, 2010 - 11:11AM

Fake security software was the biggest cybersecurity woe afflicting computer users in 2009, and Apple users lost some of their immunity to cybercrime as they stored more data online instead of on hard drives, according to the cybersecurity firm Symantec.

In a report released this week, Symantec noted that Brazil had risen to third place in the list of countries with "malicious activity," defined as spam, online scam attempts and other types of cybercrime. The United States remained in first place generating 19 per cent of malicious traffic, with China second at 8 per cent, and Brazil third at 6 per cent.

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http://www.smh.com.au/digital-life/computers/antivirus-program-sends-computers-berserk-20100422-t9jl.html

Antivirus program sends computers berserk

April 22, 2010 - 6:39AM

Computers in companies, hospitals and schools around the world got stuck repeatedly rebooting themselves on Wednesday after an antivirus program identified a normal Windows file as a virus.

Antivirus vendor McAfee Inc confirmed that a software update posted on Wednesday morning caused its antivirus program for corporate customers to misidentify a harmless file. It has posted a replacement update for download.

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http://www.computerworld.com.au/article/344145/google_docs_better_ready_take_office_/?eid=-255

Google Docs better; ready to take on Office?

The new version adds collaboration tools and drawing software, but drops the ability to work offline.

• Preston Gralla (Computerworld (US))
• 23 April, 2010 04:58

The new version of Google Docs sports considerable collaboration tools, as well as improved editing and formatting, a faster, more useful spreadsheet and new collaborative drawing software. It's a worthwhile upgrade to the Web-based office suite, especially for those to whom collaboration is of vital importance. But because it no longer allows offline access to documents (for now), and because it's still not as powerful as Microsoft Office, it's not likely to knock Office off of its throne as king of the productivity suites.

It's likely no coincidence that this major update to Google Docs comes just before Microsoft finalizes Office 2010. Based on what I saw when I reviewed the beta of Office 2010, this new version of Google Docs is far superior to the Web-based version of Office. Those who want to collaborate on documents online will want to use Google Docs, while those who want the most powerful office suite will stay with Office.

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Enjoy!

David.