Again, in the last week, I have come across a few reports and news items which are worth passing on.
These include first:
By: Joseph Conn / HITS staff writer
Story posted: April 14, 2008 - 5:59 am EDT
National health information technology programs in Australia, Canada and the U.K., as well as the Veterans Health Administration in the U.S., have joined a collaborative effort to develop common healthcare IT products and services, according to Open Health Tools, a not-for-profit organization based in Asheville, N.C., formed last year to promote interoperable healthcare IT systems using open-source tools and components.
Although a news release was issued last week, the group actually held a first meeting in November 2007 at which time it elected a governing board of stewards and approved its first two “charter” projects—Health Level 7 messaging and addressing security and privacy issues, according to the Open Health Tools Web site. The group also approved “in principle” two other charter projects dealing with academic outreach and developing testing and conformance tools.
The government-sponsored programs listed as “inaugural” members are Canada Health Infoway, the Connecting for Health program of the National Health Service in the U.K, and the National E-Health Transition Authority in Australia. The announcement also lists the Veterans Health Administration of the Veterans Affairs Department.
Other inaugural members are Health Level 7, the Healthcare Services Specification Project, the International Health Terminology Standards Development Organization and Object Management Group.
Academic members named are Linkoping University, Sweden; Mohawk College of Applied Arts and Technology, Hamilton, Ontario; and Oregon State University’s Open Source Lab, Corvallis. Some of better known corporate members listed include BT Group (formerly British Telecommunications, a prime contractor in the U.K. healthcare IT program), IBM, Oracle Corp., and Red Hat.
More here:
http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20080414/REG/257002054/1029/FREE
I think this may be an important initiative but I certainly agree that ‘time will indeed tell’.
More details here:
By: Joseph Conn / HITS staff writer
Story posted: April 15, 2008 - 5:59 am EDT
A pair of academics involved with a new international consortium of colleges and universities, information technology vendors, standards development organizations and government agencies that promote the use of health IT expressed confidence the organization will succeed in creating a viable community for open-source software development for the healthcare industry.
The group, Open Health Tools, based in Asheville, N.C., formed in November 2007, held its second board of stewards meeting Monday in Chicago.
Deborah Bryant, public sector communities manager for the Open Source Lab at Oregon State University, a member of the consortium, took time out from the meeting for a conference call with Curt Pederson, the vice provost and chief information officer at Oregon State in Corvallis.
Both academicians said that they believe that Open Health Tools can pull off creating that viable open-source healthcare IT community, not the least in part because Oregon State is putting its formidable expertise in open-source project development behind the effort.
More here:
http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20080415/REG/640763137/1029/FREE
Second we have:
Jason Dowling
April 20, 2008
MORE than a dozen confidential medical records of Victorian WorkCover patients have been sent by mistake to a member of the public in a breach of patient confidentiality.
WorkSafe Victoria has sought an urgent briefing on the unauthorised release of the documents, which include some marked "private and confidential".
It is believed the patients involved have not yet been told their private medical records have been compromised.
Rye resident Trent Flynn told The Sunday Age he was shocked when he opened his mail in February and discovered page after page of medical records concerning strangers. "It is unbelievable," he said.
Continue reading here:
http://www.theage.com.au/news/national/medical-files-sent-to-wrong-man/2008/04/19/1208025558708.html
Just a reminder that there are some difficulties associated with those old paper records!
Third we have:
Michael McKenna | April 18, 2008
LIFE-SAVING cancer research is being blocked by Queensland government restrictions on scientists gaining access to a register of sufferers throughout the state.
The Cancer Council of Queensland has launched unprecedented legal action in Brisbane's Supreme Court for access to the register to enable independent study of the disease, including blocked work into why survival rates are lower in regional and rural Queensland.
Scientists believe the study may embarrass Queensland Health because it is likely to reveal detection and treatment standards are failing outside of Brisbane.
Queensland is the only state in Australia, and one of the few jurisdictions in the Western world, where researchers require case-by-case approval to access the cancer register for the development of prevention and treatment strategies.
Queensland Health has refused to release localised cancer statistics and has failed to fund the collation of data on the stages that cancers are being discovered in different areas.
The battle has emerged as suspected cancer clusters - involving the ABC's Brisbane studios and fire-fighters in north Queensland - are being investigated by the Government.
Documents obtained by The Australian show that some of Australia's leading scientists - including former Australian of the Year Ian Frazer - have repeatedly appealed to Premier Anna Bligh and Health Minister Stephen Robertson to grant routine access to the data.
The Cancer Council of Queensland - which was awarded management rights of the register in 2001 - has been denied access or forced to wait up to a year for approval to use the information and start the research.
More here:
http://www.theaustralian.news.com.au/story/0,25197,23558212-601,00.html
and here:
http://www.theaustralian.news.com.au/story/0,25197,23558144-5006786,00.html
This is really a terrible bit of nonsense. Clearly legitimate researchers need easy and timely (i.e. prompt and non bureaucratic) access to cancer registry data. This is an issue that should be totally apolitical and just happen as needed. What information emerges from the use of such registries simply must not be blocked or suppressed by politicians as has been seen in the US with the Bush Administration.
If there is a problem the role of the politicians is to fix the issue not suppress it.
Fourthly we have:
Commentary - Alan Kohler
7:24 AM Apr 17, 2008
Finance Minister Lindsay Tanner’s decision to bring in Sir Peter Gershon to review the Government’s spending on information and communications technology (ICT) represents a turning point for the industry.
It will not only profoundly shake up the way every Government department and agency operates, but along with the national broadband network tender it will also have as large an effect on Australia’s technology industries as the Button car plan had on the motor industry.
Sir Peter Gershon was knighted for saving the Blair Government £23 billion as a result of a review in the UK of all public procurement when he was chief executive of the Office of Government Commerce. He is also a director of four companies and a non-executive director Her Majesty’s Treasury (apparently they have them) and in 2005 conducted a review of Ministerial and Royal travel spending.
Getting him to do the Australian review is quite a coup; he doesn’t even want to be paid – he has asked that his fee go to charity.
As Steve Hodgkinson, the director of Ovum’s public sector practice in Australia remarked to clients: “Strewth! Hold onto your hats."
“Inviting Sir Peter Gershon to lead a review of ICT is highly symbolic, and Canberra’s ICT vendors and CIOs will now be under no illusions that Finance Minister Lindsay Tanner means business when he talks about taking a fresh look at the way the Government buys and manages ICT to drive cost savings and enable a more connected approach to services.”
More here:
http://www.businessspectator.com.au/bs.nsf/Article/Central-nervous-system-DRSCT?OpenDocument
This is a very interesting move. What is even more interesting is that Sir Peter did not suggest a cut in the National Program for Health IT – suggesting he was supporting it. There is no way he could have ignored it given its scale and complexity. I wonder what he would think about the waste of money we have seen so far in Australia.
Fifth we have:
LESLEY RUSSELL
In August 2007, in one of his last speeches as federal health minister, Tony Abbott admitted that the statement made in his first speech in the portfolio in November 2003 that failure to establish an electronic patient record within five years would be an indictment against everyone in the system, including the government was a rashly declared standard.
As shadow minister for health, Nicola Roxon was critical of the Howard government's failures in this area, stating that e-health in Australia lacked a coordinated national approach and national leadership.
However, the Rudd Government's election policy was very light on e-health details, despite the crucial need for health IT infrastructure and services to help deliver health-care reforms, and the Government is yet to indicate any commitment or funding for e-health measures.
It is salutary to note that a report produced by the King's Fund in Britain last year found that a decade of expensive National Health Service hospital reforms had failed to deliver expected economic benefits because the proposed e-health program, recognised as key to productivity improvements and health gains, was well behind schedule.
And such has also proved to be the case in Australia. Contracts for the development of a unique patient identifier have only just been signed, despite budget commitments made in 2006, and progress has lagged in many areas.
There is no need to commit to new spending, when more than 50 per cent ($41.5million) of the funds allocated to e-health in 2006-07 remains unspent. Money has never been a problem for e-health, but national agreement on a vision and focused and strategic long-term planning have been in short supply.
Many consultants have prospered, many projects have been set up and fallen over with no lessons extracted, and our e-health system is currently as national and as unified as the railway system was last century.
Who now remembers the Australian Health Information Council or the $128 million HealthConnect program it was to deliver? The Health Information Council disappeared and was replaced by the mysteriously named National E-Health Transition Authority, which is now also going through a shake-up in the wake of the recent resignation of its chief executive and a tough report from an outside review.
The Boston Consulting Group's review, finalised last October, made a number of critical points about the transition authority and its work to date, in particular that the transition authority must start to communicate sensibly and openly with stakeholders, and work with them to meet needs. Most tellingly, the review called for a national health IT strategy to be developed.
It is shocking to realise that one does not currently exist.
Despite this, the transition authority is preparing a business case for a personal e-health record to be made to the Council of Australian Governments without any involvement by the public or clinical professionals, and without any explanation as to whether a personal e-health record is the same as a shared e-health record, which used to be the focus of the transition authority's work.
More here:
http://canberra.yourguide.com.au/news/opinion/opinion/ailingehealth-afflictsall-sides/1222574.html
This is an important opinion piece from a serious thinker in the area. Dr Russell is the Menzies Foundation Fellow at the Menzies Centre for Health Policy, University of Sydney/Australian National University and has been worry at this topic for a good while. The Roxon leadership of the health sector will be serious called into question if there is not some major movement and announcements in this space quite soon.
I have a sense the next few weeks, leading up to the budget, may be quite determinative.
Sixth we have:
Karen Dearne | April 15, 2008
FEDERAL Privacy Commissioner Karen Curtis will today release draft guidelines on how companies and governments should report breaches of privacy involving customer data.
Commission draft guidelines will fill the gap ahead of the Government's overhaul
The guidelines are intended as an interim, voluntary, measure ahead of the Rudd Government's planned overhaul of the Privacy Act.
Ms Curtis said people from government agencies and businesses had been ringing her office for guidance on how to respond to wrongful information exposures occurring now. "Generally there has been a mishap - nothing major - but they want to know whether to notify the affected individuals," she said. "I thought it sensible to address the issue.
"Our laws don't presently require notification, but obviously if the financial records of 100,000 people are lost, there's a real risk of serious harm and those people would expect to be notified."
Ms Curtis recommended mandatory breach notification under certain circumstances in her submission to the all-encompassing Australian Law Reform Commission review of the Privacy Act, due for completion mid-year.
The government's response and the ALRC process could mean it was several years before new laws were introduced, she said, and in the meantime "it's useful to have some guidance".
Ms Curtis is calling for comment on the draft guidelines by June 16, and will then hold roundtable meetings to thrash out the issues. "I want to get feedback from businesses, government agencies and individuals so we can make the voluntary rules as practical and useful as possible," she said.
Continue reading here:
http://www.australianit.news.com.au/story/0,24897,23539443-15306,00.html
This is important stuff. I just hope the needs of the health sector are carefully considered, especially since it seems likely that medical identity theft is likely to become more or a problem in coming years.
Last we have:
April 14, 2008
The nation’s health care system is woefully unprepared to care for baby boomers, who will start to reach age 65 in just three years, according to a major new report from the Institute of Medicine. Among the report’s many conclusions is that assistive technologies should be used to improve the quality of life and care in the home.
…..
Assistive technologies range from walkers and canes to telemonitoring, which can improve compliance with medication and treatment regimens and detect if a homebound person needs immediate help. “In addition to increasing patient safety, this type of communication system has been shown in one study to reduce hospital stays, reduce demand for home care services and assist in relieving caregiver stress,” according to the report.
The report, “Retooling for an Aging America: Building the Health Care Workforce,” is available at iom.edu.
More here:
http://www.healthdatamanagement.com/news/home_health_geriatic26087-1.html?ET=healthdatamanagement:e351:100325a:&st=email
This is an important report which fits into the general framework of needing to make healthcare services more sustainable as the population ages – and that technology has a serious part to play.
The report brief can be downloaded here
http://www.iom.edu/Object.File/Master/53/507/HealthcareWorkforce_RB.pdf
More next week.
David.
