The Commonwealth Department of Health Consults on Identifiers - In Our Dreams!

A day or so ago we had the announcement of a consultation process around the NEHTA developed Individual and Provider Identifiers:

The basic information can be found here:

http://aushealthit.blogspot.com/2009/07/having-worked-on-it-for-years-doha-now.html

The direct link is here:

http://www.health.gov.au/internet/main/publishing.nsf/Content/pacd-ehealth-consultation

Government releases UHI consultation paper

I have now had a chance to browse the paper which can be downloaded from the above link.

Of course the document is not a consultation on the UHI. In fact the title of the document makes it clear just what it is:

Healthcare identifiers and privacy: Discussion paper on proposals for legislative support.

Translation. We know we need to get some legislation together to get started – we are not very organised in terms of aligning the jurisdictions - so we will need to just rush forward and hope for the best.

The rather messy situation is well discussed here:

National health data problems

Karen Dearne | July 14, 2009

THE nation's health ministers cannot agree on a uniform privacy framework for patient identifiers and are preparing to launch a Medicare number-based system with just a few tweaks to laws that forbid the use of Medicare data for such purposes.

As part of the $98 million Unique Healthcare Identifier program, Medicare is building a system that assigns an individual patient number to each Medicare number. Doctors and other medical providers will then be able to use the number on the Medicare card to access a person's records wherever they are held.

With the identifier service due to be ready by mid-next year, the Australian Health Ministers' Advisory Council says it cannot wait for public discussion of proposed reforms of health information privacy laws slated by the Rudd government in its response to the Australian Law Commission's comprehensive review.

Instead, the health ministers want to extend existing state and federal laws to include the new healthcare identifiers -- despite acknowledging current arrangements are "a patchwork of inconsistent and overlapping requirements" that cause confusion and increase compliance costs.

The new system is intended to ensure correct identification of patients and their health data, and will underpin more secure information sharing between medical providers.

More here:

http://www.australianit.news.com.au/story/0,24897,25777369-5013040,00.html

You can read a great deal about the NEHTA eID here:

http://www.nehta.gov.au/connecting-australia/e-health-id

The brief summary is as follows (from the site):

“The first requirement of any e-health system is the ability to uniquely identify and authenticate everyone involved in a single healthcare transaction. This includes the person receiving healthcare, the person administering healthcare, the place where healthcare is given and all people accessing health information systems.

The e-health ID Services will uniquely identify all parties involved in a healthcare transaction ensuring there is no misunderstandings about who health information belongs to. e-health ID Services enable healthcare providers to be assured that the information they need relates to the right person, has gone to the right place and was received by the right person.

Once the health information is exchanged it is also important to ensure only those authorised have access to it. Therefore Australia’s e-health system will be underpinned by a simple yet secure authorisation service for healthcare providers and healthcare administrators, using the best technology available.”

It is worth noting that most of the documents there are over 18 months old and, as an example the Concept of Operations (for the UHI) has all sorts of ‘to be determined statements’ running all through it.

As far as I can tell there are no technical specifications as to how the service will work – and the draft privacy framework is over 2 years old. Endless quantities of business requirements however!

The problem with all this is as follows. This is meant to be a public consultation on key privacy approaches and then legislation for the national e-Health identifier system and all that is offered as context couple of motherhood pages on what a good thing identifiers are and how we really need one for health.

Now all that may be true but I think before I signed up to approve what the quite draconian approach of using information on 20 million people to create a new identity database, using information which they gave for another purpose (getting Medicare payments) I would like to know a little more!

I would like to know answers to questions like:

What approaches are used in the rest of the world to address identification in e-Health and is what is being planned global best practice – and what is the evidence for that?

What did the various Privacy Impact Statements that NEHTA has developed say and why have they not been made available for public scrutiny?

What does the business case for this whole exercise say in terms of cost (short and long term) and benefits of this system (short and long term)? How is this system to be paid for when the establishment grants have expired.

Given the issues identified here with a similar system in the UK what steps have been taken to understand if there are implications for Australia?

GP raises concern about PDS security

14 Jul 2009

Renewed concerns have been raised about the security of the Personal Demographics Service after a GP was able to access details of colleagues and staff without being detected.

Dr Paul Golik, a GP in Stoke-on-Trent, Staffordshire, and secretary of North Staffordshire Local Medical Committee, told the GP magazine Pulse that he had accessed his own details and, with permission, those of several other people without the unauthorised accesses being reported.

Dr Golik told Pulse that he was “appalled” that such information was available to everyone with a smartcard. More than 600,000 smartcards have so far been issued, according to NHS Connecting for Health.

Dr Golik added: “It’s basically open – we might as well put our names and addresses on Google. If I know what your name is and roughly how old you are, within about ten seconds I can find your exact date of birth, your full name, your address, potentially your telephone number and your NHS Number.”

More gruesome details here:

http://www.ehiprimarycare.com/news/5024/gp_raises_concern_about_pds_security

As I read it any authorised provider in Australia could do the same thing – all 600,000 of them! If you reckon there won’t be one or two corrupt apples in that many providers whatever you are smoking sure is not legal!

The bottom line is that what DoHA should have done was not produce an isolated partial consultation document with a short deadline, but a complete up-to-date package that addresses all the issues raised above, puts the issues in context and then allows a reasonable time for careful review. There is no great rush and the public should be consulted on the whole package –not just one bit.

This is a Clayton’s consultation of ever there was one!

David.

The Real Reason We HAVE to do E-Health.

The following article puts the case for e-Health in the US as clearly and simply as I have seen it done.

Wednesday, July 08, 2009

Where's the HIT in HCR (Health Care Reform)?

by Bruce Merlin Fried, Esq.

Let's give credit where credit is due. From where I sit, Congress took a big step toward a digital health care system by including the HITECH provisions in the American Recovery and Reinvestment Act of 2009.

Approximately $30 billion in new federal spending was authorized for various health IT activities, the bulk of which goes toward economic incentives for physicians and hospitals to be "meaningful users" of certified electronic health records. Monies were also allocated for extension services, state initiatives, loans and grants. All good.

But I should have known. It was predictable. Certainly there is no reason to be surprised. Having included HITECH and its authorized funding in ARRA, it appears Congress thought its health IT work was done. Were it only that easy.

If we are to have real health care reform, a greater health IT effort is required than what was accomplished in ARRA.

Let's take a brief digression. It is essential, in my mind, that everyone working in health IT -- from the code writers to the technology geeks to the folks in the C suite -- understand that health care reform is the business justification for building a digitized health system. What is driving policymakers to reform the health system is not an altruistic sense of moral obligation.

Sure, there is certainly some of that. But the real driver is the fear that results from a clear-eyed assessment that our current health system is unsustainable. Absent substantial reform, the way we have organized and financed health care will collapse the system (and I don't just mean the health care system, I mean THE system, the economic system of the country).

More here (with links):

http://www.ihealthbeat.org/Perspectives/2009/Wheres-the-HIT-in-HCR-Health-Care-Reform.aspx

As far as the US is concerned Bruce is utterly spot on and everyone from the President down knows it.

How close are we to the same problem – healthcare becoming un-affordable and unsustainable – here in Australia?.

The following comes from Australia’s Health 2008.

This full report is found here:

http://www.aihw.gov.au/publications/index.cfm/title/10585

Health expenditure

• Australia spent 1 in every 11 dollars on health in 2005–06, equalling $86.9 billion, 9.0% of gross domestic product (GDP).

• As a share of its GDP, Australia spent more in 2005 than the United Kingdom (8.3%), a similar amount to Italy (8.9%) and much less than the United States (15.3%).

• Health spending per person was 45% more in 2005–06 than a decade before, even after adjusting for inflation.

• For Indigenous Australians in 2004–05, health spending per person was 17% higher than for other Australians.

• The spending on medications increased by 1.6% between 2004–05 and 2005–06—much less than the average increase of 8.6% per year in the decade before.

Point 3 is the really scary one!

We are a ‘boiling frog’ believing we can keep adjusting inflation adjusted personal spend up by 45% per decade because we are a rich country and so on! Health Spending essentially means out of pocket expenses. How long before the amount is bigger than the aged pension?

Here is the awful number:

“Over the decade, estimated real growth in health expenditure (that is, after removing the effects of inflation) averaged 5.1% per year (Table 8.2). Real growth in expenditure is measured using ‘constant prices’ (see Box 8.2).” (Health Expenditure is the total cost of Health Services etc)

Simple maths tells us that on this path, if sustained, we will double health expenditure about every 14 years. That means it will be about 18% of GDP by 2019 (from 2005-6) and 27-30% or so by 2035.

The 2019 figure would pretty much finish us and the 2035 figure would bankrupt the county –easy as that!

Worse still the clinical workforce are about to hang up their collective shingles and head for the exits.

Even the NHHRC sees a real issue:

“These projections indicate that, over the next 25 years, health and aged care spending will

increase to $246 billion – about one-quarter of a trillion dollars. By 2032–33, health and aged

care services will consume 12.4 per cent of gross domestic product.” (Note to only get here must assume a lot of economic growth which is not as sure as it used to be!)

Page 302 of Interim Report.

Then they say:

“If we continue with business as usual, the fastest growing areas of spending will be for acute

services, such as hospitals and aged care (see Figure 13.2). Changing how much, and where,

we spend will require greater investment in prevention and primary care, coupled with a real

commitment to keeping people healthy.”

The estimates come from here:

http://www.aihw.gov.au/publications/hwe/pahced03-33/pahced03-33-sum.html

Woo hoo. We need way more than that! How can they be so utterly stupid? We need a total health system transformation which drives efficiency, quality, safety etc up with every other trick we can think of to not top 12-15% of GDP by 2030.

See here for the Productivity Commission Estimates of the base state:

http://www.pc.gov.au/__data/assets/pdf_file/0004/13666/technicalpaper04.pdf

Guess what with medical inflation just 1% above GDP growth we get to 17% of GDP by 2030 and 20% by 2045 or so (quite unaffordable of course). Like climate change you can dispute the details of the figures but to pretend there is not an ‘oncoming train’ would be just silly (the precautionary principle applies for sure!)

The bottom line is that tinkering around the edges is not going to work! If we want to be able to afford the clinical care we actually need we must change to have less waste, less re-work, more efficiency, higher quality and so on. Health IT can help a great deal along with programs to increase evidence based practice and research that ensures we only do those things for patients that have a real chance of helping. What these things are and how to apply the information that is already available could also do with more effort – along with the preventive approaches so long promoted.

We are all going to regret it if we do not begin a transformation to an evidence based, e-Health enabled Health System sooner rather than later.

David.

Seems They Are All Lining Up to Be Enthusiastic!

E-Health Record To Help Ensure Better Treatment - 13 July 2009

A National e-health record promises to ensure patients have access to more expedient and better informed medical treatment, Medicines Australia chief executive Ian Chalmers said today.

Welcoming today’s decision by the Australian Health Ministers’ Conference to move towards establishing a secure national e-health system, Mr Chalmers said patients and healthcare professionals would be the big winners.

“If healthcare professionals understand what treatments a patient has received and what medications have been previously prescribed and dispensed, they will be much better placed to determine quickly the most appropriate treatment option.

“This initiative goes to the core of Quality Use of Medicines.

“An e-health record will help ensure doctors and other health professionals prescribe the right medicine to the right patient at the right time and at the right dose.

“This is a significant step in ensuring medicines are used correctly and avoiding adverse outcomes through the misuse of prescription medicines.”

Mr Chalmers said a national e-health record would also provide an important opportunity to deliver an advantage to Australia’s extensive clinical trial capability.

“There is an opportunity to capture greater value from an e-health record system by ensuring the system also provides remote access to the medical records of trial participants in Australia who have consented to such use of their details.

“Remote access to trial data would remove geographical barriers to participation in clinical trials.

“This would shorten the time taken to complete clinical trials in Australia and would therefore improve Australia’s attractiveness as a destination for global investment in clinical research.

“Medicines Australia has long argued for a national e-health system. I congratulate the Australian Health Ministers’ Conference for taking forward this initiative.

“It is important that all stakeholders have the opportunity to consider this proposal carefully. I look forward to engaging with the Health Ministers during the consultation period.”

ENDS

CONTACT: Jamie Nicholson

Medicines Australia, Media Communications Manager

The release is found here

http://www.medicinesaustralia.com.au/pages/view_news.asp?id=141

I wonder why this insight has suddenly come after so long! Could it be a bit of empire building from an organisation with a lamentable record in building and deploying software for clinicians?

David.

Note: In this comment I confused Medicare Australia and Medicines Australia - so the comment is partly incorrect. See comments. D.

Full Text of the AHMC Release is Now Available.

Media Releases and Communiqués

First step taken towards national e-health system

In an out-of-session communiqué, the Australian Health Ministers’ Conference has announced that the first step has been taken towards a national e-health system. National consultations are set to begin on the legislative framework to underpin the governance, privacy and agreed uses for national healthcare identifier numbers essential to a secure national e-health system.

PDF printable version of First step taken towards national e-health system (PDF 17 KB)

13 July 2009

National consultations are set to begin on the legislative framework to underpin the governance, privacy and agreed uses for national healthcare identifier numbers essential to a secure national e-health system.

Healthcare Identifiers are unique numbers that will be given to all healthcare providers, healthcare centres and healthcare consumers. These unique numbers will provide a new level of confidence when communicating patient information between the myriad of private and government healthcare providers and systems.

To date there has been no single method of accurately and reliably identifying the patient receiving healthcare, the healthcare providers or the organisations managing care.

Mismatching of patients with their records and medical results is a documented problem for the health system. There is a clear link between avoidable patient deaths and poor medical records management.

All Australian residents will be allocated an Individual Healthcare Identifier (IHI) to support better communication between healthcare providers involved in patient treatment – but no patient will be forced to use it to access any health service.

The IHI service will be managed initially by Medicare Australia – a trusted and secure provider of dedicated health related services. This will be separate to its funding and claims functions. The IHI will not replace a patient’s Medicare number, which is used for claiming government healthcare benefits.

The IHI service will hold only enough information to clearly identify the person. No clinical information or medical records will be stored in the IHI service and an IHI will not need to be declared for an individual to receive healthcare.

The Australian Health Ministers’ Conference asked for consultations to be held so that a broad range of perspectives can contribute to making the legislation robust and effective – balancing the privacy of personal information with the healthcare benefits that can be gained through better sharing of health information.

Consultations with key industry stakeholders will be held during July and a discussion paper detailing the legislative framework will be available online from 13 July to allow broad community input.

The consultations on the drafting of legislation build on earlier consultations with key stakeholders about the recommendations in the Australian Law Reform Commission’s report on its review of Australian privacy laws, including health privacy protections.

The Australian Health Ministers’ Conference believes strong privacy protection for patient health information is fundamental to delivering high quality individual and public health outcomes.

The discussion paper can be accessed online at www.health.gov.au/eHealth/consultation from 13 July.

The release is found here:

Enjoy – comments are welcome! I would note I had believed we took the first steps in 1999 with the Health On-Line reports that led to HealthConnect – but it seems I have simply developed a state of severe confusion or historical amnesia. (We won’t even mention the June 1993 Health Communication Network Business Plan – will we? - Everyone who was involved in that is probably dead by now )

David.

Having Worked on it For Years – DoHA Now Wants to Consult on e-Health Identifiers!

The following arrived on the NEHTA RSS today.

From:

NEHTA RSS

Link:

http://www.health.gov.au/internet/main/publishing.nsf/Content/pacd-ehealth-consultation

Government releases UHI consultation paper

Important facts to note:

------

Submissions will not be made publicly available but will be shared with relevant government agencies to inform jurisdictional consideration of national privacy arrangements. Please note that submissions or comments will generally be subject to freedom of information provisions.

The closing date for comments and submissions is 5pm (Australian Eastern Standard Time), 14 August 2009.

-----

Don't you love these people! As always, terrified someone might have an opinion they are not comfortable with. Have they actually heard of democracy?

I wonder after the development of all the Privacy Impact Assessments (PIAs) over the last few years – and a failure to publish them – why they are not released to encourage and facilitate informed discussion? Your guess is as good as mine!

Could it be, to release them, might just alert people to things they may have missed?

Can you really believe COAG authorised this work in 2006 and we are hoping it might start in 2010. Speedy Gonzales this collection of bureaucrats are not! (why do comparisons with an inability to organise a few drinks in a brewery leap to mind?)- see intro on web link!

Of course, whatever they propose still have to get through the Senate. That might mean a start date in 2020!

David.

The NHHRC Final Report will be Released Soon. What Must it Say About E-Health?

The Final Report of the National Health and Hospitals Reform Commission is due out in the next couple of weeks.

As soon as I spot it I will provide a link. I assume it will be found from this front page:

http://www.nhhrc.org.au/

For the e-Health component of that reports to be seen as being in anyway useful and positive I believe it will need to make the following points.

First that leadership and governance of the e-Health space are crucial for success. The report should recommend how a satisfactory level of leadership, governance and accountability is to be achieved for the needed investment. Within the governance framework there has to be total clarity as to what the ongoing role of NEHTA should be and how the critical things it either does not or cannot do can be delivered. Clearly I believe just ‘business as usual’ or handing it all over to NEHTA and hoping they will ‘fix it’ is utterly flawed and idiotic. Also flowing from the need for governance and leadership is a deep requirement to ensure e-Health governance is clear that implementation of systems must be conducted in ways that understand, and are sensitive to, the culture of the health sector. Lastly in this area is a crucial need to learn from experience overseas to get the balance of local versus national implementation approaches correct.

Second it should be quite clear that as the health system is about patient care and patient safety that the emphasis on technology deployment should be in those areas where those outcomes can be improved.

Third it should recognise that in the times of Web 2.0 and individual interest by patients in their health records that Personal Health Records will have an important supplementary role to the provider health records.

Fourth it should recognise that Health IT provides the capability to provide far more efficient and connected care for patients and that any re-engineering of the health system should fully and properly take advantage of these capabilities. Just automating a broken or inefficient manual system is just not good enough.

Fifth the report needs to reflect a version of this basic truth:

“Every industry except healthcare has figured out how to become more efficient by replacing administrative work with information technology, he said. Nurses spend a third of their time documenting – a procedure Cutler said often involves printing digitized information and re-entering it into another IT system.”

See here:

http://www.healthcareitnews.com/news/saving-healthcare-industry-emrs-are-beginning-not-end

In a nutshell – Information Technology can do a lot for efficiency and effectiveness in things like administration, human resource management, supply chain management and billing – as well as clinical safety, performance and so on. – Both need to be properly addressed

Sixth there needs to be a clear realisation that without a significant investment in Health IT any hope for long term sustainability of the health system, especially in the era of the ageing population, is out the window.

Seventh there has to be an overall plan and vision for how e-Health and the other proposed reforms are going to interact. Neither can be planned, or successfully realised, in isolation. This needs to be recognised clearly and each needs to move forward assisted by the other.

Eight it needs to be clearly articulated that we need a nationally funded system for the provision of both consumer and professional health information to optimise both patient understanding an clinical care.

Ninth there needs to be a recognition that we have an e-health skills and capability deficit and that this needs to be formally addressed.

Last the report has to either strongly recommend implementation of the Deloittes developed National E-Health Strategy or offer an obviously more cogent and appropriate plan.

These ten points I rank pretty much equally. They all have to be in place.

When we see the report I will provide my view of the quality of the report and the e-Health outlook based on what is provided by the NHHRC and the Ministerial Response to the NHHRC report.

I am hoping I will be a happy camper - but somehow I doubt it.

David.

Announcement Alert – Privacy Consultation on the IHI.

The following appeared today.

No quick cure for health as hospital takeovers go to the back of the queue

• Mark Metherell
• July 13, 2009

Kevin Rudd is expected to stall, if not ditch, his threat of a federal takeover of public hospitals, raising the question of just how serious he might be about health reform.

Having installed the most exhaustive series of reviews of the health system since at least the Whitlam era, the Prime Minister's credibility on health is about to go under the X-ray.

The National Health and Hospitals Reform Commission and two taskforces on primary health care and preventive health have filed their reports to the Government, which is expected to release them within days.

......

The federal and state governments are already moving on the sensitive issue of electronic health records which have the potential to transform health services, with the announcement today of a national consultation on legislation for individual patient ID numbers which will underpin the system. This may help shore up Rudd's credibility on health reform, given the likely retreat on the hospital takeover ambit.

.....

Full article here:

http://www.smh.com.au/opinion/no-quick-cure-for-health-as-hospital-takeovers-go-to-the-back-of-the-queue-20090712-dhc2.html

It will be interesting to see what is asked.

More material is here:

Ministers to refine details of e-health safeguards

Mark Metherell

July 13, 2009

AUSTRALIA'S health ministers are moving to quell Big Brother fears about the planned patient identity numbers to be assigned to every Australian by mid-next year.

The ministers today will announce national consultations with health experts and privacy groups to formulate legal safeguards for the electronic health system, which is expected to transform health-care efficiency and safety.

Full article here:

http://www.theage.com.au/national/ministers-to-refine-details-of-ehealth-safeguards-20090712-dhe1.html

It is of note that patients are to have their identifiers within a year. I suspect getting provider identifiers in place may a little longer but we shall see. I wonder how many computer systems will be ready to use these identifiers in the next year?

David.

Useful and Interesting Health IT News from the Last Week – 12/07/2009.

Again, in the last week, I have come across a few news items which are worth passing on.

First we have:

CSC Appoints E-Health Director

Tech chief Smith to tweak Viocorp ad tools

AMBITION: Paul Broekhuyse | July 07, 2009

.....

CSC has appointed Lisa Pettigrew to the new position of Australian health services director. She has more than 15 years of experience in business and IT change programs.

"Lisa will undoubtedly be an asset to CSC as the company charges ahead with its focus on playing a strategic role in the Australian government's e-health agenda," CSC public sector health and financial services vice-president Matthew Day says. "Our aim is to become the leading health systems integrator and foundation IT services partner across the Australian e-health landscape."

Pettigrew has a deep understanding of the Australian health system, inter-government relations, policy and funding processes coupled with knowledge of overseas health systems, including North America, Britain, western Europe and the Asia-Pacific region.

She has experience in helping health delivery organisations improve operations, including throughput, patient experience and staff engagement.

CSC has more than 4700 staff working in health-related IT and more than 30 years of experience in the field.

In the US, the company supported three of the five National Health Information Network prototype projects to demonstrate the effective use of electronic health records (EHR).

In Britain, CSC manages one of the largest programs in the world at the National Health Service, supporting more than 60 per cent of the system.

The company has successfully implemented more than 250 patient administration systems and 30 theatre systems, and deployed about 40 picture archiving and communications systems and 38 radiology information systems.

CSC has also worked to establish e-health and EHR programs in Denmark and The Netherlands. The company has three primary lines of business: business solutions and services, the managed services sector and the North American public sector.

It offers systems design and integration, information technology and business process outsourcing, applications software development, web and application hosting, mission support and management consulting. CSC has about 92,000 employees and reported revenue of $16.74 billion for the 12 months ended April 3.

.....

More here:

http://www.australianit.news.com.au/story/0,24897,25742414-5013038,00.html

The bolded paragraph made me wonder does CSC know something about what Ms Roxon is planning that is being kept from the rest of us.

I am being consistently being told (over the last few weeks) there are a number of presently quite well developed plans in areas like Health Information Privacy and the IHI and how e-health is to be moved forward. It will be interesting to see just what emerges out of these processes and how wider consultation has been undertaken.

Second we have:

Laptops record patient stats

BY JESSICA WELSH

9/07/2009 8:59:00 AM

Macksville Health Campus has gone digital – staff are now using laptops to record patient information.

The electronic medical recording system, or EMR, was launched at the hospital yesterday (8th).

Nurse Unit Manager Darren Hawkes said laptop computers had replaced paper charts, enabling patient information to be accessed quickly and easily throughout the whole of the North Coast Area Health Service.

Where once you would have seen a nurse or doctor writing information on a clipboard at a patient’s bedside, there would now be a laptop on a trolley.

Doctors and nurses at the hospital had spent the past month familiarising themselves with the new system and its programs.

Mr Hawkes said the new electronic system was the next step to one day making the hospital completely paper-free.

More here:

http://www.nambuccaguardian.com.au/news/local/news/general/laptops-record-patient-stats/1563230.aspx

This is really good news that smaller hospitals are starting (and only starting it would seem – see last paragraph) to see some e-Health support. NSW Health is to be encouraged to keep it up as feedback I am getting suggests system performance is not yet ideal on the North Coast.

Third we have:

Crikey July 10, 2009

8 . Federal Court grants ACC access to indigenous kids' medical files

Darwin insider Henri Ivrey writes:

A full bench of the Federal Court today ruled that the Australian Crime Commission (ACC) must take the interests of Indigenous children into account when investigating child abuse in Indigenous communities in the Northern Territory.

Under the Northern Territory Intervention the ACC was given special powers -- and a considerable budget -- to chase down former Indigenous Affairs minister Malcolm Brough’s claims of "paedophile rings" on Aboriginal communities.

This has extended to draconian powers to seize documents and question people in pursuit of their investigations.

Two Aboriginal health services in the Territory -- known only as NTD8 and NTD9 -- refused to hand over documents, and took federal court action against the ACC, claiming that such breaches of privacy in medical records would dissuade Aboriginal minors from attending clinics in regions where remote clinics are the only choice available. A number of other clinics, including NT Government clinics, handed over material to the ACC.

More at www.crikey.com.au (subscription required)

I find using children’s medical records as evidence, unless they are making a compliant, pretty troubling. People need to be confident their records will remain between themselves and their carers and no-one else. Makes no difference if the records are paper based or electronic.

Fourth we have:

iSOFT closes $7 million contracts in Australia and New Zealand

Sydney – Monday, 6 July 2009 – iSOFT Group Limited (ASX: ISF) – Australia's largest listed health information technology company today announced that it closed deals totaling more than $7 million in Australia and New Zealand in June.

The agreements include contracts with district health boards in New Zealand, a second early adopter for iSOFT’s community care solution in Australia, and a strategic foothold in the Council of Australian Governments’ (COAG) new GP Super Clinics National Program. iSOFT also sold pharmacy and medicines management solutions developed by Hatrix, the Canberra-based software company that was acquired in April.

“These contracts demonstrate that iSOFT is going from strength to strength in Australia and New Zealand, which is one of our core markets,” said Gary Cohen, iSOFT Executive Chairman & CEO. “We are building on our global footprint by offering existing clients our latest solutions, as well as seeking out new partnerships.”

In New Zealand, the district health boards (DHB) of Northland, Canterbury, Mid-Central, and Wairarapa signed a five-year support and maintenance agreement for iSOFT’s patient administration system, totaling about NZ$5.2 million ($4.1 million). iSOFT will also provide a range of enhancements to a number of other district health boards in New Zealand in agreements worth more than NZ$500,000 ($395,000).

Full article here:

http://www.abnnewswire.net/press/en/61001/iSOFT_Group_Limited_%28ASX:ISF%29_Closes_A7_Million_Contracts_In_Australia_And_New_Zealand.html

It seems that iSOFT is on a bit of a roll at present with new work all over the place. (Usual disclaimer of having a few shares)

More good news is found here:

http://abnnewswire.net/press/en/61017/iSOFT_Group_Limited_ASX:ISF_Achieves_Milestone_With_WebPAS_Go_Lives_In_Australia_And_New_Zealand.html

iSOFT Group Limited (ASX:ISF) Achieves Milestone With WebPAS Go-Lives In Australia And New Zealand

Sydney, July 8, 2009 (ABN Newswire) - iSOFT Group Limited (ASX:ISF) - Australia's largest listed health information technology company today announced it successfully completed more than 30 installations of its Web-based patient administration system (webPAS) in Australia and New Zealand this year.

Fifth we have:

GPs say no to computers: study

Karen Dearne | July 08, 2009

GENERAL practitioners may have a computer on their desk, but less than one-quarter are making full use of its capabilities, according to a new report.

While 97 per cent of GPs had access to a computer for either clinical or administrative use in 2007-08, up from 87 per cent in 2000-01, just over 11 per cent of GPs did not use it at all, the Australian Institute of Health and Welfare report on GP activity said.

The findings are based on an analysis of 10 years' data collected continuously through the Bettering the Evaluation and Care of Health (BEACH) program.

Federal Health Minister Nicola Roxon said the report showed GPs were spending an increasing amount of time with older patients, and managing more chronic diseases.

.....

A 2006 study found only 21.7 per cent made use of all of their software's clinical functions including holding all data electronically.

Lots more here:

http://www.australianit.news.com.au/story/0,24897,25751029-15306,00.html

This is quite an interesting study. The full report is a very useful review of what is presently going on in GP in Australia

It is downloadable from here:

http://www.aihw.gov.au/publications/gep/gep-24-10721/gep-24-10721.pdf

Sixth we have:

Super-thin hearing aid gets good reception from Cochlear investors

Eli Greenblat

July 6, 2009

BIONIC-EAR implant company Cochlear is expected to roll out its new "super thin" next-generation device this month after a positive response from stakeholders at a key British implant conference.

The device is just 3.9mm thick, compared with the older 6.9mm product.

UBS health-care analyst Andrew Goodsall said he believed briefings of European Union clinics across Germany and Britain on the new implant were on the agenda.

"We understand that Cochlear is now rolling out the product this month, via multi-centre trials which allow key centres to 'champion' the product," Mr Goodsall said.

The analyst said he expected United States Food and Drug Administration approval for the implant in coming weeks, which auger well for a September quarter 2009 US launch. UBS is tipping EU approval for a December 2009 quarter launch.

More here:

http://business.smh.com.au/business/superthin-hearing-aid-gets-good-reception-from-cochlear-investors-20090705-d999.html

This is good news for one of Australia’s premier high-technology health related companies.

Seventh we have:

Funds wrangle hits NBN rollout

Mitchell Bingemann | July 07, 2009

THE spearhead of the federal government's $43 billion national broadband project appears to have been blunted as the likelihood of construction starting in Tasmania this month slips away while government costing negotiations drag on.

When the government announced on April 7 it would scrap the original national broadband network tender and replace it with a state-owned enterprise that would construct a fibre-to-the-home network, Tasmanian residents were tipped to be the first to get a taste of the new super-fast network.

At the time, federal Communications Minister Stephen Conroy said negotiations had begun between the federal and Tasmanian governments and a construction timeline would soon be finalised.

Although negotiations were expected to be finalised in the months after the April announcement, the government said construction of the network would begin this month through the state government-owned power utility, Aurora Energy.

More here:

http://www.australianit.news.com.au/story/0,24897,25742272-15306,00.html

It seems that already the NBN program is already hitting slowdowns which are to be expected and are virtually inevitably going to get worse.

Eighth we have:

http://news.theage.com.au/breaking-news-national/nsw-seeks-laws-to-stop-wave-of-id-frauds-20090711-dgdg.html

NSW seeks laws to stop wave of ID frauds

July 11, 2009 - 9:24AM

Tough new laws aimed at clamping down on identity fraud are being drafted by the NSW government.

Almost half a million Australians lost a combined $997 million to identity fraud in the last year, according to the Australian Bureau of Statistics (ABS).

The ABS attributed the crime wave to the rapid expansion of internet technology, and electronic data sharing and storage.

NSW Attorney-General John Hatzistergos said proposed new laws would make it an offence to trade any information that identifies a person, such as their name or address, driving licence, PIN or password, for the purpose of committing a secondary offence.

Much more here:

http://news.theage.com.au/breaking-news-national/nsw-seeks-laws-to-stop-wave-of-id-frauds-20090711-dgdg.html

This is definitely good news for the citizens of NSW. We need to be sure systems like the IHI do not cause any issue in this domain.

Lastly the slightly more technical article for the week:

Google plans Chrome-based Web operating system

by Stephen Shankland

That Google operating system rumor is coming true--and it's based on Google's browser, Chrome.

The company announced Google Chrome OS on its blog Tuesday night, saying lower-end PCs called Netbooks from unnamed manufacturers will include it in the second half of 2010. Linux will run under the covers of the open-source project, but the applications will run on the Web itself.

In other words, Google's cloud-computing ambitions just got a lot bigger.

"Google Chrome OS is being created for people who spend most of their time on the Web, and is being designed to power computers ranging from small Netbooks to full-size desktop systems," Sundar Pichai, vice president of product management, and Linus Upson, engineering director, said in the blog post.

The move has widespread implications.

One is that it shows just how serious Google is about making the Web into a foundation not just for static pages but for active applications, notably its own such as Google Docs and Gmail. Another: it opens new competition with Microsoft and, potentially, a new reason for antitrust regulators to pay close attention to Google's moves.

The move also gives new fuel to the Netbook movement for low-cost, network-enabled computers. Those machines today run Windows or Linux. Google Chrome OS provides a new option that hearkens back to the Network Computer era of the 1990s espoused by Sun Microsystems' Scott McNealy and Oracle's Larry Ellison.

Much more here:

http://news.cnet.com/8301-17939_109-10281744-2.html?tag=nl.e703

This is a very interesting development which raises a lot of questions. Some of these are answered here:

http://www.computerworld.com.au/article/310506/faq_google_chrome_os_riddle?eid=-255

FAQ: The Google Chrome OS riddle

Google chrome project raises a ton of questions

John Fontana (Network World) 09 July, 2009 08:06

More next week.

David.