I Think The Scale of Outrage Can only Build. It will Become Political Soon I Reckon!

Last week I reported on the NEHTA Annual Report.

See here for the link and download:

http://aushealthit.blogspot.com/2009/10/nehta-releases-annual-report-for-2008-9.html

Since then we have had the following appear in the OZ!

NEHTA spends $26m on consultants

Karen Dearne | October 29, 2009

THE National E-Health Transition Authority spent $26.2 million - almost half its $65 million budget - on consultants in 2008-09, compared with just $2.3m the previous year.

NEHTA ended the financial year with a deficit of $2.2m, compared with a $2m surplus on taxpayer funding worth $39m in 2007-08, according to its annual report.

Funding for NEHTA is provided by the federal and state governments under a 50:50 share agreement; the jurisdictions jointly own the not-for-profit organisation and are represented on the board through their respective health department heads.

NEHTA is tasked with developing better ways of "electronically collecting and securely exchanging personal health information", including the delivery of cornerstone projects such as clinical terminologies, healthcare identifiers and secure messaging capabilities.

This year, the new independent chair, David Gonski, was joined by an independent adviser to the board, Lynda O'Grady, in February.

Ms O'Grady is managing director of strategic and operations consultancy Advanced Management Services, and is understood to have held positions with Telstra, PBL and Alcatel.

NEHTA's other large expense was employee and contractor remuneration at $30.2m, up from $27m.

Employee salaries were $21m, while contractor costs were $9.2m; at June 30, there were 190 full-time staff, including contractors.

More background here:

http://www.australianit.news.com.au/story/0,24897,26275833-15306,00.html

There are two major issues that have been running around in my mind about this report over the weekend.

First is the total lack or public accountability regarding the fate of $26.2M of public money. All of NEHTA’s directors have to report to the public on consultancies over about $100,000 in their annual reports. They usually say how much, what the engagement was about and who undertook the work.

So just exactly why does not NEHTA’s Annual Report provide the same detail do you suppose?

The stream of e-mail I have had about this has been pretty excited and deeply angry – and I know a range of politicians are already being asked to either explain this lapse or to ask questions in the big house on the hill in Canberra.

Regular readers of my blog will have noticed the amazing stories coming out of e-Health Ontario where there have been some major tendering irregularities. For those who came in late here is a good link:

Examining eHealth Ontario

Key players in the agency's contract and spending scandal

Last Updated: Wednesday, July 22, 2009 | 10:16 PM ET

CBC News

EHealth Ontario became embroiled in a scandal focusing on more than $5 million in untendered contracts. (CBC)

The revolving door at eHealth Ontario has been spinning quickly since the provincial agency was first fashioned out of the rubble of its failed predecessor.

Premier Dalton McGuinty proclaimed the agency's creation last September and put Dr. Alan Hudson and Sarah Kramer at its helm, in hopes the two health-care problem solvers could turn the organization around.

But seven months later, Kramer became the first to take the fall for a mounting scandal focused on more than $5 million worth of untendered contracts, conflicts of interest and anger over high-price consultants nickel-and-diming taxpayers.

The agency's goals were lofty: create an electronic health record system by 2015, cut emergency wait times and increase patient safety.

Here's a rundown of the predecessor organization, key players and the companies who received untendered contracts.

All the details here:

http://www.cbc.ca/canada/story/2009/07/22/f-ehealth-players-0722.html

As I thought about it I asked myself just when was the last time I saw a NEHTA tender for services or any evidence of proper competitive practice. Sadly I couldn’t remember. Oh dear, and the e-Health Ontario CEO has now gone and ministers are looking shaky. The parallels are amazing.

I am also told the Canadian Federal Auditor General is about to report on Health Infoway – a NEHTA like agency for the whole of Canada. That may make for very interesting reading as well!

Second I was thinking about this new ‘Independent Board Adviser’.

Here is some background:

http://www.pftc.com.au/pftc/about/content.asp?pageid=16&top=&menuparent=6

Lynda O'Grady - Lynda O'Grady is Managing Director of Advanced Management Services, strategic & operations consultants to a diverse range of organisations across a number of industry sectors including ICT, biomedical, manufacturing, retailing, waste and green energy. Lynda has held senior executive roles in Telstra Corporation, PBL and Alcatel. She is a member of the council of National Science & Technology Centre and Advisor to the Board of NEHTA (National Electronic Health Transition Authority).

As Advanced Management Services lacks a web site there is not much more out there!

Just what exactly has Ms O’Grady been hired for? As far as I can tell we are not to know. She is essentially unknown to the Australian e-Health community and does not appear to bring any specific expertise in that area, which was the intent of the Boston Consulting Group recommendation of 2 years ago to expand the NEHTA Board with some independent domain expertise. I am not sure previous involvement with Questacon is quite what we need!

Maybe, as a strategic consultant, she could explain to the Board the scale of public outrage they have triggered by their obfuscatory and totally unsatisfactory Annual Report. The public are only going to be taken for mugs for so long.

The risk of NEHTA blowing up like e-Health Ontario must be rising.

David.

NEHTA Invent a Paper Based Electronic Prescribing System.

Just a quick heads up that NEHTA have released their first attempt at ETP (Electronic Transfer of Prescriptions) documentation.

These can be found here:

http://www.nehta.gov.au/e-communications-in-practice/emedication-management

The key document is the Concept of Operations document. Amazingly it seems to assume just paper and no electronic transfer for now! They are also assuming there will be multiple providers of prescription repositories as best I can tell!

Comments due by 10 December 2009 – So get reading.

Read and be amused.

I may comment in detail next week as there are some great lines to be quoted.

David.

This is an Issue We Are Going to Hear Much More About.

The following was posted a day a few days ago.

Senator Grassley: You’re on Track About EMR Problems, But Here Are Some More Questions to Ask

Posted by Vince Kuraitis on October 25, 2009

Filed in EHRs/PHRs, Health Policy/Reform, Information & Communication Technologies (ICT) · Comments

An article in today’s Washington Post links to a letter written by Senator Charles E. Grassley.

The letter is directed at 10 EMR (electronic medical record) vendors, and asks very pointed questions about whether the vendors have been negligent in not addressing patient safety issues in their technologies.

Senator Grassley, you have the scent and you’re on the trail. There are several other questions you should be asking these vendors:

• Prior to the HITECH Act, why did EMR vendors promote and government policy tolerate non-interoperable EMRs? Health care isn’t like computer operating systems — where competing, non-interoperable tech is fine. Lives are at stake.

More points here:

http://e-caremanagement.com/senator-grassley-youre-on-track-about-emr-problems-but-here-are-some-more-questions-to-ask/

I am planning to do some more work over the next few weeks on this.

Comments are more than welcome.

David.

Weekly Overseas Health IT Links 26-10-2009

What I have spotted this week.

http://huffpostfund.org/stories/2009/10/fuzzy-math-rising-costs-governments-digital-health-stimulus

Fuzzy Math? Rising Costs in Government's Digital Health Stimulus

Spending Could Be Double The Obama Administration's Public Estimate of $19 Billion

By Fred Schulte
Huffington Post Investigative Fund

1:01 pm | 15 Oct 2009

Creating digital medical records for every American within the next five years – a key provision of President Obama’s stimulus package -- could cost more than twice the $19.5 billion figure that has been cited by federal officials.

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http://ehealtheurope.net/news/5311/private_medical_records_offered_for_sale

Private medical records offered for sale

20 Oct 2009

Medical records of patients treated at a private British hospital, The London Clinic, have been illegally sold to undercover investigators.

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http://www.technologyreview.com/biomedicine/23777/?nlid=2446

Wednesday, October 21, 2009

Massive Gene Database Planned in California

The data will be compared against electronic health records and patients' personal information.

By David Talbot

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http://www.kfsm.com/sns-ap-ks--e-healthrecords-planning,0,200292.story

Kansas to begin work on statewide system for electronic sharing of patient records

By Associated Press

4:01 AM CDT, October 22, 2009

TOPEKA, Kan. (AP) — The Kansas Department of Health and Environment has applied for $9 million in federal grants to encourage physicians to switch patient records to computers.

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http://www.modernhealthcare.com/article/20091023/REG/310239993

HIT sector outperforms others in third quarter: report

By Jean DerGurahian / HITS staff writer

Posted: October 23, 2009 - 11:00 am EDT

The health information technology sector continued to improve in the third quarter, but the market is still waiting to see when federal funding will have an impact on profitability, analysts say.

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http://www.modernhealthcare.com/article/20091023/REG/310239992

IT programs can help improve outcomes: AHRQ

By Jean DerGurahian / HITS staff writer

Posted: October 23, 2009 - 11:00 am EDT

Health information applications can help engage patients in their care and improve outcomes, according to research released by the Agency for Healthcare Research and Quality.

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http://health-care-it.advanceweb.com/Editorial/Content/Editorial.aspx?CC=208737

CIOs: CPOE Provision Won't be Easy to Achieve

Implementing order systems involves significant work if benefits are to be achieved, CIOs say.

By Fred Bazzoli

The use of computerized provider order entry (CPOE) is growing among U.S. health care organizations, according to results from a recent survey of members of the College of Healthcare Information Management Executives (CHIME).

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http://health-care-it.advanceweb.com/editorial/content/editorial.aspx?cc=208739

Getting Connected

Health information exchange links physician EMR systems with hospital labs.

By Charles Halfpenny

Integration of clinical systems has always been challenging. As the number of physician practices deploying electronic medical record (EMR) systems increases, so does the demand for electronically exchanging orders and results between the hospital system and the practice EMR. Without an interface, practices must manually enter results into the EMR, which is both labor-intensive and error-prone.

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http://govhealthit.com/newsitem.aspx?nid=72238

Standards panel explores patient access to EHRs

By Mary Mosquera

Thursday, October 22, 2009

A federal advisory panel has begun to explore how patients might access health information from their physicians and what data should be included in their personal health record. To probe the issue, participants in an Oct. 14 Health IT Standards Committee meeting examined the experience of providers who already share clinical information with their patients.

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http://www.healthcareitnews.com/news/physicians-have-doubled-their-time-online-2004

Physicians have doubled their time online since 2004

October 22, 2009 | Bernie Monegain, Editor

BOSTON – The head of a New York-based healthcare market research firm says physicians who might have spent four hours a week online in 2004 are now spending at least eight hours in front of a computer.

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Web 2.0 Summit: Fed CTO Talks Healthcare IT

Federal CTO Aneesh Chopra says government spending on IT can help cut healthcare costs and improve care quality.

By J. Nicholas Hoover, InformationWeek

Oct. 22, 2009

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=220900162

The federal government can use IT to help lower the cost and improve the quality of healthcare in the United States, federal CTO Aneesh Chopra said Wednesday.

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http://www.ihealthbeat.org/perspectives/2009/health-2-0-real-hope-beneath-the-hype.aspx

Friday, October 23, 2009

Health 2.0: Beneath the Hype, There's Cause for Real Hope

by Michael L. Millenson

Health 2.0 is a trend accompanied by both buzz and buzzwords. That worries some advocates for the poor, underserved and just plain old and sick. Will those groups be left behind in the latest information revolution?

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http://www.e-health-insider.com/Features/item.cfm?&docId=314

E-prescribing

It’s almost a decade since the Audit Commission called for e-prescribing in secondary care. Progress has been slow, but that may be about to change. Daloni Carlisle reports.

There are some people who don’t follow fashion, at least not in the conventional sense. Steve Reggione, senior project manager for e-prescribing software specialist JAC is one of them.

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http://www.edmontonjournal.com/health/Clinic+medical+files+vanish/2127101/story.html

Clinic's medical files vanish

Privacy commission launches probe

By Ryan Cormier, Edmonton Journal

October 21, 2009

The Information and Privacy Commissioner is raising a red flag for doctors after a Fairview clinic lost two years worth of electronic patient records.

----

http://www.fierceemr.com/story/it-pros-say-emr-breaches-are-all-too-common-doubt-organizational-commitment-security/2009-10-2?utm_medium=nl&utm_source=internal

Four out of five healthcare IT pros had at least one data breach last year

October 22, 2009 — 12:28pm ET | By Neil Versel

Even IT professionals in hospitals are concerned that their organizations aren't doing enough to safeguard electronic patient information, according to a newly released survey. The Traverse City, Mich.-based Ponemon Institute, with the support of security management firm LogLogic, reports that 61 percent of health IT practitioners doubt that their organizations have the resources to meet privacy and security requirements, while 70 percent say senior management isn't making data protection a priority.

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http://www.fierceemr.com/story/wealth-information-online-could-threaten-privacy-de-identified-emrs/2009-10-22?utm_medium=nl&utm_source=internal

Wealth of information online could threaten privacy of de-identified EMRs

October 22, 2009 — 10:01am ET | By Neil Versel

Back in 1997, it took an MIT statistician to find ways to re-identify electronic patient data that had been stripped of identifiers--using then-Massachusetts Gov. William Weld as the unsuspecting guinea pig to make a point about privacy. Nowadays, there's so much personal information widely available on the Internet that the task has become much easier, the New York Times reports.

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http://www.thescugogstandard.ca/news/2009/october-09/oct22-09/eHealth_inquiry-156.html

STAYING IN TOUCH

eHealth inquiry is required

By John O'Toole/The Scugog Standard

Ontario’s eHealth scandal has grown to the point where only a public inquiry can do justice to the concerns raised by opposition MPPs and indeed by virtually all taxpayers.

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http://www.itworldcanada.com/blogs/insights/2009/10/22/the-other-side-of-the-ehealth-story/52193/

The other side of the eHealth story

Posted Oct 22 2009, 11:07 AM by Dave Webb

Amid the flood of coverage of Auditor General Jim McCarter'sreport on out-of-control spending at eHealth Ontario -- much of it of increasingly hysterical tenor -- I received an e-mail from Aaron Blair. Blair's a former employee of Smart Systems for Health Agency, eHealth Ontario's predecessor in the initiative to bring Ontario's health-care community online, and he's troubled by the suggestion that Ontario taxpayers have nothing to show for the seven years and $1 billion invested in the effort.

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http://www.modernhealthcare.com/article/20091021/REG/310219987

Growth in teleradiology market appears to lag

By Shawn Rhea / HITS staff writer

Posted: October 21, 2009 - 11:00 am EDT

Expansion of the teleradiology market appears to be slowing, according to a study to be published in the November issue of the American Journal of Roentgenology.

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http://fcw.com/articles/2009/10/26/cdc-side-murky-crystal-ball.aspx

A murky crystal ball?

Critics say too many systems are collecting data on disease outbreaks with little coordination among them

• Oct 21, 2009

About 300 systems at federal, state and local agencies monitor disease outbreaks and chemical exposure. Some critics say that multiplicity is a problem.

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http://www.healthdatamanagement.com/news/acquisitions-39225-1.html?ET=healthdatamanagement:e1054:100325a:&st=email

Report: Acquisition Activity Down

HDM Breaking News, October 20, 2009

Health care information technology company stock prices have risen significantly during 2009 but acquisition activity has yet to catch up, according to a quarterly summary of vendor activity by Healthcare Growth Partners LLC, a Chicago-based strategic and financial advisory firm.

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Why Your Next IT Job Will Be In Healthcare

Federal stimulus billions are fueling demand for up to 50,000 new information technology positions. Most sought after are tech pros with real-world implementation experience, Windows experts, and network admins.

By Marianne Kolbasuk McGee, InformationWeek

Oct. 20, 2009

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=220700404

Hospitals and medical practices are scrambling to deploy e-medical record and other clinical information systems to meet federal requirements for the more than $20 billion in stimulus incentives included in the American Recovery and Reinvestment Act. And that means many of them are expanding their IT teams to bring in the skills and expertise they need to implement these systems.

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http://www.ihealthbeat.org/Features/2009/Comparative-Effectiveness-Research-About-To-Hit-Prime-Time.aspx

Wednesday, October 21, 2009

Comparative Effectiveness Research About To Hit Prime Time

by George Lauer, iHealthBeat Features Editor

An obscure acronym edged a little closer to the mainstream earlier this year as part of the federal stimulus debate. Now, with Congress about to dive into health reform legislation in a big way, CER may move firmly into the cultural crosshairs.

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http://www.healthdatamanagement.com/news/e-prescribing-39218-1.html?ET=healthdatamanagement:e1051:100325a:&st=email

Vermont Docs to Get Free E-Prescribing

HDM Breaking News, October 19, 2009

A $1 million federal grant to Vermont Information Technology Leaders Inc. will enable physicians in the state to access free electronic prescribing software.

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http://www.healthleadersmedia.com/content/240774/topic/WS_HLM2_TEC/Five-Lessons-on-How-to-Get-Physicians-to-Adopt-CPOE.html

Five Lessons on How to Get Physicians to Adopt CPOE

Carrie Vaughan, for HealthLeaders Media, October 20, 2009

I often read or hear about "physician buy-in"—as I'm sure most of you do too—as the key component to successfully implementing many IT projects, including computerized physician order entry. While I agree that physicians need to join the effort for CPOE to be successful, I also think there is a lot more behind the successful implementations—like dogged persistence.

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http://www.technologyreview.com/computing/23545/?nlid=2443

Prescription: Networking

A new urban network suggests how technology could remake health care.

By David Talbot

A crow flying from Vera Sinue's apartment in Boston's Roxbury neighborhood to her job as an insurance representative near the Charles River in Brighton would skirt the edge of the Longwood Medical Area, a district of medical institutions including Brigham and Women's Hospital, Beth Israel Deaconess Medical Center, Children's Hospital, the Dana-Farber Cancer Institute, and Harvard Medical School. These institutions are among the nation's most respected. They supplied some of the experts now leading the Obama administration's effort to reform the nation's health-care system.

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http://wolandscat.net/2009/10/18/the-crisis-in-e-health-standards-iii-solutions/#more-65

The crisis in e-health standards III – solutions

Stakeholder Aspirations and Needs

Before going so far as to offer a solution to the e-health standards problem, I want to have a look at what we consider to be the requirements that such standards, and indeed health informatics in general is meant to address.

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http://www.nytimes.com/2009/10/18/business/18stream.html?_r=1

October 18, 2009

Slipstream

When 2+2 Equals a Privacy Question

By NATASHA SINGER

TIME to revisit the always compelling — and often disconcerting — debate over digital privacy. So, what might your movie picks and your medical records have in common?

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Enjoy!

David.

NEHTA Releases an Annual Report for 2008-9. What Fun!

Oh dear. Spin Central from NEHTA rolls on.

Here is page 5 of the report. You find the spin (Italics are a clue)!

Introduction to e-health

E-health is the electronic collection, management, use, storage and sharing of healthcare information. This information can include individual items such as test results, discharge summaries, vaccination history, medication history and diagnoses, to comprehensive medical records which keep all of this information about a person in one place.

The governments of Australia recognise that e-health and an Individual Electronic Health Record (IEHR) are vital to the achievement of major health reform in the next decade.

E-health systems that can securely and efficiently exchange data can significantly improve how important clinical and administrative information is communicated between healthcare professionals.

As a result, e-health systems have the potential to unlock substantially greater quality, safety and efficiency benefits.

E-health has the capacity to benefit all Australians – individual consumers, healthcare providers and healthcare funders.

The National E-Health Transition Authority Limited (NEHTA) is a company established by the Australian, State and Territory governments in 2005 to develop better ways of electronically collecting and securely exchanging health information.

As a collaborative vehicle, NEHTA has been assigned responsibility for a number of related projects aimed at establishing the foundations for the widespread and rapid adoption of electronic health (e-health).

----- End Extract.

Has anyone noticed Australian Government commitment to this. Given the Health Department Secretary’s most recent comment I do not think so.

The most amazing figures are here:

Employee benefits expense and contractors

2008/9 $30,212,229 – Last Year $27,041,497

Consultants

2008/9 $26,148,157 – Last Year $2,293,259

The consultant budget rose by 1000% in a time of un-employment – why not just employ the people? What a money trough for those involved!

Why no detailed explanation of this amazing rise?

Read the full report here:

http://www.nehta.gov.au/component/docman/doc_download/857-nehta-annual-report-2008-2009

David.

Promised Response to Some Anonymous Questions.

This was left as a comment a few days ago:

Anonymous has left a new comment on your post "I Guess This is a Good Time to Stop All This, and Say Goodbye and Good Luck!”:

Thank you David.

Your closing remarks on the following issues would be interesting.

Firstly, how would the accurate and secure transmission of health information between general practice and other providers be achieved when the GP/primary care provider does not receive the end benefit, does not want bear the cost of the capability and the funder of those health providers does not want to fund the capability?

Secondly, how would state (eastern seaboard?) clinical system implementations move to more integrated health records when the two major suppliers have no interest in integration (particularly for medications), such changes are capital funded and severely constrained (eg. http://www.treasury.nsw.gov.au/__data/assets/pdf_file/0005/10778/tpp06-10.pdf, with 250k limits), Treasury's are not inclined to fund IT integration over tunnels and rail, the GITC framework is too constrictive, the needs of Australia must compete with international demands that pay more and re-tendering and system replacement is not an option?

Thirdly, integrated health records require the co-operation of all health sectors, yet in the public sector, (presumably) most of the decision makers have performance contracts that focus on tertiary care and the priorities within. Therefore, state investment in cross-setting IT initiatives is not a priority, nor a KPI.

No, you are right. it's easy and everyone involved is incompetent.

-----

Q1 Response:

My consistent view on this has always been is that those who are benefiting should pay the costs for a service. In each case it is then a matter of working out who are the winners and losers across each information flow and making sure there is an equitable and reasonable flow of funds in the appropriate direction.

In some situations there will also be intermediaries, such as messaging providers, and they need fair cost recovery and a reasonable profit for their services – ideally in a competitive market.

It has been clear for a long time that clinicians are frequently not beneficiaries while payers (Government and Health Funds) are. Sorting this out is vital to achieve Health IT adoption.

This is an area where appropriate national governance could make a real difference as an impartial arbitrator of who pays for what.

Q2 Response:

I believe that within organisations (e.g. an area health service, hospital or region) it is an internal issue to get internal system integration in place. Where information needs to flow across the boundaries (e.g. Hospital to GP via say a discharge summary) we need pragmatic workable standards in place to facilitate this. This is a job that NEHTA and IT-14 should do and then some funds be made available nationally to have all legacy providers comply with import / export requirements and all new procurements ensure standards are part of the mandatory requirements for future purchases. This will take time due to the long time there has been no real e-Health governance (again).

Q3 Response:

This is really a pure governance and leadership issue –as identified in the Deloittes Strategy. The failure to look at and plan for a whole health system properly is a key NEHTA failing in my view – but what do you expect when you have a board that predominantly only represents State health systems and not the rest of the sector.

It is not easy to solve issues like this. Needs leadership, working national governance structures and some funds. At present we have zero out of three!

David.

Weekly Australian Health IT Links - 25-10-2009

What I have spotted this week.

http://www.medicalobserver.com.au/News/0,1734,5498,23200910.aspx

Plan for accreditation to rely on e-health

Elizabeth McIntosh - Friday, 23 October 2009

THE Federal Government is considering a proposal to make e-health capabilities a requirement of practice accreditation, which would leave GPs little choice in whether to sign up to the national e-health agenda.

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http://www.theaustralian.news.com.au/story/0,25197,26252646-23289,00.html

Costly data-exchanging IT system fails to connect with doctors

Adam Cresswell, Health editor | October 24, 2009

Article from: The Australian

A FEDERAL scheme to provide thousands of GPs with communications encryption technology so they can send sensitive health information securely over the internet risks turning into an expensive white elephant because hardly any other health workers can decode the messages.

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http://www.theage.com.au/national/impotence-fears-over-robotic-surgery-20091023-hdfo.html

Impotence fears over robotic surgery

NICK MILLER

October 24, 2009

NEW evidence suggests that robotic prostate cancer surgery, far from being the saviour of men, is leaving them with more incontinence and impotence than traditional techniques.

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http://www.computerworld.com.au/article/323434/nhmrc_it_systems_up_scratch_anao?eid=-255

NHMRC IT systems not up to scratch: ANAO

Auditor finds NHMRC's systems not adequate for reporting on the awarding of grants

Trevor Clarke 23 October, 2009 07:52

The National Health and Medical Research Council's (NHMRC) IT systems do not adequately support its core focus of granting millions of dollars in research funds, according to the Australian National Audit Office (ANAO).

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http://tc106.metawerx.com.au/Rustreport/rust_newsletter_story.jsp?id=1882

iSoft signs up BI alliance

Australian healthcare systems developer iSoft has entered an agreement with US company Rocket Software (www.rocketsoftware.com) that will enable it to include business intelligence and strategic management applications in its products.

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http://www.6minutes.com.au/articles/z1/view.asp?id=502572

Private specialists shun e-health

by Michael Woodhead

Specialist physicians are e-health luddites, with as few as one in ten using computers in their private practice, a new survey suggests.

And comment

http://www.6minutes.com.au/articles/z1/view.asp?id=503165

Private specialists shun e-health

...read original article

First, it is unwise to generalise as the 27% of specialists who have actually invested in IT often have very elaborate IT setups. Second, apart from the HealthConnect program in SA there has never been an incentive program directed at specialists (or allied health providers for that matter), whereas GPs have benefited from multiple targeted incentive programs over the years.

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http://www.6minutes.com.au/articles/z1/view.asp?id=502244

NEHTA misquoted

...read original article

Is it not surprising to anyone that the public are less than enthusiastic about e-health when the so called experts can’t agree amongst themselves about what is or isn't an electronic health record. Someone or something needs to show leadership if this is ever going to get off the ground.

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http://www.6minutes.com.au/articles/z1/view.asp?id=502747

College gets cosy with chemists

by Jared Reed

The RACGP has formed a strategic alliance with the Pharmaceutical Society of Australia, in a bid to get more clout on e-health issues such as electronic prescribing.

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http://www.smh.com.au/technology/security/unbreakable-windows-7-may-lock-out-the-law-20091021-h8z9.html

'Unbreakable' Windows 7 may lock out the law

MARISSA CALLIGEROS AND SCOTT CASEY

October 22, 2009 - 9:38AM

Queensland police fear criminals will use high-tech encryption software on Microsoft's new Windows 7 to bury pornographic images and files deep within computer networks.

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http://www.australianit.news.com.au/story/0,24897,26232296-15306,00.html

Privacy changes put data at mercy of scams

Karen Dearne | October 20, 2009

BUSINESSES will be able to send customer information to "dangerous" countries such as Russia and Nigeria under proposals to update the federal Privacy Act for the digital age.

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Enjoy!

David.

Looks Like Any Major e-Health Investment in Australia is Off the Table.

The following great summary of the e-Health Section of Senate Estimates Hearings from last week appeared this morning. What we learn certainly requires being highlighted!

NEHTA on target, says Health secretary

Karen Dearne | October 26, 2009

THE nation's top health bureaucrat Jane Halton has ruled out major investment from government in e-health systems "to have everything happen instantly".

Pressure has been growing within the e-health community as a growing pile of reports warn of the cost of inaction, following the Council of Australian Government’s acceptance of a National E-Health Strategy last December.

The strategy put the cost of establishing a nationwide electronic health record system at around $1.6 billion over four years.

Queensland Liberal Senator Sue Boyce was seeking information on progress of various National e-Health Transition Authority outcomes previously promised for delivery by December this year, including specifications for secure messaging, clinical terminologies, electronic referrals and e-prescribing.

Earlier this month, NEHTA released its own strategic plan, positioning itself as an implementation agency as adoption of e-health accelerates.

"The e-health community is feeling a little irritated by what they see as a lack of progress in this area," Senator Boyce said. "The view has been put to me that NEHTA was established in 2004 and their budget has been more than $200 million."

Responding to questions at an estimates hearing this week, the federal Health Department secretary said the bottom line was that "we are trying to build a national system that will enable private investment and private engagement".

Ms Halton said all of the work on NEHTA's delivery schedule was on target "and is as good as you will get around the globe. Genuinely I think that. Okay, they might want several billion dollars more. That is fine as an ambition. But in terms of taking relevant, logical, ordered steps towards this e-world, I think actually we are not doing too badly".

Ms Halton said NEHTA's job was to ensure that there were not six or eight railway gauges in this country in respect of e-health.

"None of us wants a world where what we have stored in terms of our medical records is controlled by a proprietary product in a doctor's surgery or something else," she said. "We want interoperability and the ability to say, 'Are you Senator Boyce?' such that no-one can steal your identity or misconnect a record about you.

"This is not just about security, and security is absolutely fundamental. It is also about ensuring that there are not islands of information over here that somebody owns and islands over here that somebody owns, and any notion of basically connecting those two up - which would be in your interests medically - is either controlled and charged for privately by somebody or is just not able to happen."

Lots more here:

http://www.australianit.news.com.au/story/0,24897,26259868-15306,00.html

This is a must read summary. For the full transcript of the hearing my earlier post provides a direct link.

See here:

http://aushealthit.blogspot.com/2009/10/spin-alert.html

All one can now think is that we have the situation where NEHTA is building one of those ‘highways to nowhere’ so beloved of the US and Japanese porkbarrelers.

Looks like the target NEHTA was aiming for has just been taken down and carted away!

If there is no plan to invest in the systems that will use what NEHTA is building in the relatively near-term future then why bother? There is a real risk it will all be an outdated white elephant by the time anyone get round to adoption at this rate!

It is good Ms Halton thinks we are doing ‘not too badly’. She is actually ‘not doing too badly’ at doing essentially nothing and attempting to pass it off as activity.

We are hardly likely to see much investment from the private sector with this being what Government is planning, so I think her strategy to attract funds is doomed from the start!

Just hopeless!

David.

Postscript:

There is more commentary that I have just found here:

NEHTA unsure of own success

By Suzanne Tindal, ZDNet.com.au

26 October 2009 12:34 PM

The National E-health Transition Authority (NEHTA) was unable to measure how many organisations were using the products it was creating, according to a secretary for the Department of Health and Aging.

Much, much more here:

http://www.zdnet.com.au/news/software/soa/NEHTA-unsure-of-own-success/0,130061733,339299215,00.htm?omnRef=1337

I find what Ms Halton said here just plainly offensive. To quote:

“When Boyce raised community concerns that e-health was not progressing, Halton said that people needed to "calm down a bit about this".”

She clearly does not care about the lives e-Health, when implemented, can save.

D.