Submissions Regarding The Sneak Exposure Draft of the HI Services Bill (2010).

Dr Juanita Fernando has kindly posted a listing of the current public submissions for the request for public comment conducted while DoHA employees holidayed over Christmas.

Publicly available submissions addressing the Draft HI Bill are listed here. These and others will eventually be available from the Department of Health website.

If you'd like to add your submission to those listed below, please email us and we'll post your link accordingly.

• Australian Dental Association
• Australian Privacy Foundation (APF)
• Australian Private Hospitals Association (APHA)
• Australiasian College of Health Informatics (ACHI)
• Council of Social Service of NSW (NCOSS)
• Civil Liberties Australia (CLA)
• Consumer Health Forum Australia (CHF)
• Law Council of Australia (LCA)
• Victorian Council for Civil Liberties (VCCL)

As new entries may be added – it might be worth checking back here every few days.

http://www.consumerehealth.org/hi_bill_subs_14.html

This is a very useful thing to have done and I am sure she would be happy if I publicised her work.

The submissions confirm the view that there are a lot of unaddressed issues and that without prior publication of the regulations associated with the legislation the consultation is a total farce.

David.

Weekly Overseas Health IT Links 13-01-2010

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article.

-----

http://fcw.com/articles/2010/01/04/hhs-electronic-health-records-ehr-final-rule.aspx

Proposed rules set stage for e-health records incentives

Proposed rules address stimulus law payments, meaningful use and certification

• By Alice Lipowicz
• Jan 04, 2010

Physicians will have to submit 80 percent of their clinical orders electronically, while hospitals will have to do so for 10 percent of their orders, under expansive new proposed regulations released by the Health and Human Services Department for meaningful use of electronic health records (EHRs).

The Centers for Medicare and Medicare Services (CMS) released a 556-page proposed rule on Dec. 30 about the definition of “meaningful use” and how eligible professionals and hospitals may qualify for incentive payments as meaningful users under the American Reinvestment and Recovery Act (ARRA) of 2009. The Recovery Act allocates at least $17 billion for such payments by doctors and hospitals that buy and meaningfully use certified EHR systems.

-----

http://www.healthleadersmedia.com/content/TEC-244313/Marathon-of-Meaningful-Use-EHR-Standards-Just-Beginning.html

Marathon of Meaningful Use, EHR Standards Just Beginning

Dom Nicastro and Janice Simmons, December 31, 2009

With the release yesterday of its "meaningful use" definition and standards, government agencies have laid the foundation for an "evolutionary process in achieving and maintaining the meaningful use of certified EHR technology," says Frank Ruelas, director of compliance and risk management at Maryvale Hospital and principal, HIPAA Boot Camp, in Casa Grande, AZ.

CMS and the Office of the National Coordinator for Health Improvement Technology (ONC) on Wednesday, December 30, released two anxiously-awaited regulations providing both the definition of "meaningful use" for electronic health records (EHRs) and the standards to improve the efficiency of health information technology used nationwide by hospitals and physicians.

-----

http://www.europolitics.info/social/organs-health-inequalities-consumer-head-spanish-priorities-art258933-26.html

Health and consumers

Organs, health inequalities & consumer head Spanish priorities

By Marianne Slegers | Monday 04 January 2010

The Spanish EU Presidency has set out three main priorities for public health. Health inequalities, human organs and chronic diseases are high on its agenda. On the first priority, Spain will organise an expert conference in April ahead of the informal Health Council on 22-23 April. According to sources, the “main challenge” is to agree on “better indicators” and improved health information systems across the European Union to make it easier to identify inequalities in the first place.

-----

Spain’s third priority in this area is to provide a policy framework to tackle the looming EU wide problem of chronic diseases. The Presidency will organise two expert conferences on this issue: one will focus on e-health and the other on patient safety related to infectious, cardiovascular and chronic mental health diseases, such as Alzheimer’s, which will become common as a result of the EU’s ageing population.

-----

http://www.ihealthbeat.org/perspectives/2010/innovation-inspired-by-economics-2010-health-it-forecast.aspx

Monday, January 04, 2010

Innovation Inspired by Economics: 2010 Health IT Forecast

by Jane Sarasohn-Kahn

Health IT is one of the fastest-growing business sectors, expected to grow by 11% annually through 2013, according to Scientia Advisors. That's a bullish expectation, especially in the context of continued financial challenges for U.S. health providers.

Health IT purchases will be made despite fiscal constraints such as reimbursement pressure, inflationary costs for labor, supplies and other operating expenses, as well as high patient bad debt expenses.

Necessity being the mother of invention, a constrained economic environment will lead to health IT innovations in two ways.

-----

http://www.ehealtheurope.net/news/5511/tech_vital_to_medication_adherence

Tech vital to medication adherence

04 Jan 2010

Information technology has a vital role to lay in cutting medication-related errors and improving medication adherence among older people, suggests a recent report.

The report says that of the 3 billion medication prescriptions issued each year in the US, 12% are never picked up by the patient and 40% are not taken correctly.

Published by the US Centre for Technology and Aging in Oakland, California, the report says "widespread use" of technology aimed at older people has the potential to save thousands of lives and billions of dollars.

-----

http://www.healthcareitnews.com/news/study-says-telemedicine-doesnt-improve-icu-outcomes

Study says telemedicine doesn't improve ICU outcomes

December 30, 2009 | Molly Merrill, Associate Editor

CHICAGO – The use of telemedicine in intensive care units does not improve patients' risk of death or length of stay, according to a recent study.

The study, published in the December issue of the Journal of the American Medical Association, assessed the effect of a tele-ICU intervention on mortality, complications and length of stay in six ICUs of five hospitals in a large U.S. healthcare system. It was led by Eric J. Thomas, MD, of the University of Texas Health Science Center at Houston and colleagues, who measured outcomes before and after implementation of the tele-ICU system.

"Remote monitoring may be a partial solution for the intensivist shortage, but it is expensive, its use is increasing and there are few data in the peer-reviewed literature evaluating its effect on morbidity and mortality," said the authors.

-----

http://www.bostonherald.com/business/healthcare/view.bg?articleid=1221632

At-home technology can monitor seniors for safety

By Associated Press | Monday, December 28, 2009 | http://www.bostonherald.com | Healthcare

At 88, Grif Crawford knows he’s at risk of a fall or other sudden health problem. So he wears a pendant around his neck that can summon help if something goes wrong.

"It’s kind of like life insurance," said Crawford, of Lee Summit, Mo. "I feel very comforted with this."

The device has come a long way since the days when it merely allowed the wearer to alert someone that he or she had fallen and couldn’t get up. Crawford’s equipment also can be programmed to answer his phone, remind him to take his medicine or alert him to a fire, among other things.

It’s one of several new products designed to help seniors stay in their homes rather than move to a nursing home or assisted living facility.

-----

http://www.informationweek.com/blog/main/archives/2010/01/so_what_is_micr.html;jsessionid=I01NAO3HS0DHLQE1GHOSKHWATMY32JVN

So What Are Microsoft's Tablets? Chopped Liver?

Posted by David Berlind, Jan 6, 2010 01:51 PM

Yesterday, on the way home from my interview of Free Software Foundation founder and president Richard Stallman, I listened closely as Slate's Farhad Manjoo told NPR's Neal Conan the facts about Apple's forthcoming tablet PC: that there are no facts. Well, there's one. Apple's brand has gotten so powerful that everyone including the stock market is putting faith in pure vapor as though the tablet mode of Microsoft's Windows 7 doesn't matter. Nary a mention. What gives?

The credit Apple is already getting for reinventing the tablet market is 100 percent lock stock and barrel based on the belief (faith for many) that Apple can do for tablets what it has done for music and smartphones. Although I love Apple (I made the switch to Mac OS X over 2 years ago and have never looked back and own several iPods), I'm unconvinced that a tablet from Apple can achieve the same sort of market success.

-----

http://www.itbusinessedge.com/cm/blogs/bentley/e-health-records-data-privacy-continue-to-be-hot-topics/?cs=38567

E-Health Records, Data Privacy Continue to Be Hot Topics

Posted by Lora Bentley 06-Jan-2010 12:58:12

Monday I noted that posts about online privacy were among my most read of 2009. Posts about the HITECH Act and electronic health records were also at the top of the list.

Interestingly, the seond-most-read governance post of the year touched on both the HITECH Act and privacy issues -- it addressed the data breach notification rule included in the HITECH Act.

To review, the Health Information Technology for Economic and Clinical Health Act was enacted as part of the American Recovery and Rehabilitation Act, which Congress passed shortly after President Obama took office. Along with setting aside nearly $22 billion for health information technology, the act extended the reach of the data privacy and security requirements of the Health Insurance Portability and Accountability Act (HIPAA) to include business associates of health care organizations.

-----

http://www.futuregov.net/articles/2010/jan/07/building-healthy-malaysia/

Building a healthy Malaysia

By Jianggan Li | 7 January 2010

Malaysia’s Ministry of Health has come a long way on its e-health journey, with many success stories as well as lessons learned. Some of the key planners share their stories with Jianggan Li.

Like many of its neighbours, Malaysia has been experiencing changing disease patterns. The era of acute infectious diseases and malnutrition has been succeeded by one of chronic diseases and lifestyle related illnesses. So the country’s healthcare strategy has had to shift from making traditional health and hygiene improvements to promoting healthier lifestyles and managing chronic diseases.

“This calls for change in the role of healthcare professionals and the delivery interface between the consumer and health system,” says Dato’ Dr Jai Mohan, Professor of Health Informatics at Kuala Lumpur-based International Medical University and the Vice President of the Malaysia Health Informatics Association.

-----

http://www.modernhealthcare.com/article/20100105/REG/301059985

Family docs unhappy with EHR support: AAFP

By Andis Robeznieks / HITS staff writer

Posted: January 5, 2010 - 5:59 am ET

Family physicians who use electronic health-record systems employ a wide range of products, have been using them for only a few years, and are generally not that happy with vendor training and support, according to a survey of American Academy of Family Physicians members published in the most recent issue of Family Practice Management, an AAFP journal.

The survey questionnaire was open to the AAFP's 94,600 members and was published in the journal and posted online with 2,556 members responding. Out of those, 544 were excluded for various reasons such as those who responded by saying they don't use an EHR (477), while others named a practice-management program instead of an EHR when asked which system they used.

-----

http://www.healthleadersmedia.com/content/TEC-244439/Nine-Healthcare-Executives-Respond-to-the-Meaningful-Use-Definition.html

Nine Healthcare Executives Respond to the Meaningful Use Definition

Carrie Vaughan, for HealthLeaders Media, January 5, 2010

The long-awaited definition of meaningful use is finally here. Just before the New Year, the Centers for Medicare & Medicaid Services and the Office of the National Coordinator released both the definition of "meaningful use" for electronic health records and the standards to improve the efficiency of health information technology.

Hospital and provider group organizations have already offered their criticism of the proposed regulations. Yesterday, my colleague Janice Simmons offered a good evaluation of the American Hospital Association, Medical Group Management Association, and the American Medical Association concerns.

I was curious what individual providers thought of the definition, so I asked physicians, chief information officers, and other industry leaders whether they thought the meaningful use bar was set too high or low, and what they thought was the most significant change to the HIT Policy Committee's recommendations, if any. Many executives are still delving into the 700+ page document, but here are their initial reactions.

-----

http://www.signonsandiego.com/news/2010/jan/06/a-medical-breakthrough-va-kaiser-to-share-records/

Medical breakthrough: VA, Kaiser to share records

National-level alliance has been elusive goal

By Keith Darcé, UNION-TRIBUNE STAFF WRITER

Wednesday, January 6, 2010 at 12:01 a.m.

Kaiser Permanente and the U.S. Department of Veterans Affairs today will launch an electronic medical-data exchange program in San Diego that could become the seed for the much touted but equally elusive national health records system.

The collaboration, which will be detailed at a news conference in La Jolla, marks the first time a computerized patient-records system operated by a federal agency has been linked to one operated by a private organization.

-----

http://health-care-it.advanceweb.com/editorial/content/editorial.aspx?cc=213238

Buying into BI

Technology helps hospital executives apply business strategies to health care.

By Marianne Slight

As in traditional corporations, health care providers are facing increased pressure to accomplish strategic business goals, such as increasing profitability, reducing costs, improving patient satisfaction and doing more with less. As a result, many hospitals function like business corporations: Management sets high-level objectives; objectives cascade down the organization in the form of targets and budgets; and those targets are turned into tactical operational plans, which evolve and change based on external pressures and internal constraints.

Because the health care industry is now expected to accomplish the same sorts of strategic goals as ordinary businesses, it should come as no surprise that business intelligence (BI) is becoming increasingly utilized by health care organizations to make course corrections, hit targets at all levels of the organization and accomplish strategic objectives.

-----

http://www.e-health-insider.com/news/5519/first_clinical_director_for_informatics

First clinical director for informatics

05 Jan 2010

The Department of Health has announced that it has appointed Charles Gutteridge as the first national clinical director for informatics.

Dr Gutteridge has been the medical director at Barts and the London NHS Trust since 2002, and the DH says he has been closely involved in confidentiality, patient safety and informatics issues.

He was the Caldicott Guardian for Barts, led the Health Foundation’s Safer Patients Initiative from 2006-8, and chaired the Clinical Informatics Design Authority.

-----

http://www.govhealthit.com/newsitem.aspx?nid=72905

Health IT panel gropes for NHIN authentication plan

By Mary Mosquera
Friday, January 08, 2010

To accelerate use of the nationwide health information network (NHIN), a panel of the Health IT Policy committee met yesterday to explore methods to verify the identity of healthcare providers who will use the network to exchange patient data.

Authentication verifies identity and assigns credentials for electronic transactions but there are a variety of approaches to accomplish this basic component of e-health exchange, experts told the NHIN work group Jan. 7.

-----

http://www.ihealthbeat.org/features/2010/california-health-it-sphere-in-flux-in-wake-of-calrhio-shake-up.aspx

Thursday, January 07, 2010

California Health IT Sphere in Flux in Wake of CalRHIO Shake-Up

by George Lauer, iHealthBeat Features Editor

CalRHIO, one of the country's first organizations designed to oversee the exchange of digital health information, has been thrown into a state of flux after failing to win designation as California's lead health IT agency. Leaders and employees have left. Some of CalRHIO's board members may still be active in negotiations with the state, but the future of the organization is unclear.

The upheaval at the California Regional Health Information Organization leaves the recently reorganized California eHealth Collaborative as the front-runner in the race to win the state's nod to oversee billions of federal stimulus dollars for health IT projects. The first wave of federal money -- about $40 million -- is expected to begin flowing into California early this year. The state-designated agency could end up disbursing billions of dollars through a variety of federal programs over the next several years.

-----

http://www.seattlepi.com/local/413941_infection07.html

Infection data helped Swedish clean up its act

State now lists infection rates of hospitals on Web site

By ERIC NALDER

HEARST NEWSPAPERS

The state aired the dirty laundry, or shall we say the infected laundry, of certain hospitals on Wednesday.

And there were some surprises when the Washington State Department of Health went live shortly before noon with its long-awaited Web site revealing the infection rates for hospitals statewide.

The biggest shock involved Swedish Medical Center, one of the state's biggest and most prominent hospitals. Swedish was listed as one of only two hospitals in the state with unusually high infection rates caused by tubes known as "central lines" that are inserted into patients.

-----

http://www.healthcareitnews.com/news/hhs-unveils-nations-first-health-security-strategy

HHS unveils nation's first health security strategy

January 07, 2010 | Bernie Monegain, Editor

WASHINGTON – Health and Human Services Secretary Kathleen Sebelius has unveiled The National Health Security Strategy, focused on protecting people's health during a large-scale emergency.

Sebelius said the "comprehensive" document, the first for the nation, sets priorities for government and non-government activities over the next four years.

"As we've learned in the response to the 2009 H1N1 pandemic, responsibility for improving our nation's ability to address existing and emerging health threats must be broadly shared by everyone – governments, communities, families and individuals," Sshe said. "The National Health Security Strategy is a call to action for each of us so that every community becomes fully prepared and ready to recover quickly after an emergency."

-----

http://www.computing.co.uk/computing/news/2255850/1bn-spent-far-national

£6.1bn spent so far on National Programme for IT

Figures is £2bn less than original forecasts due to slow progress on scheme

Written by Tom Young

Computing, 08 Jan 2010

The government will have spent £6.1bn on the NHS National Programme for IT (NPfIT) by April, some £2bn less than it had forecast.

The figure is for central spending by Connecting for Health only – it doesn't include any of the £3.6bn which was expected to be spent by NHS trusts on the NPfIT by now. However it does include recent contracts awarded to BT in the South.

The figures were released by NPfIT minister Mike O'Brien in response to a parliamentary question by shadow health minister Stephen O'Brien.

-----

http://www.ehiprimarycare.com/news/5513/tory_manifesto_has_records_for_all

Tory manifesto has records for all

04 Jan 2010

David Cameron has promised that online health records will underpin a new direction for the NHS if the Conservative Party is elected in this year’s general election.

In a speech at Westminster today, the Tory leader unveiled the first chapter of the Conservative Party’s draft manifesto, which focuses on the health service.

Cameron said: “It’s the patient who’ll have the power in our NHS. You’ll be able to check your health records online in the same way you do your bank account.

-----

http://www.ehiprimarycare.com/news/5509/cancer_detection_software_to_be_trialled

Cancer detection software to be trialled

30 Dec 2009

Software to help GPs to detect the early signs of cancer is to be trialled in England in 2010.

The new computer-assisted cancer risk assessment announced by cancer tsar, Professor Mike Richards, will help GPs to decide whether the symptoms a patient presents with indicate the presence of cancer and whether further tests or investigations are needed.

-----

http://www.healthleadersmedia.com/content/TEC-244376/How-to-Prevent-Top-Three-Health-Information-Breaches.html

How to Prevent Top Three Health Information Breaches

Dom Nicastro, for HealthLeaders Media, January 4, 2010

Major breaches of patient information in 2009 break down into three types: snoopers, hackers, and those involving large quantities of data.

So let's examine the top breaches from the past year and find out what facilities can do to prevent similar problems.

-----

http://www.govhealthit.com/newsitem.aspx?nid=72852

Provider groups raise a clamor over 'meaningful use'

By Mary Mosquera

Monday, January 04, 2010

Health providers and IT policymakers returned from the holiday weekend on Monday having had just enough time sort through the administration’s “meaningful use” proposal, its 700-page incentive plan designed to spur hospitals and physicians to pursue digital make-overs of their practices.

Their first impression: That the administration’s hugely ambitious, carefully crafted, $20 billion incentive plan may provide too much stick for the carrot.

-----

http://www.healthdatamanagement.com/news/meaningful_use_survey_hospitals_EHR_HITECH-39606-1.html?ET=healthdatamanagement:e1127:100325a:&st=email

Survey: Hospitals Not Ready for MU

HDM Breaking News, January 4, 2010

A small survey of 58 hospitals of all sizes shows they are not ready for meaningful use of electronic health records requirements.

Consulting and I.T. services firm Computer Sciences Corp. conducted the survey this past fall and released results on Jan. 4. The proposed rule for meaningful use requirements issued on Dec. 28 retains many expected provisions that were first recommended by federal advisory committees last summer.

.....

Full survey results are available at csc.com/musurvey.

-----

http://www.modernhealthcare.com/article/20100104/FREE/301049998#

NQF endorses 70 data-related measures

Posted: January 4, 2010 - 5:15 pm ET

The National Quality Forum is endorsing 70 performance measures that combine data from various electronic sources—such as administrative claims, pharmacy and laboratory systems, and registries—in order to advance the use of electronic data platforms to measure, report and improve quality.

The NQF reviewed more than 200 measures used by health plans to assess physician performance, but endorsed less than half of those.

-----

http://www.nytimes.com/2009/12/22/health/22cyst.html?_r=2

Tool in Cystic Fibrosis Fight: A Registry

By MILT FREUDENHEIM

HARTFORD — In the 1950s, children with cystic fibrosis usually died before they reached kindergarten age, their airways choked with mucus by a genetic disorder that disrupts their ability to clear infections from their lungs.

Today, many people with the disorder are living well into their 30s and beyond, and children like Caroline Castonguay, a preteen patient at the Central Connecticut Cystic Fibrosis Center here, can do all the things their classmates do — ski, ice-skate, play soccer, get top grades in school.

These patients owe their lives, at least in part, to a carefully updated nationwide collection of personal profiles called a patient registry.

-----

Enjoy!

David.

Weekly Australian Health IT Links - 12-01-2010

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article.

General Comment:

The apparent trend to capture additional personal information at every turn seems to be really accelerating. The famous comment, which I paraphrase, “Your privacy has gone, so get over it!” becomes more true by the day!

The implications of all this for the adoption of, and trust in, e-Health is pretty obvious!

-----

http://www.cebit.com.au/news/health/sa-leads-with-eHealth-super-system

SA takes the lead with eHealth super system

6 Jan 2010

South Australia has taken the lead in e-Health with Australia’s first fully integrated electronic health record system, careconnect.sa.

The Enterprise Patient Administration System (EPAS) component of the platform will replace the highly complex network of electronic health record systems that are currently in place.

SA Health says the aim of careconnect.sa is to create a personal, web-based platform for patients to access information from various, currently disparate sources.

“There will be no confusion as to which system holds the information; there will be one fully integrated information system and that will be careconnect.sa,” explained a spokesperson for SA Health.

-----

http://www.6minutes.com.au/articles/z1/view.asp?id=508849

Medicare Easyclaim usage doubles

by Michael Woodhead

Medicare Australia says that patient electronic claiming is taking off, with one in four rebates now claimed at medical practices.

The agency claims that the number of services processed using Medicare Easyclaim has doubled from around 500,000 services to more than a million in December.

Medicare says the number of medical practices offering Easyclaim has also increased from around 8000 in April to almost 15,500 last month.

In a statement, Minister for Human Services Chris Bowen said practices that used Medicare Easyclaim integrated with their practice management software were now transmitting almost 70 per cent of patient claims electronically.

-----

http://www.australiandoctor.com.au/articles/c1/0c0665c1.asp

End to Easyclaim incentives

4-Jan-2010

By Paul Smith

The cash incentives used to fund electronic Medicare claims in GP surgeries have ended despite a rapid uptake over the last six months.

The Federal Government has paid practices 18 cents for each claim lodged through the Easyclaim system under a $6 million Transitional Support Package introduced last year.

The payments, worth up to $12,000 a year for an average sized practice, ended on 1 January despite lobbying from GP groups which claimed the incentives were helping to cover the system’s administration costs.

-----

http://www.heraldsun.com.au/news/victoria/myki-to-share-our-data/story-e6frf7kx-1225817703820

Myki 'to share our data'

• Peter Rolfe
• From: Sunday Herald Sun
• January 10, 2010 12:00AM

PRIVACY concerns have been raised over Victoria's troubled myki "smartcard", with fears the new public transport system may be used as a Big Brother-style tool to watch commuters' moves.

The Transport Ticketing Authority has confirmed it will share commuters' travel itineraries and personal information with police.

It also may supply private information to agencies such as VicRoads, Ambulance Victoria and Metropolitan Fire Brigade.

The data-sharing scheme could result in passengers' names, phone numbers, ages and addresses being passed between agencies.

-----

http://news.smh.com.au/breaking-news-national/facial-recognition-nabs-licence-cheats-20100110-m0an.html

Facial recognition nabs licence cheats

January 10, 2010 - 9:59AM

AAP

The Roads and Traffic Authority (RTA) has begun using facial recognition technology designed to catch out licence cheats, the NSW government says.

Anyone applying for a driver's licence or photo card will now have their photo matched against the entire RTA photo database, Assistant Transport Minister David Borger says.

-----

http://www.cio.co.uk/news/3209759/former-isoft-bosses-charged-with-fraud/

Former iSOFT bosses charged with fraud

iSOFT bosses prematurely recognised revenues as market valued company at £1bn

By Mike Simons | Published: 12:20 GMT, 08 January 10 | CIO UK

The Financial Services Authority has launched fraud proceedings against four former directors of iSOFT Group.

Patrick Cryne, Stephen Graham, Timothy Whiston and John Whelan are to appear in court on 29 January to answer charges of making misleading statements to financial markets.

The action follows a three-year investigation of the company and relates to the recognition of revenues in accounts from the 2004 and 2005 financial years, when iSOFT was a key supplier to the £12.7bn National Programme for IT (NPfIT).

-----

http://www.smh.com.au/technology/enterprise/future-of-the-operating-system-is-cloudy-20100104-lp82.html

Future of the operating system is cloudy

BRAD HOWARTH

January 4, 2010 - 2:29PM

Microsoft's Windows 7 desktop operating system may have just hit retailers' shelves, but already a new battle to control the future of personal computing is breaking out. And this time it has nothing to do with the desktop.

A four-way fight erupting between Microsoft, Google, Amazon.com and Salesforce.com is to win the title of the dominant operating system on the web, and become the most prominent company in the rapidly emerging market for cloud-based computing.

-----

http://news.cnet.com/8301-13860_3-10423985-56.html?tag=nl.e703

January 4, 2010 12:41 PM PST

Understanding Windows 7's 'GodMode'

by Ina Fried

Although its name suggests perhaps even grander capabilities, Windows enthusiasts are excited over the discovery of a hidden "GodMode" feature that lets users access all of the operating system's control panels from within a single folder.

By creating a new folder in Windows 7 and renaming it with a certain text string at the end, users are able to have a single place to do everything from changing the look of the mouse pointer to making a new hard-drive partition.

-----

Comment. This actually works and a search of Cnet.com will find other interesting modes.

I have tried it. Just rename a new folder - (use copy and paste) to the following:

GodMode.{ED7BA470-8E54-465E-825C-99712043E01C}

Just amazing!

Enjoy!

David.

AusHealthIT Man Poll Number 5 – Results 13 January, 2010

The question was:

Should NEHTA be Subject to Freedom Of Information Requests and Audit by the Auditor General?

Results:

No Way

- 0 (0%)

Possibly

- 2 (3%)

Probably

- 0 (0%)

Definitely

- 56 (96%)

Total Votes 58.

Comment:

All I can say is that this is an amazingly clear outcome. It makes it clear readers of this blog believe NEHTA is just not properly accountable for disclosure of appropriate information and is not financially audited to a level of transparency readers would prefer.

The government should take note of these view.

Thanks again to all who voted.

David.

DoHA Messes Around Seeking Advice on E-Prescribing and Looses its Way!

DoHA sought some advice on an approach to e-prescribing – thought for over six months - and then just canned the whole thing! They had asked for, and received responses, in May, 2009

The following was just sent to those who tendered for the work:

Request for Tender 27210809 for the Development of an ePrescribing and Dispensing of Medicines Benefits Realisation and Implementation Plan

Thank you for responding to the Open Tender call for submissions for an eprescribing andDispensing of Medicines Benefits Realisation and Implementation Plan.

As you may be aware, the National Health and Hospitals Reform Commission (NHHRC) released its Final Report 'A Healthier Future for All Australians' in June 2009. The recommendations of this report have materially affected the Department's anticipated workplan in the eprescribing and Dispensing arena.

In light of these developments, and considering the Government's health reform agenda, the Department has taken the decision to terminate the eprescribing and Dispensing of Medicines Benefits Realisation and Implementation Plan tender.

The governance arrangements for electronic medication management, including eprescribing and Dispensing, will now be addressed within the scope of the broader eHealth agenda.

I appreciate the time and effort that you put into your tender submission and sincerely apologise for any inconvenience the closure of this process may cause. Any future tender opportunities in this area will be posted to the Austender website at www.tendcrs.gov.au.

Should you wish to discuss this matter further, please feel free to contact MS Janine Bevan, Director, Clinical Communications Section, eHealth Branch.

Signed

Mr David Dennis

First Assistant Secretary (Acting)

Primary and Ambulatory Care Division

January, 2010

----- End Quote.

These guys are just hopeless. They ask people to do a great deal of work preparing a response for the typically complex tender – wait ages and then say to people sorry you did all this for nothing. Failing to mention, of course, it was their problem, not those who were bidding, for not knowing what to do and what they wanted.

Essentially DoHA has been blindsided by eRx and Medisecure and we have NEHTA / Standards Australia busily developing national Standards for something that has the feel of having slipped beyond their grasp. I happen to think this is a very bad outcome for Australian e-Health.

Just pathetic.

David.

South Australian Health Treats NEHTA as Essentially Irrelevant!

The following interesting piece appeared on ZD-Net a few days ago.

SA Health plans statewide e-health records

By Renai LeMay, ZDNet.com.au

05 January 2010 05:23 PM

South Australia's health department has put the finishing touches on detailed plans to replace its complex network of electronic health record systems with one integrated platform to serve all patients.

The state late December and this week went to market for the Enterprise Patient Administration System (EPAS) component of what it described in tender documents as "Australia's first fully integrated statewide electronic health record system", dubbed careconnect.sa.

South Australia's move comes as other states are also gradually unifying their disparate electronic health record systems into single platforms under the top-level guidance of the National E-Health Transition Authority, an organisation set up by the state and federal governments to oversee the process.

In some cases, records will need to be transferred from existing paper-based systems.

In tender documents, SA Health said the ultimate goal of careconnect.sa — slated to be completed by 2017 — was to establish a "personal, web-based entry point" for patients to access information integrated from various sources.

"There will be no more confusion as to which system holds which information; there will be one fully integrated information system and that will be careconnect.sa," they added. The goal of implementing the platform will be an improvement in the quality and safety of health care in the state.

As part of the integration, SA Health said it had centralised ICT governance and services within its operations.

Some of the functions EPAS will fulfil will relate to scheduling, patient registration and discharge, bed management, workflow management, clinical decision support, clinical documentation and electronic document management. In addition, SA Health will require various additions to its platform, such as a patient billing system and emergency department management.

More is found here:

http://www.zdnet.com.au/news/software/soa/SA-Health-plans-statewide-e-health-records/0,130061733,339300239,00.htm

The article also mentions that there has been a tender for an Enterprise Patient Master Index to support the very broadly scoped EPAS.

With these newly developed tenders I thought the documentation would provide some useful insight into how the NEHTA certification approaches were being implemented and what NEHTA related requirements were included.

I was also interested to see how the lessons of NSW and Victoria in terms of mega implementations had been absorbed to reduce implementation risk.

Sadly I have to report the information is amazingly thin on the ground.

In the EPAS Full Statement of Requirements we have NEHTA mentioned:

Page 18 – in the glossary of terms NEHTA is defined.

Page 64 – we find in the requirements:

“5.8.1. Secure Messaging

NFR3901

SA Health wishes to provide a messaging facility for EPAS Users that will enable them to communicate online, through the system, with other EPAS Users. What support does the system provide for this messaging?

NFR3902

Describe how your solution can be configured to cater for different message formats, especially for inbound e-referrals and outbound discharge summaries.

NFR3903

Ability to support messaging to other secure messaging systems such as Argus and Medical Director.

SA Health will follow the secure messaging guidelines issued by NeHTA.”

Later in the section on futures we find (page 69):

5.11.4. Future Standards

NFR5701

Describe your organisation’s policy for adopting future medical and ICT standards. Make particular reference to expected NeHTA standards.

And that is it. Not a single mention in the pro-forma response I could find.

As far as the Enterprise PMI Tender we have no mention at all.

Given the “huffing and puffing’ from NEHTA about certification and compliance I find this outcome passing strange. Maybe it is all to happen with a nod and a wink?

As far as the second issue of implementation approach is concerned the news seems to me to be very bad indeed.

It seems that over seven years SA Health plans to integrate and implement a huge system to service the needs of all their hospitals and that this will be a ‘single instance’ for the whole SA Health System.

I simply do not believe such an approach makes sense when one considers the operation, functional and workflow differences between the Flinders Medical Centre and some tiny community hospital in the north of SA.

A third issue is the EMPI Tender.

Page 7 describes what SA Health is planning:

“3.4. ENTERPRISE MASTER PATIENT INDEX (EMPI) INITIATIVE

SA Health aims to fundamentally improve the quality and safety of healthcare in South Australia by providing leadership in health reform, policy development and planning. Toward this end, SA Health’s vision is to implement an integrated electronic health record as a part of its careconnect.sa initiative.

The multiple, standalone systems used by SA Health lead to duplicate patient records being created, including creating duplicate Patient Administration System (PAS) identifiers due to a lack of a sophisticated system for searching and matching of patient records and a centralised single state level patient identifier. To achieve and maintain a single health record for each person, we wish to combine these duplicates and prevent future ones from being created by incorporating an EMPI that all relevant systems can use to manage a single patient index across SA Health in real time.

It is widely accepted that the ability to authoritatively identify patients is fundamental to the safe and effective delivery of care. SA Health therefore plans to go to market to find and purchase the most appropriate, world class EMPI product for use by all SA Health applications.”

The project objectives are as follows (page 8):

The key objectives of the EMPI Project are:

· To implement an accurate and accessible single authoritative source of patient identity data;

· To implement a single authoritative reference source of accurate address data, for Sector-wide use;

· To potentially implement an accurate and accessible single authoritative source of provider identity data; and

· To implement quality driven management across all identity data to enable improved data quality within the operation of the proposed new EMPI Service.

This work will:

· Efficiently provide a single unique identifier for each patient, (provider), facility, organisation and address to be used throughout the Sector; and

· Enable improved electronic information sharing and collaboration in an environment where privacy and security requirements are met.

I leave it as an exercise for the reader to figure out what NEHTA initiative this most reminds them of (Hint: The HI Service) and for the reader to figure out just why this is being acquired when the NEHTA HI Service is to go live essentially before the SA procurement is complete.

I am sure there are better ways to create an effective Health IT infrastructure for SA Health than seems to be on the table here. I would be curious to know just what external advice was sought given the scale, implementation risk and probable cost of this proposal.

We can all admire vaunting ambition when we see it, but I suspect a slab that is very much too big to be safely chewed has been torn off here!

It is also quite clear SA Health has effectively ‘thumbed its nose’ and NEHTA’s plans, presumably because they do not feel they will have any impact in the foreseeable future! This is all really very odd. I look forward to aggrieved comments from those in SA explaining how I have got it all wrong!

David.

There Are Many Unresolved Concerns Regarding the Exposure Draft of the Health Identifiers Bill 2010.

Over the blog rest period, rather predictably, we had the Department of Health and Ageing conduct a second round of so called “consultation” on the Health Identifiers Bill 2010.

I told readers about the consultation period here:

http://aushealthit.blogspot.com/2009/12/e-health-news-from-doha-new-draft.html

and provided my feelings about the exposure draft here:

http://aushealthit.blogspot.com/2009/12/nehta-medicare-australia-health.html

Since then a few serious groups have made their submissions – which were due on January 7, 2010 public.

First we have:

6 January 2010

Re: The exposure draft Healthcare Identifiers Bill 2010

The Australian Privacy Foundation (APF) is the country's leading privacy advocacy organisation. I am writing in my capacity as Chair of the Health Sub Committee of the APF.

The Foundations’ feedback to the exposure draft Healthcare Identifiers Bill 2010 is listed below.

1. The APF policy statement in relation to eHealth data and Identifiers has been brought to the attention of senior health officials and has been publicly available for several months at http://www.privacy.org.au/Papers/eHealth-Policy-090828.pdf (Appendix A). The policy, which restates submissions we have made repeatedly over many years, is completely overlooked in the draft HI Bill.

The APF submits that the draft legislation fails to take account of significant privacy concerns despite these having repeatedly been drawn to the attention of senior health officials.

Because this initiative is at odds with the APF’s stated policy on the matter, we reiterate our opposition to this initiative in its entirety.

If the Department is intent on continuing down this path, despite the serious concerns, then we draw the following specific defects to your attention.

The rest of the 8 page or so submission can be read from here:

http://www.privacy.org.au/Papers/HId_Bill-100107.pdf

Second we have a submission to Government from the Australian College of Health Informatics.

Executive Summary

The Australasian College of Health Informatics (ACHI) is pleased to provide comment on the "exposure draft Healthcare Identifiers Bill 2010" with its supporting documents. The College combines the region’s peak health informatics expertise and experience and welcomes this opportunity to help inform the Health Identifier (HI) national e‐Health endeavour from an extensive background of significant knowledge and experience in health information systems and identification implementations.

1. ACHI is concerned the draft HI Bill may be enacted yet COAG has not yet made any decision about a national Electronic Health Records implementation. The draft seems to establish the framework for an e‐Health system that may never exist or be funded. It seems to ACHI the information available regarding any possible framework is also very scant and inadequate.

2. There are several major omissions from the draft Bill that are referred to in the documentation supporting the draft Bill, especially the "Building the foundations for an e‐health future … update on legislative proposals for health care identifiers:

• The legislation does not specifically cover consumer ability to access information even though we understand it to be a requirement of the Health Identifier service provider.

• The Bill appears to lack details of governance arrangements in place to manage the misuse of provider details in the provider directory, eg stalking.

• There is no information about the NASH process or controls in the draft Bill or in papers supporting the Bill.

• The Bill appears to lack clarity around the operation and governance of the HI Service.

• Future development through regulation would be improved by linkages to Standards Australia and the International Standards Organisation.

In addition, we are concerned that a substantial pilot of the HI system for evaluation has not occurred.

Future development through regulation would be improved by linkage to Standards Australia and the International Standards Organisation. We also believe the HI will be affected by the lack of systems to put in place provider details, such as those to enrol some categories of Allied Health Care workers, which may take several years.

3. The punitive measures for the disclosure of patient information risk penalising clinicians in the patient care context, over which most have no control.

4. Any permitted information disclosures should comply with ISO Standard "ISO/TS 25237 Health Informatics: Pseudonomysation" (ISO TS 25237 2008).

5. A process defining the nature of accepted secondary uses of patient data needs to be made consistent with the international standards in this area and be the subject of appropriate public consultation.

6. The draft legislation links personal information to HIS. International and Australian standards on the identification of Subjects of Care and Health Care Client Identification offer a more controlled approach to linkage and implementation that does not appear to have been considered in the Exposure Draft.

7. ACHI suggests that it may be prudent to refer to international and national standards in the draft Bill rather than facilitate personal data linkages based on an outmoded technological stance.

8. The draft legislation leaves many important matters to regulation that has yet to be planned and does not leverage or comply with existing standards.

In summary, the College believes that the "exposure draft Healthcare Identifiers Bill 2010" is a timely national e‐Health endeavour. The establishment and broad implementation of a Health Identifier requires a comprehensive and mature legislative underpinning, which can be achieved by broad consultation.

With this response, the College seeks to support and contribute to this process. In particular, the College believes the identified agreed local and international standards should be leveraged and the issues surrounding implementation that we have identified should be further explored.

The Australasian College of Health Informatics comprises Fellows and Members that have led and contributed to local and international initiatives in the e‐Health area for many years. The College would be happy to leverage their expertise and experience to help ensure the national e-Health legislative framework interoperates with international standards, planned and implemented architectures as well as systems that are effective and sustainable. To this effect, ACHI would be pleased to continue and extend its input into future iterations of the legislation.

The full and quite detailed document is available at the ACHI web site:

http://www.achi.org.au/docs/ACHI%20Response%20to%20Draft%20Health%20Identifier%20Legislation%20V1.0.pdf

Thirdly – as cited last year we had the view from David Valie.

“But David Vaile, executive director of the University of NSW’s Cyberspace Law and Policy Centre, said the Bill was “contextless” and a “complete governance failure”.

“It’s almost as if they have deliberately tried to make the Bill impossible to comment on, because you can’t see the system it is a part of,” he told Australian Doctor.

The Bill did not answer whether the identifier could be used for financial monitoring, research or auditing, he said -– “things way beyond clinical care”.

He was also concerned that the legislation left some complaints to be dealt with in the Privacy Act, “which is encyclopaedic”.”

See here (registration required):

http://www.australiandoctor.com.au/articles/3d/0c06633d.asp

So we have the privacy experts, the health informatics experts and the legal experts all essentially saying this needs “lots more work”.

It would be nice to think there might be some considered rational responses to all the issues raised by DoHA and NEHTA but I guess I am dreaming.

My personal view is that if these issues are not properly addressed and we do not have a substantial expert consensus that what is being done is appropriate and reasonable then the public will likely suspect that they are being ‘mushroomed’ and act accordingly. This is just not the way for the first significant e-Health implementation, at a national level, to be conducted.

The secrecy surrounding where all this is up to, and what is actually going on, also confirms there is probably something to hide.

This is really very bad indeed in my view. It could have been done properly but it is being badly and I fear fatally mismanaged.

As Poll 3 showed the confidence of readers on success is not high.

http://aushealthit.blogspot.com/2009/12/aushealthit-man-poll-number-3-results.html

David.

Disclosure: I had a peripheral role in development of the ACHI submission.

D.

The Answer to A Question I Was Wondering About.

With all the issues with various nasty people trying to blow airliners out of the sky using explosives carried close to their bodies, and the suggestions that these advanced x-ray scanners could screen such souls – even with noise making material in their undies – I wondered whether we were all going to be overdosed with X-Rays.

The answer soon appeared.

Radiologists Downplay Health Risk From Airport Body Scanners

John Commins, for HealthLeaders Media, January 6, 2010

The American College of Radiology today downplayed concerns that full body scanners at security checkpoints in U.S. airports would pose a health risk.

In the wake of a thwarted Christmas Day bombing attempt on Northwest Airlines Flight 253 in the skies over Detroit, the Transportation Security Administration has announced that it is ramping up the deployment and use of the scanners, which produce anatomically accurate images of the body and can detect objects and substances concealed by clothing.

.....

"An airline passenger flying cross-country is exposed to more radiation from the flight than from screening by one of these devices," ACR said. "The National Council on Radiation Protection and Measurement has reported that a traveler would need to experience 2,500 backscatter scans per year to reach what they classify as a negligible individual dose. The American College of Radiology agrees with this conclusion."

John Commins is an editor with HealthLeaders Media. He can be reached at jcommins@healthleadersmedia.com.

The full article is here:

http://www.healthleadersmedia.com/content/PHY-244540/Radiologists-Downplay-Health-Risk-From-Airport-Body-Scanners.html

Thanks for that John!

Seems there is not a problem except for the most extreme of frequent fliers!

David.