Another False Dawn?

This appeared today in the West Australian.

Rudd watchdog to monitor hospitals

ANDREW TILLETT CANBERRA EXCLUSIVE,

The West Australian January 28, 2010, 2:45 am

Kevin Rudd and the States will set up a new national watchdog to scrutinise Australia's hospitals under a plan to fix the health system that stops short of a full Federal takeover.

It is understood bureaucrats are working on the $4 billion proposal, which could be announced within weeks and funded in the May Budget.

At the weekend the Prime Minister promised to make 2010 a year of major health reform and reining in costs, warning the growth in healthcare spending threatened to overwhelm State budgets.

.....

Part of the $4 billion in funding is also expected to include a big pot of cash for electronic health records, which the Government sees as a key way to cut costs and reduce life-threatening medical blunders.

The National Health and Hospitals Reform Commission, set up by Mr Rudd to much of do the policy grunt work, recommended the Commonwealth take full responsibility for running and funding primary health care, basic dental care and aged care, and pay the States for the number and types of procedures performed in public hospitals instead of giving them block grants.

.....

Full Article here:

http://au.news.yahoo.com/thewest/a/-/breaking/6729890/rudd-watchdog-to-monitor-hospitals/

We shall wait and see. And will they have a clue about how to spend whatever funds are made available properly? Your guess is as good as mine!

The idea of using e-Health to monitor hospital performance is hardly new and key to success is having the right indicators being measured (clinician designed ideally) and having the information derived from operational systems so the answers can't be 'adjusted' by pressured bureaucrats!

Of course this all requires hospitals which have all those feeder systems and we are not quite there yet I would suggest.

If the leak is accurate it is also a worry that the other areas of the health sector do not seem to be included in some form of upgrade.

As I said above - we shall see!

David.

Has The Time Come To Just Ignore NEHTA and Get on With It?

In the last few weeks I have been wondering just where NEHTA, as a company limited by Guarantee, really fits into the picture.

As far as I can tell there is no Government Act or regulation which enables NEHTA activity in the sense that other regulators – for example the Therapeutic Good Administration (TGA) – undertakes.

A search for NEHTA at the Australasian Legal Information Institute - A joint facility of UTS and UNSW Faculties of Law reveals no legislation at all.

The only mentions found in the zillions of databases refer to Australian Law Reform Commission reports on privacy and the like.

See http://www.austlii.edu.au/

On the other hand a search for the TGA immediately finds the Therapeutic Good Act (1989) and all the associated material.

See here:

http://www.austlii.edu.au/au/legis/cth/consol_act/tga1989191/

There are hundreds of citations and cases where the TGA has used it powers to enforce its decisions.

We also know that NEHTA needed to work with the Commonwealth Health Department of Health to get the Draft Legislation for the HI Service going – tells me they have no powers in that regard either.

Additionally, I am told that internally within NEHTA it is well recognised that while NEHTA has funding via the COAG process its actual regulatory and enforcement powers, when push comes to shove, are non-existent except in the commercial domain where they could influence some jurisdictional purchasing decisions.

I will note that as we saw with the recent SA Health Tender it is not clear just what even influence they had in framing and specifying what was needed.

See here:

http://aushealthit.blogspot.com/2010/01/south-australian-health-treats-nehta-as.html

My feeling is that while it may be pragmatic to ‘play ball’ with them whenever possible, where there are commercial or reputational issues at stake taking some advice on just exactly where one stands and discovering what is bluster and what is real authority, may be pretty smart. I suspect they are a ‘paper tiger’!

Well considered and relevant projects should not be blocked or slowed down just because of an almost certainly impotent regulatory fiat! The time has come for NEHTA to transform into something that is of value to the e-Health task in Australia or just get out of the way.

David.

Submissions to the Public Consultation on the Health Identifiers Bill 2010 Now Online

The following has been made available.

Revised legislative proposals for Healthcare Identifiers - Submissions

This page contains submissions received from the public consultation on the revised legislative proposals for healthcare identifiers, including the release of an exposure draft of the Healthcare Identifiers Bill 2010.

The Australian Health Ministers’ Conference agreed to a second round of consultations on the legislative proposals for healthcare identifiers being held so that a broad range of perspectives could contribute to making the legislation robust and effective.

Submissions were invited from interested stakeholders. The public submission process closed on 7 January 2010.

In total, 54 written submissions were received. Submissions are available with the permission of the author.

The submissions are available for download from here.

http://www.health.gov.au/internet/main/publishing.nsf/Content/eHealth-submissions2

The Department must have a time machine – because at the bottom of the page we find:

Page last modified: 08 December, 2008

Reading through it is amazing.

A whole lot of people want better controls and a whole lot of others want to hand the ID out and link to all sorts of things for all sorts of reasons – research, management, clinical registries etc

Non-providers seem to want to be able to use the HI and Doctor are wondering if they need to black them out every time when they send a paper report to an insurer!

The Wisdom of Solomon will be needed and this is before we even get to where homeopaths fit and all the consent issues!

Yet again the Commonwealth Privacy Commissioner has some stern not quite ready remarks!

The Public Interest Advocacy Centre also makes a large number of pretty interesting points as does the Civil Liberties Australia.

I suspect, in sorting this out they are going to get very tangled up!

Some good reading for those interested in the area.

It will be fascinating to see what finally emerges and just how well it will actually work!

David.

Weekly Australian Health IT Links - 25-01-2010

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:

It seems we have a run of quite bizarre press releases from NEHTA. This sudden rush to the media suggest to me that there is a rising tide of panic as it is recognised that it is only a few months until it becomes clear to all that NEHTA has over-promised and under-delivered.

The issue all of those who actually hope e-Health can be a genuine enabler of a higher quality, safer and more sustainable health system in OZ is how we can get from where we are now to where we need to be. NEHTA is a failed experiment and we need a new approach – perhaps as suggested in the Deloittes National E-Health Strategy.

Suggestions welcome!

-----

Since writing this a day or so ago there have been some discussions in some private technical groups about the future for NEHTA. I was interested to note that among some I recognise as more than technically and clinically competent there is a rising feeling that we are watching an inevitable train-wreck and the time to really put an end to all this is fast approaching.

I really wonder what can be done, as it is now clear that NEHTA is actually hindering e-Health progress in a whole range of domains. It is producing products and services that are probably not fit for purpose and whose use seems unlikely. It is also likely, with the election looming, to have its deeply flawed HI Service legislation delayed – if not canned – and lastly is failing at even the basic role of achieving basic compliance with already agreed standards (HL7 V2 etc).

I wonder how long it will be before we see that staff bailing out as they recognise the ship they have joined has some serious leaks?

Sadly I guess the only response to the issues raised will be another deceptive press release!

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http://www.medicalobserver.com.au/News/0,1734,5803,22201001.aspx

Patient e-identifier a legal risk for GPs

Elizabeth McIntosh - Friday, 22 January 2010

GPs risk falling foul of strict new e-health regulations and face hefty fines and jail terms, say doctors’ groups who are seeking a review of proposed legislation governing the use of unique healthcare identifier (UHI) numbers.

Released late last year, the draft Healthcare Identifiers Bill 2010 outlines proposed regulations around access to and use of UHIs, which will eventually be allocated to every Australian.

The 16-digit UHIs are intended to enable secure electronic transfer of patient information between health professionals, and misuse of the numbers could see health professionals slapped with fines of up to $13,200 or two years’ imprisonment.

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e-Health news sparks more criticism

Health identifiers to be assigned this year

• Darren Pauli (Computerworld)
• 21 January, 2010 10:08
• Comments

A release promoting extra safeguards for national e-health identifier by its governing body has been labelled ‘chaff’ from a long-term industry advocate.

The Healthcare Identifiers Bill 2010 proposes that unique healthcare identifiers be in operation within 10 years, spearheaded by Medicare. Each Australian will have a unique record held in a single national database that can be accessed by different health professionals.

Pundits and analysts say e-health identifiers can improve communication between pharmacies and doctors and introduce transparency into patient medical histories, but many are concerned that the government is not paying dues to privacy concerns or addressing governance issues.

More and Associates consultant, Dr David More, said the governing National E-Health Transition Authority (NEHTA) has not provided enough information on record content and access and how health providers will be authenticated.

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http://topnews.us/content/210065-ihis-protect-identity-oz

IHIs to protect identity in OZ

Submitted by Jason Ramsey on Wed, 01/20/2010 - 09:32

To keep records of well-known personalities people in OZ will soon be given fake identities. A 16-digit health ID number will be assigned to everyone to serve this purpose.

The federal agency responsible for the rollout yesterday stated that this identity would lessen the risks of exposure to someone’s information.

"There was a "need to provide special protection for vulnerable people such as well-known personalities and victims of domestic violence. Pseudonymisation is not intended to be a generally available option," a spokesperson for NEHTA said.

------

http://topnews.net.nz/content/21787-national-e-health-plan-plagued-privacy-concerns

National E-Health Plan Plagued by Privacy Concerns

Submitted by Ketan Mukherjee on Tue, 01/19/2010 - 09:54

The Rudd Government has not been able to calm the fears and concerns that are currently plaguing people with regards to the patient privacy and data security risks which could be related to the planned Healthcare Identifiers routine. Consumer and industry groups are now warning that the draft Bill is very "flawed".

Concerns are that the proposed identifier system will end up allowing the linkage of "personally identifiable information across multiple networks", the proposed routine is based on an old technology and has been designed in order to support a countrywide e-health records system that might never be built.

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http://www.news.com.au/couriermail/story/0,1,26610127-952,00.html

Health ID cover-up for some exposes risks

By Renee Viellaris

January 20, 2010 12:00am

THE same people who claim a new national health identity system will be safe from fraud will be able to get fake ID to keep their own records secret.

While every Australian will soon be assigned a 16-digit health ID number, politicians and other "well-known personalities" will be able to take advantage of false identities to stop their records falling into the wrong hands.

The 16-digit health number is a "building block" towards national electronic health records, which will be eventually shared among health professionals.

The federal agency responsible for the rollout yesterday conceded the safeguards would be built into the system to "mitigate against the potential risks of exposure to this information". But access to the extra level of protection offered by the false IDs, known by the federally funded National E-Health Transaction Authority as "pseudonymisation", will not be widespread.

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http://www.theage.com.au/national/hospitals-resort-to-virtual-wards-20100119-mj3v.html

Hospitals 'resort to virtual wards'

JULIA MEDEW

January 20, 2010

VICTORIAN hospital staff are being run off their feet as they try to keep up with soaring demand, and hospitals are manipulating their data to make it look like they are performing better than they are, a junior doctor says.

Candice Simpson said her employer, Geelong Hospital, had been under extreme pressure in recent weeks and that hospitals were ''resorting to data manipulation and 'virtual wards' to make their numbers look good for the Government''.

''This situation isn't limited to Geelong Hospital only, it's endemic within the healthcare system, all hospitals around the state are doing the same thing. The problem lies with inadequate funding,'' she wrote in a letter published in the Geelong Advertiser on Friday.

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http://www.smh.com.au/world/science/dead-man-winking-discovery-offers-hope-to-paralysis-victims-20100119-mj78.html

Dead man winking: discovery offers hope to paralysis victims

NICKY PHILLIPS

January 20, 2010

SCIENTISTS have made the eyes of a dead person blink, in a world-first use of artificial muscle that could eventually benefit people with facial paralysis after a stroke or injury.

Researchers from the US used artificial muscles made from silicon that can expand and contract when activated by an electrical impulse, the same process that allows muscles to move in the body. The technology is known as electroactive polymer artificial muscle.

The researchers were able to make the eye blink by inserting a bundle of muscle fibres from another part of the face above the eye of a cadaver. The ends of the fibres were then connected to the artificial muscle which is powered by a battery and contracts and releases, moving the eyelid.

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http://www.computerworld.com.au/article/332968/government_called_step_up_leadership_over_e-health/

Government called on to step up leadership over e-health

Concerns over e-health issues arise as government pushes ahead with reforms

• Kathryn Edwards (Computerworld)
• 19 January, 2010 15:06
• Comments

The Rudd Government needs to boost its leadership and learn from other countries implementing e-health strategies, according to a leading healthcare industry CIO.

Malcolm Thatcher, CIO of Queensland-based Mater Hospital, said the government needs to recognise and implement enablers for e-health, including the management of health identifiers, secure messaging, common terminologies, patient privacy and industry incentives and recognise that e-health is a complex challenge.

Thatcher also stressed the need for closer alignment among the state health bodies.

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19 January 2010

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr10-nr-nr010.htm?OpenDocument

E Health to Deliver a Better, More Efficient System

18 January 2010

Patient care will be improved and inefficiency in the health system will be cut by new e-health legislation soon to be introduced by the Rudd Government.

Today I visited Medicare Australia to see first hand how the secure e-health system currently being developed will work for patients and health care professionals.

The demonstration clearly showed how useful tools like electronic health records, medications-management systems and electronic clinical messaging (discharge, referrals, pathology, and prescriptions) will help improve delivery of health care – particularly when patients are being cared for by multiple providers.

The first step in creating an e-health system will come into effect in the middle of the year when unique healthcare identifiers are assigned to all health consumers as well as to health professionals and the organisations that provide health care in Australia.

Note: This is the official press release.

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http://www.news.com.au/adelaidenow/story/0,22606,26604444-5006301,00.html

Expert claims health records can't be kept secret

TORY SHEPHERD

January 19, 2010 12:01am

PRIVACY fears over Federal Government plans to put personal medical details in a national health database have been ignored and personal information put at risk.

An ex-employee of the National E-Health Transition Authority says he quit in disgust after his concerns about the system were ignored.

A privacy expert says hackers will target the "honeypot" of information and the Australian Privacy Foundation warns the draft legislation contains "defects" and ignores important privacy concerns.

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http://www.news.com.au/adelaidenow/comments/0,22638,26604444-5006301,00.html

Readers' Comments

Health records 'won't be secret'

TORY SHEPHERD

January 19, 2010 12:01am

PRIVACY fears over Federal Government plans to put personal medical details in a national health database have been ignored and personal information put at risk.

An ex-employee of the National E-Health Transition Authority says he quit in disgust after his concerns about the system were ignored.

A privacy expert says hackers will target the "honeypot" of information and the Australian Privacy Foundation warns the draft legislation contains "defects" and ignores important privacy concerns.

Note: A huge number of comments follow!

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http://www.theaustralian.com.au/australian-it/privacy-concerns-persist-on-national-e-health-plan/story-e6frgakx-1225820990882

Privacy concerns persist on national e-health plan

• Kareen Dearne
• From: The Australian
• January 19, 2010 12:00AM

THE Rudd government has failed to calm fears over patient privacy and data security risks related to its proposed Healthcare Identifiers regime, with consumer and industry groups warning the draft Bill is flawed.

They say the proposed identifier system will enable linkage of personally identifiable information across multiple networks, it is based on old technology, and designed to support a nationwide e-health records system that may never be built.

Meanwhile, concerns about the cost of integrating new ID numbers into medical IT systems and the wisdom of excluding health funds -- which now offer members a range of better-health programs -- have emerged in responses to a tight consultation period over the holiday period.

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http://www.theaustralian.com.au/australian-it/e-scripts-to-be-subsidised/story-e6frgakx-1225820971735

E-scripts to be subsidised

• Karen Dearne
• From: The Australian
• January 19, 2010 12:00AM

PHARMACISTS will be funded 15 cents per script completed electronically - up to $36 million annually - while pharmacy software vendors will be compensated to incorporate e-prescribing features into dispensing systems.

The deal is part of the Fifth Community Pharmacy Agreement, just negotiated between the Rudd Government and the Pharmacy Guild.

Doctors issue around 240 million scripts for patients each year.

No funding or upgrade subsidies have been announced for GPs and other medical practitioners who originate electronic scripts on their desktop systems.

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http://www.heraldsun.com.au/news/commuters-using-fake-names-to-register-for-myki-transport-smartcard/story-e6frf7jo-1225821393917

Commuters using fake names to register for myki transport smartcard

• Ashley Gardiner
• From: Herald Sun
• January 20, 2010 12:00AM

COMMUTERS are using fake names to register for myki.

One wit sent a myki card to the Herald Sun registered with the name Useless Mongrel.

It came with a letter from Transport Ticketing Authority chief executive Gary Thwaites that began: "Dear Useless, welcome to myki."

A card was also issued for Santos L Halper, a reference to The Simpsons episode when Bart applies for a credit card under the name of his dog, Santa's Little Helper.

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http://www.smh.com.au/national/privacy-fears-growing-as-police-tighten-national-grip-20100117-mecr.html

Privacy fears growing as police tighten national grip

GEESCHE JACOBSEN CRIME EDITOR

January 18, 2010

PRIVATE details of more and more people are finding their way on to databases used by the nation's police.

Information about licensed drivers and car owners are to be added to a network that already holds nearly 9 million police records.

Police say it makes their job faster and safer, but critics warn of the potential for the misuse of such mountains of information.

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http://www.theaustralian.com.au/australian-it/bypassing-telstra-proposed-to-cut-nbn-costs/story-e6frgakx-1225820992223

Bypassing Telstra proposed to cut NBN costs

• Mitchell Bingemann
• From: The Australian
• January 19, 2010 12:00AM

WHILE Telstra and the government continue discussions on the possible sale of the telco's passive network assets into the $43 billion national broadband network, a British fibre-optic deployment specialist says it has the expertise to bypass the incumbent's network and deliver fibre for a fraction of the cost.

The government has been desperate to strike an agreement with Telstra on the telco's role in its ambitious broadband plans, but so far has only secured tentative terms that could result in it moving traffic from its copper network to the NBN.

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http://ces.cnet.com/8301-31045_1-10434346-269.html

CES: CNET's 3D TV FAQ

by David Katzmaier

The recent flood of news about new 3D TVs, itself spurred by the hype surrounding the 3D release of Avatar, has raised a few questions. At CNET, one of our main jobs is to explain "new" technology, so this article, arranged in the tried-but-true manner of "Frequently Asked Questions," attempts to answer them as well as we can at this early stage.

We polled the six major TV makers who announced new 3D models--LG, Panasonic, Samsung, Sony, Toshiba, and Vizio--to help with some answers. Although many of the questions came back "we'll get back to you on that," we did learn something. With asking the manufacturers, and some judicious trolling of Web resources (special thanks to AVS forum and the friendly folks at EngadgetHD), we came up with the following. It will be updated and expanded as--inevitably--parts are proven wrong or we're actually given some hard information; however, in the meantime feel free to leave a comment. Or at least vote in the poll.

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The next gadget to spend too much money on? I wonder what the e-Health applications might be? Remote surgery? As I understand it the current ‘surgical robots’ already use 3D techniques.

Enjoy!

David.

It Seems We Have Another Blogger Interested in E-Health in OZ!

I noticed the following post a day or so ago from the beautiful north coast of NSW.

Sunday, 24 January 2010

Australian Health Minister Nicola Roxon is not telling the truth about the Medicare e-card

Remember over the course of 2009 the Federal Health Minister Nicola Roxon assuring everyone within hearing that the new Medicare smart card would contain data and, give access to a database, which could be checked for accuracy by individual patients and that information would only be given out if the individual patient agreed to participate in the e-health scheme?

This is what the Minister was putting about at the time:

Eventually, the plan is for each person to have an individual e-health record, which holds their personal details; a summary health profile that can be shared with the person's permission between treating doctors; event summaries such as hospital discharge reports, care plans and test results, and a self-care management record where people can add their own material. and Ms Roxon has said participation in e-health records schemes would be voluntary and yet again 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.

Believed her did you?

Well, she told whoppers - barefaced and knowingly.

The proof is in the draft Healthcare Identifiers Bill 2010 which contains no precise provisions along those lines.

Much more here:

http://northcoastvoices.blogspot.com/2010/01/australian-health-minister-nicola-roxon.html

I have to say I am much attracted by the quotation provided in the side bar of the blog.

“The Universal Declaration of Human Rights

Article 19

Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers. [Adopted and proclaimed by United Nations General Assembly resolution 217 A (III) of 10 December 1948]”

I had not realised blogging has such high level support and encouragement!

The rest of the blog is worth a browse to see what you think, but as I read it I think I am reading a blogger who is pretty unhappy about how the Rudd Government in general and Ms Roxon in particular are going about the e-Health task.

It is worth a mention that today’s articles describing Mr Rudd’s concerns about how the overall health sector is to be sustained and funded seem to even give e-Health the briefest comment.

See here:

http://www.theaustralian.com.au/news/kevin-rudd-in-alert-on-health-spend/story-e6frg6n6-1225823075398

Kevin Rudd in alert on health spend

• Samantha Maiden, Online political editor
• From: The Australian
• January 25, 2010 12:00AM

KEVIN Rudd has declared 2010 a year of "major health reform", warning that health spending alone will outstrip state tax revenues within two decades.

In the latest in a series of speeches in the lead-up to Australia Day, the Prime Minister yesterday warned that Australia faced the choice of cutting pensions, health services and aged care; running massive deficits; or, his preferred option, boosting productivity as the population aged to help lift tax revenues.

-----

And here:

http://www.theage.com.au/national/states-face-health-cost-avalanche-20100124-msl7.html

States face health cost avalanche

MICHELLE GRATTAN AND LORNA EDWARDS

January 25, 2010

FEDERAL Government spending per person on health will rise in real terms from $2290 today to $7210 in 2050, with state governments at risk of being overwhelmed by rising costs, Prime Minister Kevin Rudd has said.

Treasury projects that, on present trends, the total health spending of all states will exceed all of their tax revenues, excluding the GST, by 2045-46, and possibly earlier in some states.

This year the Australian Government is spending the equivalent of 4 per cent of GDP on health, but the third Intergenerational Report, prepared by Treasury with projections to 2050, forecasts this will increase to 7.1 per cent in 2050.

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This is all a bit of a worry as e-Health is certainly seen around the world as one of the enablers of health system sustainability long term. Not with Rudd and Roxon it seems.

David.

The NEHTA Spin Machine Pops A Gasket – And Tells Porkpies – With Its Latest Effort.

The following release dropped into view via the NEHTA RSS feed a day or so ago.

The original seems to have come from the Royal Australian College of General Practitioners.

Health Records Security Top Priority

22 January 2010

A general practice at the heart of the Black Saturday bushfires, awarded the Royal Australian College of General Practitioners (RACGP) 2009 Victoria General Practice of the Year Award, has worked tirelessly to get the practice back on its feet a year on from the fires.

One of the painfully slow after-effects of the Black Saturday bushfires has been to rebuild all of the vital community information that was lost, including the medical records of all the patients at the Marysville Medical Clinic, now located in Buxton.

When the Marysville Clinic burnt to the ground that day, along with it went all the files, paper records and patient history of many families and individuals living in the area.

Dr Lachlan Fraser, the solo rural GP in Marysville, had back-ups of the data, but the copies saved off-site were burned when his secretary lost her home and nearly her life in the township.

Thankfully they also had an old back up version that was kept in, Alexandra, half an hour north, an area that was also threatened with fire. But the clinic had still lost the past year and half of data, so along with the task of setting up and working from a temporary building, they has also had to re-establish vital medical data for patients.

“We perhaps had half of the information we would have liked and in particular it meant that we lost our recent records that involved patient pathology results or x-rays that we needed to follow up. It has meant that we needed to reconstruct patient histories which is a huge process and extra work during this difficult time for everyone,” said Dr Fraser.

Peter Fleming, CEO of the National E-Health Transition Authority (NEHTA) said that in the future, the difficult situation of starting to build patient files again will be one less thing that GPs have to worry about following a bushfire or natural disaster.

NEHTA is the lead organisation supporting the national vision for e-health in Australia.

“E-health is the electronic collection, management, use, storage and sharing of healthcare information instead of using paper records. A national e-health system will ensure that health information is safely and securely stored at all times.

“This means that the medical treatment for any person affected by a tragedy such as Black Saturday will never again have to be delayed while waiting for all information to be updated or assessed,” he said.

For this reason, the RACGP, which is the largest representative body for Australia's urban and rural general practitioners, is determined that GPs such as Dr Lachlan Fraser be a leader in the adoption of e-health in Australia.

“We are currently developing the next edition of the RACGP Standards for General Practices (4 th edition) and are working with NEHTA to make sure that the Standards are now fully integrated with e-health so that our RACGP members can deliver the highest standard of care to their patients,” said Dr Chris Mitchell, RACGP President and GP in northern New South Wales.

“The new RACGP Standards for General Practices will ensure that what the Marysville Medical Clinic and also GPs in flood affected areas of Australia have gone through will never have to be repeated.

“Trauma and grief counselling are high on the list of immediate services provided in these circumstances. However, maintaining high quality health services such as diabetes management and access to pathology results is very important, particularly for our patients with chronic diseases. The quick re-establishment of high quality general practice services can help high risk patients who lost everything back to health,” he said.

Dr Fraser agreed and added that electronic records would be a far better way to safeguard patient records which could then be accessed by healthcare providers anywhere in Australia and so helpful for those who did not re-settle in the same location.

Publication Date: 22 January 2010

Authorised By: Media

The release is found here:

http://www.racgp.org.au/media2010/35858

The release is also found here (complete with RACGP Logo)

http://www.nehta.gov.au/media-centre/nehta-news/590-bushfire-release

and it has appeared overseas here:

http://www.medicalnewstoday.com/articles/176861.php

With the title:

Health Records Security Top Priority, Australia

What just amazes me here is the arrant nonsense spouting from the mouth of NEHTA CEO.

“Peter Fleming, CEO of the National E-Health Transition Authority (NEHTA) said that in the future, the difficult situation of starting to build patient files again will be one less thing that GPs have to worry about following a bushfire or natural disaster.

NEHTA is the lead organisation supporting the national vision for e-health in Australia.

“E-health is the electronic collection, management, use, storage and sharing of healthcare information instead of using paper records. A national e-health system will ensure that health information is safely and securely stored at all times.

“This means that the medical treatment for any person affected by a tragedy such as Black Saturday will never again have to be delayed while waiting for all information to be updated or assessed,” he said.”

This is just wrong, most especially the paragraph I have bolded. A severe fire anytime in the present, or next few fire seasons, would lead to the same outcomes and NEHTA knows it!

Now I, like all Australians, was greatly saddened, and horrified, by the awful loss of life and property in the Black Friday fires a little over a year ago.

This said there is just no excuse for this release. Nowhere in any NEHTA plan is the provision of off-site GP record archiving that has even been mooted let alone costed and funded, which is what is being suggested here.

An off-site summary record may be a twinkle in NEHTA’s eye, but after a year of trying they have not had that funded, let alone a more comprehensive provider record.

What is also undeniable is that if we sadly have another event like Black Friday in the next few years there is a high likelihood that there will be exactly the same outcome for the local GPs data – as there is nothing NEHTA has yet done or even planned, or will do in the foreseeable future, which would make the least bit of difference.

A different release from the College pointing out that natural disasters do happen, using this sad case as an example, and alerting GPs to think about secure cloud based encrypted backup over the internet would be much more sensible – as might be a review of possible providers of such services the College could endorse. Maybe such a suggestion for the next set of RACGP Standards?

The College should withdraw this present ill-conceived release in my view. I am sure many of those with serious e-Health knowledge and experience within the College, and there are many, would find this release rather opportunistic if not just offensive.

NEHTA should also apologise for making claims there is no way they can justify. I bet this release was not initiated by the College, but, of course, I am always open to surprises!

David.

AusHealthIT Man Poll Number 6 – Results 23 January, 2010

The question was:

Does the Current Federal Health Minster Understand the Potential Importance and Value of E-Health?

Results:

Totally

- 2 (2%)

Pretty Well

- 8 (11%)

Marginally

- 32 (47%)

Not at All

- 25 (37%)

Votes: 67

Comment:

84 % it seems are not sure she ‘gets it’!

It seems there is a deep scepticism among readers that Ms Roxon has her head around e-Health in any useful way. Maybe that is part of the reason why we are having such difficulties.

Someone needs to provide her with a decent E-Health 101!

Thanks again to all who voted.

David.

An Uninformed Blog Takes a Shot at AusHITMan.

This dropped into view today.

Friday, January 22, 2010

'es mad about e health.

I got emailed an article in Computerworld this week, which seem

This article seems to be based on the rants of one individual who is blogging his way into retirement. The fact that one of the main objectives of this person's blog is to "provide commentary on what seems to have become the lamentable state of e-Health in Australia" and "to foster improvement" is hilarious. Obviously there will be a negative perspective of a topic irrespective of any merits of benefits there might be.

The blogger seems to be aiming target at NeHTA, as he has failed to recognise the challenges of being handed a poisoned chalice. Having been involved a little at NeHTA, it was easy to see that while every effort is being made to define pragmatic Australian standards for e-health information systems, numerous other parties will directly influence the likelihood of success. One instance that springs to mind was NeHTA had developed a simple directory service to identify nodes on the network. It was put forward as an Australian standard, but one vendor who had a hugely complex and excessively featured commercial non-standard product, vetoed the standard, forcing the market place to use it.

Lots more here:

http://rowlyemmett.blogspot.com/2010/01/es-mad-about-e-health.html

What to make of this?

Does he mention all the educational stuff I post?

Does he mention all the positive suggestions I make for improved leadership and governance etc.

Does he actually understand that lack of key stakeholder involvement is a death blow?

What ‘poisoned chalice’ cannot be sorted out after an organisation has been operational for 5+ years with competent management?

Has he actually read an understood more than the most recent 20 posts and the heading?

Anyone have a clue what this actually means?

“Dr More also seems unaware that as well as defining technical implementations, operational standards are also being defined to ensure the technical implementations are not compromised by poor work practices. Certainly, some areas in NeHTA (although I can't speak for all) recognise that no matter how well the system is designed, if the configuration, operational practices, support processes and policies are weak, the technical systems will be vulnerable.”

I sure don’t. Sounds to me like a consultant trying to sell something..but what would I know? (A very great deal as it happens is the answer).

When his has a blog with 50 sensible e-health posts I am sure we will all take him more seriously!

A worthy rant. I suggest readers make up their own mind if the “Procrastinator” has a clue. He has been on Blogger since 2002 and has never posted on e-Health and has only averaged 7 or 8 posts a year. Clearly travel to Fiji, testing stuff and not e-Health is the passion here!

And to the much broader point. Does this blogger think we are (in OZ) doing OK in e-Health and what is he doing to improve it – given he says I am doing nothing?

We all await a decent and coherent response!

David.

Note: The first paragraph of the post is messed up..not sure why.

D.