Australian Health Information Technology

This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Friday, February 12, 2010

Weekly Overseas Health IT Links 11-02-2010.

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. Note also that full access to some links may require site registration or payment.

-----

http://press.himss.org/article_display.cfm?article_id=5229&

Stories of Success! Health IT’s Impact on National Safety Goals & Priorities

Emphasizing the link between improvements in healthcare quality and patient safety and health IT – HIMSS and ASQ (American Society for Quality) announce the selection of 16 real-world and peer-reviewed case study submissions. The case studies were selected for inclusion in Stories of Success! Leveraging HIT, Improving Quality & Safety program. Members of the HIMSS Patient Safety & Quality Outcomes Committee and additional subject matter experts from The Joint Commission, the National Committee for Quality Assurance and the American Society for Quality contributed to the review process. The National Quality Forum also supports the project.

Introduced in October 2009, Stories of Success! showcases outstanding accomplishments in the adoption and use of information technology to achieve improved patient safety, quality, effectiveness and efficiency. The call for case studies highlights the fulfillment of the national priorities established by the National Priorities Partnership (NPP) and The Joint Commission’s National Patient Safety Goals (NPSG).

-----

http://health-care-it.advanceweb.com/Web-Extras/Online-Extras/A-Roadmap-to-the-EMR.aspx

A Roadmap to the EMR

Your hospital can get there from here.

Chris Macmanus

The United States boasts some of the world's finest hospitals, but they face a potentially daunting task with the government's mandate regarding the move to electronic medical records (EMRs). The adoption of EMRs is a rare point of health care policy consensus. Most believe the EMR is a necessary prerequisite to shift hospitals from the incentives of "fee for service" and toward integrated clinical practice, better patient outcomes and lower unit costs. The EMR promises to support coordination across providers, services and settings, reduce errors and highlight lower cost, more effective practices. In fact, a RAND Corporation study projects an annual savings of $77 billion from EMR adoption.

The EMR has existed in various forms for nearly 20 years, but its cost and complexity have kept it beyond the reach of many hospitals. Although transition to the EMR appears complicated and costly, your hospital can make a smooth changeover -- with careful planning and execution.

-----

http://www.healthleadersmedia.com/content/TEC-245999/IBM-Continues-Expansion-into-Health-IT.html

IBM Continues Expansion into Health IT

John Commins, for HealthLeaders Media, February 3, 2010

IBM has signed a definitive agreement to acquire privately held Initiate Systems, a Chicago-based provider of information-sharing software for healthcare organizations and government. The deal is expected to be finalized by the end of March. Financial terms were not disclosed.

It's the 30th acquisition IBM has made in the information and analytics arena, as Big Blue positions itself for the release of about $20 billion in federal stimulus money for the comprehensive, nationwide adoption of electronic medical records.

"With the addition of Initiate's software and its industry expertise, IBM will offer clients a comprehensive solution for delivering the information they need to improve the well-being of patients at a lower cost," said Arvind Krishna, general manager, Information Management, IBM, in a joint media release. "Similarly, our government clients will now have even more capabilities for gathering and making use of information to serve citizens in a timely and efficient manner."

-----

http://www.healthcareitnews.com/news/five-healthcare-it-decisions-avoid

Five healthcare IT decisions to avoid

February 04, 2010 | Chip Means, New Media Manage

Providers eager to capitalize on incentives offered through the federal government's definition of 'meaningful use' of healthcare IT may find themselves evaluating their relationships with existing and new IT vendors.

Modifying an agreement with a vendor during the contract phases can be a crucial step to aligning IT projects with federal incentive funds, said Jeffery Daigrepont, senior VP at Coker Group. "Many vendors offer a money back guarantee if their product does not comply with stimulus," Daigrepont said. "Every contract should have a warranty that requires a vendor to correct defects at their expenses and under NO circumstances should you ever sign a contract without being entitled to future upgrades and new releases."

-----

http://news.yahoo.com/s/nm/20100203/hl_nm/us_internet_health

More than half of Americans use Internet for health

Tue Feb 2, 10:04 pm ET

WASHINGTON (Reuters) – More than half of Americans looked up health information on the Internet last year, U.S. government researchers reported on Tuesday.

But only 5 percent used email to communicate with their doctors, the survey by the National Center for Health Statistics found.

Researcher at the center used a survey of 7,192 adults aged 18 to 64 questioned between January and June 2009.

-----

http://www.fiercehealthit.com/story/report-more-physicians-communicating-online-patients/2010-02-01

Report: More physicians communicating online with patients

February 1, 2010 — 2:00pm ET | By Neil Versel

While the majority of doctors still do not communicate with patients via email, secure messaging portals or instant messaging, online patient-physician communication is no longer a rarity, according to a new report from Manhattan Research. About 39 percent of physicians now have electronic communications with their patients, a 14-point increase since 2006, the healthcare market research company says.

-----

http://www.modernhealthcare.com/article/20100203/NEWS/302039988

HITSP future unclear under new administration's rule

By Joseph Conn / HITS staff writer

Posted: February 3, 2010 - 11:00 am ET

It appears the Healthcare Information Technology Standards Panel, or HITSP, has become yet another organization formed at the behest of the Bush administration that is being forced to reapply for its job under the federal government's new heath IT regime.

HITSP was launched in 2005 by American National Standards Institute, a certification body for standards development organizations. ANSI had help from “strategic partners” the Healthcare Information and Management Systems Society, a trade association for health IT users and vendors; Booz Allen Hamilton, a technology and management consultancy for healthcare and national intelligence services; and the Advanced Technology Institute, an arm of SCRA, an organization that, among other things, provides project management services for Defense Department weapons systems research and development programs and IT for intelligence sharing for ports security and law enforcement, according to its Web site.

-----

http://www.healthcareitnews.com/news/docs-face-frustrations-search-it-article-shows

Docs face frustrations in search for IT, article shows

February 01, 2010 | Mike Miliard, Managing Editor

WASHINGTON – Doctors who have shopped for healthcare software have sometimes come to regret their purchases, according to a new story reported by the Huffington Post Investigative Fund.

In her feature, Emma Schwartz finds that physicians are often frustrated with their switch from paper to electronic medical records – spending hundreds of thousands of dollars on software programs, only to find that the new systems are faulty or ineffective. Sometimes, the software vendors go out of business, leaving the doctors with no choice but to file suit in order to recoup their investment. One Florida surgeon called his experience with new IT "a disaster."

-----

http://www.healthdatamanagement.com/news/acquisition_ibm_initiate_data_management-39740-1.html?ET=healthdatamanagement:e1158:100325a:&st=email

IBM Agrees to Buy Initiate Systems

HDM Breaking News, February 3, 2010

IBM Corp. has signed a definitive agreement to acquire health care data management vendor Initiate Systems Inc. for an undisclosed price.

Privately held, Chicago-based Initiate sells enterprise master patient index, provider registry and record locator applications.

Initiate in 2009 acquired Irvine, Calif.-based Accenx Technologies Inc., bringing Initiate expanded integration and interoperability technologies. Accenx's software suite includes a health information exchange platform to connect hospitals and physicians for orders, results and other interactions. The suite also includes practice management/electronic health records integration, secure messaging and data synchronization applications, as well as consulting services.

-----

http://mobihealthnews.com/6359/mhi-mhealth-revolution-is-unstoppable/

mHI: mHealth “revolution” is unstoppable

Wednesday - February 3rd, 2010 - 12:43pm EST by Brian Dolan

The Mobile Health Initiative (mHI) event in Washington D.C. this morning began with two keynotes from the mHI’s founders Peter Waegemann and Claudia Tessier, who built on their previous presentation of the mHI’s 12 clusters for mHealth and overall vision for mHealth’s opportunity.

While it may not be too surprising given the mHI’s previous focus on EMRs as the Medical Records Institute, the thrust of much of their presentations were on provider-prescribed and physician-driven mHealth applications as opposed to consumer- or patient-directed. As one attendee noted, consumer adoption would follow physician adoption, but a good portion of the current activity in mHealth seems to be the other way around.

-----

http://www.ehiprimarycare.com/news/5607/cyber_patients_cause_gps_anxiety

Cyber patients cause GPs anxiety

02 Feb 2010

GPs feel anxious when patients bring information from the internet to a consultation, but are developing strategies to overcome their anxiety, according to a new study.

Research to be published in the February issue of the British Journal of General Practice found GPs “experienced considerable anxiety” when patients brought online information into consultations.

It found their concerns focus on the poor quality of some online information, the time involved in dealing with internet information, and a feeling that their expertise is being challenged.

-----

http://www.govhealthit.com/GuestColumnist.aspx?id=73070

All NHIN identity management is local

· By Lorraine Fernandes

· Monday, February 01, 2010

Over the last few years, federal and state health IT policymakers have paid little attention to the problem of managing provider identities.

The exception is the National Provider Identifier (NPI), a unique 10-digit identification number the Centers for Medicare and Medicaid Services (CMS) began issuing to providers in 2006 to help manage transactions protected by the Health Insurance Portability and Accountability Act.

But while the NPI supports Medicare and Medicaid payments, it does not address broader provider identity management challenges that will become more critical as health information exchange (HIE) evolves and the nationwide health information network (NHIN) begins to spreads its roots.

-----

http://www.govhealthit.com/newsitem.aspx?nid=73063

NIST project to evaluate health IT ease-of-use

By Mary Mosquera
Thursday, January 28, 2010

The Commerce Department’s National Institute for Standards and Technology (NIST) said it wants to develop standards to help evaluate the ease-of-use of health IT systems.

In a notice on a federal contracting web site, NIST announced it was looking for companies that could create a “usability framework” for health IT systems. The job would require , “development, refinement and harmonization of HIT usability standards and certification processes.”

-----

http://www.healthleadersmedia.com/content/TEC-245708/Hospital-Creates-Electronic-Medication-List-to-Achieve-Consistency-Help-Patients.html

Hospital Creates Electronic Medication List to Achieve Consistency, Help Patients

Sarah Kearns, for HealthLeaders Media, January 29, 2010

In 2007, The Joint Commission made an addition to Goal #8 regarding medication reconciliation: Along with compiling a list of medications upon admission, each patient must receive a list of his or her medications upon discharge.

Washington Hospital Healthcare System (WHHS) in Fremont, CA, embarked on a mission to comply with this goal by implementing a new admission and discharge process concerning medication reconciliation.

Kinzi Richholt, RN, MSN, clinical nurse specialist and chief of system operations and management support; Nasim Karmali, RPh, medication safety officer; and the medication reconciliation team began the process of changing the facility's medication lists from being handwritten to electronic lists that are easy to read and accessible to all physicians.

Since introducing the new electronic tool, more than 99% of patients at WHHS have a home medication list compiled upon admission.

-----

http://www.healthleadersmedia.com/content/TEC-245900/Little-Known-ARRA-Provision-Can-Help-Finance-Health-IT.html

Little Known ARRA Provision Can Help Finance Health IT

Carrie Vaughan, for HealthLeaders Media, February 2, 2010

It is an understatement to say that many hospitals, health systems, and physicians could use a helping hand when it comes to purchasing, implementing, and becoming meaningful users of certified electronic health record products. One of the biggest hurdles is finding the money to purchase health IT, because providers won't receive their share of the government incentive payments outlined in the American Recovery and Reinvestment Act of 2009 until after the technology is in place, and they are deemed meaningful users of the technology.

But a little known provision in ARRA, known as the Bank-Qualified Rule, may help solve that challenge for some nonprofit healthcare providers. I recently spoke with Randy Waring, managing director at GE Healthcare Financial Services, about how this provision can help organizations purchase health IT.

-----

http://www.healthleadersmedia.com/content/QUA-245777/Surgeons-Still-Forgetting-To-Remove-Objects-from-Patients.html

Surgeons Still Forgetting To Remove Objects from Patients

Cheryl Clark, for HealthLeaders Media, February 1, 2010

Why do hospital teams unintentionally leave more than 30 types of surgical tools or other items inside their patients, a category of hospital error that California officials say is the second most common preventable adverse event in acute care?

And why does the number of these forgotten items continue to increase?

State health officials want to find out and propose using $800,000 in administrative penalties collected from hospitals since 2007 for a collaborative project to study the problem.

-----

http://www.usatoday.com/news/health/2010-02-01-radiation01_ST_N.htm

NIH will start keeping track of patients' radiation exposure

By Liz Szabo, USA TODAY

Concerned that Americans may be accumulating too much lifetime radiation exposure from medical tests, doctors at the National Institutes of Health will begin recording how much radiation patients receive from CT scans and other procedures in their electronic medical records.

A study in the Archives of Internal Medicine in December estimated that radiation from such procedures, whose use has grown dramatically in recent years, causes 29,000 new cancers and 14,500 deaths a year.

-----

http://www.modernhealthcare.com/article/20100201/NEWS/302019973

Project BOOST aims to cut readmission rates

By Andis Robeznieks / HITS staff writer

Posted: February 1, 2010 - 11:00 am ET

Working with Blue Cross and Blue Shield of Michigan and the University of Michigan, the Society of Hospital Medicine announced that it will be launching a 15-site implementation of its program designed to avoid unplanned or preventable hospitalizations and emergency department visits 30 days after discharge.

The program is called Project BOOST, which stands for Better Outcomes for Older adults through Safer Transitions, uses tools such as identifying high-risk patients, educating patients on their conditions and possible side effects of medication, scheduling follow-up physician appointments, and medication reconciliation at discharge to ensure that drugs prescribed at discharge don't harmfully interact with previously prescribed drugs, said Mark Williams who edits the SHM's Journal of Hospital Medicine and serves as the principal investigator of the project.

-----

http://www.fiercehealthit.com/story/revolution-health-kills-its-phr/2010-02-01?utm_medium=nl&utm_source=internal

Revolution Health kills its PHR

February 1, 2010 — 1:18pm ET | By Neil Versel

So much for the Revolution.

Revolution Health, a much-hyped venture of AOL co-founder Steve Case, is terminating one of its signature products, an online personal health record for the masses. In an email to users, the company said: "Thank you for being a loyal user of the Revolution Health Personal Health Record. Unfortunately we will be discontinuing this service as of the end of February 2010 and removing all records, information, and data from the Revolution Health website." No further explanation was given.

The company recommended that users print out or download the contents in a PDF file so they don't lose their records. That likely means that the data can't simply be imported into another PHR product, providing yet another example of siloed electronic health information.

-----

http://www.healthcareitnews.com/news/revolution-health-phr-its-time

Revolution Health PHR 'before its time'

January 28, 2010 | Bernie Monegain, Editor

WASHINGTON – Most personal health record offerings are not ready for prime time, says Marjorie Martin, general manager for Everyday Health, the parent company of Revolution Health. For consumers, the experience can be laborious and frustrating, she said.

Martin explained Wednesday why Revolution Health was retiring its PHR offering on its Web site. In an e-mail to users on Wednesday Revolution Health said it would discontinue the PHR offering on Feb. 10 and destroy the records. The company advised users to download their records in a PDF format for future reference.

Martin attributed the decision to retire the platform to "low utilization."

-----

http://www.ihealthbeat.org/features/2010/consumers-not-ready-for-doityourself-phrs-experts-say.aspx

Tuesday, February 02, 2010

Consumers Not Ready for Do-It-Yourself PHRs, Experts Say

by George Lauer, iHealthbeat Features Editor

Revolution Health's exodus doesn't necessarily mean the PHR market is moribund, but it probably does mean the world isn't ready yet for a do-it-yourself version for consumers, industry observers say.

Revolution Health, started by AOL co-founder Steve Case in 2005, launched its personal health record a couple years after the company's start. The product attracted much fanfare, and predictions abounded that PHRs would empower patients and change the system by giving people tools and information to actively manage their health. Last week, Revolution Health told account holders the PHR service will shut down at the end of February.

"I think this shows the direct-to-consumer market for PHRs just doesn't work," said John Moore, founder of Chilmark Research, a research and analysis company specializing in health IT. "It's too much work for consumers -- you can't expect them to collect, input and keep track of all that data," Moore said.

-----

Obama Budgets $78 Million For Health IT

The president wants to increase funding for the national health IT czar to get doctors and hospitals using e-heath records meaningfully.

By Marianne Kolbasuk McGee, InformationWeek

Feb. 1, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=222600689

President Obama's proposed federal budget for fiscal 2011 released on Monday includes $78 million for programs to help propel health IT adoption and use.

In the proposed fiscal 2011 budget released by the White House, the U.S. Department of Health and Human Services is requesting funding of $78 million for its Office of National Coordinator for Health IT, an increase of $17 million over the $61 million allocated to the office for fiscal 2010.

-----

http://www.e-health-insider.com/news/5598/east_midlands_defers_lorenzo_deployments

East Midlands defers Lorenzo deployments

01 Feb 2010

NHS East Midlands has decided to defer two of its three Lorenzo deployments for 2010 until next year.

The board paper shows that only Kettering General Hospital NHS Foundation Trust will implement Lorenzo, the strategic EPR system from iSoft that is due to be implemented by local service provider CSC under the National Programme for IT in the NHS. It is expected to go-live in May 2010.

The board papers, which were published in November 2009, state: “The strategic health authority is working with local health communities to identify the organisations and deployment dates for the period from June 2010 through to December 2010.

"Based on a modest capacity profile provided by the Lorenzo delivery team, it is unlikely that there will be any further East Midland organisations scheduled to go-live with Lorenzo systems in that period.”

-----

Enjoy!

David.

Thursday, February 11, 2010

NEHTA Fantasises About What it Will Deliver with the HI Service.

The following lobbed today. Comments in italics in the text.

Healthcare Identifiers Bill 2010 marks e-health progress

10 February 2010.

A major step towards the implementation of a national e-health system occurred today with the introduction of the Healthcare Identifiers Bill 2010 into the House of Representatives.

The Governments Bill represents the culmination of more than a decades work in developing a framework for the introduction of e-health in Australia across different jurisdictions and with the assistance of professional bodies.

Comment: What what do we think NEHTA means by the introduction of e-Health? NEHTA has been around for 5 years and what are the changes they have delivered? And what exactly is the “e-Health System” they are talking about? Would be good to see the end state that is planned so we can all decide what we think about it. Is an IEHR involved and how is this to work?

The legislation provides for the introduction of a unique identifier which will allow all Australians to have their confidential medical information transferred electronically between health providers.

Comment: Yes, we all get a compulsory number and as far as I read there is no choice in this. I am not sure I want another identifier and why was I never asked? Non-consent in e-Health has been strongly associated with project failure in my experience.

One of the features of the legislation is a guarantee of patient privacy and doctor-patient confidentiality including audits of access to the system and penalties for breaches of privacy.

Comment: How is doctor patient confidentiality changed by all this? We know it will be years before all health providers (and their staff) will have secure identities issued, so what happens while all this –which is not planned or funded as far as the public knows- happens?

National E-Health Transition Authority chief executive Peter Fleming said the legislation would have the effect of improving the safety of patient records and over time provide significant improvements in treatment of patients, particularly those with chronic illnesses.

Comment: And the evidence for this is? And the evidence that this system will deliver is? There is none that what they plan will work (they have never tried it) and they are just in unproven fantasy mode. A serious pilot and evaluation might help – but this just not planned as far as we know.

“We believe the new system will be a vast improvement on the current system where paper records can be damaged or go missing and practitioners often spend large amounts of time locating, collecting and analysing medical records from other providers,” he said.

Comment: The HI Service is about identifiers, so how is this related to that paragraph unless there in an attached EHR which at present is not planned or funded. Indeed it seems to be denied this is the plan!

“This can lead to huge duplication and added cost to the system and frequently results in unnecessary repetition of tests and procedures.”

Comment: This all assumes comprehensive EHRs are in place everywhere. Not that we have seen this so far. Local systems can provide most of the possible benefits without the huge central infrastructure.

Mr Fleming said privacy was paramount and the new system will have a number of built-in safeguards including the feature that the new healthcare identifiers will not contain any medical information.

“The identifier allows the system to ascertain the identity of a patient, but in itself it carries no medical information,’’ he said.

Comment: So all this has no Health Information attached but will make a dramatic difference to the handling of health information. If you believe this well..

ENDS

The full release is here:

http://www.nehta.gov.au/media-centre/nehta-news/597-hibill

Even now there is no clear discussion as to why any single provider or software provider would adopt all this, given the cost in time and inconvenience.

I believe this project will be DOA without careful piloting and evaluation – and then modification on the basis of the findings. This assumes NEHTA will not review a range of alternatives we know exist to solve the problem without a ‘great big’ centralised ID database.

Fantastic thinking is alive and well at NEHTA if they think this can all roll out and work nationally over the next 6 months! If this is not the plan, maybe they could tell us what the plan actually is?

David.

AusHealthIT Man Poll Number 8 – Results - 11 February, 2010

The question was:

How Well is the Rudd Government Doing With The Health System Overall?

10/10

- 1 (1%)

8/10

- 2 (3%)

6/10

- 13 (20%)

4/10

- 18 (28%)

2/10

- 22 (34%)

0/10

- 8 (12%)

Votes: 64

Comment:

So what we have here is readers giving the Rudd / Roxon team a failing mark 75% of the time. The badly need to lift their game in my view. Certainly the e-Health readership seem to have lost confidence.

Thanks again to all who voted.

David.

Weekly Australian Health IT Links - 10-02-2010

Here are a few I have come across this week.

General Comment:

Last week we saw a few leaks from NEHTA and some discussion about the overall future of health reform.

The next few months are certainly going to be critical for both the overall health sector and for e-Health. How the Rudd Government handles both these issues I think will have an impact on the overall election outcome which we are due for later in the year.

-----

http://www.theaustralian.com.au/news/health-science/the-patient-needs-urgent-attention-healthcare-is-dysfunctional/story-e6frg8y6-1225826902882

The patient needs urgent attention: healthcare is dysfunctional

OPINION: Ian Hickie
From: The Australian
February 06, 2010 12:00AM

FAMOUSLY, James Carville, Bill Clinton's 1992 campaign manager, hung a sign in their headquarters with three key messages: change v more of the same; the economy, stupid; and, don't forget health care.

In his Australia Day address, Kevin Rudd highlighted the fact that the broader economy will be unable to sustain healthcare spending without big improvements in productivity. However, we now face another election without any substantive progress on health reform.

Why no action? In reality, the more conservative professional, bureaucratic and business interests in health resist substantive change. Through skilful use of scaremongering, most are pushing hard for retention of our highly protected and dysfunctional local industry. Meanwhile, the deteriorating state of public hospitals, the increasing size of out-of-pocket expenses and the very poor access to quality care for those with chronic diseases, dental problems or mental ill-health are high on any community-rated priority list.

-----

http://www.businesswire.com/portal/site/home/permalink/?ndmViewId=news_view&newsId=20100203005770&newsLang=en

Picis and iSOFT Enter into Global Strategic Alliance for Picis Solutions

Delivering a Complete Range of Healthcare IT Solutions That Contribute towards Improving the Overall Efficiency of Hospitals

LONDON--(BUSINESS WIRE)--Picis, the leading provider of information systems for the accident and emergency (A&E), operating theatres and intensive therapy units of hospitals, and iSOFT, one of the world’s biggest healthcare information technology (HIT) companies, have entered into a strategic alliance whereby iSOFT will distribute, implement and provide international support for selected solutions from the Picis CareSuite® family of high-acuity solutions, focusing initially on ICU and anaesthesia in the United Kingdom, Ireland, Scandinavia, Australia and New Zealand.

“Our expanded software portfolio further demonstrates our commitment to providing our clients with interoperable solutions that meet their business and clinical documentation needs, ultimately helping them improve their overall efficiency.”

-----

http://www.mja.com.au/public/issues/192_03_010210/zaj11318_fm.html

Postcard from New York

Medical identity fraud in the United States: could it happen here?

Jeffrey D Zajac

MJA 2010; 192 (3): 119

Rebecca Nicole Hannah Zajac is not a name two people are likely to have. Yet, my daughter, living in the United States, found that someone with this name and the same birthday as her had opened three bank accounts and overdrawn these accounts substantially. Thus, when Rebecca came to open a bank account in New York City, she was told it was not possible because she already had three accounts on which money was owed at another bank. This is a real and not uncommon scenario in the US where, because of the complexity of the banking system, identity fraud is rife. For Australians visiting or living in the US since the new homeland security laws came into force, it is quite difficult to open a bank account there. On the other hand, having one’s credit card skimmed to duplicate the cardholder’s name, the card’s number and other data is easy.

-----

http://www.theaustralian.com.au/news/nation/artificial-pancreas-offers-better-chance-for-diabetics/story-e6frg6nf-1225827284851

Artificial pancreas offers better chance for diabetics

Adam Cresswell, Health Editor
From: The Australian
February 06, 2010 12:00AM

SCIENTISTS have successfully tested an "artificial pancreas" that promises to reduce the danger that a person with type 1 diabetes will have a seizure or even die in their sleep because their blood sugar falls too low. The invention will give hope to many of the 100,000 Australians with the condition, who often have to wake up during the night to check their blood sugar levels with a finger-prick test.

A person with type 1 diabetes needs regular injections of insulin, which maintains blood sugar levels, because the pancreas cannot manufacture it.

Although there are already devices that can measure blood sugar levels, and others that can inject insulin, there is so far no way for the machines to "talk" to each other -- and people have to interpret the readings and adjust the insulin dose.

-----

http://www.medicalobserver.com.au/News/0,1734,5854,01201002.aspx

Primary care reform needs $830m kickstart: AGPN

Elizabeth McIntosh - Monday, 1 February 2010

THE Federal Government needs to make a “critical down-payment” on general practice with $830 million in infrastructure grants to fund health reforms, according to the AGPN.

As part of its 2010-11 federal Budget submission, the network has restated previous calls from United General Practice Australia for the Government to invest $530 million in general practice.

A further $300 million is also needed to help practices transform into comprehensive primary health care centres as proposed by the National Health and Hospitals Reform Commission, the AGPN submission claims.

-----

http://www.smh.com.au/technology/technology-news/how-labor-lost-the-first-broadband-race-20100204-ngb4.html

How Labor lost the first broadband race

MARK DAVIS

February 5, 2010

WHEN A federal election is called, senior bureaucrats draw up hefty documents known as ''incoming government briefs'' for both sides of politics. The idea is to present the winning party with the advice it needs to hit the ground running.

In December 2007, the Communications Department handed Stephen Conroy a brief which identified Labor's plan for a national broadband network as its top priority.

Kevin Rudd won the election as the man with the plan to spend $4.7 billion of government funds working with the private sector to build a communications network providing high speed internet access to 98 per cent of the population.

The brief outlined a competitive assessment process to solicit private sector bids, but flagged some of the risks to be managed.

It advised the cost of the plan was likely to be ''very significant''; it would require using Telstra's networks; and extending the network to Australia's most remote homes and businesses could be ''extremely problematic, even with a major capital contribution by the government''.

-----

http://www.misaustralia.com/viewer.aspx?EDP://1265148123369&section=news&xmlSource=/news/feed.xml&title=Ovum%3a+Electronic+health+remains+illusive

Ovum: Electronic health remains elusive

Wednesday, 03 February 2010 | Rachael Bolton

A report has taken aim at the federal government’s electronic health policy saying that in spite of an estimated $5 billion expenditure on various e--health initiatives over more than a decade, real outcomes remain elusive and ultimately unlikely to bear fruit.

Entitled National e--Health Strategy Progress in Australia, the report by analyst firm Ovum Research has slammed the proposed system as a "myth", urging technology vendors to remain focused on local and regional initiatives instead.

But time is of the essence. The report said years of uncoordinated, unconnected e--health strategies and implementations had resulted in a landscape so fragmented it was fast approaching a stage where integration costs would be "prohibitively high"

-----

http://news.smh.com.au/breaking-news-technology/rewriting-european-privacy-law-for-digital-age-20100201-n70o.html

Rewriting European privacy law for digital age

SOPHIE ESTIENNE

February 1, 2010 - 8:50AM

European legislation covering the protection of private data is being dragged into the digital age in a potential threat for social networking sites like Facebook where users display foibles, often without a thought for consequences.

European Commissioner Viviane Reding cited the arrival of privacy issues raised by such social networking sites when she announced last week a flagship drive to rewrite European law for the Internet generation, turning the old 1995 text into something fit for purpose.

Data protection for private citizens is a sensitive issue in Brussels, which has been in conflict with the United States for years seeking greater controls on personal details gathered under anti-terror drives there.

-----

http://news.smh.com.au/breaking-news-national/fingerprint-id-for-port-airport-workers-20100201-n6uu.html

Fingerprint ID for port, airport workers

February 1, 2010 - 6:29AM

AAP

Australia's port and airport workers could face mandatory fingerprinting under recommendations from law enforcement agencies to the federal government.

The change could come in an effort to beat terrorism and criminal infiltration of the 200,000 workforce at Australia's air and sea ports, Fairfax newspapers report.

The agency that checks the backgrounds of workers with access to sensitive sections of ports and airports, CrimTrac, has told a parliamentary inquiry name-based background checks used now can be bypassed with aliases and assumed identities.

-----

http://www.computerworld.com.au/article/334080/5_open_source_office_suites_watch/?eid=-219

5 open source office suites to watch

The latest open source and Web-based office tools are proving to be worthwhile alternatives to more expensive packaged software suites -- and they won't break your budget!

Rodney Gedda (CIO)
04 February, 2010 13:01
Comments

The Microsoft Office productivity suite has risen to become the dominant application of its type for business IT management. But there are open source office productivity suites available that may provide a suitable alternative to Office, depending on your requirements.

Despite the scores of additional features found in products like Microsoft Office, most workers only need a simple word processor or spreadsheet to complete their day-to-day office tasks. If your staff are not “power users” then having a full-blown office suite on their desktop can be overkill.

In this edition of 5 open source things to watch, we take a look at office suites that can manage you business information without emptying the company coffers.

-----

Enjoy!

David.

Wednesday, February 10, 2010

Roxon Press Release - Hear It from The Source! More From Spin Central!

This came out today.

Release of E-Health Foundations to be Laid

10 February 2010

Today the Rudd Government has introduced legislation that lays the foundations for a future secure electronic health (e-health) system.

Today’s legislation is an important part of the Rudd Government’s reform agenda. Without healthcare identifiers there cannot be an integrated, consistent, e-health system in Australia.

The legislation, the Healthcare Identifiers Bill, allows for a unique 16 digit number to be created for every Australian and all health care providers by the middle of this year. The unique healthcare identifiers will provide a new level of confidence and accuracy – for both consumers and providers – for electronic communication of patient information between providers involved in patient care.

Individual Healthcare Identifier’ or IHI’s, will be provided to all individuals, in addition to Medicare numbers, as a further step to ensure the privacy and security of an e-health system.

IHI’s are essential in creating a single process to accurately and consistently identify patients and healthcare providers.

For example, when a patient visits their GP for a checkup, the identifying number on their health record is different to the number at the pharmacy where they have their prescription filled or the pathology laboratory where they have their blood tests done.

The establishment of IHIs spells the end of this fragmented approach which causes inaccuracies and inefficiencies in the health system and puts patients at a higher risk of mismatched records and duplicate medical tests.

The Health and Hospital’s Reform Commission found that the availability of personcontrolled individual electronic health records ‘one of the most important opportunities to improve the quality and safety of health care, reduce waste and inefficiency, and improve continuity and health outcomes for patients’.

The Rudd Government believes that e-health is a key part of reforming the health system by improving patient care and cutting inefficiency. The Government has backed its commitment to e-health by contributing to $218 million via COAG to fund the National E-Health Transition Authority to 2012.

Minor amendments will also be made to the Privacy Act to ensure that the Federal Privacy Commissioner can act against any individual or company that misuses an individual’s healthcare identifier. The expansion of the Privacy Commissioner’s powers is a further example of the Government’s determination to ensure the privacy and security of an e-health system.

The release is here.

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr10-nr-nr023.htm?OpenDocument

Is there some reason the Government is talking about electronic patient records (which the Health Identifier Service is not) when they have not announced or funded that initiative.

Unplanned, un-co-ordinated and unfunded.

What a pathetic, spin laden and inconclusive con.

David.

A Few Thoughts on the Draft Health Service Identifier Bills (2010).

We now have the Bills that have been introduced in the Australian Parliament.

The relevant Bills can be accessed here:

http://parlinfo.aph.gov.au/parlInfo/search/summary/summary.w3p;adv=yes;orderBy=priority,title;query=Dataset%3AbillsCurBef%20SearchCategory_Phrase%3A%22bills%20and%20legislation%22%20Dataset_Phrase%3A%22billhome%22%20Portfolio_Phrase%3A%22health%20and%20ageing%22;

With the obvious disclaimer that I am no lawyer I find this all pretty alarming.

I will look forward to the comments of some serious lawyers but in the mean time a few points that strike me.

For a start there are a few gaps I would have thought might have been addressed.

A search shows that Pseudonomysation and anonymous care are not even mentioned.

There is a total loss of any choice about having an ID (See page 6-7).

“(4) In exercising a power under subsection (1), the service operator is not required to consider whether a healthcare provider or healthcare recipient agrees to having a healthcare identifier assigned to the healthcare provider or healthcare recipient.

(5) The regulations may prescribe requirements for assigning a healthcare identifier to a healthcare provider or to a healthcare recipient, including providing for review of decisions made under this section.

There is a document explaining how the HI service is to work and it also does not really provide any useful information – anonymous is found twice in the whole 40 pages.

This is the link to the explanatory document.

Building the foundations for an e-health future: update on legislative proposals for healthcare identifiers (PDF 966KB).

Another explanatory document is the NEHTA Concept of Operations found here:

http://www.nehta.gov.au/component/docman/doc_download/872-concept-of-operations

Sadly there seems to be no linkage made in the Bills between the above documentation and how the system will actually work based on the legislation. This is a magnificent example of the 'trust us, we are from the government'. Sorry I just don't.

There also seems to me to be an issue around all the exclusions to the way the actual legislation works found in Section 38, but it could be that I don’t get the legalese!

Last as far as I can tell virtually all the public submissions would appear to have not had much impact on what we see being put to Parliament.

Here is the only place all the detail is found. The legislation does not guarantee anything of this will ever become real as it clearly will all depend on the regulations which we are all yet to see.

For this Bill to pass without those regulations being made public would be an outrage in my view.

Sadly I can’t check about the regulations at the moment as www.aph.gov.au is being attacked by hackers and barely can show you a front page. Nevertheless the point stands – until we all see the regulations this should pass in my view.

I also have to say that virtually none of the issues identified by the Australian College of Health Informatics (ACHI) seem to have been addressed.

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

Enough said. We need the regulations pronto!

David.

Health Identifier Service Legislation has been Introduced Into Parliament Today.

This is now available:

DRAFT HOUSE MINUTES

No. 143

Wednesday, 10 February 2010

.....

5 Healthcare Identifiers Bill 2010

Ms Roxon (Minister for Health and Ageing), pursuant to notice, presented a Bill for an Act to provide for healthcare identifiers, and for related purposes, 9:04:22 AM.

Document

Ms Roxon presented an explanatory memorandum to the bill and to the Healthcare Identifiers (Consequential Amendments) Bill 2010, 9:04:26 AM.

Bill read a first time, 9:04:35 AM.

Ms Roxon moved—That the bill be now read a second time, 9:04:41 AM.

Debate adjourned (Mrs Gash, 9:16:53 AM), and the resumption of the debate made an order of the day for the next sitting.

6 Healthcare Identifiers (Consequential Amendments) Bill 2010

Ms Roxon (Minister for Health and Ageing), pursuant to notice, presented a Bill for an Act to deal with consequential matters in connection with the Healthcare Identifiers Act 2010, and for related purposes, 9:17:14 AM.

Bill read a first time, 9:17:21 AM.

Ms Roxon moved—That the bill be now read a second time, 9:17:31 AM.

Debate adjourned (Mrs Gash, 9:20:25 AM), and the resumption of the debate made an order of the day for the next sitting.

7 Health Insurance Amendment (Pathology Requests) Bill 2010

Ms Roxon (Minister for Health and Ageing), pursuant to notice, presented a Bill for an Act to amend the law relating to health, and for related purposes, 9:20:44 AM.

Document

Ms Roxon presented an explanatory memorandum to the bill, 9:20:47 AM.

Bill read a first time, 9:20:51 AM.

Ms Roxon moved—That the bill be now read a second time, 9:20:57 AM.

Debate adjourned (Mrs Gash, 9:24:53 AM), and the resumption of the debate made an order of the day for the next sitting.

----- End Extract.

Here is the link:

http://www.aph.gov.au/house/info/liveminutes/index.htm

I wonder have they got this right? Will be interesting to see what was finally moved.

David.

ABC Australia Talks Covers Individual Electronic Health Records

The following was broadcast last night.

Individual electronic healthcare records

Legislation is currently underway to assign all Australians a health identification number by mid this year. It's regarded as the building block to creating personal electronic health records with your private health history by 2012. E-health is supposed to provide shared access to health information by medical and allied health professionals. So will electronic health records benefit patients and make health care more efficient? Or do you worry about privacy and security risks?

Here are more details of the show.