What Mr Hockey Said on E-Health. He Makes Some Points The Government Needs to Address!

I wanted to find what was said.

Found this

http://joehockey.com/mediahub/nprDetail.aspx?prID=975

No mention. Pity about that!

Then I found this:

Rudd e-health plan a 'falsehood': Hockey

• UPDATED: Fran Foo
• From: Australian IT
• May 19, 2010 2:48PM

OPPOSITION Treasury spokesman Joe Hockey today outlined the Coalition's reasons for rejecting the federal government's controversial e-health records proposal.

In last week's budget Treasurer Wayne Swan said $467 million over two years will be set aside to introduce "personally controlled" individual electronic health records as part of the Rudd government's health reforms.

Patients will control what is stored on their health records and will decide which health professionals can view or add to their files.

According to Mr Hockey, the biggest barrier to e-health adoption was the fact that the Healthcare Identifiers Bill was still in limbo and giving the scheme half a billion dollars was akin to putting the cart before the horse.

"The fundamental issue about the current e-health initiative is the government hasn't even delivered on its e-health identifier ... an e-health identifier is obviously hugely important to health records," Mr Hockey said in answer to a question after his National Press Club budget response.

Under the HI Bill, all Australians using private or public health services will be assigned an identifier by Medicare over time, but the speed of uptake by private practitioners and hospitals will depend on their IT systems having the capability to "populate" internal records with the national number.

The bill has passed the lower house and is now due for debate in the upper house.

Mr Hockey's second reason for rejecting the government's plan was a lack of commitment from the states on software compatibility.

"I would want to see every state government sign up in blood that they're not going to have different software programs that are incompatible when it comes to e-health records.

"I just don't believe them when they say they've got good intentions about harmonising the software that is going to be behind e-health records."

His final reason was the funding element, which he says was grossly inadequate.

The government allocated $185.6m in 2010/11 to establish the base for an individual e-health records regime. In the following financial year it will receive $281.2m.

"The irony of the government's allocation in the budget is they're funded for the first two years but there's a great damn hole for the next two years.

"Hang on, how does that work?

"The first two years we're going to fund this e-health initiative but every single dollar stops for the next two years? It's a falsehood because you've got to keep investing in this so-called wonderful initiative," Mr Hockey said.

Lots more here:

http://www.theaustralian.com.au/australian-it/rudd-e-health-plan-a-falsehood-hockey/story-e6frgakx-1225868733018

I look forward to a willing debate and some real funding to actually address the issues raised by both sides.

I would love comments from all!

There are some comments on the Australian site here:

http://www.theaustralian.com.au/australian-it/rudd-e-health-plan-a-falsehood-hockey/comments-e6frgakx-1225868733018

Right now I think we are all in never, never land!

David.

A Few Interesting e-Health Press Releases I Missed in the Last Few Weeks.

First we have:

http://www.data.com.au/news.htm

May 2010 DCA invests in e-Health

DCA has entered into an agreement to acquire Ballarat based ArgusConnect, leaders in secure document exchange between GPs, specialists, allied health practices and health services.

In a separate arrangement, DCA is in the process of taking responsibility for the Connectingcare service directory and e-referral solution used by 19 Victorian primary care partnerships (PCPs).

The ArgusConnect Response is here:

http://www.argusconnect.com.au/node/135

EXCITING NEWS : DCA to acquire ArgusConnect business

4th May 2010

Attached Files

DCA Company Announcement-3 May-10 .pdf

Database Consultants Australia (“DCA”) is pleased to announce that it has entered into a definitive agreement to acquire the Ballarat based business of Argus Connect International (“Argus”).

You can read the announcement detail in the attached PDF, further information on the acquisition and what it means to Argus users will be announced on the web site in coming weeks.

More information about DCA can be found at: http://www.data.com.au/

Information about DCA's 'The Care Manager' product can be found at: http://www.thecaremanager.com.au/

Second we have:

http://oceaninformatics.com.au/News-and-events/whats-news/Ocean-in-health-technology-transfer-to-Kazakhstan.html

Press Release - Ocean in health technology transfer to Kazakhstan

12 April, 2010

12 April 2010, Astana, Kazakhstan – The Ministry of Health (MOH) of the Republic of Kazakhstan has signed a contract for consultants’ services with the Australian company Ocean Informatics Pty. Ltd. within the framework of the World Bank-supported Kazakhstan Health Technology Transfer and Institutional Reform Project.

The objective of the agreement is to develop the basis of improvement of the existing healthcare information systems based on international standards that will enhance patient care and management efficiency; and create a sustainable institutional base for further deployment of the system and for ensuring long-term technical and operational sustainability. The tasks include:

• Provision of technical assistance and transfer of know-how to help the MOH in improvement of design and architecture of the national health information system; inter alia, modules for patient management, financial and resource management, and their integration.
• Development of standards, design (architecture and infrastructure) and technical specifications for ensuring interoperability of various software systems based on results of pilot components integration.
• Development of materials for training the information system user community (managers, administrators, clinicians etc.) to provide real-time access to data on patient care, financial and resource management and utilization of information technologies in daily practice.

The contract was signed by Mr. Bolat Sadykov, Executive Secretary of the Ministry of Health of the Republic of Kazakhstan and Ognian Pishev, Director Business Strategy, Ocean Informatics.

Now that is a long way from home!

Last we have:

http://ihe-australia.wikispaces.com/SMD+Connectathon+Results+April+2010

IHE Australia 2010 SMD Connectathon - Results

Date: April 19 - 23, 2010

Venue: University House, Canberra, Australia

8 Australian companies successfully tested 8 products against the Australian Technical Specification: ATS 5822:2010 – e-Health Secure Message Delivery.

See the site for details.

All information that is worth being aware of.

David.

There is a Serious Throwing The Baby Out With the Bathwater Risk Here!

We have the Opposition Treasury Spokesman saying that he and Mr Abbott want to scrap the planned investment in e-Health.

See here:

http://www.theaustralian.com.au/news/nation/joe-hockey-takes-swing-at-e-health/story-e6frg6nf-1225868400495

Joe Hockey takes swing at e-Health scheme

• Patricia Karvelas, Political correspondent
• From: The Australian
• May 19, 2010 12:00AM

JOE Hockey will today map out the Coalition's return to economic conservatism, promising to cut the Rudd government's controversial new e-Health scheme to save $467 million and announcing a review of the Trade Practices Act to help small business.

In a speech to the National Press Club, the opposition Treasury spokesman will announce that the review -- which he will describe as the most significant in decades -- will not be headed by Treasury secretary Ken Henry. That is an apparent swipe at the independence of the Treasury boss.

The "root and branch" review will be charged with easing burdens on small business and infrastructure projects through the laws defining business conduct.

And the Coalition will kill the e-Health scheme which was announced with the budget and which will cost $467m over the next two years.

Mr Hockey will argue that the initiative is fundamentally flawed.

And here:

http://www.news.com.au/breaking-news/coalition-to-scrap-e-health-plans/story-e6frfku0-1225868528569

Coalition to scrap E-health plans

• From: AAP
• May 19, 2010 9:49AM

THE Coalition plans to reject Federal Government plans for a national electronic health database in its Budget response today.

Opposition treasury spokesman Joe Hockey later today will unveil the Coalition's detailed response to last week's Federal Budget at the National Press Club in Canberra.

It is expected to include a "root and branch" review of the Trade Practices Act to help ease the burdens on small business, and scrapping the E-health scheme, which was funded in the Budget.

The scheme would see patient records stored in one national database, available to different health professionals.

As far as we know they have no alternate approach or policy.

While it is true I am very critical of the current Government for the lack of any clarity on just what they plan to do with the money – I am even more critical of the Opposition approach of just canning the initiative with no better plan.

A pox on both their houses for now! We need e-Health investment that is properly disclosed and discussed, well considered, well targeted and well managed and led!

David.

Weekly Australian Health IT Links - 17-05-2010.

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.

General Comment:

Clearly the big news this week is the Budget allocation for e-Health.

It is fascinating to see how much is also going on. The additional finding for Aged Care Health IT seems like a good plan.

Another blog will collect the reactions to date on the new funding

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http://www.techworld.com.au/article/346614/privacy_concerns_won_t_stymie_e-health_uptake_nsw_health

Privacy concerns won’t stymie e-health uptake: NSW Health

Privacy shouldn't be confused with security

Rodney Gedda (CIO) 14/05/2010 05:52:00

People concerned about the privacy implications of a move to transferable electronic health and medical records should not be dissuaded by doubt as the benefits outweigh potential drawbacks, according to health industry executives.

Dr Tim Smyth, deputy director-general of NSW Health, said it is very interesting times in NSW as the state is “beavering on” with the rollout of electronic medical records and is undertaking a business case for the provision of an electronic prescribing service.

Smyth is adamant privacy concerns around electronic medical records are overstated and can lead to unnecessary concerns.

“I’ve never seen privacy as an obstacle and it’s often used as an excuse by some players not to do anything,” Smyth said.

“Healthelink in NSW was all opt-in and about 90,000 people are using it. Only a small percentage have left the service.”

Note: this is wrong. Healthelink was opt-out NOT opt-in.

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http://www.medicalobserver.com.au/news/easyclaim-uptake-climbs-despite-end-of-incentives

Easyclaim uptake climbs despite end of incentives

14th May 2010

PRACTICES continue to take on the Medicare Easyclaim system despite cessation of the incentives paid to practices to use it.

Under a transitional support package, practices were being offered up to $1000 to install the system and 18 cents for each Medicare claim processed via Easyclaim.

The incentives ended on 31 December, but the number of claims being processed via Easyclaim has continued to climb. During March 2010, 8490 healthcare providers transmitted a patient claim via Medicare Easyclaim compared with 7684 providers in December 2009.

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http://www.theaustralian.com.au/in-depth/budget/govt-to-spend-40m-on-aged-care-it-systems/story-e6frgd66-1225865546255

Govt to spend $40m on aged care IT systems

• Andrew Colley
• From: Australian IT
• May 12, 2010 2:04PM

THE federal government will spend nearly $40 million on IT systems to support its plan to take responsibility for aged care service from states and territories.

Budget papers reveal that the Department of Health and Ageing will spend $38.3m over four years on a new national IT system as part of its plan to reform management of Home and Community Care (HACC).

An initial tranche of $20m was expected to be spent establishing the system in the 2011 financial year, the government said.

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http://www.dailyexaminer.com.au/story/2010/05/12/doctors-blast-hospital-data-recording-system/

Doctors blast data system

Terry Deefholts | 12th May 2010

THE electronic medical records (EMR) system meant to streamline hospital data continues to frustrate North Coast doctors more than six months after its installation.

One US study has found software produced by the same company has increased paediatric mortality in one emergency department (ED).

The study, entitled Unexpected Increased Mortality After Implementation of a Commercially Sold Computerised Physician Order Entry (CPOE) System, was completed by eight doctors and related to the implementation of a CPOE system (produced by Cerner) in the Children’s Hospital of Pittsburgh in 2002.

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http://www.cio.com.au/article/346484/govt_e-health_push_can_help_cios_innovate/?eid=-601

Govt e-health push can help CIOs innovate

Medical providers need to learn from each other

Health industry CIOs have a real opportunity to drive innovation and break down siloes of information in light of the federal government’s allocation of $467 million to electronic health records over the next two years.

Speaking at an AIIA CIO e-health forum in Sydney, CIO of St Vincent’s Health Australia, David Roffe, said one of the most important aspects of e-health is change management.

“Before we put anything in we need to find out how we will change processes,” Roffe said.

Roffe is supportive of the government’s decision to invest more in e-health.

St Vincents has been investing in and developing IT health systems for at least 25 years and has re-written its own patient records system three times.

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http://www.nzdoctor.co.nz/news/2010/may-2010/11/expert-advises--against-centralised--e-health-records.aspx

Expert advises against centralised e-health records

Virginia McMillan vmcmillan@clear.net.nzTuesday 11 May 2010, 4:31pm

New technology that can gather patient data from wherever it is stored

New Zealand is unlikely to find a complete electronic health records system at a price it can afford, warns an Australian GP, research fellow and entrepreneur.

Sam Heard, visiting New Zealand from Darwin to talk with groups interested in health IT, is a founding partner in Australian firm Ocean Informatics, developers of a platform for health-information sharing called openEHR.
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http://www.computerworld.com.au/article/346108/clinics_gps_first_step_e-health_academic/?eid=-255

Clinics and GPs the first step to e-health: Academic

E-health systems should focus on General Practitioners first, before widening to hospitals and specialists, according to the Professor of Surgery at the University of Sydney

• James Hutchinson (Computerworld)
• 11 May, 2010 16:19

Updated: Federal Treasurer, Wayne Swan, has announced an additional $2.2 billion in funding for the Australian health system, bringing the Government's total investment to $7.3 billion over five years, and $23 billion over the next decade. Of the new funding, $467 million will go to voluntary electronic health records.

General practitioners are the first step in implementing an effective e-health system, according to the founder of the Institute of E-Health interest group at Nepean Hospital, Professor Mohamed Khadra.

Khadra, who is also Professor of Surgery at the University of Sydney and a urological specialist, told Computerworld Australia that the majority of healthcare took place in the community, and not in hospitals or specialist care.

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http://www.networkworld.com/news/2010/051110-e-health-key-to-national-health.html

E-health key to national health reform

By Lisa Banks, IDG News Service

May 11, 2010 04:43 PM ET

IT and healthcare professionals have called for more funding for e-health on the eve of the Federal Budget.

E-health has been the subject of much debate across the healthcare sector. The head of surgery at the University of Sydney, Professor Mohamed Khadra, has witnessed the frustrations of the current health system firsthand. He desribes himself as "a rare blend of doctor" who couples experience in the healthcare industry with a graduate computer degree from Deakin University and a degree in education.

Khadra first realised the lack of technology in the health care industry was an issue back in 1998.

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http://www.smh.com.au/technology/technology-news/study-casts-doubt-over-net-filter-support-20100512-uvo0.html

Study casts doubt over net filter support

LOUISA HEARN

May 12, 2010 - 10:24AM

As Kevin Rudd attempts to fend off a slump in the Labor's approval rating, evidence is mounting that one of its key initiatives - mandatory internet filtering - may not prove as popular with voters as the government had hoped.

In February a phone survey run by McNair Ingenuity indicated widespread support for the initiative among ordinary voters, but new findings from a study commissioned by the Safer Internet Group indicate that the more parents find out about the proposed filter, the less they support it.

The filter has been mired in controversy since its inception, with internet industry groups, academics and backbench ministers from both sides of government labelling it heavy handed. The US State Department has also raised concerns about the plan.

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http://www.computerworld.com.au/article/346207/budget_2010-11_what_it_ict_/?eid=-255

Budget 2010-11: What's in it for ICT?

e-Health, ePassports, NBN, Centrelink, biosecurity all winners

• Trevor Clarke (Computerworld)
• 12 May, 2010 07:41

The Federal Government last night delivered a scaled back budget with the aim of returning it to surplus and reducing debt. So far it’s been described as a ‘no thrills, no frills’ performance. But what’s in it for ICT?

Here are the major winners for ICT in the 2010-11 federal budget:

• $466.7 million will go to the development of a “personally controlled electronic health records”. The move is being pitched as a “key building block of the National Health and Hospitals Network”.
• The National Broadband Network (NBN) has already funds allocated, but last night the Government also tipped in $12.9 million to the Department of Broadband, Communications and the Digital Economy and $2.1 million to the Department of Finance and Deregulation to help with policy and regulatory measures, contract oversight and management of NBN Co shares.
• On the mandatory ISP-level filter, the Government said it "will reallocate existing cyber‑safety funding of $40.8 million available over five years and provide additional ongoing funding of $3.0 million per annum". It restated its plan to introduce legislatin to require all ISPs to run a filter of refused classification material hosted on overseas servers.

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http://www.brisbanetimes.com.au/queensland/queensland-health-payroll-team-unprepared-for-problems-20100511-up36.html

Queensland Health payroll team unprepared for problems

JESSICA MARSZALEK

May 11, 2010 - 6:40AM

A preliminary report into Queensland Health's payroll bungle shows the team responsible for the new pay system was unprepared for problems.

And Premier Anna Bligh says anyone subsequently found accountable for the blunder - another two reports are to be prepared - will be dealt with.

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http://www.nehta.gov.au/media-centre/nehta-news/638-snapper

CSIRO develops software solution for NEHTA to assist in SNOMED CT-AU uptake

11 May 2010. CSIRO researchers at the Australian E-Health Research Centre (AEHRC) have developed a software tool, Snapper™, for the National E-Health Transition Authority (NEHTA) designed to assist the healthcare sector adopt SNOMED CT-AU*. SNOMED CT-AU is considered the most comprehensive, multilingual clinical healthcare terminology in the world and the preferred terminology for Australia.

“The way patient clinical information is captured and shared by healthcare providers is vital to improving the quality and safety of healthcare delivery and is fundamental to the success of e-health in Australia,” said NEHTA Chief Terminologist Paul Frosdick.

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http://www.zdnet.com.au/vic-budget-heralds-it-spending-drop-339302980.htm

Vic budget heralds IT spending drop

By Steve Hodgkinson, Ovum on May 10th, 2010

analysis In past years, appendix A of Budget Paper Number 3 has been essential reading for those eager to learn about the Victorian Government's procurement intentions regarding major operational transformation and IT projects.

$650 million of funding for IT projects over four years in the 2005/06 budget. $525m in 2006/07. $120m in 2007/08. $460m in 2008/09. $400m in 2009/10.

Past budgets have accumulated a rolling four-year funding portfolio that peaked with a total of around $500m of commitment in the 2008/09 year to major new IT-enabled transformation programs such as public transport ticketing, train and bus systems, HealthSmart, the Ultranet, VicSmart fibre to schools, major systems development projects in Justice and Police plus a range of smaller projects across the other portfolios.

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http://www.misaustralia.com/viewer.aspx?EDP://1273536992401&section=news&xmlSource=/news/feed.xml&title=Budget+must+address+e-health+funding+shortfall

Budget must address e-health funding shortfall

Tuesday, 11 May 2010 | Rachael Bolton

http://www.afr.com/p/business/technology/fears_over_health_budget_blind_spot_4jVoNUhBxkI70QZdI0od1I

Fears over e-health budget blind-spot

Analysts and the health industry are concerned the federal government won’t give the right level of support for electronic health services, which would greatly improve efficiency.

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http://www.theaustralian.com.au/australian-it/e-health-plan-needs-16bn-in-funding/story-e6frgakx-1225864737163

E-health plan needs $1.6bn in funding

• Karen Dearne
• From: The Australian
• May 11, 2010 12:00AM

THE health technology sector is hoping for about $1.6 billion in today's budget, but will be happy to get $200 million to $300m to fund real e-health programs.

While disappointed health IT was ignored in the national health reform program, industry leaders are quietly hopeful "a decent chunk of money" will be on offer.

Deloitte partner and National E-Health Strategy lead author Adam Powick said it would cost about $1.6bn over four years to implement the strategy.

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http://www.theaustralian.com.au/australian-it/study-blasts-lack-of-commitment-to-e-health/story-e6frgakx-1225864734966

Study blasts lack of commitment to e-health

• Karen Dearne
• From: The Australian
• May 11, 2010 12:00AM

E-HEALTH programs could cut healthcare spending by 3 per cent annually, saving at least $7.6 billion in 2020 alone, according to a Booz & Co study released last week.

The firm has developed a global e-health investment modelling tool and used publicly available information to come up with its findings -- the first time a comprehensive benefits/cost comparison has been possible.

"Commitment to a full e-health program now could help save an estimated 5000 lives annually, once the system is fully operational," the Optimising E-Health Value report says.

"Furthermore, more than 2 million primary care and outpatient visits could be avoided each year, along with 500,000 emergency department visits and 310,000 hospital admissions.

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http://www.theaustralian.com.au/australian-it/lifeline-for-e-health-talks/story-e6frgakx-1225864693703

Lifeline for e-health talks

• Karen Dearne
• From: Australian IT
• May 10, 2010 5:50PM

THE federal Health Department is "finalising a commitment" to the medical software industry over the troubled Healthcare Identifiers project as crisis talks continue today.

Chief executives from more than 60 leading firms flew into Sydney to meet with Health officials in a bid to resolve outstanding technical issues before the HI service commences operation.

Medical Software Industry Association president Geoffrey Sayer said the plan was to help the Rudd government meet its July 1 deadline.

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http://www.smh.com.au/digital-life/digital-life-news/robbed-of-identity-now-she-must-change-her-name-20100514-v4hc.html

Robbed of identity, now she must change her name

GEESCHE JACOBSEN CRIME EDITOR

May 15, 2010

Carmela Grande can trace the moment she lost her identity. It was the last week of October 2007. Now, in a battle to regain it, she is about to give up her name.

Her nightmare started in October 2007. After a few days away, she had no mail waiting for her. It was unusual, but she blamed a post office redirection error.

About four weeks later, about $25,000 had disappeared from her account after fraudsters had changed her mailing address and applied for new bank cards. They had stolen her mail from a locked letterbox and created fake IDs, using her name and birthday and someone else's photo.

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http://www.theaustralian.com.au/australian-it/it-industry-to-profit-from-public-service-reform/story-e6frgakx-1225864731036

IT industry to profit from public service reform

• Fran Foo
• From: The Australian
• May 11, 2010 12:00AM

BIG-BANG, big-ticket items such as the $2 billion digital education revolution project could be missing from today's budget, but there are signs the federal government will spend hundreds of millions of dollars to improve citizen engagement, which would see the IT industry as the main beneficiary.

Industry players have been expecting a relatively low-key budget for the IT industry and were surprised to learn that all 28 recommendations in Terry Moran's blueprint for Australian Public Service reform had been accepted.

The 96-page report was prepared by the Advisory Group on Reform of Australian Government Administration, led by Mr Moran, secretary of the Department of the Prime Minister and Cabinet.

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http://www.nehta.gov.au/connecting-australia/healthcare-identifiers/discover-the-model-healthcare-community

Discover the Model Healthcare Community

See how the Healthcare Identifier works. A tour through the Model Health Community is a chance to understand the potential of e-health to the Australian health sector and talk face-to-face with the people behind the development of national e-health.

There are five simulation stations in the Model Healthcare Community led by knowledge experts from the National E-Health Transition Authority (NEHTA) and Medicare Australia (the HI Service Operator). They paint a picture of what the health system would be like once vendors adopt their health IT software solutions to use healthcare identifiers. The five simulation areas represent a clinical reception, a general practice, a hospital, a pharmacy, and a clinical specialist.

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http://www.theaustralian.com.au/news/opinion/whats-fast-in-theory-and-will-cost-a-big-bundle/story-e6frg6zo-1225864730573

What's fast in theory and will cost a big bundle?

• Malcolm Colless
• From: The Australian
• May 11, 2010 12:00AM

COMING soon to your home by overhead cable from a nearby telegraph pole: the Rudd government's state-of-the-art scheme to build the communications revolution.

This is the glimpse Communications Minister Stephen Conroy gave us of his vision for the government's $43 billion high-speed national broadband network when he finally unveiled the implementation study on the project last week.

It involves 55 per cent of the 10 million premises to be cabled being connected above ground, and 45 per cent through underground ducting.

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http://www.computerworld.com.au/article/346079/telstra_bill_will_finally_make_it_senate_tomorrow/?eid=-6787

Telstra Bill will finally make it to the Senate tomorrow

Telstra may finally see structural separation, according to a bill set to be tabled in Parliament tomorrow

• James Hutchinson (Computerworld)
• 11 May, 2010 13:11

The Federal Government will introduce a Bill that aims to structurally separate Telstra to the Senate on Wednesday.

The Telecommunications Legislation Amendment (Competition and Consumer Safeguards) Bill 2009, which communications minister, Senator Stephen Conroy flagged would be tabled last week, targets three issues:

• Concerns about Telstra's monopolistic behaviour
• Access and anti-competitive conduct regimes
• Consumer safeguard measures such as Universal Service Obligation (USO), Customer Service Guarantee (CSG) and priority assistance.

The Bill, according to an Explanatory memorandum, will enhance competition in the telco industry while also strengthening consumer rights surrounding misconduct.

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http://www.theaustralian.com.au/higher-education/neanderthal-lives-in-us-all/story-e6frgcjx-1225865188007

Neanderthal lives in us all

• Cheryl Jones
• From: The Australian
• May 12, 2010 12:00AM

IT was expected to be a ruling on rival models of human evolution, written in a code of billions of letters. But an analysis of the draft Neanderthal genome sequence, published last week, has widened the dispute over our ancestry.

Opposing camps are claiming support for their theories in the celebrated cavemen's DNA.

Attention is returning to Australian Aborigines and fossils of Indonesian Home erectus for evidence to settle the long-running dispute over human origins and dispersal.

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Enjoy!

David.

Crikey Alerts Us To a US Blog Covering an E-Health Fiasco in Australia!

While taking my usual fix from Crikey.com.au I came across the following article.

3. Botched software upgrade produces mass X-ray failure

Crikey intern Nicole Eckersley writes:

HEALTH, IT, RADIOLOGY

A botched $8.4 million software upgrade in Western Australia public hospitals has left radiology departments in chaos, delivering false patient X-ray results and constant crashes.

Radiologist and imaging software blogger Doctor Dalai reported on the saga last Thursday, after a barrage of complaints from radiologists in WA. A source inside WA Health confirmed to Crikey a "dramatic impairment" in hospital procedure.

Dalai reported a litany of problems with the PACS software: unacceptable system down time, images that don’t match patient names and/or records, left-right reversed mammograms and non-chronological previous case lists, and processing slowdowns so severe that a Code Yellow -- signifying a failure of essential services -- was declared across all WA hospitals, including a hold on all new admissions and elective surgeries.

The WA Health source said the system failures impacted radiology departments across all public hospitals.

"Efficiency has been dramatically reduced, with departments now unable to cope with their daily workloads, and patient exposed to significant risk due to missed or delayed diagnosis," they report.

Lots more is available to Crikey subscribers at www.crikey.com.au.

I decided to track down the source blog and see what was happening.

Go here to read the blog post.

http://doctordalai.blogspot.com/2010/05/blunder-down-under.html

No point in really commenting. Dalai’s blog says it all. Sounds like a bit of a mess over in the West to me!

Sounds like another one of those centralised, foisted on the clinicians solutions gone ‘pear shaped’. When will they ever learn?

David.

A Committee I Bet You Have Never Heard Of. It Might Be Very Important to the Future!

The Committee is part of a really labyrinthine management structure which has to be causing some of the grief we are currently feeling in e-Health.

Just where it fits can be figured out by downloading this small 2 page PowerPoint presentation.

www.aihw.gov.au/committees/health_reporting_structures.ppt

The committee of which I speak is the grandly named:

Joint Standing Committee on Health Informatics Standards

As far as one can tell the committee reports to the National E-Health & Information Principal Committee. This in turn then reports to the Australian Health Ministers’ Advisory Council (AHMAC) which then reports to the Australian Health Ministers’ Conference (AHMC) which is the ‘top banana’ and which feeds in to the Council of Australian Governments (COAG).

All this can be reviewed here:

http://www.ahmac.gov.au/site/home.aspx

Having come upon a document which said it was commissioned by this group I was curious to see where it all fitted and having found this also discovered, from page 2 of the slides, where the National Health Chief Information Officers Forum (NHCIOF) fitted and that there actually exists a National E-Health Strategy Project Steering Committee – if this document is correct. I wonder where the minutes of these committees hide?

The report I found had this title:

Identification of Priority E-health Standards

Project Report

Joint Standing Committee on Health Informatics Standards

Final - Version 1.2

April 2010

The Executive Summary reads as follows:

Executive Summary

Convergence e-Business Solutions and SecureWorx Consulting were engaged by the Joint Standing Committee on Health Informatics Standards (JSC-HIS) to “identify priority e-health standards that are requisite to the progress of e-health within Australia”. We were assisted in this project by the JSC-HIS and an invited Stakeholder Reference Group comprising jurisdictions and a number of health informatics specialists.

The starting point for the project was the collected works-in-progress and plans of Standards Australia Health Informatics Sub-committee IT-14 and NEHTA which were mapped these against 12 agreed priority e-health components. The components were drawn in the main from the National E-Health Strategy, which we assumed to be the best available expression of the agreed requirements for e-health in Australia.

The mapping of standards against e-health components incorporated three independent weightings: the relative importance of the components themselves; the criticality of each given standard to progressing the components; and the amount of effort needed to complete the development of each standard. Values for all of these weightings were determined by surveying the Stakeholder Reference Group and taking the median value of their responses.

A spreadsheet was developed that implements the mapping model, applying the weights to each standard, and assigning it an overall score. After ordering the standards, they were allocated to four evenly divided quartiles, and assigned overall priorities on a four point scale.

The result of this analysis was a list of 21 standards that, in the absence of other considerations such as specific project imperatives or requirements deriving from a broader context, should be given top priority in development in order to progress e-health in Australia. As a final quality check, the output of the model was then reviewed by a group of selected subject matter experts to identify any inconsistencies in the analysis and any gaps in the resulting priority list.

The results of this work should not be taken as the final word in setting development priorities for e-health related standards in Australia. Neither should the results be regarded as being beyond reproach. Several relatively narrow considerations, which were accepted in the proposal and the methodology as it was developed, can be expected to have biased the results. Most significantly of course is the explicit reference to e-health. Thus, a standard that might be considered indispensible to hospital procedures or general practice for instance, will not have been rated highly by this treatment. Further, a standard deemed critical by one jurisdiction to a defined e-health program may have been weighted down if no other jurisdiction considered it particularly important.

A remarkable finding of our surveys was the great variance in priorities assigned to the 12 national components by various state health agencies. For the components Prescriptions, Care Plans, Decision Support for Tests, Chronic Disease Management and Secondary Interfaces, priorities ranged right across the board, from highest to lowest. Only one component (Referrals) was uniformly rated by all respondents. While the National E-Health Strategy defines clear priority areas, we found that there remains significant disagreement about the relative importance of those areas. This exposes the main limitation of our methodology: its statistical rationale is weakened in the event that there is not sufficient underlying agreement amongst stakeholders about what e-health itself needs to achieve. By the same token, we suggest that the tool and the collaborative discovery of stakeholders’ views about e-health imperatives serve to usefully uncover and catalogue the many competing interests. Therefore the process itself is of value for raising visibility and providing stakeholders fresh opportunities to understand one another’s issues.

We believe the model and the analysis tool developed here to be a useful new way to demonstrate the relationships between standards, and their respective contributions to realising e-health objectives. We suggest that in further work, the tool be used to help facilitate debate and resolution of priorities amongst jurisdictions and other stakeholders.

During the course of this project, the consultants observed the working relationship between NEHTA and Standards Australia. This relationship operates effectively and the two organisations cooperated strongly on the standards prioritisation process. In a complex multi-facetted area, both bodies exhibited a remarkable level of agreement on all substantive matters.

The development of standards for e-health in Australia is largely driven today by Standards Australia and NEHTA, in cooperation with other agencies, such as HL7 and IHE Australia, who bring specific relationships with organisations in the international health standards arena. Convergence/SecureWorx believes that the current working relationship between the two organisations has shown to be effective in advancing the development of standards for e-health and we see no reason to change their role in this regard. We recommend that these two organisations continue to perform their central role in the development of e-health standards.

Finally, the project has identified the need for some overall coordination in the timing and prioritisation of standards development to meet national e-health objectives. To this end we recommend that the role of NHISSC be extended to include reviewing and where necessary, setting, the priorities for the development of e-health standards in supporting Australia’s strategic e-health goals. This work should be undertaken collaboration with the NHCIOF.

----- End Executive Summary

The full file is not available on the web so I have made it available here:

http://moreassoc.com.au/downloads/E-health%20standards%20Final%20Report%202010-04-29.pdf

All this raises a few interesting questions.

First just why is such work being done at the behest of a very obscure committee which may have major impacts on e-Health priorities and capabilities essentially in secret from the broader e-Health Community. The Steering Committee as made up of public sector health bureaucrats and the Project Reference Committee as very thin on the ground in terms of both primary care and private sector input.

A search using Google and Bing find 4 hits and no minutes of meetings etc. I believe this utter lack of openness is a problem and is symptomatic of the narrow health department centric approach adopted by DoHA and NEHTA and their masters which is getting key directions totally wrong in my view.

The internal disagreement on priorities in the Executive Summary makes all this quite clear.

The second obvious issue is, with the new, recently announced funding, how are we actually going to mobilise coherent appropriate investment if there is this sort of priority differences? The answer is that the risk of throwing good money after bad is very high when things are managed in this fashion.

The PowerPoint (which is dated Mid 2009) is really a guide book to the totally failed e-Health Governance approach which must be swiftly opened up, made transparent and broadened to include many more stakeholders and experts.

The third issue regards what other reports this group have commissioned that should be more widely know?

All this poses a ‘clear and present’ danger to any success with this new money in my view.

David.

Microsoft Offers a Perspective on e-Health in Australia.

I had an nice e-mail from James Kavanagh who is a Healthcare Solution Architect, Microsoft Australia today.

He wrote (in part)

“Over the last little while there’s been a lot of speculation around the concept of personal electronic health records (and some pretty confusing announcements). I do a lot of work in that area (helping with the technical planning for Healthvault), but like you I have a strong belief that clinically led solutions built to support evidence based models of care are actually the most important investments we need to make. Those solutions may include electronic health records but more importantly need to be directed towards better coordination of care, better clinical decision making and easier flow of information around our health system.

I recently wrote a whitepaper bringing together some of the work of Microsoft and our partners in Australia in providing solutions for chronic care. Unfortunately I still believe there’s just not enough focus on targeting e-Health towards people with chronic conditions and as a result I don’t think people really understand the value of e-Health to the population that would get the most advantage from it.

I’ve attached the whitepaper if you’re interested, and if you think it’s worthwhile then please feel free to consider publishing it on your blog.”

You can link to it directly at:

http://download.microsoft.com/documents/australia/health/Whitepaper_Caring_for_people_with_chronic_conditions.pdf

I think James makes some interesting points here and provides some interesting perspectives provided by system providers both here and overseas.

Only one nit (Page 4).

The urgent need to focus on chronic disease

The burden of chronic disease is one of the greatest challenges facing the Australian health system. Our longer lives and improved ability to treat what were previously acute, fatal conditions are two contributing factors. These are compounded by modern lifestyles with increased exposure to risk factors such as smoking, excessive alcohol consumption, lack of exercise and poor diet with more than half of Australians overweight.”

I don’t think we are getting credit for actually reducing smoking dramatically over the last 20-30 years – although to the rest we have to plead guilty!

Well worth a browse. Links nicely with some of the stuff I have been writing on the “Medical Home” concept.

See here:

http://aushealthit.blogspot.com/2010/05/we-really-need-to-work-out-how-these.html

David.

AusHealthIT Man Poll Number 19 – Results – 17 May, 2010.

The question was:

Will The Health IT Funds Provided in the Budget be Adequate, Well Targeted, Strategic and Appropriate?

Results

For Certain

- 2 (5%)

Probably

- 6 (15%)

Don't Know

- 1 (2%)

Just Possibly

- 3 (7%)

Almost Certainly Not

- 26 (68%)

Votes : 38

Comment:

This is a pretty clear result. There is major scepticism that the e-Health spending will be well managed with 75% not at all sure!

Again, many thanks to all those who voted

David.