Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Sunday, July 11, 2010

Weekly Australian Health IT Links – 11 July, 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:

Well it seems the clearing of the decks before the election is well and truly underway! We have a time-table for health reform, a cancelling of the internet filter for now and lots of NBN activity – to say nothing about advertising for an e-Health CIO for the Department of Health.

The pace of all this – in the middle of winter – suggests something is really afoot!

For myself all I really would like is to see a coherent plan for e-Health, or the lack of it as an election issue. Dream on I guess!

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http://www.smh.com.au/national/fears-health-reform-plans-being-rushed-through-20100708-102bq.html

Fears health reform plans being rushed through

MARK METHERELL

July 9, 2010

The federal government's release of a detailed plan to deliver health reform has triggered criticism from health groups that the complex changes are in danger of being rushed through with little input from consumers.

The Australian Healthcare and Hospitals Association, which has supported the reforms, has voiced concern that the reform time frames might be ''unrealistic'' and said it was disappointed at the lack of consultation with consumers.

The association's chief executive, Prue Power, said the most critical element in implementing the new structure of local hospital networks and Medicare locals, and one which had not yet been detailed in the plan, was the integration of patient care between the community and hospital sectors.

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http://www.theaustralian.com.au/news/nation/reforms-rushed-says-australian-healthcare-and-hospitals-association/story-e6frg6nf-1225889560692

Reforms rushed, says Australian Healthcare and Hospitals Association

  • Adam Cresswell, Health editor
  • From: The Australian
  • July 09, 2010 12:00AM

THE peak body for Australia's public hospitals has criticised the planned rollout of the federal government's health reforms.

And the Australian Healthcare and Hospitals Association has warned that some measures risk being introduced too fast while also criticising the transparency of the process.

A day after federal Health Minister Nicola Roxon released a detailed timeframe for implementing its reform program, the AHHA said some of the timeframes appeared "unrealistic", particularly for measures that depended on new systems for collecting information.

The AHHA said while it welcomed the document for making "concrete the government's commitment to genuine reform", it was also "disappointed" there was neither a formal mechanism to guide consultations, nor one to include consumer groups in the process. The lack of a formal evaluation plan for the changes also meant Australians "will not know whether or not the reforms have achieved their stated objectives", the AHHA said.

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http://www.medicalobserver.com.au/news/expert-claims-reform-think-tanks-biased

Expert claims reform think tanks biased

9th Jul 2010

Andrew Bracey

ATTEMPTS by the Federal Government to overhaul the health system were flawed from the start, a health policy expert has argued, as the independent think tanks steering reform directions were loaded with industry figures unable to “think outside the box”.

Speaking at a health reform forum hosted by the Australian National University last week, Ian McAuley, a fellow of the Centre for Policy Development, said the Government’s advisory bodies, including the National Health and Hospitals Reform Commission, had too much representation by health industry insiders.

The bodies had failed to deliver a blueprint for a better integrated system, he said. Policies such as the controversial diabetes funding scheme focused on “coordinating existing disparate programs rather than re-designing programs themselves”.

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http://bayside-leader.whereilive.com.au/news/story/it-system-diagnosis-questioned/

IT system diagnosis questioned

SANDRINGHAM Hospital will get a controversial patient records system upgrade early next year.

The Cerner IT project, in place at the Alfred hospital since March, will be rolled out to Sandringham by early next year.

But the upgraded system, which records patients’ medical history, has been blasted by doctors.

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http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr10-nr-nr140.htm

Release of Roadmap to Reform

7 July 2010

The timeline for the further delivery of better health and hospital services was today released by the Minister for Health and Ageing.

The Government’s ambitious plan to reform our health system is a complex and extensive task, particularly after so many years of neglect under the former Government. It is vital that the implementation of these extensive reforms is carefully planned and well-executed.

The Government’s implementation plan spells out the details as to when initiatives such as extra sub-acute beds, more doctors and more nurses will be part of our health system. It has clear, defined goals for improving the system to which the Government expects to be held accountable.

The plan is carefully structured to ensure that the planned improvements to our health system are delivered to provide better, more connected services for all hard working Australians.

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http://www.nehta.gov.au/media-centre/nehta-news/661-youth

Youth lead the adoption of e-health

The ‘net’ generation, spanning 13 to 33 year olds, has embraced technology as the norm and is expected to adopt e-health as just par for the course in their highly connected lives according to several leading youth health experts.

Jonathan Nicholas, Chief Executive Officer of the Inspire Foundation, the organisation behind the web-based mental health support service for young people, ReachOut.com said, “As an organisation that uses the internet to connect with young people, we see a number of benefits for young people flowing from the proposed e-health record.

“They have grown up archiving their life on social networking sites such as Facebook, so saving personal data into web environments is neither alien, nor something they fear. To the contrary, they expect to be able to access their information when they need it, and save it into a secure, centralised location.”

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http://www.zdnet.com.au/timetable-confirms-2012-e-health-date-339304399.htm

Timetable confirms 2012 e-health date

By Josh Taylor, ZDNet.com.au on July 8th, 2010

in brief The Federal Government has formally laid out a two-year timetable for delivering e-health to all Australians.

In a statement released yesterday, Health Minister Nicola Roxon outlined the government's "roadmap to reform" in health over the next two years, including the government's plans for an e-health portal. Roxon had previously indicated that she expected the delivery of the online portal that would allow patients access to their e-health records to take around two years, but in her statement yesterday she set a more exact deadline of July 2012.

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http://www.computerworld.com.au/article/352600/telstra_gps_e-health_agreement/?eid=-255

Telstra, GPs in e-health agreement

Telstra plays a card in the e-health game, signs MOU with the Royal Australian College of General Practitioners

  • AAP (Computerworld)
  • 09 July, 2010 07:49

The nation's GPs and Telstra have reached an agreement on the roll-out of "critical first step" e-health reforms.

The Royal Australian College of General Practitioners (RACGP) has signed a memorandum of understanding with the telco giant, outlining a range of hi-tech services to be brought online from next year.

The first would allow the nation's 17,200 GPs to access health care applications, diagnostic tools and an array of other clinical and administrative software programs using a "single log-on" web service.

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http://www.zdnet.com.au/act-hospitals-buy-intensive-care-system-339304385.htm

ACT hospitals buy intensive care system

By Colin Ho, ZDNet.com.au on July 8th, 2010

Intensive Care Units (ICUs) at Canberra Hospital and Calvary Public Hospital in the Australian Capital Territory will be adopting a new, $1.7 million digital information management system following an announcement yesterday by ACT Health Minister Katy Gallagher.

Delivered by Vision Software Solutions, the information management system will enable paperless management of patient records in the ICUs.

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http://www.computerworld.com.au/article/352643/victorian_ict_industry_successes_awarded_by_aiia/

Victorian ICT industry successes awarded by AIIA

AIIA CEO, Ian Birks, sees government engagement as key to Victoria excellence in IT

Government engagement has been key to the success of the ICT industry in Victoria of late, according to Australian Information Industry Association (AIIA) chief executive officer, Ian Birks, but other states are catching up.

Speaking to Computerworld Australia, Birks, said the thriving industry in Victoria could be attributed to financial and innovation input from the State Government.

.....

eHealth

  • iCare Solutions Pty Ltd. iCare Solutions Aged Care electronic health record – winner
  • Saeid Nahavandi – Multi-Point Haptics for Next-Generation Medical Procedures and Training – merit

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http://www.cio.com.au/article/352367/isoft_claims_healthsmart_win/?eid=-601

iSOFT claims HealthSMART win

E-health giant shrugs off troubles to complete Victorian healthcare project

iSOFT announced it had completed the rollout of new patient management systems in mid-June to Victorian hospitals under Victoria's delayed HealthSMART project begun back in 2003, as financial problems continue to plague the Australian e-health giant.

The overall HealthSMART project was initiated under the Bracks Labor government back in 2003 with a pricetag of $323 million and a due date of 2007. It has since had another $37 million pumped into it, with the due date gradually extending — several years ago it was slated to be finished in 2009.

The iSOFT implementation reflects one substantial chunk of the project — other vendors involved include US-based Cerner and InterSystems subsidiary TrakHealth. iSOFT won an open tender for its portion in December 2005.

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http://abnnewswire.net/press/en/63242/iSOFT_Group_Limited_%28ASX:ISF%29_Secures_A30_Million_Equity_Line_Of_Credit_Facility_With_YA_Global.html

iSOFT Group Limited (ASX:ISF) Secures A$30 Million Equity Line Of Credit Facility With YA Global

Sydney, July 7, 2010 (ABN Newswire) - iSOFT Group Limited (ASX:ISF) today announces that it has secured a A$30 million equity line of credit facility with US-Based Investment Fund YA Global Master SPV Ltd (YA Global).

iSOFT secured the facility in order to provide flexibility in cash management. It will initially be used to replenish cash balances drawn down to fund acquisitions and other capital investments undertaken during the 2010 financial year.

Under the terms of the facility, iSOFT may, at its discretion, issue shares to YA Global at any time over the next 60 months, up to a total of A$30 million. iSOFT may draw down these in tranches of up to A$2.5 million, although this may be varied by agreement with YA Global.

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http://www.e-health-insider.com/news/6062/three_more_lorenzos_by_autumn

Three more Lorenzos by autumn

08 Jul 2010

Three more trusts will go-live with Lorenzo Regional Care Release 1.9 over late summer and early autumn, the Department of Health has told E-Health Insider.

The early adopter sites - Birmingham Women’s NHS Foundation Trust, Pennine Care NHS Foundation Trust and Kettering General Hospital NHS Foundation Trust - have all had significant delays to their go-live dates, after waiting for University Hospitals of Morecambe Bay NHS Trust to go live earlier this year.

A spokesperson for the DH said: “The Department of Health understands these three early adopter trusts are planning to deploy Lorenzo Release 1.9 over late summer and early autumn.

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http://www.theaustralian.com.au/business/health-firm-secures-30m-credit-facility/story-e6frg8zx-1225889571771

Health firm secures $30m credit facility

LIFE isn't getting any easier for iSOFT, but that could be exactly what potential suitors are hoping for.

Within weeks of chief executive Gary Cohen copping a few embarrassing margin calls, the health IT outfit this week unveiled a strange-looking $30 million credit facility with little-known US investment fund YA Global Master. iSOFT plans to use the credit to replenish cash used to fund acquisitions and can pay back the borrowing over the next five years through equity issues. YA will probably get a good price too, with iSOFT yesterday clarifying it would issue shares via a generous formula. iSOFT shares have plunged about 75 per cent so far this year after some disappointing first-half results and fears of a poor full year. There are murmurs of Primary Healthcare and private equity sizing up the group.

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http://press-releases.techwhack.com/56887-isoft-9

iSOFT wins A$1m electronic health record deal with India’s AMRI

Sydney – 7 July 2010 – A $1 million contract with Advanced Medicare Research Institute (AMRI) Hospitals for an electronic health record (EHR) for six of its hospitals in India has been won by iSOFT, after a competitive tender.

Replacing an outdated hospital information system, iSOFT’s Enterprise Management gives AMRI a single, integrated EHR and 700 concurrent users ready access to patient and clinical information to improve efficiency and the quality of care.

The solution is being installed at three hospitals now and three more that have yet to be identified by AMRI. The three hospitals are at Mukundapur, Salt Lake, and Dhakuria, in the state of West Bengal.

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http://www.theaustralian.com.au/australian-it/states-health-payroll-change-was-adopted-untested/story-e6frgakx-1225888223958

Queensland health payroll not fully tested

QUEENSLAND Health had a back-up plan but it failed when its botched payroll and human resources system went live in March, a damning report finds.

The failure left thousands of workers with little or no pay.

Warnings by SAP, IBM and others to properly test the system were not heeded because it was considered too great a task. From the outset, Health, as the main user of the new payroll system, was not kept in the loop, reported Queensland Auditor-General Glenn Poole.

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http://www.couriermail.com.au/news/queensland-health-pay-woes-may-affect-public-service/story-e6freon6-1225888541480

Queensland Health pay woes may affect public service

THE same systemic problems that led to the full-scale Queensland Health payroll debacle pose a risk to many more state government financial transactions including payment of thousands of public servants across a range of departments.

A damning report by Auditor-General Glenn Poole has found that financial disaster resilience – the ability to continue paying people in the face of a complete system failure – is lacking across the Government with insufficient safety nets in place over all three shared service agencies.

This means that thousands of public servants employed by the Government are potentially exposed to a crisis like the QH payroll.

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http://www.theaustralian.com.au/news/nation/auditor-general-glenn-poole-warns-payroll-disease-may-spread/story-e6frg6nf-1225888699745

Auditor-General Glenn Poole warns payroll disease may spread

PAYROLL blunders like the one in which Queensland Health workers were underpaid for months may spread in the state's public sector.

In his annual report, the Auditor-General Glenn Poole also criticised the government for allowing contractors to complete paperwork out of sequence and inadequately safeguarding against conflicts of interest. The report noted some systems used by CorpTech, the government's corporate IT agency, were due to become unsupported by 2013. There was therefore a "critical" need to consolidate CorpTech's systems, the report said.

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http://www.misaustralia.com/viewer.aspx?EDP://1278457812802&section=news&xmlSource=/news/feed.xml&title=Qld+AG+releases+second+damning+payroll+report

Qld AG releases second damning payroll report

The Queensland Auditor General has released another damning report warning the state government is at risk of financial security failures that could result in a further payroll debacle.

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http://www.couriermail.com.au/lifestyle/experts-cool-on-thermal-imaging-for-breast-cancer/story-e6frer4f-1225888270813

Experts cool on thermal imaging for breast cancer

HEALTH authorities are warning women about thermal imaging clinics offering breast-cancer screening, saying free mammograms are more effective in detecting tumours at an early stage.

The emergence of thermography clinics has Queensland Health, the Cancer Council Queensland and the Royal Australasian College of Surgeons concerned.

Brisbane breast surgeon Ian Bennett said thermography was a primitive form of imaging not much better for detecting breast cancer than self-examination.

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http://www.smh.com.au/technology/security/online-id-fraud-losses-explode-to-13bn-a-year-20100705-zxbj.html

Online ID fraud losses explode to $1.3bn a year

ASHER MOSES

July 6, 2010 - 7:00AM

One in 10 Australian internet users have lost money to online identify fraud over the past year with losses totalling $1.286 billion, according to the VeriSign Online Fraud Barometer figures released today.

The findings represent a significant increase on the figures reported in June by the Australian Bureau of Statistics, which surveyed Australians in 2007 and found that just over 800,000 had been victims of personal fraud. Back then, combined losses were $977 million.

VeriSign's figures suggest 1.37 million Australians, or 10 per cent of internet users, have fallen victim to online fraud in the past year. The results are based on a survey of 2510 Australians aged 18 years and over conducted in June this year by Galaxy Research.

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http://www.computerworld.com.au/article/352086/nbn_could_opt-out_tasmania_premier/?eid=-6787

NBN could be opt-out in Tasmania: Premier

Tasmanian Premier, David Bartlett, told a Senate estimates hearing that an opt-out model is feasible for the NBN

Tasmanian State Premier David Bartlett has committed to ask the Tasmanian NBN Company whether it would be feasible for Tasmanians to be required to opt-out from having the planned optic fibre cables connected to their premises -- reversing the current policy where they are required to opt-in.

"When I next meet with Doug Campbell, the chair of TNBN Co, I am happy to raise it with him and ascertain whether it has been considered," Bartlett said in a parliamentary estimates committee last week in response to questions on the matter from opposition MP Michael Ferguson.

"I do not think it is the Government's to consider; effectively it is TNBN Co's to consider ... I think your logic in simplistic terms sounds reasonable but I would not know what various legislative or other regulatory impacts on that logic there might be. It might be that governments do not have the power to just connect anything to any house and if you do not like it you had better have opted out," Bartlett added.

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http://www.smh.com.au/technology/technology-news/22-questions-you-need-answered-on-the-national-broadband-network-20100703-zufy.html

22 questions you need answered on the national broadband network

July 3, 2010

When it comes to internet, it's all about connections, writes David Humphries.

1. How does NBN differ from my existing internet connection? Current internet connections are based on copper networks, which do not have sufficient capacity for video services. The network will operate mainly on optical fibre, a thin glass or plastic strand that carries light from lasers shone down the fibre and detected by receivers at the other end.

2. Why change to an NBN connection? Quality in relation to security, privacy, reliability and speed, the advantages are most noticeable with video services. The network will be be 50 to 100 times faster.

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http://www.news.com.au/breaking-news/nbn-to-be-the-gateway-to-better-services/story-e6frfku0-1225887791300

NBN to be the 'gateway to better services'

  • From: AAP
  • July 05, 2010 12:17AM

FAST broadband will improve health, education and the environment, a national think tank will hear in Brisbane today.

Terry Cutler, chair of the ATC Centre of Excellence for Creative Industries and Innovation, said attention should shift from infrastructure to public benefits now that a deal had been struck with Telstra on the rollout of the National Broadband Network (NBN).

On June 20, after protracted talks between the government and Telstra, an $11 billion deal was struck for Australia's biggest telco to lease its infrastructure to NBN Co, the company that will build and run the network.

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http://www.theaustralian.com.au/australian-it/labor-ups-nbn-trial-sites/story-e6frgakx-1225889317373

Labor ups NBN trial sites

THE Gillard government has rushed ahead with its NBN plans even though the project will be cancelled if it loses the next election.

Communications Minister Senator Stephen Conroy yesterday announced that the government would soon unveil at least 20 more mainland NBN construction sites.

"It's full steam ahead with the NBN. We recently announced the agreement with Telstra, and we're very close to announcing the next 20 or so mainland sites where we will be connecting and the trucks will start rolling,'' Senator Conroy said.

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http://www.theaustralian.com.au/business/national-broadband-network-cost-could-balloon-says-chief/story-e6frg8zx-1225890003753

National broadband network cost could balloon. says chief

THE cost of funding the national broadband network construction is unknown and could balloon NBN Co chief executive Mike Quigley says.

The man in charge of the federal government's nascent national broadband network said the "nation-building project" was potentially a bottomless pit when it came to funding and he had no idea what the cost would ultimately be.

"When it comes to cost you always have to ask at what point do you stop? It's a very long-term project -- money will be out into this network for years and years and years, as it is upgraded," Mr Quigley said.

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http://www.smh.com.au/technology/technology-news/gillard-to-stick-with-web-filter-despite-disquiet-20100707-100qe.html

Gillard to stick with web filter despite disquiet

ARI SHARP COMMUNICATIONS CORRESPONDENT

July 8, 2010

THE Prime Minister will push ahead with controversial plans for a mandatory internet filter despite acknowledging public concerns that it will interfere with ''legitimate use''.

In Julia Gillard's first comments on the filter since becoming Prime Minister, she told ABC radio in Darwin that the proposal was an effort to control the ''dark side'' of communications technology.

''Images of child abuse, child pornography - they are not legal in our cinemas,'' she said yesterday. ''Why should you be able to see them on the internet? I think that that's the kind of moral, ethical question at the heart of this.''

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http://www.theaustralian.com.au/australian-it/filtering-legislation-on-the-way/story-e6frgakx-1225889109550

ISP filtering legislation on the way

  • Fran Foo and Andrew Colley
  • From: Australian IT
  • July 07, 2010 6:30PM

THE federal government hopes to introduce legislation to enable its controversial internet filter by the end of the year.

Communications Minister Stephen Conroy said the legislation would be this year "sooner rather than later''.

Timing for the web filter legislation, which has earned the ire of ISPs and internet freedom advocates, depends on the date for the looming federal election and whether Labor wins office.

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http://www.theage.com.au/technology/technology-news/internet-filter-wont-protect-kids-20100708-102ap.html

Internet filter 'won't protect kids'

ARI SHARP

July 9, 2010

PROTECTING children online could be harder with a mandatory internet filter in place, a coalition including state schools, librarians and key players in the internet industry has warned.

The recently formed Safer Internet Group argues that the federal government's proposed filter is a simplistic solution to shielding children from harmful content on the internet.

''We believe that real online safety can be delivered without the implementation of a mandatory internet filter, which locks parents and the industry out of keeping kids safe online,'' the group wrote in a submission to a parliamentary committee on cyber safety.

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http://www.computerworld.com.au/article/352649/filtered_internet_70_web_users_under_government_deal/?eid=-6787

Filtered Internet for 70% of web users under government deal

National Internet content filtering delayed for a year

Up to 70 per cent of Australians will have filtered Internet access under a deal between Telstra, Optus, iPrimus and the Federal Government, Communications Minster Stephen Conroy said today.

Under the deal, the Internet Service Providers (ISPs) will impose web content filtering for their customers and in turn the Federal Government will postpone its national mandatory Internet content filtering scheme for a year.

The Federal Attorney-General‘s office will also review the filter blacklist - or refused classification content - to be administered by the Australian Communications and Media Authority (ACMA).

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http://www.theage.com.au/national/gillard-dodges-flak-on-filter-20100709-1046r.html

Gillard dodges flak on filter

DAN HARRISON

July 10, 2010

AS JULIA Gillard clears the decks for an election that could be called as soon as next weekend, she has moved to limit the political fallout from Labor’s controversial plans to filter internet pages by putting the proposals off indefinitely.

The politically motivated deferral — which the opposition immediately branded a ‘‘humiliating backdown’’ — follows other recent policy reversals, softenings and adjustments as the government rushes to allay the concerns of various constituencies before the poll.

The latest U-turn is Ms Gillard’s new asylum policy, embracing offshore processing.
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Enjoy!

David.

Friday, July 09, 2010

Weekly Overseas Health IT Links - 7 July, 2010.

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.
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Improving the Quality and Cost of Healthcare Delivery

The Potential of Radio Frequency Identification (RFID) Technology

By: Anna-Marie Vilamovska
This study investigates whether an upcoming class of health information technology (HIT) can be used to address currently outstanding issues in the quality and cost of healthcare delivery. Expert interviews and a literature review were used to describe the 2009 universe of in- and outpatient healthcare RFID applications and to identify those applications expected to have the largest positive impact on the quality and cost-effectiveness of healthcare delivery over the next five to ten years. Next, case studies of actual RFID implementations across seven hospital sites in the U.S. and Europe were conducted to gain an understanding of how each leading RFID application type creates value, what aspects of care it impacts, and what the critical factors driving the promising RFID’s organizational benefits and costs are. As part of this work, an original set of healthcare RFID cost-benefit evaluation tools was developed and tested. The study’s findings indicate that in contrast to other types of HIT, the majority of benefits associated with successful RFID implementation are directly related to money saved (occurring as direct capital and operational cost savings), and that select RFID applications can substantially impact both the cost (e.g., efficiency) and the quality (e.g., timeliness, capacity for continuous improvement) of care delivery. Critical challenges for RFID adoption are described.
Free, downloadable PDF file(s) are available below.
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Monday, June 28, 2010

Patient Engagement in Health IT Efforts Could Be Crucial

At the Health 2.0 conference earlier this month in Washington, D.C., several patient advocates stressed the need to include patients in federal health IT efforts.
Trisha Torrey, who writes the Every Patient's Advocate Blog, noted that many of the policy terms thrown around by the health IT community, like "HITECH" and "meaningful use," are meaningless to patients.
A day later, a survey -- conducted by Harris Interactive for the Xerox Corporation -- was released, finding that only 16% of U.S. adults with a health care provider or institution said they have been approached by that provider or institution to discuss converting to electronic health records.  The survey also found that respondents ranked patients as last among groups to benefit from EHRs, with 26% reporting that patients have the least to gain from EHR adoption.
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Possibility of National Electronic Medical Records System Growing

By Andy Opsahl
In San Francisco, Accenture recently hosted the last of its three town hall meetings gauging citizen views on health-care challenges and solutions in partnership with the Council for Excellence in Government. The other two meetings occurred in Miami and Detroit. As health-care costs and the number of uninsured citizens climb, some form of government-supported universal health coverage is becoming more likely in the United States, according to panelists at the San Francisco meeting.
Universal health coverage could make a national electronic medical record (EMR) infrastructure critical to managing such a massive, complex health-care system. A national move to EMRs would create new business opportunities for the IT industry. These gatherings allowed Accenture to test the waters of citizen receptivity to a national EMR system. Meeting attendees have been surprisingly open to the EMR idea, said Ken Dineen, global managing director of Accenture’s health industry practice. The company’s polling data showed 79 percent support for EMR among Miami citizens, 59 percent in Detroit and 74 percent in San Francisco. Privacy and security concerns about such a system fuel the usual objections.
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More IT outreach needed: eHealth Initiative

Posted: July 2, 2010 - 12:15 pm ET
Electronic healthcare initiatives have made headway over the last several years, but health information technology remains an undervalued tool, a new report concludes.
The National Progress Report on eHealth, 2010, released July 1 by the not-for-profit, Washington-based eHealth Initiative, found that significant progress in health IT has been made over the past three years. The American Recovery and Reinvestment Act of 2009 is cited as a key driver of progress.
However, challenges remain, said Jennifer Covich Bordenick, CEO of the eHealth Initiative, in a written statement. "Coordinating public- and private-sector efforts and communicating the true value of HIT and HIE to consumers will be critical as we move forward," she noted.
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20,000 SCRs viewed via Adastra system

29 Jun 2010
More than 20,000 Summary Care Records have been viewed out-of-hours via the integrated solution provided by software supplier Adastra.
The company said the figures covered viewings at the three early adopter sites in Bolton, Bury and Medway, where SCRs are available for the majority of the population.
Dr Alex Yeates, medical director for Adastra, said the 20,000th viewing was recorded over the weekend by a doctor working at night in one of the three centres.
He told EHI Primary Care: “Although it’s only a number, it is a milestone which shows that in these three areas it is now becoming normal to have that record available and to view it when needed.”
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“Slow and steady” may not be so bad

By Jeff Rowe, Editor
Given the variety of kinks that still need to be worked out of emerging systems, is it really such a bad thing that the public is slow in understanding the potential benefits of HIT?
 That’s the question that came to mind as we skimmed through the results of the most recent Harris Interactive/HealthDay poll that looked at American’s understanding of their physician’s IT capabilities.
According to the press release announcing the poll, “despite years of hype around the issue, less than one in 10 American adults now utilize electronic medical records or turn to e-mail to contact their doctor.”
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Children’s Cancer Hospital Egypt 57357 Improves Patient Safety with Cerner Health Information Technology Solutions

Published Today - 08:51 GMT
The Children's Cancer Hospital Egypt 57357 (CCHE) has successfully gone live with state-of-the-art healthcare information technology (HIT) solutions from Cerner Corporation. More than 700 clinicians and staff are using Cerner Millennium® solutions to provide superior care and improve patient safety for cancer patients at Egypt's leading pediatric cancer hospital. The Cerner® electronic health record (EHR) is the Single Source of Truth™ for accurate patient information, including allergies, the latest diagnostic results and accurate patient weight at the point of care so that CCHE caregivers can safeguard their pediatric patients. CCHF implemented Cerner technology to help ensure safety and reliability in the delicate process of caring for pediatric cancer patients.
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Health Reform Presents I.T. Challenges Big and Small

By Joseph Goedert
Health Data Management Magazine, 07/01/2010
You can't say the first 18 months of the Obama administration have been boring for the health I.T. industry.
The administration kicked things off with the HITECH Act and its health records, health information exchange and privacy/security provisions. I.T. executives' plates were pushed to overflowing with implementation of the HIPAA 5010 transaction sets and ICD-10 code sets, and the annual modifications to Medicare and Medicaid policies and payments.
The federal government now has served up the Patient Protection and Affordable Care Act, commonly known as the health care reform law, also frequently referred to by both proponents and critics as ObamaCare.
Health Data Management's June and May issues covered several new reform-related challenges, including new "operating rules" to further standardize HIPAA transactions, electronic enrollment for public health and human services programs, lower Medicare/Medicaid reimbursements, and demonstration programs to better coordinate care and adopt best practices.
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Royal Free builds Cerner checklists

30 Jun 2010
The Royal Free Hampstead NHS Trust has developed a fully auditable set of guidelines and actions for clinicians within its Cerner Millennium electronic patient record system.
The trust has been working with Cerner and the BMJ Evidence Centre to pilot a standardised checklist of actions to help clinicians make the best decisions for patients with gastro-intestinal (GI) bleeding.
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CIOs: We Won't Meet MU in Time

HDM Breaking News, June 29, 2010
A survey of 120 hospital CIOs finds that half believe their organization will meet the first set of electronic health records meaningful use criteria in time to get incentive payments in 2011, and a full 80 percent worry about being able to meet expanded criteria in 2015.
Later stage criteria that is worrisome includes using advanced decision support, providing and populating personal health records, and improving health outcomes through data exchange with outside organizations.
New York-based consultancy PricewaterhouseCoopers LLP surveyed the CIOs, all members of the College of Healthcare Information Management Executives, during the second quarter of 2010. The firm also conducted in-depth interviews with 14 CIOs or leaders of delivery systems, health information exchanges, insurers and regional extension centers.
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Hospital CIOs confused over e-health records rollout standards

Lack of clarity about government rules slowing efforts, survey says

Lucas Mearian
June 30, 2010 (Computerworld)
The vast majority of hospital CIOs recently surveyed by PricewaterhouseCoopers LLP (PwC) said they're concerned that they won't be able to demonstrate "meaningful use" of electronic health records (EHR) -- and therefore won't qualify for federal reimbursements for rolling out the technology.
Ninety-four percent of the CIOs responding to the survey whose results were released Tuesday said that they're concerned they can't meet government requirements about how to report meaningful use of EHRs, and 92% said that they're concerned about a lack of clarity in the criteria used by the government.
Last year, the American Recovery and Reinvestment Act (ARRA) set aside $36 billion to help hospitals and doctors purchase equipment to computerize patient medical records, but even the most sophisticated hospitals in the country are struggling to qualify for the payments, PwC's study indicated. Clinicians and hospitals that deploy the technology and prove that it meets a set of government "meaningful use" standards showing it's being effectively used can receive up to $44,000 per doctor in reimbursement funds beginning next year.
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R.I. ACLU sues state over rules governing medical records

01:00 AM EDT on Wednesday, June 30, 2010
By Felice J. Freyer
Journal Medical Writer
A suit filed Tuesday alleges that newly adopted regulations fail to adequately protect patient privacy under the state’s developing system for exchanging electronic medical records.
The suit by the Rhode Island affiliate of the American Civil Liberties Union says that regulations developed by the state Department of Health are full of gaps that leave patients vulnerable.
The regulations govern the Health Information Exchange, a system that will enable doctors, hospitals, laboratories and pharmacies to easily access and exchange patient information.
The exchange, using the name Currentcare, is already enrolling patients and providers but is not yet operational. Patients may choose whether to participate in the exchange and may also specify who can have access to their records. But patients can’t exclude from their records any aspects of their care, such as treatment for addiction or mental illness.
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Resistance To EHRs May Widen Healthcare Disparities

Small medical practices serving Medicaid patients have been reluctant to adopt electronic health records because they're already overwhelmed with providing medical services.
By Nicole Lewis,  InformationWeek
June 28, 2010
As the push to implement new health information technology (HIT) among healthcare providers continues, many small physician practices offering services to Medicaid patients have shown a reluctance to adopt HIT, such as electronic health records (EHRs).
If these medical practices continue to resist implementing modern HIT systems, the situation threatens to widen healthcare disparities in the coming years, said Dianne Hasselman, director of quality and equality at the Center for Health Care Strategies (CHCS), at a recent public hearing on how technology can improve healthcare delivery among low-income populations.
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ONC now taking EHR certifier applications

Posted: July 1, 2010 - 12:30 pm ET
The application window is now open for organizations seeking government recognition as testing and certification bodies for electronic health-record systems eligible for reimbursement under the American Recovery and Reinvestment Act of 2009.
So far, the Office of the National Coordinator for Health Information Technology at HHS has received about 40 inquiries regarding applications and had 14 requests for applications, Carol Bean, an ONC standards harmonization analyst, reported to a meeting of the federally chart.
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Computerized sign-out holds promise, study finds

Posted: July 1, 2010 - 12:08 pm ET
A system for "computerized rounding" and handover of patient responsibility—also called "sign-out"—developed at the University of Washington may help ease the challenges of complying with medical resident 80-hour work limits.
The Web-based system the university developed, called UW Cores, was found to reduce the time residents at two Seattle hospitals spent managing patient information and generating sign-out materials by 30 to 45 minutes a day "without weakening systematic defenses against error or jeopardizing patient safety," according to a report published in Academic Medicine.
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EHR, Operating Cost Hikes Challenge Practice Managers

John Commins, for HealthLeaders Media, June 29, 2010

Rising operating costs, managing finances amid Medicare reimbursement shifts, and installing electronic health records are the top three challenges for medical practice managers, according to Medical Practice Today: What Members Have to Say, an annual survey from the Medical Group Management Association.
"It is not surprising that 'maintaining finances with the uncertainty of Medicare reimbursement rates' jumped to the No. 2 spot this year due to the continued congressional irresponsibility in not permanently addressing the flawed sustainable growth rate formula," said William F. Jessee, MD, president/CEO of Englewood, CO-based MGMA.
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ONC Advisors Tackle Data Exchange

HDM Breaking News, June 28, 2010
The HIT Policy Committee, an advisory group to the Office of the National Coordinator for Health Information Technology, has recommended that ONC encourage the use of models for exchanging personal health information that do not expose any unencrypted PHI.
These models include direct exchange from message originator to message recipient, or exchange using an intermediary that only performs routing services and has no access to PHI.
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After $127 million, VA starts over on scheduling

Posted: June 29, 2010 - 12:00 pm ET
Weaknesses in management and effective oversight have hindered efforts by the Veterans Affairs Department to replace its outpatient scheduling system, the Government Accountability Office has concluded.
In a report released on its website Monday, the GAO chronicles the VA's unsuccessful first attempt to modernize its outpatient scheduling project, otherwise known as the Scheduling Replacement Project.
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ONC to issue ‘rules of the road’ for NHIN Exchange

By Mary Mosquera
Friday, June 25, 2010
The Office of the National Coordinator for Health IT plans to establish rules of the road for the nationwide health information network (NHIN Exchange) in order to expand the kinds of organizations that can participate in it.
Participation in the NHIN Exchange is currently limited to federal health agencies and healthcare organizations that contract with them or are federal grantees.
As the first step in the rulemaking process, ONC will publish a request for information in August to get public comment on the governance process. It expects to then release a proposed rule in early 2011, and to finalize it next summer, said Mary Jo Deering, senior policy advisor in ONC's Office of Policy and Planning.
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VA building mobile version of personal health record

By Mary Mosquera
Thursday, June 24, 2010
The Veterans Affairs Department is exploring a number of applications of wireless technologies to improve the health outcomes of veterans, especially those in rural areas that may be hundreds of miles from the closest VA clinic or hospital.
Wireless technologies can link veterans with their providers through personal cell phones and enable them to manage their health, said Gail Graham, deputy chief officer in health information management in the Veterans Health Administration.
For many veterans, “geographical distance from VA’s physical healthcare assets often presents a challenge to receiving care,” she said at a hearing of the House Veterans Affairs Committee health subcommittee June 24.
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Mobility To Lead Health IT Innovation

Government stimulus funds will help, but not quickly cure, the lag in health IT adoption caused by years of failure to invest in new technology.
By Nicole Lewis,  InformationWeek
June 25, 2010
The federal government's stimulus investment in healthcare IT is not a panacea, primarily because during the last decade the healthcare industry failed to invest in technology innovation. For that reason, it will take two to three years for the healthcare industry to catch up to other industries such as retail and banking, a new report concludes.
The report, published this month by Crosstree Capital Partners, a Tampa, Fla.-based investment banking firm, also predicts that the only place where completely new inventions are expected is in the wireless device space.
"While there are a few, mostly generic, applications used by doctors on their iPhones and Blackberrys, the devices are still pretty much used as cell phones, text messaging devices, and for e-mail," said Rob Tholemeier, author of the report and a principal covering health IT at Crosstree Capital. "In the next two to three years this will change dramatically as wireless communications and devices will proliferate throughout all aspects of healthcare delivery."
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Leapfrog finds high risk of order-entry errors

Posted: June 30, 2010 - 11:45 am ET
The Leapfrog Group, a Washington-based healthcare quality organization formed by large employers, has issued a report urging hospitals and information technology vendors to take a closer look at computerized physician order-entry systems to make sure they are detecting potential errors.
In the study that served as the basis for the report, 214 hospitals evaluated their CPOE systems using a Web-based simulation tool from Leapfrog. The simulations, which involved 10 test patients and 50 medication orders, took place between June 2008 and January 2010. More than half of the total medication orders processed in adult hospitals did not trigger the warnings they should have, according to the report. And among 311 potentially fatal medication orders processed in adult hospitals, only 32.8% prompted a warning.
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PACS adoption has reached 'mature stage,' study says

June 25, 2010 | Mike Miliard, Managing Editor
DES PLAINES, IL – A new report from the research firm IMV has found the market for electronic picture archiving and communication systems (PACS) is largely in "replacement mode."
According to "The PACS/IT Continuum: Present Access and Future Integration Strategies, 2010-2012," released by the IMV Medical Information Division, replacement has become the primary motivation for purchasing new systems in 2010, with 85 percent of the planned purchases of complete systems being replacement systems, compared to 15 percent for first buyers.
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Advice: Start now to appraise fitness of EHRs

June 25, 2010 | Bernie Monegain, Editor
FALLS CHURCH, VA – Hospitals and physicians that plan to meet meaningful use eligibility for government incentives must start now to assess their technology and talk with their vendors about certification, says Erica Drazen, managing partner of consulting firm CSC's Healthcare Group.
The Office of the National Coordinator announced the final rules for the temporary certification process on June 18. Certification entities are expected to be in place by late summer.
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ONC plans governance rule to expand NHIN participants

By Mary Mosquera
Friday, June 25, 2010
The Office of the National Coordinator for Health IT plans to establish rules of the road for the nationwide health information network (NHIN Exchange) in order to expand the kinds of organizations that can participate in it.
Participation in the NHIN Exchange is currently limited to federal health agencies and healthcare organizations that contract with them or are federal grantees
As the first step in the rulemaking process, ONC will publish a request for information in August to get public comment on the governance process. It expects to then release a proposed rule in early 2011, and to finalize it next summer, said Mary Jo Deering, senior policy advisor in ONC's Office of Policy and Planning.
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HIMSS: RFID still mostly used for equipment tracking

Despite more interest in using radiofrequency identification (RFID) to reduce medical errors and increase patient safety, the technology is mainly deployed for non-patient functions, according to a report from the Healthcare Information and Management Systems Society (HIMSS).
The society administered an online survey to 222 participants in May to discuss RFID technology. Nearly one-third (31 percent) of survey respondents believed that the widespread use of RFID applications will benefit healthcare organizations in the area of patient safety, followed by assets and/or biomedical equipment tracking (24 percent).
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Kirkland: EHR systems are important, but...

Posted: June 28, 2010 - 12:01 am ET
He was for them, now he's against them—even though he still thinks they're a good idea.
On his Dr. Ron Kirkland for Congress Facebook page, Ronald Kirkland, Congressional candidate and former chairman of both the American Medical Group Association and the Jackson (Tenn.) Clinic 120-physician multispecialty group, denounces the stimulus law's subsidies to help physicians buy electronic health-record systems and vows to return any such subsidy should he receive one.
At the opening of the AMGA's March 2009 annual conference in Las Vegas, however, Kirkland sang a different tune, explaining how congressional staffers reached out to the AMGA while drafting the American Recovery and Reinvestment Act of 2009, also known as the stimulus law. This led to the inclusion of an $18,000 subsidy for physicians who adopt information technology, Kirkland said. "If this doesn't excite you," he added, "ask a doctor to check your pulse.”
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White House releases identity-security plan

Posted: June 28, 2010 - 12:01 am ET
Citing the critical need to improve security and curb identity theft and fraud in cyberspace, the White House, in partnership with other public- and private-sector organizations, has released a plan to promote safer data exchange.
The government's proposed plan, called the National Strategy for Trusted Entities in Cyberspace, aims to address issues such as the safety of personal health information and banking data and relies primarily on the creation of an “identity ecosystem.” The identity ecosystem, according to the draft, is an online environment that would reduce the need for multiple passwords and logins by offering people the opportunity to obtain a secure, interoperable credential for multiple-use authentication.
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Are We Rushing the Push for Electronic Health Records?

Advocates of electronic health record (EHR) systems, which will likely soon be a fixture in medical settings, claim that the use of EHR will reduce health care costs and improve medical outcomes. Although benefits of bringing information technology to health records can be substantial, EHR systems also give rise to increased liability risks for health care providers due to possible software or hardware problems or user errors.
Two Case Western Reserve University professors, in a scholarly article published in the Berkeley Technology Law Journal, shed light on liability concerns and EHR systems.
Sharona Hoffman, JD, LLM, professor of law and bioethics and co-director of Case Western Reserve’s Law-Medicine Center, and Andy Podgurski, PhD, professor of computer science at the university’s School of Engineering, recently wrote the article, “E-Health Hazards: Provider Liability and Electronic Health Record Systems,” which offers a comprehensive analysis of the liability risks associated with use of this complex and important technology.
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Legal Study: EHRs under-regulated, propose serious liability risks

Despite their many proposed benefits, electronic health record systems could put healthcare providers at significant risk for lawsuits due to software, hardware and user errors, according to a new study in the Berkeley Technology Law Journal.
The design of the current electronic health record (EHR) systems and the legislation governing them do not adequately protect against — and indeed may increase the risk of — malpractice claims and privacy breach claims, the authors said in a press release announcing their study.
The risks of EHRs have received little attention in the legal literature, despite the fact the U.S. Department of Health and Human Services seeks to implement EHRs nationwide by 2014, according to the release.
·         Reference:
Hoffman S, Podgurski A. E-Health Hazards: Provider Liability and Electronic Health Record Systems. Berkeley Technology Law Journal [Internet]. 2010 Jun;Case Legal Studies Research Paper No. 09-25(Forthcoming). Available from: http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1463671.
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Enjoy!
David.

Thursday, July 08, 2010

We Have Utter Madness Afoot at DoHA. This Is An Election Pending e-Health Fraud I Believe.

The following is from page 48 of a document that was released yesterday by the Federal Health Minister (07 July, 2010)
The document in full can be downloaded from here:
The document title is

A National Health and Hospitals Network for Australia’s Future – Delivering the Reforms

Stream 8 — eHealth

Overview
The Commonwealth will make a landmark $467 million investment over two years in the key components of an electronic health record system, so that all Australians have access to a personally controlled electronic health record (PCEHR) if they choose to. In order to fully realise the significant benefits of this Commonwealth investment, states and territories will also need to continue their planned or expected investments in core health information systems. States and territories will also need to provide the complementary investments to build their capacity in readiness for connection to this national system.
This will enable Australians to access their own health care information and permit authorised health care providers to access and use this information, when and where it is needed, to provide better coordinated and effective care for the individual. Implementation is expected to focus initially on people who have the most contact with the health and hospital system. These include people with chronic and complex conditions, older Australians, Aboriginal and Torres Strait Islander peoples, and mothers and their new-born children.
A PCEHR system will enable Australians who choose to have an electronic health record to have more confidence in the information available to them and their health care providers. It will help patients experience smoother transitions between health care providers, reducing waste and inefficiency, and enable better and safer care that is more responsive to patients’ needs.
Additional privacy safeguards will be established through supporting legislation, regulation, and robust governance arrangements. The national eHealth records system will also be designed to incorporate audit trails, technology, and data management controls and an appropriate security access framework. These features will ensure availability of high-quality information and assist patients to have greater control of their health information.
In addition to the national activities above, it is intended that a number of lead PCEHR implementation sites that align with the national work program, will be concurrently funded across different geographic and functional parts of the Australian health sector. The purpose of these lead implementation sites will be to:
Deploy and test national eHealth infrastructure and standards in real world health care settings;
Demonstrate tangible outcomes and benefits from funded eHealth projects;
Build stakeholder support and momentum behind the national PCEHR system work program; and
Provide a meaningful foundation for further enhancement and roll-out of the national PCEHR system.
Within the agreed national framework of governance, standards, workforce etc, lead implementations will focus on implementing PCEHR components that support sharing of electronic health information.
This investment builds on the work of the National eHealth Transition Authority (NEHTA), which has among its priorities the development of eHealth foundations, the coordination of solutions and processes, and the accelerated adoption of eHealth in Australia.
This investment also builds on the Healthcare Identifier (HI) Service established by legislation in June 2010 and being operated from 1 July 2010 by Medicare Australia. The HI Service will allocate unique identifiers to healthcare recipients, healthcare providers and healthcare organisations to improve safety and accuracy in electronic management and communication of health information. Healthcare identifiers are a key building block for the PCEHR system.

Outcome: Australians have access to their own personally controlled electronic health record

Stream Purpose
To provide better access to health information enabling better health outcomes through more integrated care centred around the needs of patients.
Objectives
Provide every Australian with a PCEHR that is controlled by them.
Ensure individuals’ privacy.
Improve efficiency in the healthcare system through streamlining access to patient information thereby reducing duplication and improving use of scarce resources.
Provide continuity of care by enabling access to patient information at the point of care.
Improve safety and quality in healthcare.
Key Milestones
  • PCEHR interim governance framework agreed and in place
  • PCEHR long term governance framework agreed and in place
  • stakeholder consultation – state and territory governments
  • stakeholder consultation - health care providers and software vendors are informed and engaged in development activities
  • public consultation – public website established
  • public consultation – collect and analyse public views
  • change management – work practice analysis
  • change management – implement training and awareness activities
  • change management – monitor and evaluate training and awareness activities
  • change management – revise and implement ongoing awareness and take up strategies based on lessons learned
  • lead implementation sites – selected (minimum of three)
  • lead implementation sites – contracted
  • lead implementation sites – operational
  • lead implementation sites – initial evaluation
  • lead implementation sites – final evaluation
  • PCEHR analysis, IT architecture and requirements developed
  • PCEHR IT standards developed
  • national infrastructure established
  • legislative amendment as required
  • PCEHR available for registration on-line
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A little analysis reveals this for the utter bunkum it is.
Some examples (there are heaps).
1. The lead implementation sites (at least 3) are to be selected, contracted, operational and implemented and evaluated  by Apr/Jun 2011 and by the same time relevant standards are to be developed.
2. Analysis and development of the IT architecture is to be done Jan/March 2012 after the lead implementations and at the same time as the National Infrastructure is being established.
3. There is funding until June 2012 and the system is not available until then or a bit later. How ongoing operation is to be funded is left hanging.
4. Consultation with providers does not happen until after the lead implementations are completed. So what on earth is going to be in these records and why would any professional access them?
5. It is utterly unclear what happens after the lead implementations are evaluated. Do they all just roll on, turn into mushrooms or what?
All this ignores the points I have made about where the information in the PCEHR is to come from etc etc.
See here:
and here:
This is a fiasco waiting to happen and we can be sure it will be a mess that won’t deliver the claimed benefits on the basis of these plans.
Download and read for yourself!
David.