My Response To The E-Health Central Blogger.

David More July 28, 2010 at 10:23 pm

“Anyone who knows anything at all about the system would be aware that both those claims are complete balderdash.

But over on his I Hate NEHTA blog, David More gets out his own egg-beater, and under the laborious heading “It Does Not Seem To Be Going Very well. NEHTA’s HI Service Seems To Be Stalled and May Not Be Safe” declares “What is new here is that direct from the ‘horse’s mouth’ we are hearing of a serious fracture between the Medical Software Industry and NEHTA. No doubt there will be all sorts of denial and spin put on this report and I can assure you – knowing those involved – that they would not have made these comments to the Australian unless the levels of unhappiness were pretty extreme.”

Charles:

I don’t hate NEHTA, I just would like some real delivery of what is promised. Also no-one pays me. I actually do this because I care what happens the the Australian Health System and the infrastructure it needs.

In the light of the recent comments on your blog are you prepared to withdraw the remarks made about Karen Dearne and myself – or do we need to let the court of public opinion expose you for what you seem to be?

At this point graceful withdrawal looks pretty good!

What you really should do is just send NEHTA’s money back and then research the issue sufficiently deeply to be able to form a serious independent view on all this.

Remember I am both a medical graduate and a PhD who has spent since 1987 in the e-Health space. I know what I am talking about, largely, do you? I know I am not anywhere near infallible but I have spent a long time giving this honest thought – and no one has paid me a cent for this work – can you grasp it might just be that as both the Boston Consulting Group and Deloittes have said – serious change at NEHTA is needed?

David.

This is all posted here:

http://www.ehealthcentral.com.au/2010/07/alarums-and-diversions/comment-page-1/#comment-468

Frankly until the level of personal invective and rudeness disappears this is all I have to say.

David.

NEHTA and DoHA are Heading in The Wrong Direction with their PCEHR Plans.

The following article appeared a few days ago.

Labor's e-health plan misses patient safety mark say doctors

Karen Dearne

From: Australian IT

July 21, 2010 6:28PM

DOCTORS say Labor's plan for personally-controlled e-health records is a distraction from the main game of delivering shared, secure electronic medical records that will actually improve patient safety.

Australian Medical Association president Andrew Pesce warns that patient care is "best served" when doctors have access to complete health records.

"Personal e-health records empower and encourage individuals to take responsibility for their own health, but their use may be severely limited in terms of their content, accuracy and the comprehensiveness of information," Dr Pesce said.

"Therefore, medical practitioners need a shared e-health record, in addition to any personal record (held by the patient)."

Launching an election wishlist in Canberra, Dr Pesce said the AMA welcomed the Coalition's commitment to mental health, but was disappointed these programs would be funded by money diverted from e-health and GP infrastructure proposals.

The Liberals say they will scrap the $467 million Budget allocation to personally-controlled e-health records, which Labor has promised to deliver a PCEHR to "every Australian who wants one" by 2012.

More Here:

http://www.theaustralian.com.au/australian-it/government/labors-e-health-plan-misses-patient-safety-mark-say-doctors/story-fn4htb9o-1225895240767

On spotting this I thought more detail would be on the AMA web site and sure enough we find this.

http://www.ama.com.au/node/5871

10. E-health

21 July 2010 - 12:30pm

Background.

An e-health system that connects patient information across health care settings, and which can be accessed and contributed to by treating doctors and other health professionals, will improve the safety and quality of medical care in Australia.

The benefits of e-health in making the best use of existing health care services and avoiding errors, duplication and waste are well known. To treating doctors, e-health means being able to access all of the clinically relevant medical information about a patient at the time of diagnosis or treatment.

Australia has made significant progress in developing technical specifications and standards for e-health systems. The time has come to build the overarching infrastructure to make e-health a reality.

Key issues for patients

Health care of the patient is best served when the medical practitioner has access to the full health record.

Personally controlled electronic health records empower and encourage individuals to take responsibility for their own health, but their use may be severely limited for medical practitioners in terms of their content, accuracy, and the comprehensiveness of information.

Therefore, a shared secure electronic medical record, in addition to any personally controlled health record, is needed to improve the safety of patient care.

Key issues for the Government

A commercial approach that relies solely on private investment and private engagement has not served the e-health agenda well. The next Government, with the State and Territory Governments, must drive and fully fund the development and implementation of a shared electronic medical record.

AMA Position

To make e-health a reality, the next Government must fund and build the overarching infrastructure to connect patient information and facilitate access by medical practitioners across the public and private health care sectors so that a summary electronic medical record can finally become a reality.

The medical profession must be a key driver of the design and implementation of the infrastructure to ensure that it works on the ground in medical practices.

A shared electronic medical record that links reliable and relevant medical information across health care settings will help provide treating doctors with the information required to inform clinical decisions.

The next Government must fund and implement a shared electronic medical record that:

• Contains reliable and relevant medical information about individuals;
• Aligns with clinical workflows and integrates with existing medical practice software;
• Is governed by a single national entity; and
• Is fully funded by Governments and supported by appropriate incentives, education and training.

- End AMA Position.

A few things are clear from this.

First the AMA prefers the direction of provider support and communications and information sharing as the first steps in the development of E-Health in Australia – just as outlined in the National E-Health Strategy.

Second they recognise that for any e-Health initiative to work it must involve clinicians from the outset and integrate into present clinical workflows – or at least not be a distraction and nuisance.

Third they are pretty clear that the leadership and governance of e-Health in Australia is not good enough.

Fourth they have noticed e-Health is both needed and should be properly funded and led.

Sadly what is missing is a recognition that there is no clarity at present as to just what the ‘right’ approach to establishing health information sharing between providers is, let alone how such information can be optimally shared with patients

From this article, and other things that have been reported from the UK, unless our doctors are much more trustworthy and accurate, large scale shared EHRs need a fair bit of work yet.

One in ten electronic medical records contain errors: doctors

One in ten medical records on a new electronic database contain errors which could put patients at risk, doctors have warned.

By Rebecca Smith, Medical Editor

Published: 8:15AM BST 17 Jul 2010

Doctors in Birmingham have found that 10 per cent of the records that have been uploaded so far contained out-of-date information including errors on current medication patients are taking or drugs they are allergic to.

These mistakes could put patients at risk if doctors relied on the information in an emergency and administered a drug they were allergic to or gave them a medicine which interacts with one they are already taking.

The system must be halted as it is not safe, doctors said.

So far around two million electronic patient records have been uploaded to the central database and if the error rate was the same nationwide, which doctors say is not unreasonable to presume, then around 200,000 people could be at risk from inaccurate information stored about them.

GP leaders in Birmingham told Pulse magazine that the organisation running the system, Connecting for Health, knows about the error rate and has not taken action.

Dr Robert Morley, executive secretary of Birmingham Local Medical Committee, which represents local doctors, told Pulse: "The fact that in Birmingham 80,000 patients have had their records uploaded, the majority without their consent, and one in ten have been put at risk from inaccurate data, shows we believe that the uploading of the Summary Care Record has to be stopped immediately because they are not safe."

Lots more here:

http://www.telegraph.co.uk/health/healthnews/7895094/One-in-ten-electronic-medical-records-contain-errors-doctors.html

The need for a good deal more work and the need to be a bit less dogmatic approach on the part of DoHA and NEHTA would be useful first step to architecting and delivering systems that might actually do the job - i.e. save lives, improve quality of care and make the system just work better!

David.

The Truth From The MSIA on A Recent Post at E-Healthcentral

Geoffrey Sayer July 27, 2010 at 10:08 pm

The intention is that Health Identifiers are to make a real difference and is a population wide initiative that will under pin the eHealth agenda – yet a best guess it that we will be years away from levels of 95% plus coverage and use of HI in all health communication exchanges – the level we will need to get the desired benefits that will reduce the negative consequences of miss-identification. For those familiar with population health the desired coverage levels of HIs in exchanges is like the concept of herd immunity in vaccine use.

Charles as a learned Journalist (you seem to have the pedigree) you would know that things in quotations are supposed to be direct quotations. You would also know that many journalists, reporters and editors tend to add to the text to make the quotations tell the story. You will note that debarcle is not in quotes. To be fair though for the report in the Australian I will stand by my quotes in quotation marks in the story.

While you have a perchance to the use of unnamed sources – but reliable one’s you assure us – who know the real story – I only have my experiences to go by; I use evidence and facts; I use my name; I don’t rely on unnamed MSIA spokes people; I have spoken publicly; I invite criticism of the arguments in these forums; and I have sat in many NEHTA engagement sessions, read documents and made submissions.

Maybe I have missed something but the following describes the current status for the HI Service:
1. The HI Patient identifiers have been populated in the Medicare database.
2. Patient identifiers can be accessed by telephone to Medicare – less than 100 have been requested. No B2B or Health Provider Online Services (HPOS) channels are yet available for electronic access.
3. Population of the Provider Identifiers (HPI-I) has been delayed due to delays at APRA – it is now likely that this data will not be loaded until at least mid-August. Timeline has slipped.
4. Forms to register for a Health organisational identifier are available from the Medicare web site but no applications have been received.
5. The next release of the service is on track for September but will not include support for software vendors to be able to access the live service as negotiated by MSIA and included in the final legislation and regulations. These additional facilities are still being specified by NeHTA. Documentation for transitional arrangements is being completed by NeHTA.
6. The Medicare developer’s environment for HI has been deployed but the test cases required for Notice of Integration (NOI) testing have not yet been finalised. They will be supplied for review to MSIA “in the near future” once they have been signed off by NeHTA – this has been promised for 2 months.
7. Medicare has only recently supplied a revised copy of the Developer agreement for HI which incorporates some of the requested changes as per the principles agreed at the MSIA CEO’s forum. However, it is not able to be shared that with the vendor community until it is approved by the Medicare executive. It still does not address a number of significant issues which will require further negotiation with DoHA, so it is still some way from being a document that MSIA could recommend anyone signing. However, due to the delays, we will be discussing with Medicare possible interim arrangements for access to the HI developer environment.
8. The operating agreement between Medicare and NeHTA has not yet been signed.
9. NeHTA have completed a safety evaluation of the HI service but it will not be released – so we can’t be sure what safety issues are identified and what will be dealt with.
10. NeHTA hope to have a conformance/compliance/accreditation plan for HI available by end of November. It is a plan not a working CCA.
11. NeHTA hope to have meetings with relevant primary care stakeholders sometime in the next 6 weeks to discuss starting to prepare a sector HI implementation plan. They have not yet contacted the relevant stakeholders.
12. The National Authentication Service for Health (NASH) has not yet been approved by the NeHTA Board and Medicare certificates will be used to access the service in the Developer environment. This may require issue of new PKI certificates depending on the functions being implemented.

So in response to your commentary:
“Anyone who knows anything at all about the system would be aware that both those claims are complete balderdash.”

Not sure who is spinning the crap Charles – but then I am not sponsored for my commentary – a cheap shot I know – on par with your “usual headline-seekers” discrediting attempt.

---- End Quote

Posted at Geoffrey Sayers request.

Go here for the original post and responses:

http://www.ehealthcentral.com.au/2010/07/alarums-and-diversions/#comments

David.

It Does Not Look To Be Going Very Well. NEHTA’s HI Service Seems To Be Stalled and May Not Be Utterly Safe.

Nicely in time to throw a tiny spanner in the Gillard Election Plans we have the following:

NEHTA, vendors lock horns over HI service

• Karen Dearne
• From: The Australian
• July 26, 2010 9:31AM

THE $90 million Healthcare Identifier system intended to help save patients' lives is sitting idle as key components do not exist.

And there are no plans in place to make the service available where it is most needed - in GPs' offices.

Doctors and medical software developers are "bitterly disappointed" that it will be years before patients see any benefits from the new HI service, built to support expanded electronic information-sharing across the health sector.

Although Medicare allocated a 16-digit unique patient identity number to every Australian in its database on July 1 to meet a deadline set by Health Minister Nicola Roxon, the number is only available by phone and cannot be used by anyone.

And the National E-Health Transition Authority plans to initially roll-out the system to public hospitals only, with a series of pilot projects underway over the next two years; however, public sector hospitals will be unable to use the identifiers to communicate with other health providers.

Medical Software Industry Association president Geoffrey Sayer said the consultation process was "dysfunctional", resulting in a "flawed" implementation plan devised by the federal-state government-owned agency.

"The real improvements in safety, quality of care and efficiencies will only come when the GPs, specialists, diagnostic services, aged care and allied health professionals are part of the system," Dr Sayer said.

"There is no plan for that despite our repeated warnings to NEHTA, and our willingness to help.

"It's like having a critical vaccine locked up in a warehouse, and not talking to the trucking companies about how to get it to doctors."

Software-makers have been hamstrung in doing the necessary work to interface medical practice systems with the HI service, as technical specifications were not released before the HI legislation was passed late last month, and this work will take some months.

Allocation of HIs to medical providers is also many months away, while the key security component, the National Authentication Service for Health, is not ready.

More here:

http://www.theaustralian.com.au/australian-it/government/health-identifier-on-road-to-nowhere/story-fn4htb9o-1225896894328

as well as the following:

Developers warned against Medicare contracts because of e-health safety concerns

• Karen Dearne
• From: The Australian
• July 27, 2010 12:00AM

THE Gillard government is refusing to back the safety of its Healthcare Identifier service, leaving users with liability for system failures.

The Medical Software Industry Association has warned its members not to sign development contracts with the operator, Medicare, under these conditions, and is trying to negotiate changes with the Health Department.

Association president Geoffrey Sayer said the $90 million identifier service -- intended to support the electronic exchange of patient information across the health sector -- may sit idle for years, as key components did not yet exist.

The association also rejects the National E-Health Transition Authority's plan for a soft launch over two years to public hospitals only, saying patients' lives would be lost due to delays in getting the system into GPs' hands.

"Nehta has had more than 18 months to prepare for the July 1 go-live date, but has not yet begun developing a rollout plan for the wider community," Dr Sayer said.

"There's no sense of urgency, despite the fact this system will actually help save patients' lives."

Dr Sayer said the identifier project, managed by Nehta, had been a debacle, and it was "incredibly frustrating" to have patient identifiers that could not be used.

Many more details here:

http://www.theaustralian.com.au/australian-it/developers-warned-against-medicare-contracts-because-of-e-health-safety-concerns/story-e6frgakx-1225897185267

Now for the regular readers of this blog none of this will come as any surprise.

We already knew that the National Authentication Service for Health (NASH) was not anywhere near ready and also knew the difficulties with the National Registration Scheme was likely to have an impact.

See here for that article.

http://aushealthit.blogspot.com/2010/07/this-may-be-further-blow-to-progress.html

Additionally I have been saying for ages that implementation of the service to a useful stage was going to be a long process.

What is new here is that direct from the ‘horse’s mouth’ we are hearing of a serious fracture between the Medical Software Industry and NEHTA. No doubt there will be all sorts of denial and spin put on this report and I can assure you – knowing those involved – that they would not have made these comments to the Australian unless the levels of unhappiness were pretty extreme.

Note that there is a bit of a chicken and egg problem here. Unless NEHTA comes down from the mountain and really works to co-operatively and comprehensively clear the various issues raised by the Medical Software Industry Association (MSIA) it will all go nowhere for the foreseeable future. That would be really sad – recognising that key to all this is to have the implementation done collaboratively with both the Software Vendors and those who are expected to use the identifiers.

I have also pointed out previously that I have some concerns about the quality of the identifying information on which the Health Identifiers are based. You don’t need much of an error rate when the system is in actual use to potentially cause mis-linkage of patient records. The risks of that sort of outcome are obvious. Hence my suggestion we really do run some pilots at scale to make sure these risks are imagined and not real.

As an aside it is probably only weeks before the bitter divisions on the Standards for Electronic Transmission of Prescriptions also break into the public domain as we see more and more of NEHTA’s agenda unravel and delivery time-tables slip. All I can say is watch this space!

In the context of the election my comments of a day or so ago stand – with the addition that both sides need to come clean and explain just what they see as the future for NEHTA and what they plan to fix the obvious dysfunction. Dreaming I guess!

David.

AusHealthIT Poll Number 27 – Results – 26 July, 2010.

The question was:

Will The E-Health Plans of Either Party Change Your Vote in Their Favour?

Move Me To Vote Labor

- 9 (31%)

Move Me to Vote Coalition

- 1 (3%)

No Change In My Vote

- 5 (17%)

Other Issues are Much More Important

- 2 (6%)

I Don't Trust Either to Deliver

- 12 (41%)

Votes: 29

Poll closed.

Well I guess the lesson here is that while the overall level of trust in either side is pretty low – what Labor is doing is preferred.

Again, many thanks to all those who voted!

David.

Frost and Sullivan Seem Pretty Confused About The State, History and Prospects for Australian E-Health.

The following press release appeared a few days ago.

Frost & Sullivan Records Strong Growth Potential Within Australian Health IT Industry

SINGAPORE, July 22 /PRNewswire/ -- Keen interest from the Australian government towards eHealth initiatives is one of the major drivers of ensuring a double digit Compound Annual Growth Rate (CAGR) of 10.15% from 2009 to 2014 for the Health IT market.

Frost & Sullivan reported that the USD 525million revenue achieved in 2009 for the Health IT market is forecasted to increase by another USD 333million by 2014. This marks a 38% rise in revenue, primarily resulting from various national and state funded initiatives promoting the implementation of a National E-Health System.

Dr. Pawel Suwinski, Director, Frost & Sullivan commented that this growth projection for the Australian Health IT market is mostly attributed to the strong commitment by the central government towards creating a national healthcare information highway promoting safer, efficient, and more equitable care through seamless health information exchange (HIE). As part of the initiative, in 2005, the National E-health Transition Authority (NeHTA) was established to map-out the most suitable strategy plan for the implementation of countrywide e-health infrastructure and services. In the following 3 years, under NeHTA direction, several studies have been conducted to identify the complexity of processes, information pathways, and interdependencies between different participants within the healthcare services industry, and in December 2008 the National E-Health Strategy has been formulated to guide the consolidated effort of Commonwealth, States, and the Regions.

NeHTA's main objective is not only to develop a strategic plan for the e-health system, but also to oversee the implementation of various programmes to ensure that by 2012 Australia would have the necessary foundation for integrated e-health services that includes a priority plan of e-health solutions deployment, training support, and governance of e-health usage.

Moving in that direction, the Australian state governments are actively campaigning for a technological evolution within the local healthcare system. State wide campaigns such as the 'careconnect.sa' web portal developed by South Australia will be amongst the first of an integrated state wide electronic health record system. The portal was designed with the intention of establishing a one-stop personal web based entry-point portal to store and access patient health information. The careconnect.sa campaign will cost South Australia USD 315million in development funds and will most likely finish its implementation by 2017.

Western Australia has also invested USD 300million to develop their own version of Health IT infrastructure. The 'ehealthWA' program was created to link valuable information across multiple platforms including pharmacy, patient administration system (PAS), clinical information system (CIS) and notification and clinical summaries (NaCS) across the state.

"The e-health initiative has recently received a much needed boost in the form of AUD 466.7million budget commitment (passed on 11/05/2010) for the next 2 years to support plans for the Personally Controlled Electronic Health Record (PCEHR) system developed to promote health information exchange between different stakeholders responsible for care management and delivery within the entire healthcare value chain. It is estimated that this investment could generate AUD 7.6billion of benefits annually by the year 2020 as reported by Booz & Company, more than 65% would be achieved by eradicating medical errors and complying to best practices – enhancing quality. It is therefore obvious that seeing through the initial investment is the most important task as many healthcare IT initiatives are plagued with failures resulting from poor management and lack of commitment and involvement by the major stakeholders. Judging from the current progress, Australia is wading exceptionally well through all the pitfalls of nationally launched IT initiatives, and the passing by Parliament on 24th June the Healthcare Identifiers Services bill is keeping up the momentum in the right direction," says Suwinski.

Lots more here:

http://www.prnewswire.com/news-releases/frost--sullivan-records-strong-growth-potential-within-australian-health-it-industry-98986304.html

At the bottom we have this:

About Frost & Sullivan

Frost & Sullivan, the Growth Partnership Company, enables clients to accelerate growth and achieve best-in-class positions in growth, innovation and leadership. The company's Growth Partnership Service provides the CEO and the CEO's Growth Team with disciplined research and best-practice models to drive the generation, evaluation, and implementation of powerful growth strategies. Frost & Sullivan leverages over 45 years of experience in partnering with Global 1000 companies, emerging businesses and the investment community from 40 offices on six continents. To join our Growth Partnership, please visit http://www.frost.com.

----- End Extract

I wondered just what a “Growth Partnership Company” was after all this and so found this:

Growth Partnership Service: Healthcare and Life Sciences IT

The Healthcare & Life Sciences IT Growth Partnership Services program combines our range of services, global perspective, and comprehensive market coverage to provide the tools that empower our clients to achieve their growth objectives. Through this program clients receive a continuous flow of market, technical, and econometric information, along with interactive applications (our TEAM methodology) focused specifically on growth. A sample list of our market coverage includes Medical Care Providers, Managed Care Services, Consumer-based Healthcare, Clinical Solutions, Business Solutions, and Healthcare Outsourcing.

Last update : 24 Jul 2010

See more here

http://www.frost.com/prod/servlet/svcg.pag/HCHL

So now I know. This is a market research wanting to have you as a client and this is a ‘teaser’ release to show you just how clever and well informed they are!

They also like to work globally as you can see and I have to say the press releases are endlessly optimistic.

Frost & Sullivan: Finding Healthcare’s ‘Holy Grail’ – HIT Shape’s Up Patient Care System

SINGAPORE, July 5, 2010 / WorldPRLine / — Faced with escalating treatment costs and pressure to be affordable while searching for efficiency and better quality, hospitals are turning towards Health IT (HIT) for assistance where patient care is no longer the sole responsibility of doctors and nurses alone.

Dr. Pawel Suwinski, Principal Consultant, Healthcare Practice, Frost & Sullivan commented that the total recorded revenue of Health IT from Asia Pacific in 2009 reached an astounding USD 7.1 billion. The sum is a near 15% contribution to the total revenue figure for the industry globally.

“With an estimated steady growth of 11.3% CAGR (2009 – 2012) and an estimated leap to USD 10 billion revenue by 2012, it will come as no surprise that a majority of healthcare providers in the APAC region indicated that they are likely to keep their IT budgets intact, if not increased, despite going through a difficult recession in 2009,” says Suwinski.

Following a research conducted by Frost & Sullivan on 40 CIO/CFO’s from leading hospitals around the APAC region, 80% reported that they are looking at retaining or increasing their hospital’s IT budget for the year.

Healthcare IT forms a pivotal role in today’s healthcare system and it extends beyond mere information capturing, storing, and management. Being able to access the relevant information at the point of care – on the go – as well as interpret the many patient’s stored medical data enables medical professionals to take the best course of action on both clinical and management level.

The healthcare industry is still lagging behind other industries in the adoption of information technologies. At present, the gap stands at about 5 to 10 years, depending on products and technologies, but it is shrinking fast as HIT adoption and growth rates are outperforming other industries.

Improving quality of care, enhancing patient safety, and increasing patient satisfaction, while drastically reducing medical errors and administration burden has become an important criteria to most hospitals. This is made possible with the induction of Health IT systems in the healthcare delivery environment.

Technologies such as the Electronic Medical Records (EMR) are meant to accurately capture patient information to be shared with each member of the hospital team. Beyond that, EMR systems link different healthcare industry stakeholders by enabling seamless flow of patients’ medical records from different healthcare providers, as well as pertinent insurance and billing information. Medical errors due to illegible notes written by physicians during patient charting are also drastically reduced with implementation of EMR systems.

Suwinski comments, “Although Asia Pacific countries may be slow adopters in Health IT, they are beginning to realize that in order to compete with their western counterparts strategically, they will need to step up their IT integration to clinical care.” Countries such as Japan and Korea have spent a total of USD 299 million and USD 56 million respectively on EMR systems within their hospitals.

More here:

http://www.worldprline.com/2010/07/05/frost-sullivan-finding-healthcares-holy-grail-hit-shapes-up-patient-care-system/

Well before you sign up for their doubtlessly expensive services consider these two paragraphs.

“Dr. Pawel Suwinski, Director, Frost & Sullivan commented that this growth projection for the Australian Health IT market is mostly attributed to the strong commitment by the central government towards creating a national healthcare information highway promoting safer, efficient, and more equitable care through seamless health information exchange (HIE). As part of the initiative, in 2005, the National E-health Transition Authority (NeHTA) was established to map-out the most suitable strategy plan for the implementation of countrywide e-health infrastructure and services. In the following 3 years, under NeHTA direction, several studies have been conducted to identify the complexity of processes, information pathways, and interdependencies between different participants within the healthcare services industry, and in December 2008 the National E-Health Strategy has been formulated to guide the consolidated effort of Commonwealth, States, and the Regions.

NeHTA's main objective is not only to develop a strategic plan for the e-health system, but also to oversee the implementation of various programmes to ensure that by 2012 Australia would have the necessary foundation for integrated e-health services that includes a priority plan of e-health solutions deployment, training support, and governance of e-health usage.”

If this is the quality of their research then I don’t plan to pay.

The facts are that NEHTA was never intended to be a planning organisation, did not have much at all to do with the development of the National E-Health Strategy by Deloittes and certainly does not have the main objective of developing a “a strategic plan for the e-health system”

Close reading will find just an endless litany of ‘not quite right’ statements

This is a ripper.

“Statewide implementation of electronic health records also presents major opportunities for business expansion. State e-health programs such as 'Healthelink' by New South Wales and the government's commitment towards developing the right technology necessary to deliver the best e-health system will accelerate the growth in this segment. In 2010, the market size is expected to be approximately USD 45million with a high 17.3 CAGR.”

Checking today the HealtheLink program looks to have died. Apparently no patients have been enrolled since November 2009 and there are no announcements of extension beyond a pilot.

I assume what they are actually talking about is the Cerner EMR implementations – which have also not been a totally unqualified success and anyway is largely complete. Hard to see exciting revenue growth from there!

See here:

http://www.healthelink.nsw.gov.au/

Front page last updated 11 February 2009

If this was going anywhere we would know by now – since the evaluation of the pilot ended in September 2008.

See here:

http://www.healthelink.nsw.gov.au/evaluation

Report here:

http://www.healthelink.nsw.gov.au/__data/assets/pdf_file/0004/67333/Evaluation_of_Healthelink_Pilot_Summary_Report_3566534_1Client-Job.PDF

Sorry guys you just don’t cut the mustard as far as knowledge of Australian Health IT is concerned. Sorry also to those NEHTA boosters who think this supports their case of unalloyed excitement and optimism. It’s rubbish in my view!

David.

Weekly Australian Health IT Links – 25 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:

-----

The present election campaign season is really utterly disappointing. As you read through the various links below you cannot but be totally despairing at the quality of debate in the e-Health space – most especially at this point from the Opposition is just saying they will scrap what the Government is planning while offering no constructive alternative.

Regular readers will know how deeply sceptical I am regarding the present, currently exceptionally vague, poorly defined and poorly communicated Government plans but to offer the alternative of ‘just saying no’ is really pathetic.

It is interesting to note that in the present poll many readers have no faith in either side to deliver, but that the given a choice the Labor approach seems to be preferred. The Opposition really need to step up to the plate and explain what they would do – and the Government needs to be much more transparent about their plans.

I have to say I am, with what we know so far, still very much persuaded that neither offering is acceptable.

From reporting I have seen recently it seems virtually the whole ICT Sector also has some issues with the offerings from both sides and also don’t really have their act together.

See here:

http://www.theaustralian.com.au/australian-it/peak-technology-sector-bodies-at-odds-on-agenda-for-election-campaign/story-e6frgakx-1225894272550

Peak technology sector bodies at odds on agenda for election campaign

• Andrew Colley
• From: The Australian
• July 20, 2010 12:00AM

TECHNOLOGY industry groups are hoping to use the federal election to win a better deal, but discord on tactics may garble the message.

The Australian Information Industry Association and the Australian Computer Society say Australia's technology performance has suffered due to Labor's fragmented approach to the sector.

However, the two industry groups disagree on how the sector should be organised within the federal government's ministries.

The Labor government split responsibility for information technology away from the previous communications portfolio held by Senator Helen Coonan through the Department of Communications Information Technology and the Arts.

And here:

http://www.computerworld.com.au/article/353568/federal_election_2010_do_it_do_it_/

Federal Election 2010: To do IT, or not to do IT?

Is that the question as we head to the polls on August 21?

• Trevor Clarke (Computerworld)
• 19 July, 2010 07:53

The fate of the national broadband network (NBN), a $467 million committment to e-Health, the computers in schools program and other ICT-related initiatives will be decided on 21 August as the country heads to the polls.

In announcing the election date, Prime Minister Julia Gillard, made specific reference to the incumbent Labor party's committment to the NBN, e-Health and the computers in schools program along with other likely key election issues such as climate change, immigration and the mining tax.

In her speech, Gillard attempted to frame the government's policies as "moving forward" while describing the Opposition's stated committment to cutting the NBN, e-Health initiatives and the computers in schools program as taking the country "backward".

And here:

http://www.6minutes.com.au/articles/z1/view.asp?id=520633

Coalition will axe GP grants and e-health

by Michael Woodhead

The Coalition says it will axe funding for e-health and GP infrastructure grants as part of its pledge to ‘stop Labor’s reckless spending’ and thus help cut interest rates.

In its list of savings measures released this week, the Coalition has listed seven key parts of Labor’s health reforms that it would cancel to save $1.5 billion.

The programs to be cancelled include $355 million in funding for general practice and primary care infrastructure, $467 million funding to set up e-health record systems, $417 million for Medicare Locals and $110 million for a National Performance Authority.

And here:

http://www.computerworld.com.au/article/354125/lib_e-health_scrap_risks_thousands_lives_/?eid=-6787

Lib's e-health scrap risks "thousands of lives"

Access Card head says e-health no political toy

• Darren Pauli (Computerworld)
• 22 July, 2010 12:40

The Opposition’s pledge to crush the Government’s national e-health scheme will risk "thousands of lives" and waste millions in taxpayer funds, according to a former advisor to the scrapped Access Card.

The Liberal Party has pledged to axe the troubled e-health project to save some $2 billion, but has yet to announce a health policy of its own.

Australia’s first e-health scheme was crushed when the Rudd Government tossed the deeply unpopular Access Card that promised to replace the Medicare card and integrate components of Centrelink and social services, along with personal biometric information.

And lastly here:

http://www.smh.com.au/opinion/politics/budget-cuts-are-the-new-black--all-trickery-little-trimming-20100720-10jgx.html?rand=1279633504885

Budget cuts are the new black - all trickery, little trimming

July 21, 2010

This election is shaping up as a contest between Labor and the Coalition to see who, if elected, will deliver least to the Australian people. Prime Minister Julia Gillard has laid down the gauntlet, promising any new promises will not add a cent to the budget's bottom line.

Her sparring partner, Tony Abbott, has taken up the challenge with gusto, appearing to relish the task of identifying programs for the chopping block. Having already claimed to have identified $47 billion in budget cuts (although only about $20 billion is real savings), yesterday he announced another $1.2 billion. Budget cuts are the new black.

After the profligate pre-election spendathons initiated by the Howard government, this newfound prudence by both parties is admirable enough.

But the obsession with balancing the books risks going too far. Worthy policies could hit the cutting room floor or never get a running start, all in the name of ''fiscal conservatism''.

Perhaps the most glaring example of false economy is in the Coalition's health announcements. Abbott has promised $1.5 billion for mental health, an area sorely in need of funding and attention. But to fund that promise, in part anyway, Abbott has also promised to cut $467 million from the e-Health initiative.

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http://www.batemansbaypost.com.au/news/local/news/general/medical-system-full-of-bugs/1892963.aspx

Medical system full of bugs

BY JOSH GIDNEY

22 Jul, 2010 04:26 PM

Doctors from Batemans Bay and Moruya Hospitals have criticized the new Electronic Medical Record (EMR) system, which has just been put into use at both hospitals.

They were surprised by the praise it was given by Great Southern Area Health Service acting eastern sector general manager Karen Lenihan in a Bay Post/Moruya Examiner article last Wednesday.

Batemans Bay Doctor Lachlan Brown said the majority of staff at the hospital were finding the new system difficult to use.

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http://www.theaustralian.com.au/news/health-science/technology-the-ticket-to-elderly-home-care/story-e6frg8y6-1225895832045

Technology the ticket to elderly home care

• Karen Dearne
• From: The Australian
• July 24, 2010 12:00AM

OLDER Australians could remain in their own homes far longer and in better health with the support of smart devices and medical systems.

In a groundbreaking study of the emerging field of gerontechnology, the Australian Academy of Technological Sciences and Engineering says huge social and financial benefits are already being derived from technology-based ageing-in-place initiatives in other countries, yet the issue is not on the agenda here.

ATSE is calling for a new national approach that shifts funding and policy models to prevention of illness and injury among the elderly, rather than spending on hospital beds and aged-care facilities.

"Using technologies to help elderly people remain in their homes is a really important way of ensuring a healthy, safe and secure future for our ageing population," says Vaughan Beck, ATSE's executive director.

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http://mobihealthnews.com/5881/australian-operator-offers-mobile-based-diabetes-manager/

Aussie operator: Mobile-based diabetes manager

Wednesday - December 30th, 2009 - 12:06pm EST by Brian Dolan

Entra Health Systems, an applied healthcare technology developer, is powering a mobile phone-based diabetes management service recently launched on Australian wireless operator Telstra’s network. The service is called the Telstra Diabetes Management Online Service in Australia, and it includes Entra’s MyGlucoHealth Wireless meter, Bluetooth technology and the user’s mobile phone. Entra is calling it the “first commercially available mobile phone application for people with diabetes” in Australia.

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http://www.abc.net.au/news/stories/2010/07/20/2958701.htm

Green light for medical video conferencing

Posted Tue Jul 20, 2010 10:17am AEST

The success of a trial of video conferencing at the Bendigo and Echuca hospitals has led to its approval for long term use.

The $10 million program linked local doctors and patients with specialists at four Melbourne hospitals over the past 18 months.

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http://www.nehta.gov.au/media-centre/nehta-news/669-etp

National Electronic Transfer of Prescriptions (ETP) specifications released

20 July 2010. NEHTA has released its latest draft of national specifications for the Electronic Transfer of Prescriptions between general practitioners and community pharmacies.

The draft is the culmination of 12 months of development and incorporates extensive feedback from clinicians, consumers and technology experts around the country. It will now progress to Standards Australia, through IT 14, for ongoing consultation and refinement with the goal of updating existing Australian standards and developing new Technical Specifications by the end of 2010.

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http://www.nehta.gov.au/media-centre/nehta-news/670-youth-racgp

Youth lead the adoption of e-health

22 July 2010. 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.medicalobserver.com.au/news/gp-practice-versus-guidelines-its-academic

GP practice versus guidelines: it’s academic

23rd Jul 2010

Kirrilly Burton

CLINICAL practice guidelines often fail to consider the difficulties of implementation in general practice and risk becoming used as an unfair benchmark, a GP claims.

In a letter to the MJA, Dr Peter Radford, a GP from Benalla in rural Victoria, said the authors of guidelines and consensus statements failed to consider that GPs had to balance competing demands and treatment recommendations.

Dr Radford was responding to the AusHEART study, which evaluated evidence-practice gaps in GP cardiovascular risk management. The study authors, mostly from the George Institute for International Health and the University of Sydney, said there was “substantial under-treatment” of high-risk patients, with only 34% receiving a combination of an anti-hypertensive and a statin, as recommended in guidelines.

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http://www.koreaittimes.com/story/9826/telstra-plans-launch-e-health-cloud-services-tip-iceberg-opportunity

Telstra Plans Launch of e-health Cloud Services, Tip of the Iceberg for Opportunity

Tuesday, July 20th, 2010

Telstra and the Royal Australian College of General Practitioners (RACGP) announced the signing of an agreement to work together to launch e-health applications on a web-hosted service platform.

The announcement comes at a time when the e-health agenda in Australia is heating up following the government's commitment earlier in the year of more than AUD460 million for a national e-health strategy and the federal parliament's recent passing of crucial enabling legislation for healthcare identifiers.

One of the biggest challenges for e-health reform is to achieve a more coherent and integrated approach to sharing information across more than 1,300 hospitals, 20,000 GP and specialist practices and 5,000 pharmacies. The fragmentation of the sector's governance regimes and ongoing turmoil in funding and organizational arrangements make top-down reform a tough game that will be played out over decades.

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http://news.idg.no/cw/art.cfm?id=F79C5697-1A64-67EA-E436A0DEBB7A3F55

Telstra needs 'more compelling' e-health offering: analyst

Lisa Banks

22.07.2010 kl 00:21 | CIO Australia

New research indicates Telstra must develop a more compelling offer on e-health if momentum is to take place in that market.

New research indicates Telstra must develop a more compelling offer on e-health if momentum is to take place in that market.

Research company Ovum said Telstra's plans to provide an e-health web portal in conjunction with the Royal Australian College of General Practitioners (RACGP) must use more than its T-Suite SaaS portal capability.

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http://www.theaustralian.com.au/australian-it/government/lessons-learnt-from-queensland-health-payroll-debacle/story-fn4htb9o-1225896084154

Lessons learnt from Queensland Health payroll debacle

• From: AAP
• July 23, 2010 1:00PM

THE Queensland government has promised it won't rush a new payroll system for police, fire and ambulance officers, in the wake of the nurse pay debacle.

Ambulance, fire, emergency service, and corrective service officers are still being paid by the outdated Lattice system -- the software used by the Queensland Health (QH) payroll office before it switched to its current troubled program.

Those in charge of implementing QH's new system -- in which many staff have been underpaid, overpaid and not paid at all -- were criticised in an auditor-general's report for rushing the system's introduction before proper testing was done and fail-safes were in place.

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http://www.abnnewswire.net/press/en/63345/iSOFT_Group_Limited_%28ASX:ISF%29_Wins_Frost_Sullivan_Company_Of_The_Year_Award.html

iSOFT wins Frost & Sullivan Company of the Year award

Sydney – 20 July 2010 – iSOFT Group Limited (ASX:ISF), one of the world’s largest healthcare information technology companies, has won the 2010 Asia Pacific, Frost and Sullivan Hospital Information Systems Company of the Year award.

The award acknowledges iSOFT’s achievements in the hospital information systems market, and used the following criteria to benchmark its performance against two key competitors:

• Growth strategy and implementation

• Degree of innovation in business process

• Leadership in customer value and market penetration

• Revenue and market share growth

The award recognised iSOFT’s ability to adopt the strategy of expanding and strengthening its core competencies through the acquisition of key companies such as Patient Safety International Pty Ltd (PSI) that uses an ontology comprising a comprehensive set of terms developed by the Australian Patient Safety Foundation. In addition, iSOFT acquired Bridgeforward a US healthcare application integration software developer, and Hatrix Pty Ltd, a company that focuses on electronic medication management systems.

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http://www.lexology.com/library/detail.aspx?g=b3ec0dff-d771-4d03-9bd1-0b0275fd7e67

Federal Court raises barriers for claiming copyright in works created by multiple authors

Freehills

Irene Zeitler and Steve Wong

Australia

July 14 2010

In brief

• Whenever works are created through the efforts of many individuals, there is a risk that copyright cannot be claimed in such works unless each individual involved in their creation can be identified.
• This risk is enhanced when the works are created through the separate contributions of individuals working relatively autonomously, rather than as a result of collaborative effort.
• Businesses involved in the creation of such works will need to introduce appropriate procedures to record the identity of each individual involved in the creation of copyright works, as well as their respective contributions and their assignment of copyright to the business.

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http://www.smh.com.au/technology/technology-news/computer-system-gives-ears-to-those-who-cannot-hear-20100718-10g3p.html

Computer system gives ears to those who cannot hear

RACHEL BROWNE

July 19, 2010

A system that allows deaf students to fully take part in mainstream education is being trialled in a Sydney school. About 10,000 Australian children with hearing loss stand to benefit.

Under the system, the teacher wears a lapel microphone that transmits the audio to a captioner who uses a voice-to-text program to send the words to the student's laptop in under seven seconds.

Deaf students and disability experts say it could revolutionise how those with hearing loss are taught in secondary and tertiary education. The system Access Innovation Live, was developed over three years by the Sydney company Access Innovation Media.

It is being trialled at Robert Townson High School in Raby in Sydney's south-west, and the company is expanding the pilot scheme nationally.

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http://www.techworld.com.au/article/353946/tax_office_goes_ubuntu_auskey_linux_standard

Tax office goes Ubuntu for AUSkey Linux standard

Generic Linux and Unix port to go public

Rodney Gedda 21/07/2010 09:35:00

The Australian Taxation Office is preparing to release a Linux port of its AUSkey authentication software with Ubuntu being the reference distribution for testing and development.

AUSkey is the federal government’s security key that can be used for single sign-on across a number of online services and is required to use the Department of Treasury’s new Standard Business Reporting (SBR) service.

The ATO has started using AUSkey as a replacement to its legacy digital certificates, but some Linux users reported compatibility problems as the client is only available for Windows and Mac OS X.

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http://www.zdnet.com.au/govt-receives-gershon-review-evaluation-339304537.htm

Govt receives Gershon Review evaluation

By Josh Taylor, ZDNet.com.au on July 14th, 2010

in brief The Department of Finance and Deregulation has confirmed that it has received the review into the government's implementation of the recommendations made in Sir Peter Gershon's report on government information technology.

In March this year, the government brought in former Sydney Olympics CIO and former National E-Health Transition Authority CEO Dr Ian Reinecke to review the implementation of recommendations from Gershon and to assess what the role of the Australian Government Information Management Office (AGIMO) will be after the ICT reform program had been completed.

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http://www.theaustralian.com.au/australian-it/coalition-to-run-with-three-prong-broadband-plan/story-e6frgakx-1225894269019

Coalition to run with three-prong broadband plan

• Mitchell Bingemann
• From: The Australian
• July 20, 2010 12:00AM

THE Coalition' broadband and communications policy will be based on three steps to improve internet access in areas with poor service.

The Coalition has feverishly been consulting over the past six months with industry stakeholders, service providers and its in-house expert, Paul Fletcher -- former Optus corporate and regulatory affairs director, and current federal Liberal member for Bradfield.

Sources close to the development of the policy said the crux of the Coalition's plan was a three-pronged broadband strategy that would involve reviving large parts of the Howard government's aborted Opel project to provide internet access to under-served parts of the country.

The Opel project called for a $1.9bn rural and regional broadband network using wireless and satellite technology, but it was pushed aside to make room for the national broadband network six months after the Labor government took office in 2007.

The other two prongs of the Coalition's broadband policy involve continuing the development of new backhaul links to areas where Telstra is usually the only broadband supplier, and to increase the discretionary powers of the Australian Competition and Consumer Commission so it can more easily settle disputes in the telecommunications industry.

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http://www.theaustralian.com.au/australian-it/government-plans-for-expert-to-check-each-banned-web-page/story-e6frgakx-1225894267976

Government plans for expert to check each banned web page

• Fran Foo
• From: The Australian
• July 20, 2010 12:00AM

THE federal government will hand-pick an "expert" to manually check up to 10,000 blacklisted online web pages.

The proposal, which one critic described as too traumatic and absurd, will come to fruition over the next year if Labor wins the August 21 election.

Labor will take to the polls its controversial policy of mandatory ISP-level filtering of refused classification (RC) content.

On July 9, Communications Minister Stephen Conroy said the government would recommend to state and territory ministers that a review of RC be conducted.

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http://www.theaustralian.com.au/national-affairs/filter-not-part-of-preference-talks-greens/story-fn59niix-1225894715706

Filter not part of preference talks: Greens

• Andrew Colley
• From: Australian IT
• July 20, 2010 6:03PM

THE internet filter was not up for negotiation when the Greens cut its preference deal with Labor for the upcoming federal election.

Greens Senator Scott Ludlam said that the party had not softened its position on the filter legislation as part of the preference deal which is expected to strengthen its numbers in the Senate after the August 21 poll.

Communications Minister Stephen Conroy earlier this month decided to shelve the filter legislation to conduct a review of the classification system in cooperation with state and territory governments.

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Enjoy!

David.

The Health Information Exchange Thrust is Building in the US.

The following turned up a day or so ago.

Survey Gives the National HIE Landscape

HDM Breaking News, July 22, 2010

An annual survey of the progress of health information exchanges across the nation has found 234 active HIEs in 2010, compared with 193 in 2009.

The 234 active HIEs include 56 state-designated HIEs that have been awarded federal funds under the HITECH Act. Out of the 234 HIEs, 199 responded to this year's survey from eHealth Initiative, an advocacy organization. Respondents included 48 of the state entities.

.....

Addressing government policy mandates is a major challenge for 131 of responding HIEs. The complete report, "2010 Annual Survey of Health Information Exchange," is available at ehealthinitiative.org.

--Joseph Goedert

Full article here:

http://www.healthdatamanagement.com/news/hie-survey-ehealth-initiative-40663-1.html

It is very interesting to see how this technology and information exchanging approach is taking off and really growing quite rapidly.

The full report is definitely worth a browse to see the benefits being derived and so on.

David.