Registration For E-Health Summit Closed and Still No Programme. Pathetic!

From the web site at 6pm, November 18, 2010.

The e-Health Conference: Revolutionising Australia’s Health Care is a key event for stakeholders interested in electronic health and telemedicine.

The two-day Melbourne conference will draw together leading health experts, clinicians, consumer representatives, health administrators and information technology specialists to explore the future of e-Health in Australia.

The conference is designed as a forum for stakeholders across the sector to listen and discuss the PCEHR system and the Australian Government’s plans to prepare our health system for tomorrow’s challenges.

Announcing the conference, the Minister for Health and Ageing, Nicola Roxon, said the Government wanted to bring stakeholders together to “ensure that there is detailed discussion about the implementation plans leading to broader community consultation”.

read more

Priority registration: RSVP close-of-business Thursday 18th November.

No more is found here:

http://www.ehealthconference.gov.au/registration.asp

Guess what the link points to applying as a Media Rep.!

One can only say..WTF!

This comment (from the earlier blog) is just wonderful:

Anonymous said...

Hey, this is an invitee only conference for 400 people. They probably won't have much of a program because it's billed as being something where the attendees do all the work, all the think and all the talk. Then the people from the guvmint will collect all the ideas say thanks and go away to digest them.

Then a big document will be produced with everyone's name at the back to give it credibility and a whole new ehealth plan will get underway. And we start all over again, again and we start all over again ... tra lala, tra lala ... lala lahaaahhhhh.

Thursday, November 18, 2010 2:34:00 PM

What can one say. Nailed it in one!

David.

A Very Interesting Move Forward in UK Health IT Standards.

The following article appeared a few days ago

If I had a hammer...

When the interoperability toolkit was launched 18 months ago, there was excited talk about it being the new way forward for healthcare IT in England. The project has just delivered its first tools. But it is far from clear whether they will be used to crack big problems or small ones. Daloni Carlisle reports.

A few years ago, teenage boys used their thumbs for flicking Subbuteo figures. SMS texting had just got going; and you could text only to someone on the same network.

Then shared standards came along. Teenagers’ thumbs found a new use as users started to text network-to-network; and some people made a lot of money.

According to Sean Riddell, chief executive of EMIS, NHS IT is on the brink of a similar breakthrough. The widespread adoption of interoperability standards, developed through the Department of Health’s interoperability toolkit, could take it into the equivalent of the texting era by enabling systems to share information in real time, he says.

A new way forward

Mike Fuller, European marketing director of InterSystems, also thinks that ITK is a fundamental technical shift.

“It’s a configuration service, a way of using standards for governance and technical web services,” he says. “It’s more sustainable because you take each new use and pass it on. It’s like moving to a situation where everyone has 13 amp plugs.”

This is the sort of green shoots vision that might appeal to Paul Jones, head of the Department of Health’s Technology Office.

In a recent interview with E-Health Insider, he said that 20 ITK services have now been tested and work is underway on several more.

The idea is to create a library of standard interfaces, each relating to specific business processes or service; such as sending a discharge summary or installing a patient check-in kiosk. Each will be accredited by the DH and available for re-use by any NHS trust.

Jones was upbeat about suppliers’ willingness to get involved despite a business model that, at first sight, limits their revenues.

Rather than demanding £70,000 a pop for a bespoke integration solution for at trust, they would be able to command four-figure sums for accredited services that are used on a repeat basis, he said.

Questions about money

But who is paying for this? At the moment it appears to be suppliers – and, in particular, some of the smaller suppliers that were frozen out of the National Programme for IT in the NHS in its early days.

Adam Towler, director of Bluewire Technologies, describes some of the early meetings between NHS Connecting for Health and suppliers that were hosted by Intellect when ITK was announced in April 2009.

“These workshops were the first time that CfH had really engaged with small suppliers,” he says. “It was very fiery, with people saying they had been trying to do this for ages but had not been able to.

“One of the fundamental questions asked – and dodged – was where the money was coming from. Would they allow any of the [local service provider] contract money to come to smaller suppliers for these developments? This still has not really been answered.”

Nevertheless, Bluewire Technologies and its partner SRC have invested in developing services that are now ITK accredited. For example, they have worked on e-discharge summary solutions, and are on the brink of rolling them out into live situations.

It’s a similar story for EMIS and INPS, which together provide 75% of primary care IT systems. This summer they set up Healthcare Gateway Ltd to develop and market a medical interoperability gateway – or MIG – to facilitate sharing of information between healthcare providers.

The MIG had been on the cards for some time, but was spurred on by the ITK. It can be used to view care records, including chronic disease records, medication records and child health information, and to exchange clinical documents such as discharge summaries.

It is already ITK accredited and is now being implemented on the ground. Current projects include transmitting discharge summaries, allowing hospital clinicians to request detailed medication histories from GP practices and allowing out of hours primary care providers to access patients’ GP electronic record.

Peter Anderson, commercial director at Healthcare Gateway Ltd, believes the business case at trust level for demanding ITK-accredited services extends to more than just the saving in licenses.

“We are working with one trust that currently generates about one million clinical documents a year at an average cost of 50p per document – and that does not include the costs at the GP surgery of scanning letters and managing them,” he says.

“If we can deliver something that captures information and files it directly into the GP workflow system, then we have a business case.”

But, says Riddell, not everybody is on board. “Unfortunately, in the healthcare industry there are still commercial organisations who believe that it is commercially advantageous not to share information but to lock it down. I won’t say who; everybody knows who they are.”

More is found here:

http://www.e-health-insider.com/Features/item.cfm?&docId=356

The initial plan for the ITK was discussed in an earlier article.

Interoperability Tookit update

The NHS has been promised an interoperability toolkit to get good, local ideas working with existing and national programme systems. Daloni Carlisle gets an update on its progress.

In April last year, Christine Connelly, the NHS’ director general of informatics, promised that an ‘app store’ style toolkit would be developed for the health service.

Connelly said that while the “core aims” of the National Programme for IT in the NHS would be retained, the toolkit was needed to “allow new products to be developed locally, accredited centrally and linked to existing deployments of information systems such as Cerner and Lorenzo.”

In other words, the toolkit was to provide more local flexibility, and to encourage trusts to learn from and spread innovation between each other.

From app store to toolkit

CfH has since been working on the Interoperability Toolkit, developing a set of standards and frameworks for interoperability covering transactional and analytical services.

Paul Jones, chief technology officer, says: “The intention of this toolkit is to release the data stored in many of our applications so it can be used in new ways and combined with other data items. The possibilities that this provides are very wide and our initial pilots are about proving the concept – it will be staff working on the frontline who will generate the best ideas for using this data and supporting patient care.”

The early applications to prove the ideas include:

• The simple integration of text message appointment reminders to help reduce 'did not attend’ rates into a system that does not provide this function as standard;
• A simple and standardised integration of self-service kiosks into a patient administration system;
• An electronic whiteboard integrated into patient administration systems to allow vital information to be recorded in a clinically intuitive way (by writing on a board), but then captured and sent to the PAS.

Jones adds: “The range of future applications is almost unlimited and this is where the real value of the toolkit emerges. The toolkit is a technological innovation that will enable further innovation to flourish.

“Although there is no shortage of innovative technological solutions to real clinical and administrative problems, without the standards and frameworks to ensure their interoperability, these solutions risk either not being taken up in service, or becoming prohibitively expensive because they require bespoke interfaces for deployment within the existing NHS estate.”

The is more information from this article here:

http://www.e-health-insider.com/Features/item.cfm?docID=330

You can read press releases from two major players here:

http://www.intersystems.com/press/2010/nica.html

and here:

http://www.orionhealth.com/newsroom/press-releases/orion-health-demonstrates-unrivalled-interoperability-during-itk-proof-of-concept-project

The Intersystem release summarises nicely just what all this is about.

“The Toolkit specification, created by the Technology Office, is a set of technical and governance standards and frameworks for interoperability. It covers transactional and analytical services aimed at accelerating the pace of delivery and is in line with the Department of Health’s strategy to ‘connect all’ rather than ‘replace all’, as outlined in the recent White Paper, ‘Equity & Excellence: Liberating the NHS’.”

There is more official documentation available here.

http://www.connectingforhealth.nhs.uk/systemsandservices/interop

With all the work and progress seemingly being had in the UK I find it odd that the most recent NEHTA document on interoperability is over 16 months old and the fact sheet - presumably current - dates from 2006.

Here we have the UK NHS proceeding with using HL7 V2.4 to enhance interoperability and information flows and NEHTA is wittering on about the HL7 Congress in January 2011. It seems to me the interoperability team have - at the very least - been keeping their work a bit of a secret.

Given HL7, Intersystems and Orion are all major players in Australia why have we not see more from NEHTA explaining what they are learning from the UK and from these parties and how it might maybe assist here.

I suppose it just another case of “hiding their light under a bushel” It is worth noting the most recent Interoperability Framework (V2) is dated September 2007, so clearly not a frequently updated area - or maybe it was already perfect?

I have to say I am conceptually keen on the idea of ‘connect all’ rather than ‘replace all’ and really would be keen to see that objective as a broad priority as I know it is with many other groups around the world (IHE for example who are working with NEHTA SMD to get some convergence - better late than never I guess).

Maybe the upcoming Summit could offer expert advice on how to move this area forward!

David

Still No Programme For E-Health Summit - Less Than 2 Weeks to Go!

Just checked to see what the program was given it begins in less than two weeks.

Sad to say - just no special guest announced and no programme!

This is really a serious money wasting joke!

David.

Medicare Locals and E-Health - Does It All Fit Together?

The following appeared rather too late for me to comment on.

Medicare Locals - discussion paper on governance and functions

PDF Medicare Locals - discussion paper on governance and functions

08 November 2010The Australian Government has committed to establishing a national network of primary health care organisations, known as Medicare Locals. This paper specifically addresses the following areas:

- What will Medicare Locals do?

- What will Medicare Locals look like?

- How will Medicare Locals interact with patients and providers?

The aim of this paper is to provide information to the public and other interested parties as to the proposed roles and functions specific to Medicare Locals.

You are invited to provide written comment on this Discussion Paper. Submissions can be sent by post or email and should be provided to the Department of Health and Ageing (DoHA) by 15 November 2010.

Full Post is here:

http://www.apo.org.au/research/medicare-locals-discussion-paper-governance-and-functions

First, what on earth is going on here the document is dated 29 October and Comment is due by November 15. Very short notice I must say.

Here is the guts of what this is about: (Page 5/1)

“From 1 July 2011 the Australian Government will establish Medicare Locals, a national network of primary health care organisations, to improve integration of primary health care services and improve access to services.

Medicare Locals will be an important part of the new National Health and Hospitals Network (NHHN). Medicare Locals will be established as independent legal entities with strong links to their local communities, health professionals, service providers and consumer and patient groups, enabling them to respond effectively to local needs.

Medicare Locals will be responsible for making it easier for patients and service providers to navigate the health care system. Medicare Locals will support health professionals to provide more co-ordinated care, while maintaining the important role that general practice plays in the primary health care sector. Medicare Locals will facilitate improved access to services for patients and encourage greater integration between the primary health care, hospital and aged care sectors.

Improvement in primary health care is critical to improving the overall health care system.

The first Medicare Locals (around 15 organisations) are expected to commence operations in mid 2011, with the remainder commencing in mid 2012. The final number of Medicare Locals to be established is to be determined by around the end of 2010 and is subject to ongoing discussions between the Commonwealth and state and territory governments, to allow consistency with the boundaries of Local Hospital Networks as appropriate.”

What will they do you ask?

“Medicare Locals will retain, and expand, the functions and activities currently undertaken by the Divisions of General Practice – including general practice support and delivery of programs.

A key role for Medicare Locals will be undertaking local health planning, identifying gaps in services at the local level, examining opportunities for better targeting of services and establishing formal and informal linkages with the acute and aged care sectors. In doing this, Medicare Locals will drive more efficient use of our health resources – by encouraging the delivery of primary care, ambulatory and acute care in the centres that are most able to safely and effectively provide them. Patients will benefit by experiencing shorter and safer patient journeys, within streamlined, and better focused clinical systems. Greater efficiency will mean that more ‘health’ can be provided for the same health care dollar.” (Page 8/4)

There is a lot more:

There are to be between 50 and 75 Medicare Locals covering anywhere up to 1,000,000 people (hardly local!)

They are to report to the Federal Government but be Companies Limited by Guarantee (like NEHTA)

They are to be important in co-ordination, safety and clinical governance.

What is missing is just how any of these hoped for improvements will actually be established, funded and staffed. It looks to me like part of a new and possibly amazingly complex bureaucracy which is likely to be very intrusive and annoying to the present clinicians. More jobs for the boys what! Maybe those failed bureaucrats who have lost out in the New Health Network structures?

E-health gets just one mention I can find. Among reform initiatives of the new hospital networks we get the task which will be undertaken or supported:

“the development of the Personally Controlled Electronic Health Record and other eHealth developments”

Certainly the concept of having e-Health at the centre of a quality, safe and co-ordinated system does not seem to be any priority.

I think we should all be pretty alarmed by this. I reads to me as policy rubbish developed by people who are a zillion miles from the actual patient coalface and are pretty clueless. Be alert and very alarmed would be my take.

David.

A Few Answers We Would Like from the E-Health Summit in Two Weeks. If They Ever Get it Together!

The following - showing just how chaotic the arrangements for the e-Health Summit are - appeared earlier today.

Conroy enlisted to help sell e-health plan

• Karen Dearne
• From: The Australian
• November 16, 2010 12:00AM

NICOLA Roxon has drafted Stephen Conroy to help talk up her $466.7 million e-health record plan at an invitees-only summit later this month.

To date, the two are the only confirmed speakers for the two-day forum in Melbourne on November 30-December 1.

The federal Health Minister's spokeswoman said the program was still not finalised as organisers were awaiting confirmation from an international speaker.

She could not supply details of local " health experts, clinicians, consumer representatives, health administrators and IT specialists" participating in the "landmark forum to explore the future of e-health in Australia".

It's understood only a trickle of invitations have gone out after a complex registration and selection process; apparently the 400-seat capacity booked at the Convention Centre was oversubscribed by almost 100 per cent.

"Over two days, compelling speakers will lead the conversation through plenary sessions, while subject matter specialists will lead streams that focus on the national e-health agenda," the invitation email says.

The Australian understands most people are still waiting for word from the department, leaving business and travel arrangements in limbo. But even those with an invitation have no idea what's on the agenda.

Ticketholders can at least access the largely empty e-healthconference.gov.au website, which is identification passcode-protected.

More discussion of the mess is found here:

http://www.theaustralian.com.au/australian-it/conroy-enlisted-to-help-sell-e-health-plan/story-e6frgakx-1225954050455

Before suggesting some questions the participants who actually get there might ask can I point out you can check the progress of organisation and the programme here - without being registered - at least for now:

http://www.ehealthconference.gov.au/home.asp

You can see how unready the whole thing is 2 weeks out!

The key questions I want to see addressed are:

1. Just what exactly is meant by a Personally Controlled Electronic Health Record (PCEHR)?

2. Exactly how is the PCEHR intended to operate?

3. What is the literature evidence that supports the adoption of this - rather than a more conventional - approach to the progressive implementation of e-Health?

4. Where has a PCEHR similar to the proposal been successfully implemented?

5. Where is the information to be held in the PCEHR to be sourced from and how will the quality of the information be assured? Will providers be paid for providing information?

6. What support is the Government planning for provider EHRs and Secure Clinical Messaging.

7. What will be the medico-legal status of information held in PCEHRs and what will be the consequences if clinicians mistakenly act on erroneous information? Will they be indemnified?

8. What is the evidence base that supports the other Government e-Health proposals (teleconsultation and the like) as the optimal expenditure of the available funds?

9. How do the PCERH and the other proposals fit with the National E-Health Strategy which has been endorsed by Health Ministers and has yet to be implemented?

10. When are the issues of absent leadership and failing governance in the e-Health domain going to be addressed?

If we could get satisfactory answers to those points - and feel free to suggest others - the Summit might just be worthwhile.

David.

Weekly Australian Health IT Links – 15 November, 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 subscription payment.

General Comment:

This is a pretty worrying report. If what is reported below is true then trust in an electronic patient record which had not been updated caused a major treatment issue. This is a very serious management issue - not a technical issue - and it is the processes around how the EHR is used needs to be dramatically improved. It is a pity the EHR and not the management processes around the record which is blamed for the problem.

Turned away by hospital in error, man commits suicide

Kate Hagan

November 8, 2010

THE mother of a man who took his own life an hour after being refused admission to Frankston Hospital's psychiatric ward believes deficiencies in its electronic patient records system contributed to his death.

Susan McIntyre said her son Carl Ranthe, 26, who had schizophrenia, presented to the hospital's emergency department on New Year's Day last year and requested admission to the psychiatric ward, but was discharged after a social worker assessed him.

A coroner's inquest in September revealed that crucial details about a similar incident a month earlier, when Mr Ranthe was also refused admission to the ward and then absconded from his residential care unit, were not included on the hospital's electronic records.

The inquest heard that the information about Mr Ranthe absconding from his care unit - managed by Peninsula Health, which also runs Frankston Hospital - was unavailable because the care unit only updated his electronic record every 13 weeks.

More here:

http://www.theage.com.au/victoria/turned-away-by-hospital-in-error-man-commits-suicide-20101107-17iyj.html

The issue is also covered here:

http://www.smh.com.au/opinion/society-and-culture/when-privacy-can-be-a-life-or-death-call-20101110-17nma.html

When privacy can be a life or death call

Merle Spriggs

November 11, 2010

Electronic health records raise difficult issues of who sees what, and when.

WOULD you want your dentist to know you have haemorrhoids or your optometrist to be aware of your HIV status? Questions such as this are at the heart of any discussion of electronic health records, something that could affect all of us very soon.

The federal government has allocated $467 million over two years to introduce a personally controlled electronic health record system, so it is essential that we assess the potential harms and benefits of such a system.

It's a complex issue, highlighted this week in reports from a coroner's inquest that crucial details about a patient were missing from a hospital's electronic records because they were updated only every 13 weeks. The missing information could have helped in the assessment of the patient before he committed suicide - the implication being that they could have helped save his life.

While it is the coroner's job to make determinations in this case, it is important for everyone to be aware of the legislation passed by the Senate in June to allow the National E-Health Authority and Medicare Australia to begin assigning individual healthcare identifiers to the Australian public.

----- End Extract.

This is also a useful and quite thoughtful contribution to the health information sharing debate.

Otherwise there is a fair bit of news which you can read about below.

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http://www.computerworld.com.au/article/367864/nsw_department_health_announces_realignment_functions_/?fp=4&fpid=18

NSW Department of Health announces 'realignment of functions'

Director of e-health and ICT strategy advertised

• Lisa Banks (Computerworld)
• 12 November, 2010 13:45

The NSW government has announced a reshuffle in the Department of Health, with a “realignment of functions” resulting in a new advertisement for the role of director of e-health and ICT strategy.

The realignment follows the implementation of the recently announced NSW Health ICT strategy, with the advertisement stating that it is an attempt to “position NSW Health at the forefront of the national e-health agenda”.

Once the role of director of e-health and ICT strategy is filled, the successful candidate will oversee all Department of Health ICT strategy, and be responsible for guiding “the ICT direction for the entire health system”, the advertisement said.

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http://www.zdnet.com.au/nsw-health-forms-e-health-branch-hires-339307192.htm

NSW Health forms e-health branch, hires

By Josh Taylor, ZDNet.com.au on November 12th, 2010

The New South Wales Department of Health is looking for a director of e-health and ICT strategy to bring the state to the forefront of the national e-health agenda.

According to a job advertisement released today in the Australian Financial Review, the leadership position has been created for a new NSW Health branch created to take advantage of the national e-health roll-out. The director will be required to develop strategies to engage clinicians to support the implementation of e-health strategies.

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http://www.theaustralian.com.au/australian-it/e-health-bodys-43m-consultancy-bill/story-e6frgakx-1225949628414

NEHTA's $43m advice bill

• Fran Foo
• From: The Australian
• November 09, 2010 12:00AM

THE National E-Health Transition Authority spent about $43.5 million on consultants last financial year.

A 67 per cent increase from the previous year.

The generosity was extended to key management personnel, whose total compensation doubled by $1.3m from last year. The expenditure on consultants represented nearly half its $95.6m budget in the 12 months to June 30, according to its annual report.

NEHTA paid about $26m to consultants in 2008-09.

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http://www.theage.com.au/digital-life/computers/laptops-damage-sperm-20101109-17m4n.html

Laptops damage sperm

Julia Medew

November 10, 2010

LAPTOP computers may be damaging male fertility because they overheat men's scrotums, new research suggests.

A study in the journal Fertility and Sterility this week measured the temperature of 29 men's scrotums while they used laptops on their knees, both with and without use of a lap pad underneath. The subjects also sat with their legs apart to see if the temperature changed.

State University of New York researchers found that when the men sat with their legs together and did not use a lap pad, it took 11 minutes for the computer to increase scrotal temperature by 1 degree - enough to damage sperm production. With the lap pad, it took 14 minutes and when the men sat with a lap pad, with legs apart it took 28 minutes.

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http://www.computerworld.com.au/article/367564/government_invests_400_million_telehealth_video_conferencing_services/

Government invests $400 million in telehealth, video conferencing services

Patients in remote areas to receive consultations via internet

• Hamish Barwick (Computerworld)
• 10 November, 2010 14:51

The Australian government has announced that from 1 July 2011 patients in remote, regional and outer metropolitan areas will receive greater access to specialists through new investments in telehealth consultations via the internet.

Confirmed in its mid-year economic and fiscal outlook, the government’s investment will provide patients with access to electronic consultations.

Minister for Health and Ageing, Nicola Roxon, said in a statement that with twice as many specialists per capita in major cities compared to regional and remote areas, this investment will help to reduce barriers to specialist medical services for patients.

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http://www.smh.com.au/digital-life/mobiles/mobile-phone-std-test--killer-app-or-fantasy-20101109-17lbl.html

Mobile phone STD test - killer app or fantasy?

Asher Moses

November 9, 2010

People will soon be able to tell if they have an STD by urinating on a small computer chip and inserting it into a mobile phone or computer, doctors and scientists in Britain claim.

But Australia's foremost sexual health expert is sceptical about the idea, saying it may be a long time before such a product is consumer-ready.

The small devices, similar to pregnancy testing kits, will reportedly be able to give people a home diagnosis within minutes. Millions of pounds have been poured into the project to combat an STD epidemic in Britain, where infections reached a record 482,696 last year.

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http://www.medicalobserver.com.au/news/online-partner-alerts-catch-on-for-patients-with-stis

Online partner alerts catch on for patients with STIs

8th Nov 2010

Rada Rouse

TEXTING and emailing are increasingly being used by patients diagnosed with STIs to inform partners who might need treatment, research shows.

The first Web-based version of the Australasian Contact Tracing Manual reflects the growing use of these technologies, sexual health physician Dr Marcus Chen says.

“We want to reflect recent research into how people contact partners in reality,” says Dr Chen, chair of the Australasian Society for HIV Medicine (ASHM) expert writing group that developed the 4^th edition of the manual.

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http://www.rncos.com/Report/Biotech08.htm

Australian Healthcare IT Market Analysis

Publish Date: May, 2010 No. of Pages: 35

Description

The current healthcare reform in Australia has induced the rapid transition of healthcare industry towards the information technology. The focus is to improve the quality of healthcare services by implementing high technology standards and integrating healthcare services through a common technology platform. With the increasing use of e-health services, the spending of healthcare industry in ICT has seen a significant surge over the recent past. As per our new research “Australian Healthcare IT Market Analysis”, the healthcare IT market of the country is forecasted to grow at a CAGR of around 5.2% during 2010-2012.

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http://www.medicalobserver.com.au/news/pharmacists-blame-gps-for-ehealth-deadlock

Pharmacists blame GPs for e-health deadlock

8th Nov 2010

Caroline Brettingham-Moore

PHARMACISTS have charged GPs with bringing e-health to a standstill, claiming doctors are not up to speed with the latest innovations in e-health technologies.

Speaking at the recent Pharmacy Australia Congress, Pharmaceutical Society of Australia president Warwick Plunkett said pharmacists had taken e-health as far as possible, and it was now up to GPs to get on board.

“Until doctors get e-health up and running in its full extent we will not be able to go any further,” he said.

While the advantages of e-prescribing were being enjoyed by some doctors, there would be even greater advantages in allowing relevant patient information to be shared electronically with pharmacists, he said.

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http://www.medicalnewstoday.com/articles/207394.php

e-health Futures Launch In Sydney, Australia

11 Nov 2010

The Royal Australian College of General Practitioners (RACGP) has brought its innovative, interactive e-health display - e-health Futures - to Sydney.

The display will be officially opened at 7pm on Thursday 11 November at the RACGP NSW&ACT Faculty office (Level 7, 12 Mount St, North Sydney). The display will be on show from 11 November until early February 2011. The College has worked closely with the National E-Health Transition Authority (NEHTA) to incorporate their Model Healthcare Community into e-health Futures.

e-health Futures is a walkthrough experience with simulations and demonstrations of how e-health information will work among healthcare professionals and between healthcare settings. Visitors can complete either guided or self-guided tours at the exhibit.

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http://www.computerworld.com.au/article/367510/brumby_promises_every_doctor_public_hospitals_an_ipad/?eid=-6787&uid=25465

Brumby promises every doctor in public hospitals an iPad

That's if the incumbent Labor state government is returned to power

• Renai LeMay (ARN)
• 10 November, 2010 09:4

Victorian Premier, John Brumby, yesterday promised every doctor in the state’s public hospital system would be issued with an Apple iPad if his incumbent Labor Government was returned to power in the state’s upcoming election.

The pledge was listed as a minor item in Labor’s health policy released yesterday. The Premier stated his party was committed to giving doctors the tools they needed to provide the best care to Victorian patients.

“As technology evolves, so do the tools that our doctors need. We will provide $12 million to buy iPads for every doctor working in Victoria’s public hospital system, so they have easy access to time-critical clinical information at a patient’s bedside,” Brumby said.

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http://www.zdnet.com.au/vic-ipad-binge-to-see-federal-laptop-issues-339307167.htm

Vic iPad binge to see federal laptop issues?

By Renai LeMay, ZDNet.com.au on November 11th, 2010

Analyst firm Gartner yesterday questioned whether Victoria's Labor party had properly analysed what management tools and supporting infrastructure it will need if it wins the upcoming state election and is required to deliver on its promise to roll out Apple iPads to every public hospital doctor statewide.

State Premier John Brumby announced the plan this week, but Gartner research director Robin Simpson said he wondered how deep Labor's proposal actually went.

"Often these programs sound wonderful on the surface ... you've really got to wonder whether this has been thought through," he said.

The analyst described Brumby's pledge as a little like federal Labor's Digital Education Revolution project, which is seeing laptops rolled out to students nationwide. The devices were the obvious target for investment, according to Simpson, but money also needed to be set aside for supporting systems.

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http://www.theage.com.au/victoria/health-funding-at-risk-20101111-17pe6.html

Health funding at risk

Julia Medew

November 12, 2010

VICTORIA would be risking millions of dollars in Commonwealth funding for its hospitals if it does not submit accurate performance data as part of the national health reform deal.

Under the national partnership agreement on improving public hospitals, which Premier John Brumby signed last week, Victoria is set to receive $149 million in bonus funding over the next three years if its hospitals meet new performance benchmarks.

Victoria could earn $62.1 million if its emergency departments meet rolling targets to introduce a four-hour treatment rule, and $86.9 million if elective surgery is performed within specific times.

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http://www.theage.com.au/victoria/state-election-2010/brumby-refuses-to-reveal-specialist-wait-times-20101109-17m57.html

Brumby refuses to reveal specialist wait times

Julia Medew

November 10, 2010

THE Brumby government has refused to release waiting times for specialist appointments in Victorian hospitals, despite doctors saying it would improve patient care.

Hospital data obtained by the Coalition this week showed that about 200,000 people were waiting to see a specialist in May. This includes 67,000 who were waiting to see one for the first time after being referred to them for expert advice.

In some cases, people had been waiting more than two years for these so-called ''outpatient appointments'', which could be with a surgeon or physician such as a cardiologist. While some of these patients may not need surgery, many will see surgeons who decide to put them on the elective surgery waiting list.

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http://www.theage.com.au/victoria/hospital-targets-cost-lives-20101110-17nr5.html

Hospital targets cost lives

Julia Medew

November 11, 2010

HOSPITALS are putting performance concerns ahead of lives as they battle to meet Victorian government targets without enough resources, an explosive report has revealed.

A survey of 124 emergency department doctors last month found that hospital chiefs were not allowing doctors to activate ambulance bypass procedures when emergency departments were full, because they did not want to fail to achieve a government benchmark that says hospitals should be on bypass less than 3 per cent of each year.

Seventy per cent of the doctors said this had been a problem for them and one said it had cost lives because ambulances were delivering seriously ill patients to overcrowded emergency departments that were unable to care for them.

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http://www.theaustralian.com.au/news/health-science/test-found-which-can-pick-up-signs-of-dementia-in-middle-age/story-e6frg8y6-1225951028409

Test found which can pick up signs of dementia in middle age

• From: AAP
• November 10, 2010 2:14PM

A BRAIN health test could become part of a doctor's check-up routine, as Australian research has found a simple way to detect the early signs of cognitive decline.

Scientists at the Australian National University (ANU) used a computer-based test which could accurately predict who, during middle-age, already had warning signs for dementia.

The test assessed a person's reaction time while also looking for erratic answering patterns, and it raised a red flag those who an MRI scan later found to have dementia-related brain lesions.

Professor David Bunce from the ANU's Centre for Mental Health Research, and London's Brunel University, said these lesions were usually seen in older dementia patients and they were an early warning sign when identified in younger adults.

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http://www.bjhcim.co.uk/news/2010/n1011015.htm

iSOFT enters healthcare business intelligence market

10 November 2010

Your browser does not support inline frames or is currently configured not to display inline frames. iSOFT has partnered with business intelligence specialist Insource to develop iSOFT Health Intelligence, its first product to enable healthcare organisations to produce reports analysing performance and outcomes.

iSOFT Health Intelligence is a modular business intelligence (BI) application. The first module, designed specifically for secondary care trusts' reporting requirements, links to iSOFT’s patient administration systems, via a range of connectors, to extract meaningful data to support business decisions. Bespoke connectors for third-party systems are also available.

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http://www.ehiprimarycare.com/news/6407/lumb_queries_lsp_deal_at_morecambe

Lumb queries LSP deal at Morecambe

10 Nov 2010

A Cumbria GP, who has led the development of primary care systems across the county, told eHealth Insider Live about his difficulty integrating with Lorenzo at University Hospitals of Morecambe Bay NHS Foundation Trust.

Dr William Lumb, IT lead for South Cumbria, said that although he had been able to develop a Community Information Network that had enabled GPs and community clinicians to share information, it had not been possible to extend it into the trust.

He said: “I do not know a lot about Lorenzo [the iSoft electronic patient record that CSC is deploying at Morecambe Bay as part of the National Programme for IT in the NHS].

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http://abnnewswire.net/press/en/64124/Pennine_Acute_Hospitals_NHS_Trust_Extends_Partnership_with_iSOFT_Group_Limited_%28ASX:ISF%29_for_Five_Years.html

Pennine Acute Hospitals NHS Trust Extends Partnership with iSOFT Group Limited (ASX:ISF) for Five Years

Sydney, Nov 9, 2010 (ABN Newswire) - iSOFT Group Limited (ASX:ISF) has agreed contracts with Pennine Acute Hospitals NHS Trust for an upgrade of an existing patient administration system (PAS) to provide additional patient and clinical functionality, under trust plans to improve patient care by improving the clinical information available to staff at its four hospitals in north Manchester, Bury, Rochdale and Oldham.

Under a new five-year deal, iSOFT will upgrade Pennine's PAS and install a number of web-based clinical solutions, including its new e-prescribing and medicines administration (ePMA) solution and HealthViews for order communications and consolidated access to patient data from across the trust. HealthViews and ePMA form part of iSOFT's new Smart Solutions portfolio.

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http://www.e-health-insider.com/news/6391/isoft_promises_new_uk_products

iSoft promises new UK products

08 Nov 2010

ISoft has pledged to invest in the development of new products for NHS customers, separate to its Lorenzo development commitments.

In an exclusive interview with E-Health Insider, iSoft’s UK managing director, Adrian Stevens, said that iSoft will invest in a new 75-strong UK based development team.

“We’ve put development centres of excellence back into the UK; that’s 75 new people working on interoperability, business intelligence, medications management and hosted Synergy,” he said.

“Isoft needs to behave like a market leader and will be bringing in new products to the market."

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http://www.smh.com.au/lifestyle/wellbeing/size-of-radiation-doses-in-doubt-20101110-17nv4.html

Size of radiation doses in doubt

Julie Robotham HEALTH EDITOR

November 11, 2010

CANCER patients may be receiving inaccurate radiation therapy doses because Australia has no formal program to check that linear accelerator machines are accurately calibrated.

A US audit had found as many as 30 per cent of facilities failed to deliver a dose accurate to within a 7 per cent margin, Annette Haworth, a medical physicist at the Peter MacCallum Cancer Centre in Melbourne, said.

"We haven't done this in Australia yet so we can't tell you whether we're as bad," Associate Professor Haworth told the Clinical Oncological Society of Australia's annual scientific meeting in Melbourne yesterday.

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http://blogs.computerworlduk.com/the-tony-collins-blog/2010/11/isoft-has-pledged-to-invest/

Should this IT project take longer to finish than Brunel's Great Western Railway?

It took six years to finish the Great Western Railway - and 10-15 years to complete the NPfIT "Lorenzo" project

Published 11:55, 08 November 10

Adrian Stevens, the UK managing director of NHS software supplier iSoft, says that people have been unrealistic about how long major IT programmes take to deliver.

He was speaking about the iSoft "Lorenzo" patient administration system which is due to be installed by NPfIT local service provider CSC at dozens of NHS trusts. Lorenzo was due to be installed in 2004 but has been delayed.

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http://www.theaustralian.com.au/national-affairs/fibre-to-the-bootstraps-how-labor-shackled-its-future-to-broadband/story-fn59niix-1225948163541

Fibre to the bootstraps: how Labor shackled its future to broadband

• Jennifer Hewett and Mitchell Bingemann
• From: The Australian
• November 06, 2010 12:00AM

IN March 2007, new opposition leader Kevin Rudd grabbed hold of the promise of high-speed broadband internet for the country and for the Labor Party.

Once in government, Rudd declared, Labor would back a $4.7 billion public investment in a new national fibre-optic network with rapid capacity.

This was sold as just the sort of "nation-building investment" that only a Labor government would undertake. It was, Rudd proudly told the party's national conference, "Labor to its bootstraps".

His passionate enthusiasm was only partly due to the long-term potential of the technology. More important politically was its short-term potential to redefine Labor as the party of the future.

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http://www.theaustralian.com.au/national-affairs/treasury-warns-over-costings-for-the-nbn/story-fn59niix-1225950465763

Treasury warns over costings for the NBN

• Sid Maher and Stefanie Balogh
• From: The Australian
• November 10, 2010 12:00AM

TREASURY has warned cabinet it needs to give "very careful consideration" to the National Broadband Network's implementation study over coming months.

The department argued that the project carried significant risks to the national balance sheet.

The advice to cabinet, originally suppressed when Treasury's incoming brief to the government was released under Freedom of Information laws in September, was revealed yesterday.

The release of the advice comes after the Department of Communications and Broadband revealed in its brief to the government that the company overseeing the rollout of the NBN disagreed with the McKinsey-KPMG implementation study over recommendations relating to the design of the high-speed broadband network and the nature of the prices and products NBN Co would offer to customers.

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http://www.techworld.com.au/article/367802/firefox_4_approaches_warp_speeds_j_germonkey/

Firefox 4 approaches warp speeds with JägerMonkey

The Mozilla Firefox browser is three to five times faster than version 3.6, thanks not only to the JägerMonkey engine

• Katherine Noyes (PC World (US online))
• 12 November, 2010 07:4

We've known for some time now that the JägerMonkey JavaScript engine seen in recent nightly preview builds of Firefox 4 would increase the browser's speed, but yesterday's release of the seventh beta version of the software shows performance increases beyond what many of us might have imagined.

That's due in large part to JägerMonkey, but also in part to the addition of support for hardware-accelerated graphics and hardware acceleration for Windows XP and Mac OS X. Firefox 4 Beta 7 also enables 3D capabilities without the need for plug-ins using WebGL.

Taken together, the result is that pages load faster and interactions with Web sites are "snappier," Mozilla says. The free and open source browser is really, really fast, in other words -- three times faster than Firefox 3.6.12 is on both the Kraken and Sunspider JavaScript benchmark test suites, and a full five times better on version 6 of the V8 benchmark.

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Enjoy!

David.

What Needs To Come From the Planned E-Health Summit? A Clear Way Forward Would be a Good Start!

A short while ago (October 28, 2010) Federal Health Minister Nicola Roxon announced there would be an e-Health Conference (or Summit) - Revolutionising Australia’s Health Care held in late November 2010.

In announcing the Summit she confirmed that she and Minister Conroy would be speaking she said that the e-Health Summit will take place on the 30 November and 1 December at the Melbourne Convention Exhibition Centre. Attendees are to be “the nation’s leading health experts, consumer groups and information technology specialists who will come together to discuss the technological revolution in the delivery of health care” The full press release is available on the Department of Health web site.

The stimulus for having the Summit is explained in the following two sentences from the release. “The Gillard Government is investing almost $470 million to introduce e-health across the health system – including the introduction of personally controlled electronic health records to be rolled out from July 2012,” and “This investment will build upon the $392 million committed to modernise the health system by providing Medicare rebates for online consultations across a range of specialties for the first time.”

I found it interesting that the release points out that three implementation sites have already been selected but that the Summit “will provide an important opportunity for cross-sector collaboration and discussion around the design, implementation and vision for future capabilities of the system.

Representatives from governments, industry, private and public sector health care organisations, clinicians and consumer groups will discuss how this innovative system will work into the future.”

In summary, with no apparent associated release of discussion documents, plans and detailed information, we are to have a collection of experts get together to work out what to do next. This is absurd in my view and made even more so when consider the timeframe involved in the calling of this gathering.

This needs to be contrasted with that happened a little over a decade ago when a similar ‘Health On-Line’ Summit was called. In November, 1999 the National Health Information Advisory Council released an initial version of Heath Online: Health Information Action Plan for Australia. This was a quite comprehensive 115 page draft plan for further consultation.

The Council then conducted a National Health Online Summit in August 2000 which resulted in 188 page Summary of Proceedings. It was this well informed and comprehensive meeting, and a range of supporting documents that ultimately led to initiation of the first national Shared EHR program which was termed HealthConnect. This plan envisaged a National Health Information Network for Australia. It is dated mid-2000.

This program was worked on with research, technical pilots, legal reports and so on but as the plan was firmed up Ministers Abbott and Hockey were apprised by bureaucrats that the costs of implementation would be in the billions of dollars and so what had been an actual project suddenly (in August 2005) became a “Change Management Plan”!

For this proposed Summit we have no clear plan - unless you include the Deloittes developed National E-Health Strategy of some two years ago which was agreed to but not funded by Health Ministers - and a set of political announcements on amounts to be spent with no information provided at any real depth as to just what is proposed and now it is to be achieved.

It seems clear to me the proposed Summit is a consultative ‘fig-leaf’ where some pre-developed concepts will be delivered to the unsuspecting delegates who will then be unable, in the time available, be able to provide the requisite quality of advice and where something dreamt up in a Canberra consulting office will be inflicted on an unwary public.

This approach to implementation of e-Health is utterly doomed to failure as have all centrally mandated and developed implementations of e-Health where there has not been comprehensive and responsive consultation of both the caring professions and the public.

At the very least we need to have the promise of the internet being realised with full video streaming and provision of interactive facilities for participation. Of course archive availability is just assumed!

What is required is that this Summit be the beginning of a conversation with relevant stakeholders and that this conversation addresses the yawning gaps we have in the leadership, governance, co-ordination, planning and implementation of e-Health. Both sides of politics seem the think ‘e-health’ is ‘a good thing’ but to date the evidence suggests neither appreciates the difficulty and complexities that await.

To see this Summit as anything other than a first step would be deeply unwise. There is a very long way to go to e-Health nirvana and a hastily organised two day Summit will not get us there. To answer the question posed in the article’s title we need to commence a process that leads to an agreed and funded plan. The Summit has to be a beginning and not an end.

Conference announcement link:

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr10-nr-nr161.htm

The comments made to a previous note on this topic make fun reading. See here:

http://aushealthit.blogspot.com/2010/11/secret-event-to-which-you-are-probably.html

What an unremitting and pathetically organised fiasco this all is!

David.

AusHealthIT Poll Number 44 – Results – 14 November, 2010.

The question was:

NEHTA Spent almost $100 Million in 2009/10. Did Australia Get Value For Money?

For Sure

- 3 (7%)

Possibly

- 1 (2%)

A Bit Doubtful

- 5 (12%)

We Were Ripped Off!

- 31 (77%)

Votes: 40

I think it is fair to say those who read here are convinced that NEHTA is wasting a good deal of money on our behalf. Time something was done I belive.

Again, many thanks to those that voted!

David.