Quote Of The Year

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

or

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

Thursday, November 25, 2010

There Are Few Mess-Ups that Could Top This - Just Amazing!

The following appeared in the Australian IT On-Line yesterday.

Government allocates $55m to e-health records sites

  • Karen Dearne
  • From: Australian IT
  • November 24, 2010 3:59PM

THE Gillard government is offering up to $55 million for the next round of e-health sites, inviting applications for project funding from a range of healthcare organisations before Christmas.

Health Minister Nicola Roxon said the money will expand the number of GP divisions working on new personally-controlled e-health records from the initial sites, in Brisbane, the Hunter Valley and Melbourne.

"Applications are welcome from a variety of patient settings including Divisions of General Practice, professional and non-government organisations, the private sector and others involved in healthcare," Ms Roxon said.

"The second wave of sites will help lead the way for future planning of a secure, reliable e-health system, improving technology and identifying what works well and what could work better."

Ms Roxon said patients would ultimately control "what goes into their health record and who can access their information".

More here:

http://www.theaustralian.com.au/australian-it/government/government-allocates-55m-to-e-health-sites/story-fn4htb9o-1225960286343

I thought it might be fun to have a look at the application for funding - given so much money is up for grabs - and see just how well developed the design ideas and functional delivery plans were.

To behave like the tabloid journalist of old I can now reveal the following.

1. NEHTA and DoHA are clueless as to just what the PCEHR is!

To quote:

“Applicants should be aware that the Department of Health and Ageing (DoHA) is prepared to disclose an early draft version of the PCEHR conceptual design document to applicants to assist them in developing their application. The document is in draft form as it is yet to go through public consultation; the document is therefore likely to change as a consequence of this consultation.

In order for applicants to receive the draft version of the PCEHR conceptual design document it will be necessary for an individual person representing an organisation, partnership or consortia to sign a Deed of Confidentiality (Attachment A), and submit a scanned copy to PCEHR.ehealth.Sites@health.gov.au. Following receipt of the signed Deed of Confidentiality DoHA will provide a copy of the draft version of the PCEHR conceptual design document to the applicant.

In addition, other information relevant to the PCEHR Program will be published on the NEHTA website: www.nehta.gov.au.”

What on earth is going on here? How about deciding what you want to do, developing a ‘system’ to deliver same, consult properly and then go to the market for help?

This whole process, driven doubtlessly, by the political pressure to ‘do something’ looks more and more like a total train wreck.

Would you make a commercial offer to deliver something (and we don't know what), with all those onerous liability clauses the contract has, when what was wanted was not thought through and agreed well enough to properly define the project. I sure wouldn’t. This is an emerging repeat of ‘pink bats’ and the BER! Cart before horse in spades!

I really think that without using very great care taking this money could be a total disaster for the organisation involved given the vagueness of what they are being asked for.

2. Worse the selection criteria for the funds has the following contents.

The following evaluation criteria will be used to evaluate the applications:

Organisation

1. A track record for successful delivery of eHealth projects, ideally involving formal collaborative partnership arrangements and change management programs;

2. Capacity to undertake the proposed project in 2010-12;

  1. Demonstrated financial viability of the project; and
  2. Quality of the proposed delivery team.

Solution

1. Sustainability following cessation of the Commonwealth funding period;

  1. Ability to improve information flows within patient community with priority needs such as mothers with newborn children, those with complex and/or chronic disease conditions, older Australians, and Aboriginal and Torres Strait Islander peoples;
  2. Ability to scale project solutions and outcomes so that they can be deployed to other related parts of the Australian health sector;
  3. Able to deploy and comply with agreed national eHealth standards and services which will ultimately enable connection to the national PCEHR infrastructure;
  4. Support of information exchange across different parts of the health sector (e.g. primary care, acute care, aged care);
  5. Able to demonstrate strong clinical governance and clinical safety management; and
  6. Able to demonstrate national demographic coverage, and/or deep sectoral coverage, and/or early benefits, and/or innovation in the lead implementation site.

Delivery

  1. Includes a change management program within the project and across other organisations;
  2. Demonstrated clinical support and readiness and acceptance within the projects target care community; and
  3. Ability to deliver tangible and measurable project outcomes within a 6-18 month period.

---- End Extract.

Amazing is not the word for the expectations from DoHA here. Gob smacking fits way better.

You, as a grantee, have to deliver a financially sustainable solution that delivers benefits within 6-18 months. i.e. The money runs out but what you leave needs to go on!

And worse you will have to work under the guidance of the nation’s holders of the record for non- delivery!

This is just utter madness in my view and will set e-Health back a very long way.

3. Does anyone understand just why the draft design documents would be secret other than to prevent embarrassment of those who developed them - who ever that was!

I cannot believe just how naïve and incompetent this all is. Again we go back to the lack of leadership and governance in the space. I wonder will the new DoHA CIO be able to fix things?

David.

Wednesday, November 24, 2010

SA Health Takes A Risky Path. A Recently Merged Company With Little Australian Experience.

The following press release appeared a few days ago.

http://www.prnewswire.com/news-releases/south-australias-public-health-system-selects-allscripts-as-vendor-of-choice-for-80-hospital-electronic-health-record-project-108659804.html

South Australia's Public Health System Selects Allscripts as Vendor of Choice for 80-Hospital Electronic Health Record Project

SA Health Cites Allscripts Success with International Healthcare Organizations

Sunrise™ Enterprise Implementation to Provide Foundation for Improved Quality, Efficiency of Care


CHICAGO and ADELAIDE, Australia, Nov. 17, 2010 /PRNewswire/ -- SA Health, the public health system of South Australia, today named Allscripts as the Vendor of Choice (VOC) for a strategic initiative to improve patient care, satisfaction and clinical workflow across its network of hospitals and health clinics. SA Health plans to deploy the Sunrise Enterprise™ 5.5 suite of advanced clinical, access management and financial solutions.

SA Health's 80 metropolitan and rural hospitals and numerous health clinics serve a population of 1.6 million in an area approximately 40 percent larger than Texas. The selection of Allscripts as VOC is part of the Government of South Australia's $300 million (AUD) initiative to implement an integrated Electronic Health Record (EHR) that will improve patient safety and the health system's efficiency by providing a single, secure, electronic patient record across all SA Health facilities.

Allscripts has been selected to provide the project's central hub, called the Enterprise Patient Administration System (EPAS), which will give healthcare professionals timely, secure access to a patient's vital information wherever and whenever they need it.

"We selected Allscripts to implement the foundation for South Australia's e-health record system because of their excellent track record delivering health information solutions for organizations around the world, including the Asia Pacific region," said SA Health's Chief Medical Officer, Professor Paddy Phillips. "Sunrise from Allscripts will help us improve clinical safety and efficiency by providing a single patient record across all of our facilities, as well as integrating all administrative, financial and clinical information for a standardized approach to care across all our health services."

Allscripts Chief Executive Officer Glen Tullman commented, "SA Health's decision to automate and connect over 80 hospitals demonstrates its commitment to provide world class health care to the people of South Australia. We look forward to finalizing this agreement, which will be one of Allscripts largest to date, and moving to rapid deployment."

An interdisciplinary team of SA Health physicians, nurses and senior management selected Allscripts as VOC after an exhaustive and highly competitive analysis of available health information technology solutions. The agreement between SA Health and Allscripts is subject to contract negotiations and final approval expected during the first half of 2011. Implementation is expected to begin in the second half of 2011.

The Sunrise Enterprise suite helps healthcare organizations save time, costs and lives by supporting best practices across the enterprise and the continuum of care on a single, integrated technology platform. As a result, the many individuals involved in a patient's care can share information seamlessly. Using integrated Sunrise solutions, information handoffs between providers, departments, shifts and facilities can be completed efficiently and accurately.

Along with the Sunrise Enterprise suite's advanced capabilities, SA Health also saw significant advantages in the Helios by Allscripts™ open architecture platform. Helios enables any healthcare organization to quickly and easily extend and integrate Allscripts solutions to communicate with other clinical, non-clinical and legacy information systems.

The Allscripts Sunrise Enterprise suite will replace more than 30 obsolete information systems and databases across SA Health.

More details on parties and links are here:

http://www.prnewswire.com/news-releases/south-australias-public-health-system-selects-allscripts-as-vendor-of-choice-for-80-hospital-electronic-health-record-project-108659804.html

The news was also covered here:

Allscripts picked for Southern Australia

19 Nov 2010

Southern Australia Health has named Allscripts as the Vendor of Choice (VOC) for a major project to upgrade clinical IT systems across the huge sparsely populated state.

Southern Australia Health now plans to deploy the Sunrise Enterprise 5.5 suite of advanced clinical, access management and financial solutions to its 80 metropolitan and rural hospitals and health clinics, which serve a population of 1.6m in an area approximately 40% larger than Texas.

The Allscripts Sunrise Enterprise suite will replace more than 30 obsolete information systems and databases across SA Health.

E-Health Insider understands that US Allscripts for was picked for the e-health project ahead of Cerner, Australia’s iSoft, and Intersystems Trak.

Full article here:

http://www.ehealtheurope.net/news/6436/allscripts_picked_for_southern_australia

The software being purchased and implemented originates from a company that used to be known as Eclyipsys and which was an entity that, as I recall, had a major focus on medical billing.

See here for merger news:

In depth analysis Allscripts Eclipsys healthcare merger, Goodbye Misys

By Amarendra Bhushanclose
Email: abdhiraj@gmail.com
Site:
http://ceoworld.biz/ceo/
About: A journalist, blogger and serial entrepreneur known for his work as Founder and CEO of ceoworld.biz and as editor of CEOWORLD Magazine
See Authors Posts (2178) for CEOWORLD Magazine Updated:June 9, 2010

Healthcare IT company Allscripts-Misys Healthcare Solutions said Wednesday that it will buy Eclipsys Corp. in a $1.3 billion all-stock deal. In another news, British software company Misys said it would cut its 55 percent stake in Allscripts health-care information business to about 10 percent and return more than $1 billion to investors.

Shareholders of Eclipsys, based in Atlanta, will receive 1.2 Allscripts-Misys Healthcare Solutions shares for each Eclipsys share as part of the merger, the companies said. Based on Allscripts’ share price yesterday, the transaction values Eclipsys at $22.10 a share, or about $1.3 billion

Details here:

http://ceoworld.biz/ceo/2010/06/09/in-depth-analysis-allscripts-eclipsys-healthcare-merger-goodbye-misys

The risks I see in all this are:

1. As far as I know there are no other installations of Sunrise Clinical Manager in Australia and as such there is major risk in getting the system to align to Australian information requirements and Australian work-practices.

I know from experience these are not easy issues to address as Cerner has already discovered! These are by no means trivial issues and require considerable effort to be got right.

2. The software being purchased has been under development for a decade and while that implies maturity one would want to be sure it is not already technologically obsolete. (I am told it is a mixture of .NET and Java code).

All we can do is wish them luck over there in SA and hope they don’t replicate the implementation approaches seen with HealthSmart and in NSW Health. The risks if the imposition of a ridged implementation model must be well understood by all by now!

David.

Tuesday, November 23, 2010

Now This Might Be A Really Big Problem For Health Reform. A Lack of Forward Planning Again!

The following Report was released today by the AIHW.

The coding workforce shortfall

The full report: The coding workforce shortfall

Executive summary

Concern about the shortfall in the coding workforce in Australia has been raised in a number of national fora. This report seeks to quantify the scope of the existing shortfall, to project future numbers required to cover increasing demands, and to provide a consolidated set of recommendations to address the issues identified. For the purposes of this report, the coding workforce has been described as comprising Health Information Managers (HIMs), Clinical Coders (CCs) and Costing Specialists (CSs).

Background

Coding has been undertaken in Australian hospitals for over 60 years for the purposes of public health measurement, health services management, planning, performance and activity monitoring and epidemiological studies. However, with the introduction of casemix management in Australia in the early 1990s, different drivers for the quality and completeness of coding emerged. The first state to implement a case based funding mechanism was Victoria in 1993–94, followed by several other states and territories whose implementation of casemix was variously for management or funding purposes.

In 2010, in light of increasing pressures to deliver quality services to an ageing population which is experiencing increasing rates of chronic diseases, greater reliance on technology, increased consumer expectations and growing workforce shortages, the National Performance Agreement on Hospital and Healthcare Reform has proposed the introduction of an Activity Based Funding (ABF) model. This will be for an increased range of services, particularly in the case of outpatient services, and is based on the need for more and better health information to support public accountability and efficiency of hospital based services. The implementation of ABF and other aspects of the National Partnership Agreement (NPA) will require a larger and more productive coding workforce as coded data provides the source of many of the performance reporting and measurement targets.

The current coding workforce

There is a recognised shortfall in the coding workforce in Australia, as has been articulated in two previous national surveys (HIMAA 1995; McKenzie & Walker 2003). This report identifies changes in the workforce across the period since 1994, including an ageing workforce, general dissatisfaction with employment conditions and salaries, a greater number of part-time workers, an increasingly flexible and mobile CC population often working across multiple facilities, increased reliance on contract coding companies and the use of shared and ‘roving’ HIMs and CCs. These latter workers often have to travel great distances in order to manage the coding in rural and remote hospitals. Despite the greater reliance on complete and accurate coded data, there is evidence that the coding workforce continues to be required to undertake many other tasks as well as their coding roles.

In addition the inclusion, for the purposes of this report, of CSs within the definition of the coder workforce has created some issues, as this group is currently not a recognised specialist workforce. Thus further work is required to define these workers if their numbers are to be measured, and therefore no comparison over time is made.

The current coding workforce, as reported by respondents to the 2010 AIHW Coding Workforce Survey compared with the previous surveys, has the following broad characteristics:

  • increasingly educated through the VET sector and not universities
  • 65.3% CCs and not HIMs (except in Victoria, where the majority of the workforce is represented by HIMs who have graduated from an undergraduate program)
  • increasing duration of coding experience
  • predominantly female (92.8%)
  • more than 50% aged 45 years or over
  • around 50% working part-time
  • two-thirds employed in public sector facilities
  • 177.4 FTE vacant positions reported in respondent facilities, with the highest percentages reported in New South Wales, Queensland and Western Australia
  • nearly 1 in 5 facilities employed contract coding companies to manage their coding workloads.

Other responses to the survey indicated issues relating to education, including the cost and duration of training, accessibility and the need to provide individualised support for new coders at facilities, regardless of how they have obtained their initial coding education. This issue was noted as difficult to manage because it also reduces the productivity of the supervisor.

The identified workforce deficit is anticipated to become more acute as the proposed government initiatives are implemented. A similar workforce shortage has been identified in a number of other countries that have also implemented case-based funding mechanisms. Australian state and territory health departments have also recognised the shortfall, and most have conducted their own studies to identify and count the workforce and to develop strategies and opportunities to improve its productivity. Common strategies identified across the states and territories include:

  • use of a state-wide licence for the use of the 3M™ Codefinder™
  • use of the Performance Indicators for Coding Quality (PICQ) tool
  • creation of Coding Auditor and Educator positions
  • state coding committees and coder websites for improved communication with coders.

This report explores past and current mechanisms for educating the coding workforce and makes recommendations for the future. Coders have been educated through undergraduate and postgraduate HIM programs conducted in four Australian universities, as well as for CCs through the Health Information Management Association of Australia (HIMAA), TAFE sector and through on-the-job training. Little is known about the CS workforce or about how they are educated. However, the universities report lack of enrolments into HIM programs and because of this, half of the previously offered undergraduate programs have been discontinued in recent years. The reported ‘invisibility’ of the coding workforce and the HIM and CC professions have affected enrolment numbers, and targeted marketing strategies are required. The announcement of the creation of Health Workforce Australia (HWA) is anticipated to provide the vehicle for engaging with the universities and other organisations that offer (or previously offered) coder training. This will assist them to identify strategies for recruitment, to better facilitate articulation between tertiary education sectors and to provide a variety of educational pathways for the workforce.

The future workforce needs

There is no way to determine exact figures for the supply and demand of coding workforce, but some attempts have been made in this report to estimate the numbers required. More importantly, this report provides a method for calculating the impact of various policy changes, so that as the details of the health reform become clearer, these calculations could be modified to test these or other hypotheses.

No attempt has been made in this section to estimate the number of CSs required for the future as, until this workforce can be more clearly defined, there are no baseline data on which to base projections. However, it can reasonably assumed that more are needed than are currently employed, and that this need will increase due to the same factors that are affecting the HIM and CC workforce.

One significant difficulty in undertaking these calculations is that the inflows to the workforce are only able to be calculated by the number of people trained, and the workload implications are only able to be calculated by the number of full time equivalents (FTEs) required to perform the function. Given the large proportion of part-time workers in this industry and the geographical challenges of delivering coding services in some areas of the country, the number of people required to meet the FTE calculations below is assumed to be much greater than the number of FTE coders estimated.

Following are the main calculations able to be derived from the data available and assumptions made for the proceeding 5-year period:

  • the net gain from HIM and CC training programs, less the anticipated retirements from the workforce, is estimated as 1,476 people
  • the results of the survey undertaken demonstrate a current national coder vacancy rate of >175 FTEs
  • to code the current volume of annual separations, 1,265 FTE coders are required
  • to keep up with the projected growth in separations, Australia will require an additional 193 FTE coders over the next 5 years
  • to code all non-admitted hospital services, an additional 1,493 coders will be required, or as few as 149 if only 10% require coder validation following some automated coding process
  • e-health and other reform initiatives are expected to require an addition of 150 FTEs, as a low end projection
  • the implementation of ABF to all states may not mean additional numbers of staff, but
  • may require more qualified staff, as per the Victorian experience.

These calculations indicate that an HIM and CC workforce of between 3,101 and 1,757 FTEs will be required within 5 years (2010 to 2015).

Recommendations

All the recommendations are based on the basic premise that there are three key ways to deal with workforce shortfalls in any area, which are:

  • increase workforce numbers and hours worked
  • retain the existing workforce
  • increase output of the existing workforce.

It is also critical to note that these recommendations are not sequential, and that it is essential that many of these are undertaken concurrently.

It is recommended that the first thing required is the establishment of a Coder Workforce Taskforce under the auspices of HWA to undertake proper workforce planning. This will include assessment of where coding workforce staff are needed, how many and at what level of skill, etc. The outcome of the work of the taskforce will be an integrated plan to address workforce shortages and to determine actions based on the recommendations and action strategies noted below.

Immediate

  1. Find non-working HIMs and CCs to fill current vacancies
  2. Promote immediate improvement in current work arrangements for existing staff.

Short-term actions

  1. Support a more in-depth body of work on the Costing Specialist Workforce, with the aim of developing a set of competencies and training packages
  2. Finalise the development of an Australian Qualifications Framework (AQF) qualification for Clinical Coding, and assist existing coders to obtain Recognition of Prior Learning (RPL)
  3. Promote careers in Clinical Coding, HIM and Clinical Costing nationally
  4. Seek to have these careers listed on skills shortage lists
  5. Investigate the value of coding software for improving quality and speed
  6. Enhance continuing professional development opportunities
  7. Undertake a national review of salary and industrial conditions for CCs, HIMs and CSs.

Longer-term actions

  1. Provide scholarships, internships and training incentives
  2. Establish Coding Workforce Units at the Local Hospital Network (LHN) level
  3. Use technology to improve access to records to allow remote coding
  4. Conduct national clinician training on diagnosis assignment and documentation
  5. Establish a national coding auditing, education and support function
  6. Define a career path for the coding workforce to integrate the existing workforce and create promotional pathway.

----- End Exec Summary

Here is the link to the Exec Summary.

http://www.aihw.gov.au/publications/hwl/46/11875-sum.html

This contains links to the full report in RTF and .pdf.

What can one say other than the introduction of both Activity Based Funding (as per health reform) and even incremental e-Health would seem to have hit a rather large roadblock which is going to take some real effort and planning to fix.

It is just typical that we see tertiary training in an area would back just as we find we need many more (think doctors a few years ago!).

I wonder which other critical skill sets will be discovered to be in short supply as we move forward?

David.

Monday, November 22, 2010

Weekly Australian Health IT Links – 22 November, 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 subscription payment.

General Comment:

The first two entries point out just how hard procurement and implementation of Health IT for the Public Hospital Sector can be. I had missed the WA report, but is makes very sobering reading. As far as South Australia’s choice of a United States provider over the locals I can only say it has all the hallmarks of a ‘courageous decision’ being a selection of software which will need considerable ‘localisation’ to meed State and Federal Information requirements.

It will also be interesting to see how the relationship with NEHTA is playing out in SA given the Tender for this system hardly mentioned them and their role.

See here:

http://aushealthit.blogspot.com/2010/01/south-australian-health-treats-nehta-as.html

It is interesting that it has taken 10 months from tender release to initial decision being taken. Of course the tender negotiation might take a good while yet!

-----

http://www.computerworld.com.au/article/364322/western_australia_auditor-general_slams_wa_health_failures/

Western Australia Auditor-General slams WA Health failures

Patient administration system to take up to eight years to be fully delivered throught WA

Western Australia residents will have to wait until at least 2014 before the state’s health department will replace its ailing patient administration system (PAS).

According to the WA Auditor-General's latest report decade-long efforts to fix the system had been hampered by allocated funds not being spent. Further a replacement system would take up to eight years to deliver to regional and rural areas of the state.

The PAS is an electronic health record system which stores personal information about patients of public health facilities and helps manage care from admission to discard. All major medical facilities use such a system to coordinate patient care and guarantee clinical outcomes.

However, a report published by WA acting Auditor-General Glen Clarke into WA Health’s project to replace its problematic existing PAS — at an estimated cost of $115.4 million — found a myriad of problems.

-----

http://www.ehealtheurope.net/news/6436/allscripts_picked_for_southern_australia

Allscripts picked for Southern Australia

19 Nov 2010

Southern Australia Health has named Allscripts as the Vendor of Choice (VOC) for a major project to upgrade clinical IT systems across the huge sparsely populated state.

Southern Australia Health now plans to deploy the Sunrise Enterprise 5.5 suite of advanced clinical, access management and financial solutions to its 80 metropolitan and rural hospitals and health clinics, which serve a population of 1.6m in an area approximately 40% larger than Texas.

The Allscripts Sunrise Enterprise suite will replace more than 30 obsolete information systems and databases across SA Health.

-----

http://www.prnewswire.com/news-releases/south-australias-public-health-system-selects-allscripts-as-vendor-of-choice-for-80-hospital-electronic-health-record-project-108659804.html

South Australia's Public Health System Selects Allscripts as Vendor of Choice for 80-Hospital Electronic Health Record Project

SA Health Cites Allscripts Success with International Healthcare Organizations

Sunrise™ Enterprise Implementation to Provide Foundation for Improved Quality, Efficiency of Care

CHICAGO and ADELAIDE, Australia, Nov. 17, 2010 /PRNewswire/ -- SA Health, the public health system of South Australia, today named Allscripts as the Vendor of Choice (VOC) for a strategic initiative to improve patient care, satisfaction and clinical workflow across its network of hospitals and health clinics. SA Health plans to deploy the Sunrise Enterprise™ 5.5 suite of advanced clinical, access management and financial solutions.

SA Health's 80 metropolitan and rural hospitals and numerous health clinics serve a population of 1.6 million in an area approximately 40 percent larger than Texas. The selection of Allscripts as VOC is part of the Government of South Australia's $300 million (AUD) initiative to implement an integrated Electronic Health Record (EHR) that will improve patient safety and the health system's efficiency by providing a single, secure, electronic patient record across all SA Health facilities.

Allscripts has been selected to provide the project's central hub, called the Enterprise Patient Administration System (EPAS), which will give healthcare professionals timely, secure access to a patient's vital information wherever and whenever they need it.

-----

http://www.theaustralian.com.au/australian-it/government/all-eyes-on-roxons-e-health-forum/story-fn4htb9o-1225956713754

All eyes on Roxon's e-health forum

  • Karen Dearne
  • From: Australian IT
  • November 19, 2010 5:44PM

A SLIM line-up of international and local talent has been roped-in for Nicola Roxon's two-day, invitation-only e-health records talkfest in just over a week's time.

The Health Minister and Communications Minister Stephen Conroy are the star attractions for around 400 selected guests at the Melbourne Convention Centre on November 30-December 1 event where Ms Roxon's $466.7 million personally-controlled e-health record (PCEHR) plan will be workshopped.

Most of the speakers will be familiar to attendees, as they are regulars on the e-health conference circuit: National E-Health Transition Authority chief executive Peter Fleming, Consumers Health Forum executive director Carol Bennett, KPMG head of healthcare and former chief executive of the Hong Kong Hospital Authority Shane Solomon, NEHTA clinical lead Mukesh Haikerwal, and Australian Medical Association federal vice-president and GP Steve Hambleton.

-----

http://www.theage.com.au/victoria/breasts-mismatch-prompts-review-20101117-17xoh.html

Breasts mismatch prompts review

Kate Hagan

November 18, 2010

THE mammograms of more than 5000 women will be reviewed due to a computer mismatch between images and names at BreastScreen Victoria.

BreastScreen Victoria chief executive Vicki Pridmore said a radiologist noticed on September 16 that the name on a mammogram did not match the client's details on an adjacent screen, and manually fixed the problem.

She said she became aware of the problem more than two weeks later, on October 4, and instructed radiologists to double-check clients' details against mammograms.

-----

http://www.zdnet.com.au/software-causes-mammogram-mismatches-339307355.htm

Software causes mammogram mismatches

By Luke Hopewell, ZDNet.com.au on November 18th, 2010

BreastScreen Victoria has written to 5339 women after data mismatches occurred in its mammogram screening software.

BreastScreen Victoria radiologists conduct mammograms by looking at two screens: one containing a patient's file data and the other containing the image. The breast X-ray is then reviewed independently by two radiologists and, if the two cannot reach a conclusion, a third is brought in for further consultation.

Radiologists flagged a problem in the screening process in early October. The program taking the X-ray images failed to match them to correct patient details. The information mismatch has cast doubt over whether mammograms were reviewed a second time by doctors between 16 September and 4 October.

BreastScreen Victoria's chief executive officer, Vicki Pridmore, has however said today that no woman needs to be re-screened, as all mammogram images have correct patient names embedded.

-----

http://www.nehta.gov.au/media-centre/nehta-news/760-funding

Funding announced for software innovators in general practice

19 November 2010. NEHTA today called for proposals from general practice clinical desktop software suppliers wishing to support the Federal Government’s first eHealth implementation sites in Victoria, New South Wales and Queensland. The Request for Proposal will establish a panel of general practice clinical desktop vendors interested in working with NEHTA and the site project teams to incorporate new national eHealth specifications and standards into their existing products.

Successful panelists will be instrumental in helping to test and fine-tune initial specifications for the Personally-Controlled Electronic Health Record (PCEHR). These are currently being defined by NEHTA in consultation with clinical, consumer and industry representatives.

The PCEHR is a landmark initiative in the National Health and Hospital Network Reform package which aims to improve the quality, safety and efficiency of patient care and ensure long term sustainability of the healthcare system. More than $466m has been allocated by the Federal Government to deliver the first phase of the PCEHR enabling Australians to choose to register for an individual summary by the end of June 2012.

-----

http://www.zdnet.com.au/gp-software-vendors-offered-e-health-funds-339307417.htm

GP software vendors offered e-health funds

By Suzanne Tindal, ZDNet.com.au on November 20th, 2010

The National E-health Transition Authority (NEHTA) yesterday put out a call for clinical desktop software suppliers to test and tweak standards for the planned electronic health record at implementation sites in Victoria, New South Wales and Queensland.

The request for proposal aims to form a panel of vendors who will build e-health standards and specifications into their general practice desktop products and give feedback. The standards and specifications are currently being worked on by NEHTA.

The government will pay the panellists to help offset the costs of software modification, part when the software is changed to conform to standards and part when general practices take up the product in the implementation sites.

-----

http://www.computerworld.com.au/article/368707/nehta_calls_vendor_submissions_support_e-health_sites/

NEHTA calls for vendor submissions to support e-health sites

Federal transition authority seeks software suppliers as part of $466 million e-health investment

The National e-health transition authority (NEHTA) has called for submissions from clinical desktop software suppliers wanting to support the first e-health sites in states across Australia.

The submissions will help test initial specifications for the personally-controlled electronic health record (PCEHR), and successful applicants will form a panel of clinical desktop vendors responsible for working with the NEHTA.

The initiative is part of a $466 million investment by the federal government aimed at enabling Australians to register for individual summaries by June 2012.

-----

http://www.theaustralian.com.au/australian-it/government/nehta-calls-for-gp-software-proposals/story-fn4htb9o-1225956723414

NEHTA calls for GP software proposals

  • Karen Dearne
  • From: Australian IT
  • November 19, 2010 6:00PM

MEDICAL software-makers are being asked to help "test and finetune" currently undefined specifications for the Gillard government's $467 million personally-controlled e-health record program, which is yet to be explained in detail.

The National E-Health Transition Authority has called for proposals from GP clinical desktop suppliers willing to join a panel and work alongside it and the three e-health implementation sites announced by Health Minister Nicola Roxon in August.

During the election campaign, Ms Roxon announced $12.5m in total funding for GP divisions in Brisbane, NSW’s Hunter Valley and Melbourne to act as pilots over the next two years.

NEHTA received an extra $300,000 to co-ordinate the project; earlier the three parties -- GP Partners, Hunter Urban and Melbourne East -- had been invited to develop "lead implementation site" proposals for which they were paid $100,000 each.

Selection of the sites raised industry eyebrows as there was no public consultation or tender process.

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http://www.medicalobserver.com.au/news/ecg-for-the-mind-wins-invention-award

‘ECG for the mind’ wins invention award

16th Nov 2010

Chris Brooker

VIEWERS of ABC TV’s popular New Inventors program have voted a ground-breaking diagnostic technique for detecting mental and neurological illness as this year’s winner.

The EVestG, is a new diagnostic technique that measures the patterns of electrical activity in the brain’s vestibular (balance) system, fast-tracking the detection of illness.

It was voted the winner by both the program’s expert panel and the People’s Choice.

The developer, Brian Lithgow, is a senior lecturer in electrical and computer systems engineering at Monash University, with research interests in neurological, neurodegenerative and vestibular diagnostics. He saw “the diagnostic potential of measuring and comparing different patterns of electrovestibular activity because the brain’s vestibular system is closelyconnected to the regions of the brain that relate to emotions and behaviour”.

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http://www.computerworld.com.au/article/368526/qh_payroll_woes_declining_auditor-general/?eid=-255&uid=25465

QH payroll woes declining: Auditor-General

Still a backlog of processing

  • AAP (AAP)
  • 18 November, 2010 15:42

Fewer Queensland Health staff are being incorrectly paid, or not paid at all, following the bungled rollout of a new payroll system, a new report says.

See more on Queensland Health's IT

Auditor-General Glen Poole, in a report tabled in parliament on Thursday, says things are improving.

But there's still a backlog of processing that needs to be done and there's no accurate record of the total number of transactions that need to be fixed.

The new payroll system was introduced in March with disastrous results. Thousands of Queensland Health staff have been underpaid, overpaid or not paid at all in fortnightly pay runs.

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http://ehealthspace.org/casestudy/new-zealand-embraces-healthcare-records

New Zealand embraces healthcare records

While many countries including Australia play host to protracted privacy debates, New Zealand is forging ahead with a low-cost, pragmatic approach to centralised healthcare records. And as Joshua Gliddon reports, the plan has met little resistance.

The Challenge: Provide a central ehealth repository in the Auckland area. Long term, the challenge is to create electronic healthcare records for all New Zealanders.

The Approach: New Zealand has reformed its public healthcare sector over the last decade. Bureaucracy was reduced, and a long-term vision was set to see all New Zealanders with a personal electronic healthcare record by 2014.

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http://www.theaustralian.com.au/news/health-science/get-ready-for-nbn-telehealth/story-e6frg8y6-1225955974837

Get ready for NBN: telehealth

  • AT THE COALFACE: Michael Williams
  • From: The Australian
  • November 20, 2010 12:00AM

TELEHEALTH is a proven means of efficiently providing specialist services to regional and rural people.

It provides equity of access to specialists, especially where there are large distances to specialist services, as in Queensland. It also can provide access to specialist team support when travel is difficult.

Health departments have installed technology and the connections delivering good telehealth, but we could be doing much more.

The National Broadband Network promises much faster data transmission, especially to businesses and homes in regional and rural areas. It is likely the NBN or its equivalent will enable rural telehealth opportunities beyond what is available at present.

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http://www.smh.com.au/business/hauling-bhp-to-the-table-a-struggle-for-ferraus-20101118-17zcl.html

…..

iSoft's hard road

iSOFT Group, the problem child of the healthcare IT sector, has struggled for good news all year, and the situation isn't brightening.

The company announced this week that it had failed to meet requirements that would have seen two tranches of short-term debt, worth £82.5 million ($A134 million), mature in June 2013. As a result, the maturity date will be 12 months earlier.

When the new facilities were announced in September, the 2013 maturity date was expressed as being dependent on ''certain conditions subsequent'' being met by 15 November.

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http://www.e-health-insider.com/news/6428/lorenzo_%E2%80%9Cnot_yet_stable%E2%80%9D_says_connelly

Lorenzo “not yet stable” says Connelly

18 Nov 2010

NHS CIO Christine Connelly says that Lorenzo 1.9 is not yet stable at University Hospitals of Morecambe Bay NHS Foundation Trust, the first site it was deployed into six months ago.

In an exclusive interview with E-Health Insider she says that Lorenzo 1.9, the electronic patient record software, bought by the Department of Health for trusts in the North, Midlands and East, is not yet stable or ready for wider deployment by local service provider CSC.

In October EHI reported that the lead clinician at Morecambe Bay had said the software wasn't ready at launch, following a September EHI report thatMorecambe Bay had launched a stabilisation plan to try and bring under control a host of problems with its Lorenzo EPR.

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http://www.theaustralian.com.au/business/banks-hard-stand-on-isoft-debt/story-e6frg8zx-1225955229020

Banks' hard stand on iSoft debt

PRESSURE is building on iSoft Group, with its banks bringing forward debt repayment after the company failed to meet stricter covenants.

iSoft, which is reviewing its business with adviser UBS, said yesterday the maturity of two non-current debt facilities worth pound stg. 82.5 million ($134.4m) had been brought forward by more than a year to March 15, 2012.

The two tranches were to mature on June 23, 2013, but were brought forward after conditions were not met by Monday, November 15.

Shares in the health IT company, formerly IBA Health, closed 2.2 per cent lower at 9c.

The shares have slumped 88 per cent this year, wiping about $730m off the company's market value, prompting speculation it could be a takeover target.

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http://www.theaustralian.com.au/business/city-beat/banks-bring-debt-schedule-forward-as-isoft-reviews-operations/story-e6frg9no-1225954914174

Banks bring debt schedule forward as iSoft reviews operations

TROUBLED iSoft Group has been dealt another blow as banks bring forward repayment of debt after it failed to meet conditions.

iSoft, which is reviewing its business with advisor UBS, said today the maturity of two non-current debt facilities worth ₤82.5 million ($134.1m) had been brought forward by more than one year to March 15, 2012.

The two tranches were to mature on June 23, 2013, but were brought forward after conditions were not “able to be met” by last Monday.

Shares in the health IT company, formally IBA Health, fell more than 3 per cent, or 0.3 cents, to 8.9c on the news.

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http://www.e-health-insider.com/news/6419/pennine_signs_five_year_isoft_pas_deal

Pennine signs five year iSoft PAS deal

15 Nov 2010

Pennine Acute Hospitals NHS Trust has signed a deal to upgrade its 20 year old patient administration system to the latest version of iSoft’s Patient Centre (iPM).

The upgrade should provide additional patient and clinical functionality by improving the clinical information available to staff across its four hospital sites in north Manchester, Bury, Rochdale and Oldham.

The deal will include the installation or trial of a number of web-based clinical applications from iSoft’s new Smart Solutions portfolio including order communications. Hardware will also be upgraded to HP’s latest iTanium hardware to deal with the significant downtime issues that the trust has been experiencing.

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http://delimiter.com.au/2010/11/15/vic-ipad-rollout-a-positive-says-isoft/

Vic iPad rollout a positive, says iSOFT

One of the world’s largest e-health vendors, Australia-based iSOFT, has welcomed an election policy which could see iPads rolled out to every doctor in Victoria’s public hospitals, flagging strong organic adoption of the Apple tablets and noting their potential to impact positively on long-term hospital problems such as scheduling across the health ecosystem.

The election promise was made last week by Victorian Premier John Brumby as part of Labor’s wide-ranging state health policy released ahead of the upcoming Victorian election. The Coalition has made a similar promise — but without specifically mentioning the iPad as a targeted device. Analyst firm Gartner has questioned whether Victoria’s Labor party had properly analysed what management tools and supporting infrastructure it will need if it wins the election and is required to deliver on the promise.

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http://www.theaustralian.com.au/australian-it/government/nsw-records-management-in-disarray-ag/story-fn4htb9o-1225955117171

NSW archives inaccessible, says Auditor-General

  • Karen Dearne
  • From: Australian IT
  • November 17, 2010 4:58PM

NSW's State Records Authority is unable to archive digital records supplied by government departments and agencies due to a lack of "infrastructure", in breach of laws requiring access to public records.

Despite former NSW Premier Nathan Rees committing to a common records standard for email, webpage and digitised documents, the authority is refusing to accept electronic material because it cannot access the information contained within these records.

The standard, which sets out minimum requirements for electronic record systems and the creation of metadata, was adopted in August 2008; public sector agencies must be in full compliance by June 2012.

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http://www.theaustralian.com.au/australian-it/government/funding-cuts-stymie-nsw-it-project/story-fn4htb9o-1225955150203

Funding cuts stymie NSW IT project

  • Karen Dearne
  • From: Australian IT
  • November 17, 2010 6:28PM

THE NSW Human Services department wrote-off a $5.2 million electronic records data management system in June, four years after the troubled community services IT project began.

NSW Auditor-General Peter Achterstraat has recommended the department introduce formal project governance and management procedures for all major IT projects.

"Whilst staged work commenced in 2006, further work was suspended in July 2008 pending clarification of funding issues and development of clearer objectives between (the former) Community Services (now part of Human Services) and the lead agency, NSW Businesslink," he said in his annual report to parliament on human services and technology.

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http://www.computerworld.com.au/article/368295/gartner_symposium_2010_enterprise_it_spending_expected_hit_us49_6_billion/?eid=-255&uid=25465

Gartner Symposium 2010: Enterprise IT spending expected to hit $US49.6 billion

Healthcare, utilities and the government sector are predicted to lead enterprise IT spending growth in Australia

IT spending among enterprise in Australia is forecasted to hit $US49.6 billion this year, following a strong 2010, while the Asia Pacific region is expected to rebound with a spending figure of $312.3 billion, according to analyst firm Gartner.

The forecast indicates enterprise IT spending in the region is expected to rebound this year with a 10.6 per cent growth, following a 1.3 per cent drop in spending in 2009. Additionally, IT spending growth is expected to jump 7.6 per cent in 2011 to reach $312.3 billion.

Speaking at the Gartner Symposium in Sydney, Gartner senior vice president and global head of research, Peter Sondergaard, said the economic downturn was responsible for the decline last year and this year's spending growth was a result of budget freezes and the replacement of ageing hardware.

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http://www.theaustralian.com.au/business/opinion/labor-creates-its-own-problems-over-telstra-and-nbn/story-e6frg9io-1225956417590

Labor creates its own problems over Telstra and NBN

STEPHEN Conroy began with a winning hand on the National Broadband Network, but he's since been busy digging himself into a hole.

Telstra chair Catherine Livingstone’s reassurance that dividends would stay at 28 cents a share for this year and next helped boost the stock price today, but uncertainty still rules.

That’s the trouble when you get politicians involved, and Communications Minister Stephen Conroy seems to be doing everything possible to turn a winning hand into a loss with his NBN games.

The starting point for Telstra shareholders is that the $11 billion deal with the government works out at around 88c per share, which, against a stock price trading up 2.7 per cent a share at $2.63, tells you the stock is a screaming buy.

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http://www.smh.com.au/technology/sci-tech/physicists-set-sights-on-spacetime-cloak-20101118-17xux.html

Physicists set sights on 'spacetime cloak'

November 18, 2010 - 2:25AM

Jewellery robbers, magicians, exam cheats and practical jokers everywhere will have an interest in an offbeat idea launched by physicists on Tuesday: to make the passage of time invisible.

The scientists have conceived of a "spacetime cloak" which manipulates light and, in essence, conceals whole events from a viewer.

The theory is based on censoring the flow of events, which we perceive as a stream of light particles, also called photons, that strike the retina.

By exploiting a characteristic of fibre optics, the flow of photons can be slowed, events edited out and stitched back together, say the team from Imperial College London and Salford University, northwestern England.

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Enjoy!

David.

Sunday, November 21, 2010

Judge For Yourself If You Can Believe What You Will Hear at the E-Health Summit.

The following appeared almost two years ago and somehow popped up as news on the weekend

Australia e-health system in the mill

The standards and foundations for nation-wide e-health solutions in Australia have now mainly been completed, according to Peter Fleming, Chief Executive Officer of National E-Health Transition Authority(NEHTA), leaving implementation on the agenda for 2009.

NEHTA has been given an “absolute mandate” from the Council of Australian Governments (COAG) to create a uniform IT infrastructure and deliver individual healthcare identifiers (which link electronic medical records together).

…..

Legislative changes are needed, but from a technical perspective we aim to be in a position this year to run some pilots,” Fleming said. “We’re in very close dialogue with a number of groups about trials of electronic medication management and hospital discharge summaries.”

…..

NEHTA has also been working closely with CIOs from state and territorial governments. The states had the “absolute intent” of following NEHTA standards with any projects they conducted, said Fleming.

Full article here:

http://www.futuregov.asia/articles/2009/jan/28/australia-e-health-system-mill/

This just shows that sometimes what you are told by the present collection of federal of e-Health spokesmen needs to be taken with a ‘grain of salt’. Implementation has not really happened in any practical sense, medication management and e-discharge summaries are hardly going great guns, if at all, essentially two years and how many millions of dollars later.

Out of their own mouths we just have huffing and puffing, Annual Reports saying it is all fabulous but just exactly where has a live practical effective system been delivered? Let me know if you know!

Rule Number One of any competent management is to under promise and over deliver. This lot are masters of doing the reverse!

I suggest people listen closely to what is said and apply great scepticism to what they hear.

David.

AusHealthIT Poll Number 45 – Results – 21 November, 2010.

The question was:

Should The DoHA / NEHTA e-Health Summit Offer Live Interactive and Recorded Streaming of the Proceedings?

Absolutely

- 28 (57%)

Probably

- 6 (12%)

Maybe

- 1 (2%)

No - I Will Be A Waste of Time

- 14 (28%)

Votes: 49

I think it is fair to say those who read here want to have the choice of watching what is going on but are not sure they won’t be wasting their time!.

Again, many thanks to those that voted!

David.