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."

Tuesday, March 29, 2011

Wave 2 Sites For the PCEHR Program - Here is the List for the Information of Readers.

The following popped up a little while ago.

Nine organisations have been selected to develop a Project Implementation Plan to run a second-wave site:

  • Medibank Private Limited Project will implement a consumer-oriented portal, which integrates consumer entered information into a ‘Health Book’. The ‘Health Book’ will be initially made available to all Medibank Private customers and their healthcare providers enrolled in Medibank’s Health Management and Chronic Disease Management programs. Medibank Private will not be using any of this information for the management of claims or eligibility for health care insurance benefits.
  • Brisbane South Division Limited Project will deliver a substantial eHealth site in one of Australia’s major capital cities. The project will aim at enrolling up to 25,000 individuals in the Brisbane and Ipswich region. A key focus will be on individuals with disabilities and their carers, war veterans and war widows, and children commencing school. The project will bring two Division’s of General Practice onboard, Brisbane South and Ipswich and West Moreton, and public and private hospitals, allied health and GP’s. The project will leverage wave 1 infrastructure.
  • Mater Misericordiae Health Project will deliver an eHealth site to enhance healthcare for mothers and newborns. The population reach of the project is 9000 mothers and involves three GP Divisions (South East Alliance, Brisbane South and the South East Primary HealthCare network), local specialist obstetricians and a software vendor InterSystems. The project will leverage wave 1 infrastructure.
  • Northern Territory Department of Health and Families Project will deliver a lead eHealth site for Indigenous Australians living in the Northern Territory, South Australia and Western Australia. The project will leverage the existing NT shared electronic health record and extend the existing service to all Northern Territory residents and Indigenous individuals in Western Australia and South Australia.
  • Greater Western Sydney eHealth Consortium (NSW Department of Health) Project will implement key building blocks for state-wide eHealth infrastructure that will allow NSW Health to connect to the PCEHR System when it becomes available. The initial focus will be on priority consumer groups in the Greater Western Sydney region. The project includes four GP Divisions (WentWest, Nepean, Blue Mountains and Hawkesbury-Hills) and will leverage previous technology investments. With a population reach of 1,750,000, the project will be able to expand the entire solution quickly to encompass a significant geographic area and ultimately the whole of NSW.
  • Cradle Coast, North-West Area Health Service Project will provide end of life policy lessons for the PCEHR System. The project targets aged and palliative care patients and their families, palliative care medical specialists and clinical nurse consultants. The project will use off-the-shelf care planning software to share the advance care directives until the national PCEHR infrastructure is in place.
  • St Vincent’s and Mater Health Sydney Project will establish a lead eHealth site based around St Vincent’s and Mater Health Sydney, in conjunction with partnering Divisions of General Practice, participating specialists and software vendors including Smart Health, Precedence, HCN and Best Practice. The project has a population reach of 1 million individuals attending the St Vincent’s campus and aims to improve clinical communication across the project’s footprint through the delivery of key PCEHR components.\
  • FRED IT Group MedView Project will demonstrate the ability for up to 2 million individuals and their healthcare providers to access their prescribing and dispensing history via a medicines repository using national electronic prescription and other standards. The project will deploy MedView to all pharmacies and GPs in the Geelong region and to a further 10% of this target market nationally. The project will bring together a grouping of private sector eHealth vendors including FRED, eRx, Best Practice, Zedmed, iCare, Microsoft and SIMPL.
  • Calvary Healthcare Project will support a cross-border population of approximately 800,000 individuals in the ACT and regional NSW by bringing together a major grouping of private sector eHealth vendors. The vendors involved include iSoft, HCN, HealthLink, Smart Health Solutions and Precedence HealthCare.


The second-wave sites will develop their plans by the end of May 2011 to ensure their work programs meet national objectives.

The eHealth sites program is being managed overall by NEHTA, under contract to the federal Department of Health and Ageing.

The full page is here:

http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/eHealth-sites-factsheet

Comments welcome!

David.

Monday, March 28, 2011

Rumour Central: Wave 2 PCEHR Projects Apparently To Be Announced Tomorrow!

The rumour goes that Health Minister Roxon will dig herself into a deeper hole tomorrow when she announces those who have had the misfortune to win Wave 2 projects in the PCEHR program.

More waste seems to be inevitable and no apparent release yet of the Concept of Operations for the project means it will be hard to know who is doing what with whom.

A leadership, governance and financial mess seems pretty likely to me if the approach is not radically re-designed. We will all know in just over a year, and hopefully much sooner if there is any hope or not!

David.

AusHealthIT Poll Number 63 – Results – 28 March, 2011.

The question was:

What Score Would You Give NEHTA / DoHA for their Efforts so far in Explaining The PCEHR Program to Affected Clinicians?

The answers were as follows:

10/10

- 5 (13%)

7.5/10

- 2 (5%)

5/10

- 2 (5%)

2.5/20

- 7 (19%)

0/10

- 20 (55%)

Well that is seems pretty clear with only 23% giving them a score of 5 or above! Clearly any money spent on clinician communications has been wasted!

Votes : 36

Again, many thanks to those that voted!

David.

Weekly Australian Health IT Links – 28 March, 2011.

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:

It has been quite a big week for e-Health with all sorts of rather left field things happening.

Examples include:

· The Pharmacy Guild President saying doctors know nothing about medication management.

· The Privacy Foundation saying DoHA and NEHTA are not trustworthy to deal with

· iSoft seeming to be about to be gobbled up (see earlier blog today).

· The HealthSMART project apparently remaining in some sort of limbo.

· The new Royal Children’s Hospital in Melbourne seemingly being left an e-Health free zone.

Amazing stuff!

I wonder what will pop up this week?

At least one thing we know will happen is a new Health Minister in NSW who will have NSW E-Health as one of the issues she will need to address. Will be interesting to see if any changes emerge. Some are probably needed!

We will probably have to wait for a good few weeks to see just what Ms Skinner (the almost certain new Health Minister in NSW) will decide to do. It may be with negotiation of the Health Reform changes there is a lot of delay in considering e-Health.

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http://www.pharmacynews.com.au/news/gp-e-health-record-management-a--joke--guild

GP e-Health record management a “joke”: Guild

Plans to have a doctor controlled medication summary as part of a personal health record are an “absolute joke”, Kos Sclavos national president of the Pharmacy Guild of Australia says.

Speaking at the 2011 APP conference on the Gold Coast last week, Mr Sclavos highlighted the important role pharmacists could play in inputting patients’ medication history in the area of compliance and adherence.

Mr Sclavos said the National e-Health Transition Authority (nehta), lead by former AMA president Mukesh Haikerwal, was too doctor-focused recommending a doctor-managed medication summary.

“Just to show how out of touch some of the [nehta] criteria are… at the end of the day Mukesh and I were discussing it and he thinks [as a doctor] the priority is the medication summary.

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http://www.theaustralian.com.au/australian-it/privacy-fear-over-agencies-mega-merger-medicare-centrelink-data-plan/story-e6frgakx-1226025592629

Privacy fear over agencies' mega-merger: Medicare, Centrelink data plan

MEDICARE and Centrelink are involved in an Orwellian mega-merger that will strengthen data linkages to citizens'personal information, say consumer advocates.

The changes -- part of the Gillard government's service delivery reform program -- are in the Human Services legislation amendment bill 2010. After a three-week inquiry, the Senate Community Affairs committee is due to report on the bill today.

Australian Privacy Foundation health spokeswoman Juanita Fernando said the bill was geared more towards delivering an Orwellian society than citizens' services. "I am amazed the government has not told Australians that integration of Medicare and Centrelink services under a single shopfront will result in many new linkages of data," Dr Fernando said.

"The bill is dreadful. Data linkages have already commenced.

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http://www.techworld.com.au/article/380543/privacy_risk_medicare_centrelink_merger_oaic/

Privacy not at risk in Medicare, Centrelink merger: OAIC

Privacy Commissioner, Timothy Pilgrim, said done correctly, internet protocols and secrecy provisions will prevent any privacy risk

The impending merger of Medicare Australia and Centrelink under new legislation will not trample Australians' privacy according to the Office of the Australian Information Commissioner (OAIC).

In its submission to the Senate community affairs committee (PDF) Australian Privacy Commissioner, Timothy Pilgrim - one of three commissioners at the OAIC - argued the merger would continue to ensure citizens' privacy under existing strictures on the way government agencies could use personal information, as well as requirements to ensure secrecy provisions could operate effectively post-integration under the bill.

“In light of the new departmental arrangements, and the increased capacity for personal information sharing under [Service Delivery Reform] programs… It is expected that DHS [Department of Human Services], in consultation with the OAIC and others will continue to have in place appropriate internal protocols for the handling of customers' personal information associated with different programs within [the department],” he wrote.

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http://www.theaustralian.com.au/australian-it/call-for-struggling-e-health-to-expand-its-focus/story-e6frgakx-1226025594019

Call for struggling e-health to expand its focus

LACK of ownership continues to delay local adoption of e-health and telehealth initiatives, the national broadband network parliamentary inquiry has been told.

Consumers e-Health Alliance convener Peter Brown has called on the inquiry to expand its scope to reflect the "significant new opportunities" becoming available to improve services and patient outcomes.

"A national e-health network is akin to establishing a business," he said. "Since 1997, (numerous) reports have laid out plans for an infrastructure supporting the secure electronic transmission of health data. But the extraordinary 'recommendation blockage' we've seen seems to arise from a common misunderstanding that health is the same but lagging other industries such as banks in using IT.

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http://www.theaustralian.com.au/australian-it/government/dell-chief-and-health-minister-nicola-roxon-talk-e-health/story-fn4htb9o-1226026070686

Michael Dell, Nicola Roxon talk e-health

  • Fran Foo
  • From: Australian IT
  • March 22, 2011 1:26PM

MICHAEL Dell signalled the importance of e-health to his company's strategy in a briefing with federal Health Minister Nicola Roxon yesterday.

Ms Roxon and Mr Dell met in Canberra to discuss a variety of issues related to healthcare and how technology could improve patient outcomes.

The Dell CEO was briefed on the government's investments in e-health records, telehealth and broadband, a ministerial spokesman said.

The Gillard government has allocated $467 million to develop a personally controlled e-health record system due to be rolled out next year.

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http://www.theage.com.au/victoria/delays-on-nurses-pose-threat-20110322-1c5be.html

Delays on nurses pose threat

Julia Medew

March 23, 2011

VICTORIA is at risk of losing valuable overseas-trained nurses because of long registration delays caused by Australia's new health practitioner registration authority, the state government says.

Health Minister David Davis said scores of nurses had complained to him about extraordinary waiting times for applications to be processed by the Australian Health Practitioner Regulation Authority, which replaced state-based registration boards last July. In some cases, the overseas-trained nurses had waited more than six months.

Mr Davis said he feared the delays could be costing the state's health system qualified health professionals who may choose to go elsewhere because of their frustrations with the registration system.

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http://www.businesswire.com/news/home/20110322006029/en/Research-Markets-Australia---Digital-Economy--

March 22, 2011 05:00 PM Eastern Daylight Time

Research and Markets: Australia - Digital Economy - E-Health 2011

DUBLIN--(BUSINESS WIRE)--Research and Markets (http://www.researchandmarkets.com/research/ed47b1/australia_digita) has announced the addition of the "Australia - Digital Economy - E-Health" report to their offering.

E-health may become an area where key killer applications which utilise truly high-speed broadband networks emerge. The Australian Government is a leader in strategic trans-sector thinking, linking e-health developments to the National Broadband Network. Early diagnosis and after-treatment patient monitoring are two areas where significant synergies may be found using applications provided to users at home.

As the financing of the public health systems in Australia becomes increasingly costly, an opportunity exists to lower costs through more effective use of web services for healthcare consumers. With widely available and cost effective high-speed broadband infrastructure, e-health is enabling customers to benefit from advances in medical technology and medical services.

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http://www.medicalobserver.com.au/news/senate-to-scrutinise-ahpra-bungling

Senate to scrutinise AHPRA bungling

24th Mar 2011

Byron Kaye

THE Senate is to launch an inquiry into the beleaguered Australian Health Practitioner Regulation Agency and its handling of the changeover to a national registration scheme for medical professionals.

The Senate yesterday approved the inquiry, demanded by the Coalition, after ongoing reports of the bungling of the registration of doctors, nurses and other health professionals.

In the most recent case, a NSW GP was forced to stop treating patients due to a processing error which left her unregistered.

------

http://www.theaustralian.com.au/news/health-science/senate-inquiry-will-look-at-registration-delays/story-e6frg8y6-1226027696057

Senate inquiry will look at registration delays

THE delays in processing medical registration that have left doctors practising illegally and patients losing Medicare rebates are to be investigated by a Senate inquiry.

The inquiry will examine the competence and resourcing of the new Australian Health Practitioner Regulation Agency, which has struggled to cope with registering 500,000 medical and health professionals.

Liberal Senator Mathias Cormann, who moved to establish the inquiry, says the Senate's Finance and Public Administration References Committee also will look at the "implications of any maladministration of the registration process for Medicare benefits and private insurance claims".

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http://www.pulseitmagazine.com.au/index.php?option=com_content&view=article&id=511:why-is-it-all-so-hard-in-pathology

Why is ‘IT’ all so hard in Pathology?

At the heart of a modern Pathology laboratory is a complex set of Information Technology (IT) systems that are critical to its operation. Users are often frustrated and disappointed at the difficulties they experience when systems fail, when requesting changes or seeking new IT functionality. Having worked in a number of industries before coming to Healthcare four years ago, I have tried to make some sense of why IT is so hard in Pathology.

We’re talking normal, run of the mill Pathology, not bio-informatics databases, leading edge cell imaging or shiny, ground breaking test developments. So why is it so hard to get some seemingly simple functionality from your IT Department? Why do all those small things that would make life a bit easier turn into long, drawn out projects that are around so long they become part of the family?

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http://www.theage.com.au/victoria/35m-childrens-hospital-pledge-lost-20110323-1c6wk.html

$35m children's hospital pledge lost

Kate Hagan and Julia Medew

March 24, 2011

A $35 MILLION donation pledged to help build the new $1 billion Royal Children's Hospital will not be delivered, the state government has confirmed.

Victorian Health Minister David Davis last night told The Age the hospital had not received the money promised to its foundation under the original private-public partnership.

The arrangement included a pledge from the winning consortium to secure donations of $35 million to the RCH Foundation from project investors. However, the promise was underwritten by a member of the Babcock and Brown group, which collapsed in 2009.

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http://www.computerworld.com.au/article/380715/it_funds_victoria_rch_guaranteed/?eid=-6787&uid=25465

IT funds for Victoria's RCH not guaranteed

State Health Minister David Davis says the previous Labor government rejected a proposal for a new IT system.

  • AAP (AAP)
  • 23 March, 2011 12:46

The Victorian government is refusing to guarantee it will set aside funds for an IT system at the new $1 billion Royal Children's Hospital(RCH).

State Health Minister David Davis says the previous Labor government rejected a proposal for a new IT system.

He said the new IT system would cost around $24 million but refused to guarantee the money would be allocated in the May budget.

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http://www.heraldsun.com.au/news/victoria/bungle-leaves-hospital-limping/story-e6frf7kx-1226026352461

Computer bungle leaves Royal Children’s Hospital limping

  • Grant McArthur, Anne Wright
  • From: Herald Sun
  • March 23, 2011 12:00AM

UPDATE 9am: VICTORIA'S new $1 billion Royal Children's Hospital will be hamstrung when it opens because of a computer bungle.

The Royal Children’s Hospital confirmed the current IT system will remain when the new hospital opens.

The Herald Sun can reveal that a hospital proposal for a new IT system in late 2009 was overlooked by the former government.

The Coalition is now trying to find $24 million for the software. It learnt of the problem when the Health Department told new Health Minister David Davis last month.

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http://www.banyuleandnillumbikweekly.com.au/news/local/news/general/health-plan-on-target-despite-long-consultation/2110493.aspx

Health plan on target despite long consultation

BY ANNA WHITELAW

22 Mar, 2011 02:23 PM

THE Coalition government’s much-anticipated health plan is ‘‘on schedule’’, Health Minister David Davis said last week.

The first ever 12-year metropolitan and statewide health plans are due to be delivered within the Baillieu government’s first 150 days in office.

Mr Davis told BNW he was ‘‘confident’’ he would meet the April 26 deadline.

However, Mr Davis did not specify when the state government planned to reveal the details of statewide audits of outpatient waiting lists and bed allocations, two key Coalition election promises.

However, he pledged more hospital data would be made public in the coming weeks.

Several big ticket election commitments – including a pledge to deliver 100 extra hospital beds – will also be due this year.

Already, the Coalition has scrapped plans to fund iPads for doctors, and has yet to commit to funding the $45 million fitout of the Olivia Newton John Cancer Centre, currently under construction at Austin Hospital.

The Coalition has yet to decide the fate of the troubled HealthSMART IT system, although Mr Davis previously told The Age it may be scrapped.

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http://www.theage.com.au/victoria/state-of-limbo-baillieus-project-logjam-20110324-1c8kv.html

State of limbo: Baillieu's project logjam

Jason Dowling and David Rood

March 25, 2011

TAXPAYER-FUNDED projects worth billions of dollars inherited from the former Labor government have been shelved or remain in limbo under Premier Ted Baillieu - placing future investment in Victorian projects at risk.

More than three months after the Coalition took office, it is still to decide on the fate of the $300 million Epping wholesale fruit and vegetable market now being built, and has not guaranteed the future of the $5 billion Regional Rail project.

In Caroline Springs, a road has been built to where the new $55 million railway station was intended to go. But the station project, like so many others in the state, is in limbo with no start date in sight. The road leads to empty paddocks.

Also shelved is a $4 million plan to deal with Hoddle Street congestion, and the Baillieu government is also considering scrapping the $360 million HealthSmart IT project for Victoria's hospitals and the $1.3 billion myki ticketing system.

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http://www.heraldsun.com.au/news/victoria/myki-dilemma-now-its-working/story-e6frf7kx-1226027690838

Myki dilemma - now it's working

  • Stephen McMahon
  • From: Herald Sun
  • March 25, 2011 12:00AM

MYKI usage has surged with more than four million trips taken using the system last month.

Growing acceptance of the troubled smartcard system is putting further pressure on the Government as it continues to debate the future of myki.

A Cabinet sub-committee is expected to provide a report on whether to scrap or retain the controversial smartcard to Premier Ted Baillieu, possibly as early as Monday.

The $1.35 billion system is expected to survive in a scaled back form as almost $725 million has already been blown on the project.

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http://www.pulseitmagazine.com.au/index.php?option=com_content&view=article&id=710:best-practice-previews-new-version-at-summit

Best Practice previews new version at Summit

Speaking at the launch of the inaugural Best Practice Summit, company founder, Dr Frank Pyefinch, previewed a selection of new features included in the latest version of Best Practice. Best Practice is a clinical and practice management solution which counts over 1400 Australian general and specialist practices as customers.

The new version, dubbed "Build 532" includes many enhancements ranging from simple inclusions such as the addition of fields for postal address details in the patient demographic screen, through to more comprehensive functionality including a new Document Scanning Module.

The Skin Module in the new version of Best Practice includes a wider range of drawing templates and the appointment book now permits small icons to be displayed in each cell to more easily differentiate appointment types.

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http://www.hospitaliteurope.com/article/24765/UK_GP_practice_switches_to_iSOFT%92s_hosted_Synergy

UK GP practice switches to iSOFT’s hosted Synergy

Wednesday 23rd March 2011

Ashfield Road Surgery in Blackpool is the latest GP practice to switch to a hosted service from iSOFT in a bid to cut costs and improve reliability.

Previously an EMIS customer, the practice has also switched to iSOFT's Synergy primary care solution. The move comes after St Paul's Medical Centre, a larger practice, took over the running of Ashfield Road. St Paul's has used Synergy for 15 years and considers the system more aligned to the needs of the GP's and the enlarged practice.

This view is shared by Dr John Lockley, GP and chair of the independent iSOFT User Group. "Synergy provides a view of the patient record that is second to none," he said. "Synergy presents doctors with a problem-oriented medical record that is a joy to use, easy to change views, highly flexible and can be used dynamically to constantly reflect the patient's current medical situation."

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http://www.computerworlduk.com/news/it-business/4128/csc-to-buy-isoft-division-working-on-key-nhs-system/

CSC to buy iSoft division working on key NHS system

NHS contractor CSC is set to buy the division of troubled software supplier iSoft that is developing the Lorenzo care records system at the heart of the NHS's 12.4bn National Programme for IT (NPfIT).

The news follows the shock decision of the iSoft board to recommend a 160m bid for the company by German firm Compugroup in place of an expected 140m takeover by Australian firm IBA.

Continuing uncertainty over the future of iSoft has raised questions over the delivery of the Lorenzo care records system which is already running more than two years late. Lorenzo is set to be supplied as a crucial NPfIT component in three out of five regions where CSC is the lead contractor.

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http://www.ehi.co.uk/news/industry/6723/isoft_may_need_further_uk_redundancies

ISoft may need further UK redundancies

17 March 2011 Sarah Bruce

ISoft has entered into a consultation that may result in further positions being made redundant.

Last month, the company posted a net loss of £52.9m (AUS $84m) for the six months ending 31 December 2010.

It also said that as part of its drive to cut costs it had reduced its fulltime headcount by 28% over the preceding 12 months.

One source told EHI that iSoft staff are concerned that the latest round of restructuring will leave UK trusts with a "skeleton crew" and limit the company's ability to carry out new implementations.

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http://www.ehi.co.uk/news/EHI/6747/trading_in_isoft_shares_halted

Trading in iSoft shares halted

24 March 2011 Jon Hoeksma

Trading in iSoft shares on the Australian stock market were halted this morning in a move likely to prove a presage a change in ownership of the beleaguered health IT company.

An ASX (Australian Securities Exchange) market announcement this morning said the halt had been requested by iSoft, “pending the release of an announcement by the company”. The halt will remain in place until an announcement on Monday, 28 March.

EHealth Insider understands in recent weeks iSoft has once again been in negotiations with its banks on re-financing its considerable debts, while also holding discussions with possible investors over a partial or complete sale of the company.

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http://www.guardian.co.uk/business/2011/mar/24/isoft-for-sale

NHS supplier iSoft suspends shares and puts itself up for sale

Troubled software firm that struggled with NHS's IT overhaul is likely to be bought by partner CSC

Troubled healthcare software firm iSoft, a major supplier to the government's crisis-stricken £12.7bn overhaul of the NHS's IT systems, has suspended its shares and put itself up for sale.

The company has for years struggled to meet agreed delivery targets to replace near-obsolete systems together with its NHS supplier partner Computer Sciences Corporation (CSC).

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http://www.techworld.com.au/article/380519/10_ways_linux_making_life_better/

10 ways Linux is making life better

From in-vehicle PCs to set-top boxes, the open source operating system now powers countless innovative and everyday devices.

Linux has long played a leading role in the world of servers, due in large part to its stability, security and lower total cost of ownership (TCO). What many don't realize, however, is just how ubiquitous it's becoming in other parts of life as well.

Not only are distributions like Ubuntu helping Linux make great strides on the desktop, but the open source operating system is now quietly powering myriad innovations that many of us take for granted.

Where can Linux be found today? Let's count just a few of the many places it's making life better.

1. Android

First and foremost, of course, is Android, Google's Linux-based mobile operating system. Well-poised to relegate Apple's successful iPhone to the realm of niche devices, Android is giving the popular iPad a run for its money as well. By putting Linux in the hands of countless mobile consumers around the globe, Android is arguably Linux's greatest mainstream success to date.

Then, too, there's also Chrome OS, which will reportedly figure prominently in a low-cost notebook PC coming from Asus this summer, among other devices.

-----

Enjoy!

David.

It Looks Like iSoft Has Had It! Pity About That!

The following appeared this morning after an ASX announcement before market open this morning.

iSoft extends trading halt on buyout talk

  • Karen Dearne
  • From: Australian IT
  • March 28, 2011 9:44AM

SPECULATION that Australian health IT leader iSoft is on the market has intensified, with the company extending a two-day trading halt last week with a voluntary suspension until next Monday.

The trading halt was requested on Thursday pending a company announcement on its strategic review this morning.

Instead, the directors have told the Australian Stock Exchange the "current status and the proposals received as part of the review process, including relating to a potential change of control, are not sufficiently advanced to permit the disclosure of complete information to the market".

More here:

http://www.theaustralian.com.au/australian-it/isoft-extends-trading-halt-on-buyout-talk/story-e6frgakx-1226029214374

The press release is here:

http://phx.corporate-ir.net/External.File?item=UGFyZW50SUQ9ODcyMTR8Q2hpbGRJRD0tMXxUeXBlPTM=&t=1

This looks very much like the end of iSoft as a stand-alone corporate entity.

If I had iSoft software operational in my organisation (eg HealthSMART in Victoria or the Macquarie Private Hospital in NSW) I would be checking contracts etc. pretty carefully!

It is a bit sad for OZ to loose its only major listed Health IT Company. The rest Global Health (ASX:GLH) and Promedicus (ASX:PME) are either unprofitable sinecures for their directors (GLH) or really so tiny that is it hard to see them making a major impact (PME). Anyone who remembers ICS will now know they have got out of the business.

HCN is, of course, now part or Primary Health Care (ASX:PRY) and it has been struggling with pathology price cuts in the last year or two.

The other significant health stocks really have only minimal Health IT exposure. (Sonic, Resmed, CSL)

The only reason to buy iSoft will be for the legacy revenue streams from maintenance. Rumours are CSC in the UK is interested! We shall see.

David.

Sunday, March 27, 2011

Some Further Views on HL7 V3, A New Compliance and Testing Tool Offered and More!

A few days ago I had an e-Mail from Professor Barry Smith letting me know about a new post on his HL7 Watch Blog.

I was pleased to see our recent discussions and comments got a substantial airing.

Saturday, March 26, 2011

An Australian View on HL7 Version 3

The Australian Health Information Technology blog has posted here a valuable discussion of the item headed Cries for Help published earlier in these pages. This discussion is interesting not least because of the large number of contributions it contains which -- unusually -- are signed by their authors. It seems that, in Australia at least, there are individuals who are willing to commit themselves publicly to a critical position as concerns the HL7 project (where the vast majority of my US informants are willing to have their views communicated only anonymously).

As David More points out in his introduction to the discussion, the implementation success of V3 thus far (and this means after some 14 years of development work) "has been somewhat patchy, with at least some proponents scaling back their enthusiasm for full adoption of the V3 Standard as some see it is lacking the necessary robustness and internal consistency for ongoing use." Dr More goes on to point out that, "While I am not sufficiently across the details of some of this to be able to form a trustworthy opinion a number of very smart people I have chatted with have expressed similar concerns."

In a comment, Grahame Grieve writes on behalf of HL7:

There's no reason for anyone to be afraid to comment. HL7 is not a police state, and there's an endless list of people who criticise and carp. They can expect a vigorous in kind response, but nothing more.

v3/RIM is not perfect. But it's not intended to be an ontology of everything. If only Barry would understand. It's just a model that has some use for interoperability. It's got some go-down-with-the ship type supporters, of course.

As does v2 (and all the other standards - they all have the folks who are going to go down with the ship). It's not enough to say it's simpler. There's more to it than that. The discussion is being had elsewhere, and here is not the place for it. HL7 continues to produce v2 (v2.7 is coming) but the community that is HL7 is switching to v3 because of it's power.

v3 itself does have a patchy record. I'm on record as saying that there won't be another full v3 implementation. People will cherry pick the parts that work - like CDA - and use them as they want.

I've got more to say but it's starting to rain and I'm out in the bush camping. Have a good weekend."

Lots more here:

http://hl7-watch.blogspot.com/2011/03/australian-view-on-hl7-version-3.html

A correspondent on the blog offered all sorts of interesting and provocative comments that followed on from the initial excerpt I have provided and makes some interesting points that are well worth browsing.

As I was digesting all this I noticed that Dr Eric Browne has also been busy.

Inching towards standardised pathology messages

2011-March-27 | 06:18 By: Filed in: exchange formatspathologyterminology

Fortunately, I’m now almost old enough to have forgotten the christmas pudding ritual – helping my father cut up the suet, spread out on sheets of newspaper on the dining room table. In those days, I was then already tall enough to also be able to peer down into the saucepan my mother used to boil clean the threepences and sixpences. And then when the pudding was finally mixed, it boiled away for hours and hours. The whole pudding making ritual seemed to take forever. All that effort for a minute morsel of pudding, that eventually arrived at the very end of an endless christmas lunch!

About this time last week, whilst reviewing the Australian Standards for pathology messaging, the smell of suet returned, reminding me of those yules of yesteryear. If, like me, your brain addles when presented with hundreds of acronyms squirming out from reams of paper, you may have some understanding of my state of mind. I really struggle when presented with bowls of suet that look something like this:-

MSH|^~\&|QDOC|HL7V1.1|AGFA|AGFA1AGFA|20051206150559||ORM^O01^ORM_O01|
00004848|P|2.4|||||||
PID|||QP-110||Norman^Harvey||19401009|M|||200^^E.ST ALBANS^^3021|ORC|SC||51205041^TGH|
|IP||^^^20051206150400^^R|||PALEX^^^^^^^^Q541||^Gasser^Rudy^^^^^^Q541|||||OPH^Ophthalmology^L|

(Apologies for the truncations!)

I thought that there had to be a better way for humans to deal with this – some easier way to interpret each arcane piece of HL7 v2 in context. I looked around, but could find nothing that met my requirements. So I have spent the past week writing an online message validator for Australian pathology messages. It is available at pathology.healthbase.info/hl7-test , and may be of some use to anyone dealing with pathology messaging, whether in the standards arena, or even if merely wanting to understand what some of the issues might be. There are a number of sample messages that can be explored. The validator also includes checking against LOINC and SNOMED terminologies.

More here:

http://blog.healthbase.info/?p=265

I think it is important that such a piece of altruism gets due publicity.

Last we had a ‘Cri du Coeur’ from an obvious expert lamenting the difficulties of the implementation of messaging standards (among other things) most especially in the Lab sector - and just how much pain and effort this was costing all involved.

Why is ‘IT’ all so hard in Pathology?

At the heart of a modern Pathology laboratory is a complex set of Information Technology (IT) systems that are critical to its operation. Users are often frustrated and disappointed at the difficulties they experience when systems fail, when requesting changes or seeking new IT functionality. Having worked in a number of industries before coming to Healthcare four years ago, I have tried to make some sense of why IT is so hard in Pathology.

We’re talking normal, run of the mill Pathology, not bio-informatics databases, leading edge cell imaging or shiny, ground breaking test developments. So why is it so hard to get some seemingly simple functionality from your IT Department? Why do all those small things that would make life a bit easier turn into long, drawn out projects that are around so long they become part of the family?

I'm sitting here at my desk massaging my temples. As the IT Manager, I've been handed the unenviable task of replacing the Laboratory Information Management System (LIMS), a job that will earn me no awards, applause or praise. We already know from past experience that it will be a difficult and traumatic project for my team as well as the whole organisation. We will grapple with new technology, interfacing and new ways of performing old processes. And for all that, we are not even expecting new functionality. We are not alone in this dilemma. At this time the IT managers of major Pathology providers in NSW, VIC, SA and WA are actively investigating replacing their LIMS. Some to modernise and consolidate, others, like ourselves, as a result of a pullout from the Australian market by a significant LIMS vendor. None will get any major new functionality. It may be easier to maintain, interface or get better reports, but it is unlikely that any new pathology breakthroughs will come as a direct result of these efforts.

Pages more here:

http://www.pulseitmagazine.com.au/index.php?option=com_content&view=article&id=511:why-is-it-all-so-hard-in-pathology

We are now over $350 Million and six years into the NEHTA experiment and still all this basic infrastructure messaging is not even agreed let alone actually implemented and operational in the way NEHTA is suggesting is vital.

Now I make no claims to fully understand what has and is going on here, but one has to suspect the award of a ‘gold star and Koala stamp’ for good behaviour to those involved is very unlikely.

Again we all know it is not beyond the wit of man to sort this out. What it is beyond is a National E-Health Governance Framework that is deeply dysfunctional and simply a fiasco.

To be clear the lack of leadership, governance and pursuit of an agreed strategy is just killing us!

We need to sort all that out and then with good will the rest can be sorted. This simply won’t happen in the present environment.

I recently had an e-mail from a colleague analysing the current motivators of the various actors. It was put this way:

  • DoHA – politics and money
  • NeHTA – power and self-preservation
  • SAI – cost mitigation
  • IT14 members (volunteers) – compromise, consensus, stubbornness

Until we have a break out of common sense and rationality the current situation will persist I fear!

David.