The Truth Is Out -The PCEHR Will Not Be Done By 2020 and That is Official from DoHA!

The following appeared yesterday. Ignore the title - just read on!

Low-cost, high-security systems that hinge on giant virtualised computers: cloud computing catches on

• Ian Grayson
• From: The Australian
• May 24, 2011 12:00AM

----- A Lot Skipped

The public sector

Looking at how you are all moving to the cloud, one of the most significant projects must be in e-health. Paul, could you give us some insight?

Madden: Naturally, it is complex. Things like a personally controlled e-health record have certain aspects that go right to the heart of privacy and security and trust -- the question of who's looking after that for me.

Connected to that are multiple providers in the health system that will have resources that will be added to this core private piece of information, bringing health records from what we call compliant data repositories and they will be, in effect, cloud-based.

If you're part of a clinic, a hospital or a GP, how you choose to get your services provided means that I need to have my information stored in a way that can be accessed into that cloud by other providers. The cloud will have to support a lot of this.

What sort of timeframe are you putting on your journey?

Madden: Well I guess the start of painting that out is July 2012, when we have that central component, which is when people can start to register for their own personal control of e-health records. There are sites at the moment where we are piloting some of the concepts to create those repositories for classes of health providers in their community.

So those things are beginning now, but I guess that's something that's going to start as a real production thing from July 2012 and start to grow rapidly from there.

Do you think we'll see all the services and all the work that you have just outlined done in this decade -- by 2020?

Madden: There will be strong examples of it, and we are already seeing examples of how the business community, including some of the medical professions, are starting to interface and demand different computing services. Will it be ubiquitous across the next decade -- I doubt it, but I think we'll have made great inroads.

----- End Extract.

Full article is here:

http://www.theaustralian.com.au/australian-it/low-cost-high-security-systems-that-hinge-on-giant-virtualised-computers-cloud-computing-catches-on/story-e6frgakx-1226061374157

Now Paul Madden is the DoHA CIO. Here is the announcement of his appointment late last year.

Health appoints Paul Madden CIO

• Karen Dearne
• From: Australian IT
• November 22, 2010 1:29PM

THE Health Department has appointed its first chief information officer, Paul Madden, who comes from the Tax Office where he oversaw the recently completed Standard Business Reporting program.

Health secretary Jane Halton said Mr Madden had "a wealth of highly developed IT and organisational experience, as well as strategic advisory and leadership experience''.

Mr Madden assumes responsibility for boosting departmental IT capabilities in support of the Gillard government's $467 million personal e-health record initiative, and will report directly to Ms Halton.

Lots more here:

http://www.theaustralian.com.au/australian-it/government/health-appoints-paul-madden-cio/story-fn4htb9o-1225958487120

So as we all knew all the rubbish about July 2012 is just that, rubbish. Maybe in a decade there will be something useful come from all this effort and expenditure - but name a project of this scale that has actually delivered under the management and direction of Government. I am struggling, certainly nothing in Australia leaps to mind!

Another concern has to be just how appropriate 'the cloud' is for private health information. Seems to me it would have to be a very private cloud!

The questions in Senate Estimates about just what the real plans are will make riveting watching next week!

At some point the spin and BS has to stop and it looks like this about to happen! Maybe we could start again with something that has some prospect of success. I can see the start of the re-setting of expectations process underway right now!

I hope he keeps his job after Ms Roxon and Ms Halton discover they have an honest man who is prepared to tell it as it really is in their midst!

David.

Have DoHA Got The PCERH Procurement Back to Front, Ridiculously Truncated or What?

The following appeared recently.

Health shortlists infrastructure tenders

Fujitsu, CSC and at least two consortia of smaller e-health providers are believed to be among those shortlisted for potential participation in the Federal Government’s $467 million personally controlled electronic health record (PCEHR) initiative.

• James Hutchinson (Computerworld)
• 24 May, 2011 12:23

The national infrastructure partner, one of four such partners sought by the Department of Health and Ageing for the e-health rollout, would deliver, integrate and provide continued maintenance for enabling systems including core system infrastructure; operations and call centres; reporting and template servicing; and separated portals for use by both consumers and healthcare providers.

Computerworld Australia believes companies including Fujitsu, Oracle, Microsoft, CSC and Telstra were among those shortlisted for phase two of the tendering process.

It is also believed they were notified both by the department and by others shortlisted earlier in May, almost a month after the initial 12 April date communicated to tenderers. The delay could push back further steps in the roadmap, which aimed to have a final stage 2 panel notified by the end of May and contracts signed by 30 June for beginning of negotiations and implementation talks.

Integration would take place ahead of a build and test phase beginning April next year, ahead of the go live date on 1 July 2012.

A spokesperson for the department said the tendering process was ongoing but refused to verify which companies had been shortlisted.

More here:

http://www.computerworld.com.au/article/387659/health_shortlists_infrastructure_tenders/?fp=4&fpid=1398720840

One never ceases to be amazed at the unreality of the PCEHR Program. Now we find that today (plus or minus a day or two) the successfully shortlisted tenders to deliver the PCEHR Infrastructure are given a few weeks to finalise a proposal and have it back to DoHA. From there their needs to be an evaluation, contract negotiations, announcements and then mobilisation to deliver whatever is to be delivered.

From here you can be sure there will be no final announcement in under a couple of months unless the whole thing is undertaken with careless indifference to the public interest.

We only have to look to the UK to see how the providers of similar services can deliver a lot less than they promised and do it very late. To finalise a delivery contract of this scale in a few weeks is frankly a joke.

This report a day or so ago in the Financial Times in London makes the risk totally clear!

Health records contract ‘holds taxpayer to ransom’

By Nicholas Timmins and Sally Gainsbury

Published: May 23 2011 23:57 | Last updated: May 23 2011 23:57

The cost of cancelling the remainder of Computer Sciences Corporation’s £3bn worth of contracts to install an electronic patient record for some 30m NHS patients could prove higher than to let it run its course, parliament’s spending watchdog was told on Monday.

Christine Connelly, head of the NHS IT programme, said the “absolute maximum” to which the NHS “could be exposed” was more than is left to run on the consultancy’s deal. Figures from the National Audit Office suggest that amounts to £1.6bn.

“We could be exposed to a higher cost” than the cost “it would take to complete the programme today”, she told the Commons public accounts committee.

Lots more here:

http://www.ft.com/cms/s/0/29cbd372-8580-11e0-ae32-00144feabdc0.html#ixzz1NFIgBRMD

We are talking a good deal more than tea money here!

It also needs to be remembered that there is presently only a DRAFT concept of operations for the PCEHR, the applicable standards have not been finalised and there are no actual specification from which a build or procurement of sub components can commence.

The DRAFT Concept of Operations does not even conclude its public consultation period until May 31, 2011. Not long to produce a useful final document also then!

This whole program becomes more and more fantastic as every week goes by!

David.

NEHTA And DoHA are Really Spin Central - How Can The Public Take These People Seriously?

We have had some responses to Questions on Notice from the Senate Estimates session a couple of months ago and just before the next session next week!

Here are some selected highlights.

Senate Community Affairs Committee

ANSWERS TO ESTIMATES QUESTIONS ON NOTICE

HEALTH AND AGEING PORTFOLIO

Additional Estimates 2010-2011, 23 February 2011

Question:E11-066

OUTCOME 10: Health System Capacity and Quality

Topic: NATIONAL EHEALTH TRANSITION AUTHORITY (NEHTA)

Written Question on Notice

Senator Boyce asked:

a) There is in existence a document that outlines a plan to eliminate ‘Argus Connect’, a supplier of medical messaging software from the Northern Territory market. Is it true that the chief executive of NEHTA, Peter Fleming, initially denied its existence?

b) Is it true that when shown the document he then claimed it wasn’t a NEHTA document?

c) What proof can you provide to support his claim?

d) If the document is indeed a NEHTA document would its contents be sufficient to warrant an investigation by the ACCC?

Answer:

NEHTA has advised the Department that:

a) NEHTA is aware of the project plan prepared by Northern Territory Department of Health and Families (NTDHF), (and documented by NEHTA) pertaining to the Web Services Messaging Application, (WSMA), Project which did state that NTDHF would replace the Argus secure messaging systems in the Northern Territory, and would replace Argus secure messaging systems for the Shared Electronic Health Record Service (SEHR) with NEHTA specification compliant web services. It also stated that as part of the expected outcomes that future release of the NT WSMA project would replace Argus Messenger in all NTDHF sites for the same reason.

The WSMA Project is a NTDHF project initiative to replace non compliant messaging product with product that is compliant with NEHTA specifications for secure messaging.

It should be noted that the project plan is a joint document that reflects the NTDHF requirements for this project. The information contained in the WSMA project plan was supplied by the NTDHF.

b) In regard to the NTDHF project plan for the WMSA project as referred to in part a), whilst this document was co-authored by a NEHTA employee using a NEHTA template, the information contained in the document, including the project plan itself, was provided by the NTDHF.

c) The document itself clearly talks about the WMSA project being a NTDHF project and it also talks about the expected outcomes of the NT secure messaging project. This detail in the document clearly delineates the articulated desire by the NTDHF to move to a NEHTA specification compliant product. The project plan also clearly describes NEHTA’s role as providing technical expertise and knowledge transfer to inform and assist so that the NTDHF product is compliant with NEHTA specifications.

d) The desire by the NTDHF to move from a non-compliant to a NEHTA specification compliant product that would also address administrative and performance issues associated with the Argus Messenger Product would appear to be a legitimate strategy for a jurisdiction to adopt.

See here for background

http://aushealthit.blogspot.com/2010/02/major-trouble-seems-to-be-brewing-in-e.html

-----

Question: E11-067

OUTCOME 10: Health System Capacity and Quality

Topic: NATIONAL EHEALTH TRANSITION AUTHORITY (NEHTA)

Written Question on Notice

Senator Boyce asked:

a) Did NEHTA ever present to DoHA or the Minister an identifier or summary health record system based on the putatively stolen property?

b) How much did they spend on computer forensics, lawyers, the time of senior staff etc in the attempt to take control of the IP of the patent?

c) Did NETHA ever intend to make use of the IP of the patents?

Answer:

a – c)

NEHTA has informed the Department that this information relates to an on-going legal matter which is confidential and subject to legal professional privilege.

-----

Question: E11-070

OUTCOME 10: Health System Capacity and Quality

Topic: NATIONAL EHEALTH TRANSITION AUTHORITY (NEHTA)

Written Question on Notice

Senator Boyce asked:

In its mission statement, NEHTA talks of ‘working openly, constructively and collaboratively with consumers’. So why does the vast bulk of NEHTA’s work focus on stakeholders rather than consumers?

Answer:

Consumers are a key stakeholder group and are a high priority in the implementation of NEHTA’s work program. In 2007 NEHTA established a Stakeholders Reference Forum and a range of Reference Groups to seek stakeholder input on the NEHTA work program. Consumer involvement is prevalent across these reference groups. Specific consumer engagement activities are also undertaken on particular projects such as the healthcare identifier and personally controlled electronic health record (PCEHR) projects.

NEHTA has advised that since the announcement of the PCEHR system in early 2010, consumer representatives have been involved in 39 forums including stakeholder working group meetings and roundtable discussions held to progress design and delivery of the PCEHR system. On 20 January 2011, NEHTA established a Consumer Reference Group to assist with discussions on PCEHR related issues.

In addition to these forums, NEHTA has established a web portal, ehealth collaborate, to allow consumers and other stakeholders to contribute their ideas and feedback.

-----

Question: E11-073

OUTCOME 10: Health Systems Capacity and Quality

Topic: eHEALTH

Written Question on Notice

Senator Boyce asked:

Can the Department provide the evidence that supports the approach being adopted with the PCEHR as opposed to other approaches to eHealth?

Answer:

The proposed approach for Australia’s national personally controlled electronic health record (PCEHR) system has considered the lessons available from early regional scale implementations and larger scale international systems to develop a model specifically targeted to Australia’s healthcare context.

The PCEHR system takes a combined approach to interoperability - one which is tailored to support the Australian federated, multi-layered, public and private health system.

Australia’s approach is based on leveraging existing systems and distributed sources of health information as a basis for populating a consolidated view of an individual’s health information. It is built on the National eHealth Strategy principles, the foundations for information exchange currently being developed through National eHealth Transition Authority and the introduction of the healthcare identifier service.

This is consistent with international experience where an evolutionary rather than a ‘big-bang’ approach is being found to be more effective in lowering risks and costs and increasing uptake by consumers and providers.1,2 In contrast, the same analysis has shown that approaches relying on localised organic growth, can lead to limitations on the information that can be captured and shared for the benefit of broader health outcomes.

The national PCEHR system will comprise a secure network of systems that will provide access to consolidated and summarised health information drawn from multiple source systems for individuals who choose to participate.

1 Coiera, E. Building a national IT system from the middle out. J Am Med Inform Assoc. 2009;16:271-273.

2 Devlies J, De Moor G, De Clercq E, Vandenbeghe A. Health Data Exchange, Health Data Sharing and Decentralised Clinical Data Collections - Recommendations from a Belgian Expert Group. In: De Clercq E, De Moor G, Bellon J, Foulon M, Van Der Lei J, editors. Collaborative Patient Centred E-Health. Amsterdam: IOS Press; 2008.

-----

Question: E11-074

OUTCOME 10: Health Systems Capacity and Quality

Topic: eHEALTH

Written Question on Notice

Senator Boyce asked:

Now that the PCEHR is approved and being implemented why is it that the public cannot review the business and benefits cases that you claim have been developed and approved by Health Ministers?

Answer:

The National E-Health Strategy released by Health Ministers in December 2008 outlines the expected benefits and the steps for developing a national electronic health record system.

The business and benefits case referred to is not a Commonwealth document and was developed through a multi-jurisdictional process. Any decision to release the document publicly would require agreement of all jurisdictions.

----

All I can say is that reading non-responses like this just turns the brain to mush!

It is clear there is an absolute determination to minimise openness and transparency and that there are some of these answers which sail pretty close to being just untrue.

As an example I know there does exist a Business Case for the PCEHR that was prepared by NEHTA and given to Treasury to justify the $477 Million over 2 years in the Budget before last. It should be available to the Senate, if they ask, in my view.

It is also clear the evidence base for the PCEHR does not exist as neither of the two papers cited in any way recommend the implementation of a PCEHR - given the term did not even exist when they were written!

When I was young and naïve I believed behaviour of this sort would be promptly exposed and corrected - now I am older and maybe a little wiser I am just resigned to the abuse Government meets out to all of us!

I leave it as an exercise for the reader to find the other little pieces of economy with the truth!

David.

Weekly Australian Health IT Links – 23 May, 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

A week with a focus on e-Health news from the States (Tas, WA and Qld) and really important news following the UK National Audit Office reporting on the UK e-Health Program.

There is no doubt there are many lessons to be learnt from the UK - whether that will happen we will see in due course.

One really does wonder whether an audit of the PCEHR after 2-3 years would find ‘value for money’ or an improvement in health outcomes!

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http://www.rustreport.com.au/issues/latestissue/australian-hospital-cios-ramp-up-it-spending-in-2011/

Australian hospital CIOs ramp up IT spending in 2011

May 20, 2011

Fifty five per cent of hospitals CIOs in Australia say they plan to increase spending on IT in 2011, five percentage points more than last year, according to an Ovum survey.

In a new report the independent technology analyst unveils the results of its latest healthcare Business Trends Survey, with reassuring results. Overall, 42 per cent of hospital CIOs questioned will increase spending on IT this year. Twenty-two per cent of these will ramp up spending significantly, compared to only 14 per cent last year. Australian CIOs were already optimistic about their IT budget prior to the government’s announcement. They plan to investment 35% of their external IT budget in 2011 on hardware, followed by software investments of 30%.

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http://www.computerworld.com.au/article/387281/health_increases_telehealth_bounty_specialists/

Health increases telehealth bounty for specialists

$216.3 million more up for grabs in incentives and rebates over online consultations

• James Hutchinson (Computerworld)
• 20 May, 2011 12:39

The federal Department of Health and Ageing has poured an additional $216.3 million to fund its telehealth consultations scheme until 2015, with expectations around ten per cent of the nation’s practitioner workforce would take part in the scheme within five years.

The initiative, announced during the 2010 federal election and confirmed in November last year, set aside $402.2 million to provide rebates for regional and remote patients consulting with doctors through videoconferencing or other technological means until the 2013-2014 fiscal year.

Of that funding, $50 million was confirmed at the time to be spent adding videoconferencing capabilities to the after hours GP helpline and providing training to that staff for its use.

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http://www.zdnet.com.au/cops-e-health-win-big-in-wa-budget-339315418.htm

Cops, e-health win big in WA budget

By Josh Taylor, ZDNet.com.au on May 20th, 2011

The Western Australian Government has committed to investing $89.6 million in this year's budget to continue e-health initiatives in the state, while the police received a stack of funding for communications and core systems upgrades.

The state's 10-year eHealthWA program has been in place since 2006 and has so far seen the state replace its core health applications with what it calls the "New Core" that will establish accessible integrated electronic patient records in WA. Since 2010, the program has been working to align itself with the requirements of the Federal Government's e-health agenda, which will lead to a national personally controlled e-health record in July 2012.

According to budget documents, as a part of a raft of investment in IT upgrades across a number of government departments, the WA Government will invest $89.6 million in WA Health ICT.

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http://www.australiandoctor.com.au/articles/54/0c070b54.asp

HCN sale tipped to fetch up to $300m

20-May-2011

THE company that makes the prescribing software Medical Director could soon be up for sale - but bidders will have to fork out $250-$300 million.

HCN (Healthcare Communication Network) was bought by the GP corporate giant Primary Health Care for about $100 million six years ago following a bidding war with IBA Health.

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http://www.theaustralian.com.au/business/industry-sectors/primary-health-care-confirms-proposal-to-sell-health-communication-network/story-e6frg97f-1226059544286

Primary Health Care confirms proposal to sell Health Communication Network

• Cynthia Koons
• From: Dow Jones Newswires
• May 20, 2011 11:11AM

PRIMARY Health Care today said it was considering a proposal for the potential sale of Health Communication Network, but that the terms of the proposal are incomplete.

Health Communication Network provides clinical and practice-management software for Australian clinicians.

Primary said that, while the proposal was in draft form, the offer remains subject to board consideration.

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http://www.computerworld.com.au/article/387235/qld_health_launches_revamped_metrics_site/?eid=-255&uid=25465

Qld Health launches revamped metrics site

The site contains a number of hospital metrics from the state's 27 reporting hospitals

• Chloe Herrick (Computerworld)
• 20 May, 2011 07:13

The Queensland Government’s health department has launched a revamped website in an effort to simplify data and make it more easily accessible for users.

Minister for Health, Senator Geoff Wilson, said the upgraded site would collate existing information into specific, easy-to-find areas for the state’s 27 reporting hospitals as opposed to having information both online as well as in quarterly reports.

“It's about a new way of doing things that means people can access more information about their hospital in a clearer way, and when they want to,” Wilson said in a statement.

The site includes comparisons to national indicators, reports on emergency department data, how hospitals are performing in elective surgery, in emergency departments, the number of people that are waiting, and the number of people that came to hospital over a certain period of time.

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http://www.medicalobserver.com.au/news/prescribing-changes-needed-to-meet-ehealth-deadlines

Prescribing changes needed to meet e-health deadlines

17th May 2011

Mark O’Brien

AXE paper prescriptions from July next year: that is the call on Government from the head of one of Australia’s leading electronic prescribing service operators.

Speaking at the 8th Annual Future of the PBS conference in Sydney last week, MediSecure CEO Phillip Shepherd said if the Government was serious about meeting its 1 July 2012 deadline for the introduction of a personally controlled electronic health record (PCEHR) it must get e-prescriptions working first.

Mr Shepherd told MO decisive action was needed to encourage the adoption of e-prescriptions by making them the only means by which a patient could access medications.

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http://www.computerworld.com.au/article/387104/tasmanian_health_dept_sick_paper_shuffling/?eid=-6787&uid=25465

Tasmanian Health Dept sick of paper shuffling

Statewide occupational health record information system will migrate thousands of paper records to digital

• Tim Lohman (Computerworld)
• 19 May, 2011 12:49

The Tasmanian Department of Health and Human Services (DHHS) is moving to cut the voluminous paper records required to monitor the health and safety of its employees via the rollout of a statewide occupational health record information system.

The system, which will manage the details of some 12,000 employees, will capture, manage and maintain a full range of occupational medicine activities for DHHS staff. Specific information includes employee health assessments, occupational exposure, vaccinations and clinical consultations.

According to the DHHS, moving to an electronic system will reduce the amount of storage required for the hard copy health records — presently some 8500 — and allow the agency to report on a number of parameters and allow easy production of vaccination updates.

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http://www.itnews.com.au/News/257907,uks-17bn-e-health-vision-nears-mission-impossible.aspx

UK's $17bn E-health vision nears mission impossible

By Liam Tung on May 19, 2011 4:34 AM (4 hours ago)
Filed under Software

CSC and BT could be in firing line.

The National Health Service’s £11.4 billion ($17.4 billion) electronic healthcare records roll out is in dire straits and has little chance of recovery, according to the UK’s National Audit Office.

A report released Wednesday into the NHS’ “National Programme for IT” concluded that the £2.7 billion already spent since 2002 “does not represent value for money”.

The vision for the program, originally due for completion in 2010, would also not be realised, according to the auditor.

It had little faith that the two main contractors, CSC and BT, could meet the new 2015-2016 timeframe, or that the fate of the planned £4.3 billion budget would be any different to what had been spent to date.

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http://www.ft.com/intl/cms/s/0/60546d42-7ff3-11e0-b018-00144feabdc0.html#axzz1MUdqAULU

Public procurement: Only the bare bones

By Nicholas Timmins

Published: May 16 2011 23:37 | Last updated: May 16 2011 23:37

When Tony Blair convened a Downing Street breakfast seminar in February 2002 to assess the information technology needs of Britain’s taxpayer-funded National Health Service, “it was like a revivalist meeting”, says Philip Hunt, the minister who was then in charge of the project.

The mood was infectious. Bill Gates of Microsoft had been impressing on the prime minister of the day the merits of an all-electronic patient record – quicker, cheaper and safer care, with no need for patients endlessly to repeat their details to every clinician they met. From that breakfast stemmed the world’s biggest civilian IT programme.

Mr Blair himself – while famously never using a computer during his 11 years in office – was bewitched by the internet age and what it could do to modernise the UK. He had for years been talking up an ideal in which, when a patient from Birmingham was taken seriously ill 90 miles or so north in Bradford, the doctors would instantly have all the records to hand.

In those far easier financial times, his government had already decided to double spending on the NHS – tackling years of underinvestment with the aim of returning it to the top of the international league table of health systems. What better symbol of modernisation – in the days of rapidly growing online banking – than achieving for all 50m patients in England the all-singing and dancing electronic patient record that had been the goal of the IT industry for 20 years?

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http://www.hospitaliteurope.com/article/25499/UK_Trust_signs_up_for_iSOFT%27s_eprescribing_system

UK Trust signs up for iSOFT's eprescribing system

Monday 16th May 2011

iSOFT has agreed contracts with Stockport NHS Foundation Trust for its strategic e-prescribing and medicines management (ePMA) solution and follows an agreement to extend its contract for iSOFT’s PatientCentre patient administration system for a further five years. The contracts total up to £2.1 million.

A fully integrated smart component of Stockport’s PatientCentre solution, ePMA will be available across the 700-bed acute trust.

“We undertook a thorough clinical engagement programme within the trust to understand the suitability of the software for an acute NHS environment and the benefits that could be delivered clinically and operationally for nursing, pharmacy, medical and management stakeholders,” said Ken Brennan, Director of IM&T at Stockport. “This involved discussions with executives and clinicians in Australia who are established users of iSOFT’s ePMA. With iSOFT’s commitment to working in partnership with the trust, we are confident of delivering tangible benefits to our patients and staff.”

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http://news.smh.com.au/breaking-news-technology/jeopardywinning-computer-delving-into-medicine-20110522-1eyeh.html

'Jeopardy!'-winning computer delving into medicine

JIM FITZGERALD

May 22, 2011 - 7:20AM

Some guy in his pajamas, home sick with bronchitis and complaining online about it, could soon be contributing to a digital collection of medical information designed to help speed diagnoses and treatments.

A doctor who is helping to prepare IBM's Watson computer system for work as a medical tool says such blog entries may be included in Watson's database.

Watson is best known for handily defeating the world's best "Jeopardy!" players on TV earlier this year. IBM says Watson, with its ability to understand plain language, can digest questions about a person's symptoms and medical history and quickly suggest diagnoses and treatments.

The company is still perhaps two years from marketing a medical Watson, and it says no prices have been established. But it envisions several uses, including a doctor simply speaking into a handheld device to get answers at a patient's bedside.

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http://www.theaustralian.com.au/news/health-science/hit-and-run-victim-has-made-medical-history-by-standing-and-walking-bringing-hope-to-paraplegics/story-e6frg8y6-1226059409328

Hit and run victim has made medical history by standing and walking, bringing hope to paraplegics

• Adam Cresswell
• From: The Australian
• May 20, 2011 9:00AM

A US college baseball champion who was paralysed from the chest down in a hit-and-run car accident nearly five years ago has made history by standing and walking again with assistance, in a breakthrough that brings new hope to paraplegic patients worldwide.

Thanks to the treatment, 25-year-old Californian Rob Summers can stand up by controlling his leg muscles himself, and remain standing for four minutes at a time, when an implanted electrode is used to electrically stimulate his spinal cord.

The length of time he can stand is able to be extended to an hour if he is given assistance when he weakens, and he can also make stepping motions on a treadmill when placed in a harness and helped by a therapist.

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http://www.theaustralian.com.au/australian-it/it-business/identity-theft-not-taken-seriously-victim/story-e6frganx-1226056962622

Identity theft not taken seriously: victim

• Karen Dearne
• From: Australian IT
• May 16, 2011 5:52PM

IT was no joke when Welsh writer and comedian Bennett Arron fell victim to identity theft more than a decade ago - he owed thousands of pounds to mobile phone companies, home shopping firms and department stores.

Today, it has become a much more familiar scenario, but back then it was unheard of, as he told the AusCERT 2011 conference on the Gold Coast this week.

Mr Arron and his new wife had found a perfect first home in London, and were ready to buy.

But the bank arranging their mortgage had some bad news: "We are writing to you because of your outstanding debts..."

It was the beginning of a nightmare that lost them the house, their rental accommodation and - with a baby on the way - left them homeless and penniless.

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http://www.theaustralian.com.au/australian-it/be-careful-of-the-cloud-warns-sophos/story-e6frgakx-1226057996270

Be careful of the cloud, warns Sophos

• Karen Dearne
• From: Australian IT
• May 18, 2011 8:47AM

COMPANIES need to be cautious about cloud computing because they are essentially putting all their data in someone else's hands, warns security specialist Paul Ducklin.

"Cloud computing isn't new, it was invented in the sixties by IBM when they brought out the first remote terminals," Sophos Asia-Pacific's head of technology told the AusCERT 2011 conference on the Gold Coast.

"But the scale is huge these days and because data is much more portable, with the interconnecting networks so much faster, your data can be anywhere, at any time.

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http://www.theaustralian.com.au/australian-it/local-cios-get-cosy-with-cloud-computing-survey/story-e6frgakx-1226058467415

Local CIOs get cosy with cloud computing: survey

• Stuart Kennedy
• From: Australian IT
• May 18, 2011 7:15PM

CLOUD computing moved sharply into the mindset of local chief information officers last year according to a new survey.

The IBM 2010 Global CEO study canvassed more than 3000 chief information officers globally and 181 CIOs in Australia and New Zealand.

The IBM Institute survey found 60 per cent of ANZ CIOs saw cloud computing as strategic and planned to implement cloud in their organisations in the next five years compared with 39 per cent of ANZ CIOs in a similar survey conducted in 2009.

Intentions to use hardware virtualisation technology – the fundamental building block of cloud computing infrastructure – also weighed heavily on ANZ CIO minds, with 76 per cent saying they were focused on virtualisation investments compared with 68 per cent globally.

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http://www.smh.com.au/nsw/gps-get-the-goahead-to-order-less-risky-scans-20110516-1epzj.html

GPs get the go-ahead to order less risky scans

Amy Corderoy

May 17, 2011

THE federal government will allow GPs to order magnetic resonance imaging scans to stop patients being sent for riskier and less sensitive imaging such as computed tomography scans.

New research shows the number of children undergoing CT scans has grown by 5.1 per cent a year over the past 20 years.

The government's decision to allow GPs to order MRI scans could prove lifesaving for children with cancers who would otherwise lose time waiting for a specialist appointment, said the head of the Royal Australian and New Zealand College of Radiologists, Matthew Andrews.

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http://www.smh.com.au/technology/sci-tech/einstein-was-right-all-along-the-future-is-dark-20110519-1ev1x.html

Einstein was right all along: the future is dark

Deborah Smith

May 20, 2011

IT'S official. The universe is slowly fading away into the distance. An invisible force thought to be pushing the cosmos ever faster apart does exist, Australian astronomers have concluded.

The team is the first to have looked at the structure of the universe more than halfway back in time, to a period when this repulsive force, known as dark energy, began to dominate over the pull of gravity.

Chris Blake, of Swinburne University, said the results of their four-year survey of more than 200,000 distant galaxies show the mysterious force is a property of space itself.

''Dark energy is real,'' Dr Blake said. ''It fills the universe.''

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Enjoy!

David.

AusHealthIT Poll Number 71 – Results – 23 May, 2011.

The question was:

Do you have confidence that NEHTAs clinical leads understand the existing eHealth landscape and standards?

The answers were as follows:

Fully

- 3 (8%)

Somewhat

- 11 (29%)

Not Really

- 14 (37%)

Too Technical For Them

- 9 (24%)

Looks like about 60% don’t think the clinical NEHTA staff really understand e-Health Standards.

Votes : 37

Again, many thanks to those that voted!

David.

The Scale of the Mess In the UK Health IT Program Is Just Terrifying! Hang On To Your Wallet!

I did a short blog on the reporting on the National Audit Office (NAO) report on the National Program for Health IT a few days ago.

This is found here:

http://aushealthit.blogspot.com/2011/05/are-we-seeing-our-future-in-way-uk.html

I have now had time to have a browse of the reports. They are pretty blunt and make riveting reading. This extended key quote gets the flavour.

The National Programme for IT in the NHS: an update on the delivery of detailed care records systems

The rate at which electronic care records systems are being put in place across the NHS under the National Programme for IT is falling far below expectations and the core aim that every patient should have an electronic care record under the Programme will not now be achieved.

Downloads

• Executive summary (PDF - 131KB)
• Full report (PDF - 370KB)
• Press notice (HTML)

"The original vision for the National Programme for IT in the NHS will not be realised. The NHS is now getting far fewer systems than planned despite the Department paying contractors almost the same amount of money. This is yet another example of a department fundamentally underestimating the scale and complexity of a major IT-enabled change programme.

"The Department of Health needs to admit that it is now in damage-limitation mode. I hope that my report today, together with the forthcoming review by the Cabinet Office and Treasury, announced by the Prime Minister, will help to prevent further loss of public value from future expenditure on the Programme."

Amyas Morse, head of the National Audit Office, 18 May 2011

The rate at which electronic care records systems are being put in place across the NHS under the National Programme for IT is falling far below expectations and the core aim that every patient should have an electronic care record under the Programme will not now be achieved. Even where systems have been delivered, they are not yet able to do everything that the Department intended, especially in acute trusts. Moreover, the number of systems to be delivered through the Programme has been significantly reduced, without a commensurate reduction in the cost.

Today's NAO report concludes that the £2.7 billion spent so far on care records systems does not represent value for money. And, based on performance so far, the NAO has no grounds for confidence that the remaining planned spending of £4.3 billion on care records systems will be any different.

The original aim of the Programme was for every patient to have an electronic care record by 2010. The systems the Department contracted its suppliers, BT and CSC, to deliver are now not all expected to be in place until 2015-16. Even so, based on performance so far, it is unlikely that the remaining work in the North, Midlands and East, where just four of 97 systems have been delivered to acute hospital trusts in seven years, can be completed by 2016 when the contract with CSC expires. Indeed, in order to meet the revised deadline, over two systems a month would need to be delivered in this Programme area over the next five years.

Progress in delivering care records systems varies dramatically between regions. There has been more progress in London in some health settings, although no GP practices are now receiving a system through the Programme and the number of systems in acute hospital settings has halved.

Where care records systems are in place, they are not yet delivering what the Department had expected. In acute trusts, the systems are mainly providing administrative benefits, rather than the expected clinical ones, such as prescribing and administering drugs in hospitals. The Department has now changed its approach and moved away from its intention to replace systems wholesale, instead, building on and using trusts' existing systems. To do this the Department estimates it will cost at least £220 million to get the systems to work together.

Publication details:

HC: 888, 2010-2012

ISBN: 9780102969689

----- End Quote

Reading through the documentation there are some vital points:

First this report is the third released on the program - with the first done in 2006 and the second in 2008. Each of the reports has become increasingly pessimistic yet the spending and effort has continued without any apparent checkpoint and re-assessment. Result has been what was an eight year program winding up being a 15 to 16 year program. Never the less our Government seems to imagine that kicking off a form of national program - with none of the levers and controls held by the NHS over all parts of the health system - is going to result in a working national PCEHR System in a couple of years - you can really only wonder what they are smoking. (I know Australians and good but are we really that good?)

My fear is that what will happen is that we will see the initial 2 years funding continued for the PCEHR - dig ourselves into a deeper and deeper ditch - and despite recognising it is not going well not do the fundamental reviews that will be (and already are) needed.

Second this report makes it clear that when Government crosses swords with smart corporates (like CSC and BT) that it is possible to contract for something, deliver less and still get paid. There is a red light flashing warning here for DoHA. May be they should hire a fox to manage their henhouse to save themselves from this outcome!

Third it is alarming that it seems the clinical systems have been the ones that have been the most under delivered. The same, to varying degrees is also seen here - reminding us again just how hard doing clinical systems on any scale seems to be.

Fourth the first bold paragraph above just re-enforces the point about how long this takes before results are really seen. Making continuing funding contingent on the results of the first 2 years is utterly absurd!

Fifth the progress that has been made with the N3 Network, PACS and other nonclinical systems reminds us all that building basic infrastructure is the easy bit - the clinical applications and use of those is very much the ‘hard bit’!

Last, the scale of the mess here means we really need to challenge the wisdom of large national programs of this sort and come up with a fundamentally different way to approach things, as this really does not appear to be a good way forward.

On balance I still think the National E-Health Strategy, with an emphasis on local provider systems and clinical information flows before moving to shared records was correct and this report and the earlier reviews by Prof Trisha Greenhalgh just confirm that view.

See here:

http://aushealthit.blogspot.com/2010/06/if-ever-there-was-some-research-to.html

We really do need not only to read the report but also have some real conversations with those who wrote it!

David.