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, July 26, 2011

We Have Some Vendor Fantasy Loose As the PCEHR Infrastructure Provider Decision Apparently Draws Closer.

You can tell a major tender result (the PCEHR Infrastructure Provider Tender) is getting close when the soft marketing opinion pieces and releases start appearing.

First we have:

Shared EHRs: Beyond initial deployment

Over the last few years, the healthcare system — including the federal government, state jurisdictions, media, technology companies and the general public — have jointly placed a major emphasis on eHealth initiatives. While various models and strategies are still being discussed and debated, there is a core principle upon which most in the healthcare industry can agree: That stakeholders along the entire care continuum need readily accessible, patient-centric clinical data that transcends systems and geography.

The ongoing debate around the exact design and priorities of the Personally Controlled Electronic Health Record (PCEHR), which was well articulated by the likes of Medical Software Industry Association, the National E-Health Transition Authority and HealthLink in the previous edition of this very magazine, is a critical step towards finding the golden path — the EHR approach suitable for Australian patients and providers alike.

In this article I will try to look beyond this area of discussion and share some perspective on things to come. This view will encompass what we have seen happening when the rubber hits the road as Shared EHRs projects are deployed, and what becomes of them as they inevitably progress to their second and third release.

So if we close our eyes for a moment and imagine the fully functional PCEHR as described in the concept of operations, we should ask ourselves, “What’s next? Will the PCEHR be sufficient as-is?”

Applying the experience gained from Shared EHR implementation in the US, Canada, Europe and the Middle East, we anticipate several likely next stages of progression.

Lots more here:

http://www.pulseitmagazine.com.au/index.php?option=com_content&view=article&id=744:shared-ehrs-beyond-initial-deployment&catid=16:oz-hit&Itemid=227&utm_source=twitterfeed&utm_medium=twitter

I am pretty sure we need to treat this as a piece of marketing gloss.

I just love this bit - to quote “is a critical step towards finding the golden path — the EHR approach suitable for Australian patients and providers alike.”

This is arrant rubbish as there is no way any clinicians I know want to use an EHR designed for consumers and vice versa. There is just major confusion about what and why the PCEHR is.

The other point to be made is that any experience this company may have with the shared EHR’s is rendered pretty irrelevant by the fact that there is nothing like the PCEHR proposed any-where else I know of. The PCEHR is a one -off!

Second we have this press release from iSoft.

iSOFT Delivers Certified GP Desktop Panel for NEHTA PCEHR Project

Friday, July 22, 2011 - iSOFT

A major milestone in the national e-health strategy to improve the safety and quality of care in Australia has been reached with the delivery of the first NATA Accredited Conformity Assessed GP desktop to NEHTA specifications, by eHealth leader iSOFT.

iSOFT is the first of the six vendors participating in the NEHTA GP Desktop Panel project to achieve third-party conformance assessment for phase I. Independent accredited testing of iSOFT's practiX GP practice software included assessment against Medicare Notice of Connectivity (NOC) requirements for the National Health Identifiers Service, as well as NEHTA specifications for identifiers, discharge summaries and specialist letters.

The National E-Health Transition Authority (NEHTA) managed project for a personally controlled electronic health record (PCEHR), is designed to provide secure access to personal health information. The $466.7 million PCEHR system is part of a wider Commonwealth government effort to deliver a national electronically interoperable health care system.

New research, from a joint Harvard Medical School and University of South Australia study, shows that poorly coordinated care increases the risk of medical error by 100% - 200%(1). Communication between primary care physicians and hospital-based physicians is especially problematic - primary care physicians receive discharge information following hospitalisation only half of the time.

NEHTA and the federal government, hope to address these problems by developing an interoperable eHealth system that improves information flow between primary and secondary care settings.

The NEHTA-conformant practiX GP desktop software will facilitate communication between GPs and hospital-based physicians by supporting the electronic exchange of high priority clinical information such as discharge summaries, specialist letters, referrals, health summaries and medications management.

iSOFT’s ability to deliver the interoperable GP desktop so rapidly, is the result of its Health Information Exchange (HIE) solution, the technology used to enable practiX and competitive applications to participate in the national eHealth agenda.

practiX is an interoperable clinical practice management solution that supports both clinical and administrative processes and facilities coordination across care settings.

(1) C. Y. Lu, E. Roughead. Determinants of patient-reported medication errors: a comparison among seven countries. International Journal of Clinical Practice, 2011; 65 (7): 733 DOI: http://onlinelibrary.wiley.com/doi/10.1111/j.1742-1241.2011.02671.x/abstract

The full release is here:

http://www.newsmaker.com.au/news/10308

I just can’t get enough of stuff like this! You should never let the facts get in the way of an exciting press release.

The big facts are:

1. The Certification is for connection to the Health Identifier Service - not the non-existent PCEHR.

2. The NEHTA specifications for all the cited clinical documents are yet to be approved as Standards and some are still draft.

3. Transmission of documents from Hospitals to many different GP systems is well established using HL7 V2.x and a range of connectivity providers.

4. The Standards to be used for the PCEHR program have not been decided or announced as far as I know.

This is clearly a press release for another purpose as far as I can tell and is really not news and not really related to the PCEHR.

David.

Monday, July 25, 2011

Weekly Australian Health IT Links – 25 July, 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 busy week came out of nowhere this week. We had Senator Boyce talking about the PCEHR and NEHTA, we have had a few hopeful PCEHR providers out with news and releases and we had the very sad case of a very elderly GP who seems to have been struggling to make good use of his electronic prescribing system.

Also on the agenda we have a number of interesting reports on robots and the like as well as ongoing news and concerns with the Medicare Locals plan (which does have significant e-health implications).

Last we have news on the pricing of NBN connections. At first glance the numbers seem a little high but looking at my personal situation the 50Mbit/sec speed (as long as voice telephony is included) for about $100/month is not too bad - with my present costs being about the same for high speed cable and voice phone package.

Quite a big week!

Late breaking news!

The submissions on the PCEHR ConOps have reappeared!

See here:

http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/pcehrSubmissionsReceived

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http://www.australiandoctor.com.au/articles/b6/0c071bb6.asp

GP ‘failed to see warning’

21-Jul-2011

An elderly GP prescribed antibiotics for a woman who was fatally allergic to the drugs after he failed to see a warning on a computer, a coronial inquest has heard.

Tracy-Lee Davis, 34, was found unconscious by her partner an hour after she was prescribed antibiotics for an ear infection by Dr Arpad Got in Adelaide in 2009.

In an affidavit presented to the inquest, Dr Got said he prescribed Ms Davis an antibiotic in the cephalosporin drug group, the same type of drugs that had caused her to be hospitalised with an allergic reaction about five years earlier.

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http://www.6minutes.com.au/news/robots-welcomed-to-provide-nursing-home-care

Robots welcomed to provide nursing home care

With the ongoing aged care workforce crisis, nursing homes are exploring the possibility of using robots to perform routine tasks such as dispensing pills, serving meals and helping residents seek assistance.

In a study (see link) of attitudes to “assistive technologies” among nursing home staff and residents, New Zealand primary care researchers found that robots would be welcomed if they could perform tasks that would free up staff to spend more time with residents.

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http://www.theaustralian.com.au/national-affairs/uk-snaps-up-patient-tracker-system-ignored-by-local-hospitals/story-fn59niix-1226097129811

UK snaps up patient tracker system ignored by local hospitals

IT cuts admissions to intensive care units by half, reduces patient deaths and the time spent in hospital. But no Australian hospital will adopt an electronic patient tracking system developed here. Instead, it is being sold overseas.

The software, which can be used on an iPhone or other electronic system, allows nurses to record a patient's vital signs electronically. It automatically pages a doctor if the patient's condition is deteriorating.

Patientrack is the brainwave of University of Tasmania intensive care specialist Michael Buist, who wanted to find a way to remove human error from patient care and ensure doctors were always aware when patients became worse.

But Dr Buist could not get an Australian hospital to trial the system, which costs $1.5 million to roll out and pays for itself within 18 months.

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http://www.itwire.com/business-it-news/networking/48606-uberglobal-positions-itself-for-e-health-spoils

UberGlobal positions itself for e-health spoils

Local cloud services specialist UberGlobal Enterprise is positioning itself to be considered as the preferred delivery platform for online services being proposed as part of Australia’s proposed e-health revolution.

Last week the company signalled that it was working with a newly formed alliance forged by software giant Microsoft and Parallels, to demonstrate how it might be possible to deliver secure, private health information services via the cloud. It now claims it has successfully demonstrated how that can work, released a white paper documenting that, and will now start to build up a range of different services and competencies which might be attractive to healthcare professionals in the future.

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http://www.news.com.au/national/only-two-people-sacked-after-queensland-health-payroll-debacle/story-e6frfkwr-1226097215197

Only two people sacked after Queensland Health payroll debacle

IT'S the punchline to one of the Labor Government's greatest failures - the only two people sacked over the Queensland Health payroll debacle have since worked with the department.

The Courier-Mail can reveal former senior bureaucrats Adrian Shea and Michael Kalimnios have worked as consultants on QH projects in the 12 months since they were made the scapegoats for the payroll problems that have affected thousands of workers.

No one else was sacked over the incident, which will leave one of the greatest stains on this Labor administration and cost taxpayers $219 million to fix.

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http://www.computerworld.com.au/article/394236/qld_health_block_sacked_bureaucrats/

Qld Health to block sacked bureaucrats

Queensland Health is seeking legal advice over whether it can stop two top former bureaucrats fired over its payroll saga from working as private contractors for the department.

  • AAP (AAP)
  • 20 July, 2011 09:03

Queensland Health is seeking legal advice over whether it can stop two top former bureaucrats fired over its payroll saga from working as private contractors for the department.

It has been revealed that since their downfall in June last year, Adrian Shea and Michael Kalimnios have worked as private consultants for Queensland Health.

They were made scapegoats for the payroll debacle and fired in June last year, after thousands of workers in Queensland's health system were underpaid, overpaid or not paid at all for weeks after a new software system went live.

The bungle is costing taxpayers a $219 million repair bill.

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http://www.pharmacynews.com.au/news/under-co-payment-data-will-exclude-pricing-informa

Under co-payment data will exclude pricing information

Plans for Medicare Australia to collect under co-payment PBS prescription data from pharmacies will have little impact on pharmacists, the Pharmacy Guild of Australia says.

Speaking to Pharmacy News, Kos Sclavos, Guild national president, said changes to dispensing software may be required in some pharmacies to meet the requirements when they come into effect from 1 April 2012, depending on the system being used.

“There is going to be little impact except for the initial change,” he said.

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http://www.pharmacynews.com.au/news/Forgery-arrest-highlights-need-for-e-prescribing

Forgery arrest highlights need for e-prescribing

Doctors should be required to use electronic prescribing systems to help stamp out prescription fraud, the Pharmacy Guild of Australia believes, after an ACT man was charged with producing fake prescriptions.

Speaking to Pharmacy News, Kos Sclavos, Guild national president said doctors needed to be encouraged to use electronic prescribing software to prevent forged prescriptions being filled by pharmacists.

“It would be naive to think that’s not prolific in the market place,” Mr Sclavos said.

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http://www.zdnet.com.au/fujitsu-scores-wa-health-datacentre-deal-339319095.htm

Fujitsu scores WA Health datacentre deal

By Luke Hopewell, ZDNet.com.au on July 22nd, 2011

IT services company Fujitsu has scored a new datacentre and managed services support contract with WA Health, replacing the department's incumbent provider InfoHealth Alliance.

The contract will see Fujitsu relocate and manage WA Health's infrastructure out of its new datacentre in Perth, looking after the agency's servers, storage, networks and security services.

Fujitsu's deal with WA Health is set to run for four years with an option to extend.

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http://www.news.com.au/national/south-australias-medvet-blood-lab-publishes-details-of-paternity-and-drug-test-applicants/story-e6frfkx9-1226096476780

Investigation into South Australia's Medvet lab after serious privacy breach

THE South Australian Government has ordered an urgent investigation into its medical laboratory, Medvet, over a privacy bungle.

The security breach, which resulted in the online publishing of the personal details of people seeking paternity and drug tests, has also opened the door to legal action against the SA Government, or for individual compensation claims.

Customer invoices from Medvet, which is wholly owned by SA Health, were still accessible on the internet yesterday, revealing the addresses and product orders of hundreds of people.

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http://www.theaustralian.com.au/national-affairs/private-data-still-online-24-hours-after-alert/story-fn59niix-1226096403027

Private data still online 24 hours after alert

CONFIDENTIAL information relating to the paternity, drug and alcohol tests of hundreds of Australian customers could still be viewed online more than 24 hours after the company responsible was alerted to a major privacy breach.

The company, Medvet, Australia's largest for drug and alcohol testing in the workplace, did not perform a deletion exercise of its customers' cached information on Google, despite having pledged on Friday that it was doing everything possible to overcome a serious privacy breach.

Customer information including names, complete home addresses and the type of test kits ordered could still be accessed on Google late on Saturday.

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http://www.smh.com.au/technology/security/paternity-and-drug-test-details-leak-online-in-privacy-breach-20110718-1hkyn.html

Paternity and drug test details leak online in privacy breach

Asher Moses

July 18, 2011 - 3:35PM

Update 2:45pm: Medvet says it has now removed all private order information from Google's cached search results. Medvet has clarified that it first became aware of the issue on Friday, not in April as some reports have claimed.

Australians who bought drug and paternity tests from one of the country's largest providers are dealing with a serious privacy scare after details of their orders were found to be available online.

Medvet, owned by the South Australian government, appears to have failed to lock down its online order system and prevent it from being crawled by Google. Hundreds of orders of tests from people all over Australia can be found by searching Google for a specific term, which Fairfax Media has chosen not to publish.

The privacy breach was revealed over the weekend and, while the orders have been pulled from Medvet's site, all were still accessible through Google's cache as at noon today. The invoices detail specifics on the type of paternity test ordered or the specific drug that the person is being screened for.

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http://www.computerworld.com.au/article/394104/medvet_labs_investigating_patient_data_leak/

Medvet Labs investigating patient data leak

Up to 800 addresses accessible online due to software error

Underdale, South Australia-based paternity and drug-testing laboratory, Medvet Laboratories, has launched an investigation into an online software error which caused the details of 800 patient's delivery addresses and product details entered into its Web store to be visible online.

According to the company, no customer bank account details or results of tests were released as a result of the glitch, which occurred on Friday, July 15.

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http://www.computerworld.com.au/article/394063/microsoft_throws_100k_sydney_uni_medical_research/

Microsoft throws $100K at Sydney Uni medical research

First local bioelectronics course now available

Software giant Microsoft has awarded a $100,000 grant to a University of Sydney academic for research into the development of electrical devices for diagnosis and monitoring of strokes and cardiovascular diseases.

Dr Alistair McEwan from the School of Electrical and Information Engineering was awarded the Microsoft fellowship for his ongoing work in “bioelectronics”, which the university describes as an emerging field combining electrical engineering and biology.

McEwan is researching the electrode-skin interface with the aim of improving emergency diagnosis of heart attacks and strokes and long-term monitoring of cardiovascular disease. He is the university’s leading bioelectronics researcher.

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http://www.healthintersections.com.au/?p=392

Free V2 to CDA Tool Release

Background

Today, HL7 Australia held a one day meeting here in Melbourne, entitled “Implementing CDA in a v2 world“. The meeting was keynoted by Ken Rubin, who gave a very interesting and insightful discussion of the relationship between v2 messages, CDA documents, and SOA (and big thanks to Ken for making the long the trip over from Washington for a few days – instead of taking interesting photos).

Australia has a deep investment in V2, with a widely deployed distribution network that distributes v2 reports from diagnostic services, along with a mix of referrals/discharge summaries/letters between GPs. Just about all GP practices and many specialists are hooked up to the network, though the connection between the network and the tertiary referral hospitals is a bit spotty. It’s not really a network in the classic sense though, distribution is performed by private carrier companies that charge for their services (though the services they offer – clinical desktop support, administration etc are not cheap to provide).

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http://www.zdnet.com.au/e-health-more-lost-than-atlantis-339319010.htm

E-health more lost than Atlantis

By Suzanne Tindal, ZDNet.com.au on July 21st, 2011

We all love the idea of e-health — the thought of medical consultations without the inevitable, "but I already said that to ten other people, and what do you mean you need my x-rays?" — but if the Opposition is right, it may never happen.

Yesterday, Liberal Senator Sue Boyce let fly with a fiery speech (health blogger David More has published a copy on his site) detailing the long history of e-health efforts in the nation, which started well before the current government came into power, and how little we now have to show for it.

It seems that both sides of government would equally like to have a functioning system to exchange medical information, but no matter how much they huff and puff, there are still so many obstacles that it feels like trying to empty a lake with a leaky bucket.

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http://www.smh.com.au/technology/technology-news/hospital-helps-magnetic-attraction-20110720-1hp0x.html

Hospital help's magnetic attraction

Amy Corderoy Health

July 21, 2011

THEY don't have much of a bedside manner, but the newest staff members at Royal North Shore Hospital are willing to work 24/7 and never take a sick day.

A fleet of 13 computer-controlled robots will carry supplies around the new acute services building at the hospital, which is due to open next year.

Every day the robots will deliver and collect about 3600 meal trays, hundreds of clean and dirty linen items, and other waste from around the hospital, the hospital's general manager, Sue Shilbury, said.

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http://www.theaustralian.com.au/australian-it/court-approves-csc-takeover-of-isoft/story-e6frgakx-1226097438826

Court approves CSC takeover of iSoft

ISOFT founder Gary Cohen was notable in his absence from the Federal Court in Sydney yesterday, when judge Arthur Emmett approved the scheme of arrangement that will hand the company to US technology giant Computer Sciences Corporation in a $188m takeover.

Cohen had earlier fought to derail the bid in court, but was chastened when close to 97 per cent of votes were cast in favour of the takeover on Friday and chairman Robert Ellis told him: "The reason we are here today is because of how this business was mismanaged by you."

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http://www.medicalobserver.com.au/news/medicare-locals-will-fail-without-gp-leadership-ama-warns

Medicare Locals will fail without GP leadership, AMA warns

18th Jul 2011

Byron Kaye

THE AMA has used the launch of its annual Family Doctor Week to reaffirm its opposition to Medicare Locals, warning the new healthcare hubs will fail if they don’t recognise the importance of GPs on their leadership structures.

AMA president Dr Steve Hambleton said Medicare Locals (MLs) would only deliver effective local healthcare if they were “implemented correctly with the right intentions, [which] means acknowledging the key role of family doctors”.

His warning came almost three weeks after the 1 July official start date for the first 19 of what are expected to be 62 MLs around the country.

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http://www.smh.com.au/national/ama-sidelined-as-rival-invited-to-lead-new-medical-centres-20110718-1hlpp.html

AMA sidelined as rival invited to lead new medical centres

Mark Metherell

July 19, 2011

IN THE face of sniping from the Australian Medical Association, the federal government has asked a rival doctors' organisation to establish a new national body to oversee the Medicare Local network.

The government has invited the Australian General Practice Network to undertake the national co-ordination of the fledgling Medicare Locals being introduced to provide integrated care by doctors, nurses and other practitioners, such as physiotherapists.

The offer represents a knock to the traditional influence of the AMA which has previously enjoyed a favoured position under the Howard and Rudd governments.

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http://www.medicalobserver.com.au/news/gps-set-to-ditch-medicare-locals-contract-over-board-restrictions

GPs set to ditch Medicare Locals contract over board restrictions

19th Jul 2011

Byron Kaye

GPs at a division awarded one of the first Medicare Locals contracts have warned the Federal Government that they will “walk away” from the deal if they are forced to give up control on their boards.

Medical Observer understands the contracts, sent to many of the first 19 winning bidders in recent weeks, explicitly state the Medicare Local (ML) must have a board of 7–10 directors with no single profession dominating.

NSW division, GP Access, is involved in one of the first tranche of MLs, and currently has six GPs among its eight board members. Board member Dr Arn Sprogis said the clause was “obviously aimed at GPs”.

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http://www.6minutes.com.au/news/agpn-to-oversee-medicare-locals

AGPN to oversee Medicare Locals

The AGPN has hit back at claims that a national body is not needed to oversee the Medicare Local network as it was invited by the government today to take on the role.

The Federal government has announced (see link) it is inviting the AGPN to form a new national body to help the planned network of 62 Medicare Locals “achieve their goals” by providing national leadership and co-ordinating closely with other parts of the healthcare sector.

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http://www.smh.com.au/digital-life/computers/blogs/gadgets-on-the-go/open-wifi--no-sympathy-20110718-1hl6v.html

Open Wi-Fi = no sympathy?

July 18, 2011 - 4:51PM

Do people get what they deserve if they leave their Wi-Fi network unsecured?

Would you feel sorry for someone who had their car stolen, if you discovered they’d left their keys in the ignition and the doors unlocked? What if their house was robbed after they went on holidays and left the front door wide open? Leaving your home Wi-Fi network unprotected is just as stupid, yet people still do it.

If you’ve got a Wi-Fi network, at home or at work, it’s essential to secure it by enabling WPA encryption and setting a password. Firstly you’re protecting yourself against leeches looking for free bandwidth, who could leave you with a throttled connection or a hefty excess data bill. You’re also guarding yourself again people using your network to do dodgy things while letting you take the blame. It’s still possible to hack into a secure network, but few people would bother unless they’re really out to get you like the neighbour from hell.

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http://www.smh.com.au/technology/technology-news/prices-for-superfast-broadband-up-to-190-a-month-20110721-1hqzw.htm

Prices for superfast broadband up to $190 a month

Lucy Battersby

July 22, 2011

THE first retail price plans for the government-built broadband network have been released, with consumers set to pay similar prices for the same services available in metropolitan areas now.

But services will become more expensive as speeds and download limits rise - reaching $190 a month for the highest speeds and download limits.

The mid-sized internet provider Internode is the first company to release its retail prices on the national broadband network. Plans start at $60 a month, including line rental and some telephone calls.

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http://www.theaustralian.com.au/australian-it/internode-buckets-nbn-pricing/story-e6frgakx-1226099220064

Internode buckets NBN pricing

SIMON Hackett, chief of South Australian headquartered ISP Internode, has come out swinging at the NBN Co as the company announced its NBN pricing plans.

Mr Hackett has pointed the blame squarely at the NBN Co in an extensive blog which accompanied the ISP's press announcement on pricing.

Internode has been forced to offer prices well in excess of those it charges customers for copper-based ADSL2+ services.

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Enjoy!

David.

AusHealthIT Poll Number 80 – Results – 25 July, 2011.

The question was:

SHOULD The Federal E-Health Program Become An Election Issue At the Next National Election?

For Sure

- 16 (43%)

Probably

- 6 (16%)

Neutral

- 1 (2%)

Probably Not

- 9 (24%)

No Way

- 5 (13%)

A reasonably balanced poll. A majority seem to think there should be some sort of political interest taken in the e-Health Program.

Votes : 37

Again, many thanks to those that voted!

David.

Sunday, July 24, 2011

Some Thoughts On the Reactions to Senator Boyce’s Comments on NEHTA and the PCEHR.

It has now been a few days since we noted Senator Sue Boyce’s remarks on NEHTA and DoHA’s plans for the PCEHR.

Here are links to some of the additional reactions I have noted.

http://www.itwire.com/it-policy-news/government-tech-policy/48646-nehta-responds-to-lib-attack

Nehta responds to Lib attack

The National eHealth Transition Authority has responded to the no-holds barred attack it faced yesterday from Queensland Senator Sue Boyce who accused it of poor progress in terms of delivering an electronic health platform for all Australians, and also called into question the value of a personal controlled electronic health record (PCEHR).

Nehta said yesterday that it wanted to carefully review what Senator Boyce had said before responding.

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http://www.theaustralian.com.au/australian-it/government/labor-bites-back-as-boyce-calls-for-nehta-overhaul/story-fn4htb9o-1226099764920

Labor bites back as Boyce calls for NEHTA overhaul

  • Fran Foo
  • From: Australian IT
  • July 22, 2011 12:50PM

Queensland Liberal Senator Sue Boyce has criticised NEHTA. Picture: Ray Strange Source: The Courier-Mail

A WAR of words has erupted between Liberal Senator Sue Boyce and the government over the $466.7 million personally controlled e-health record (PCEHR) project.

Senator Boyce called for radical changes to the National E-Health Transition Authority's structure after proposing the PCEHR project be paused.

She said a Coalition government, if in power, needs to do a thorough review of the purpose for the scheme before committing more funds.

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http://www.itwire.com/it-policy-news/government-tech-policy/48627-libs-monster-nehta-could-cull-pcehr-

Libs monster Nehta, could cull PCEHR

The Personally Controlled Electronic Health Record – which has secured Government funding of more than $466 million – could be scrapped by a Liberal Government. Senator Sue Boyce, Liberal Senator for Queensland, used a speech at a Sydney health administration conference today to claim there was no established evidence-based case for the benefits of a PCEHR; attack the National eHealth Transition Authority; and, brand much of the Government investment made to date in e-health initiatives a waste of taxpayer money.

Senator Boyce characterised her speech as “a possible platform for the Liberal Party’s intended direction.”

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http://australian-politics.blogspot.com/2011/07/crazy-plan-to-computerize-medical.html

Saturday, July 23, 2011

Crazy plan to computerize medical records nationwide

This is an absolute lulu. Big new computer programs generally do not work and Queensland health can't even get its payroll software working after over a year of trying. And the Brits had a similar medical records plan -- on which they spent OVER 12 BILLION POUNDS before they gave up on it after many years of trying to get it to work

THE Opposition has called on the Gillard government to hit the pause button on the $467 million electronic health records project until a "thorough assessment" on e-health is conducted.

The call comes less than 12 months from the roll out of the opt-in, personally controlled e-health record (PCEHR) system.

In a vitriolic speech, Queensland Liberal Senator Sue Boyce ironed out what she described as "failures" in e-health implementation over the years. She gave participants at a health administration conference in Sydney a history lesson on public sector e-health initiatives since the late 1990s during the Howard era and vowed to share what "needs to happen next".
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From NEHTA we have the following as reported by Beverley Head (link above).

“This morning a Nehta spokesperson without directly referring to the Senator’s speech said the organisation’s programme; “To support a connected health system for Australia is both ambitious and achievable. It’s been forecast that by 2020 the improvements we’re working towards will save at least 5,000 lives and $7.6 billion each year across Australia.

“We’re confident about delivering a world leading Personally Controlled Electronic Health Record system and we have a skilled and committed team working very hard to make sure this happens.”

And we have comments from Acting Health Minister Mark Butler reported by Fran Foo in The Australian (link above also).

----- Begin Extract

“Acting federal Health Minister Mark Butler said it was interesting that Senator Boyce was criticising a governance model created by Mr Abbott.

"There's one thing that Senator Boyce and Tony Abbott are united on however -- they want to cut all funding for e-health from the budget," Mr Butler said.

"If funding is cut, patients will miss out on the huge benefits that e-health records will bring.

"As Senator Boyce should know (since she was there), NEHTA is appearing at Senate estimates committee hearings," he said.

Senator Boyce said in her view: "what a Coalition government needs to do is thoroughly review the purpose of a national e-health system before committing another cent".

"It seems to me that the providers' needs and the consumers' needs, especially taking into account privacy concerns, are unlikely to be met by the same universal system ... interfacing systems may be the answer.

"There will be patients who are prepared to sacrifice privacy in return for the convenience of a single repository of their entire medical history, but not all," she said.

Mr Butler said the government had released a draft Concept of Operations and a draft legislative issues paper, "both of which set out very strong privacy protections as part of this patient controlled system".

He said the Senator's comments were misleading. "This will not be one single repository for information as Senator Boyce misleadingly says. Maybe she should go back and do her homework before her next speech".

----- End Extract

Senator Boyce has provided further text relating to her remarks of last Monday to address the area of what she is hoping to see going forward. I quote (with permission):

“In my view, what a Coalition Government needs to do is thoroughly review the purpose of a national e-health system before committing another cent.

It seems to me that the providers’ needs and the consumers’ needs, especially taking into account privacy concerns, are unlikely to be met by the same universal system. Interfacing systems may be the answer.

There will be patients who are prepared to sacrifice privacy in return for the convenience of a single repository of their entire medical history, but not all.

We also need to clarify if it is technically possible to develop a system that enables all data to be collected in a patient controlled record. NeHTA says yes, but many experts in the field say no. Certainly a system that allows the results of a GP consultation to be uploaded into a PCEHR doesn’t currently exist.

My biggest concern is the current structure of NeHTA and ensuring that any ‘son of NeHTA’ is not structured the same way.

The Board of NeHTA is currently all the secretaries of the jurisdictional Health departments. An independent chair, David Gonski, has been appointed as a nod towards the lack of commercial experience amongst the other directors.

I would prefer to see a Board similar in structure to AIHW with a mix of stakeholder and government appointees.

The Board also needs to be accountable to “someone” other than COAG. NeHTA should be required by law, not ministerial whim, to be accountable to Parliament, through appearances at Senate Estimates, and it should be subject to the Freedom of Information Act.

The answer to getting an e-health system ready to “burst out the front door” will not be easy but it starts with accountability and transparency.”

----- End Quote.

What to make of all this.

From my perspective I have been saying for years that NEHTA is appallingly unaccountable and so certainly would welcome any Opposition move to improve NEHTA’s governance as was recommended both by Deloittes and the Boston Consulting Group. (Note there is still not one member of the NEHTA board who is an acknowledged e-Health expert!)

It is really pleasing Senator Boyce recognises the fundamental importance of governance in the overall success of e-Health initiatives.

It is also pleasing to see the idea of the differing needs of consumer and professional systems being picked up in both sets of documentation. I explored this issue a week or so ago here:

http://aushealthit.blogspot.com/2011/07/i-think-i-have-now-worked-out-why-pcehr.html

On the basis that NEHTA is essentially the monkey to the organ grinder of the Commonwealth Department as far as the PCEHR is concerned, (DoHA has control of the funds!) it would seem sensible for DoHA to engage with Senator Boyce sooner rather than later to properly understand what is needed to obtain bi-partisan support. Without this an already imperilled program is utterly doomed!

David.

ps. If you haven’t looked at the comments on PCEHR and Standards you may find the views expressed interesting:

http://aushealthit.blogspot.com/2011/07/it-looks-like-desperation-and-heavy.html#comments

D.