Some Useful Pointers on Health IT Errors. What Does This Mean For the PCEHR?

A very interesting article on an article in the Archives of Internal Medicine appeared a few days ago.

Researchers propose method for counting health IT errors

By Joseph Conn

Posted: July 25, 2011 - 6:00 pm ET

A pair of Texas informatics researchers has come up with a classification scheme for categorizing—and ultimately counting—errors involving health information technology.

Their proposal is outlined in a four-page article, "Defining Health Information Technology-Related Errors: New Developments Since 'To Err is Human'" that appears in the July 15 issue of the Archives of Internal Medicine. It references the totemic 1999 study on medical errors, "To Err is Human," by the Institute of Medicine.

The authors of the article are Dean Sittig, a professor in biomedical informatics at the University of Texas Health Science Center, Houston; and Dr. Hardeep Singh, an assistant professor of medicine at the Michael E. DeBakey Veterans Affairs Medical Center, Houston, and Baylor College of Medicine. Sittig is an adjunct associate professor at the Baylor College of Medicine and the founding editor of The Informatics Review, the electronic journal of the Association of Medical Directors of Information Systems. Singh also serves as the chief of the health policy and quality program at the Houston VA's Health Services Research and Development Center of Excellence.

Sittig, in a telephone interview, said the idea for the classification scheme came after he testified about IT-related errors before an IOM panel in December. A fellow witness also spoke about medication errors. Afterward, Sittig said he was approached by an IOM person who asked whether a definition existed for EHR errors. "We decided there really wasn't any," Sittig said, which led to their research and this report.

"There are a lot of people who don't seem to understand when their EHR is responsible for something that happens," he said. "This is what we think constitutes an electronic health-record system error. By creating this definition, people can start to realize we have a problem. We're trying to heighten people's awareness of these things so they come to mind when it happens."

First, Sittig and Singh report as established fact that health IT-linked errors are real, citing 19 types of actual errors—many gleaned from their literature search and others from the authors' own knowledge. The error types are listed in a table that also presents a "sociotechnical model" for health IT evaluation and use that provides "an origin-specific typology for HIT errors."

There is more found here:

http://www.modernhealthcare.com/article/20110725/NEWS/307259891/

There is also coverage here:

How Health IT-Related Errors Hurt Patient Safety

New analysis explains how the occasional glitches with EHRs and related systems can get out of hand.

By Ken Terry, InformationWeek

July 26, 2011

URL: http://www.informationweek.com/news/healthcare/patient/231002617

As an Institute of Medicine (IOM) committee considers how medical errors related to health IT affect patient safety, a new analysis published in the Archives of Internal Medicine defines these errors, breaks down their "sociotechnical" sources, and suggests some fixes.

"These errors, or the decisions that result from them, significantly increase the risks of adverse events and patient harm," write Dean Sittig and Hardeep Singh in the Archives article. The reason, they explain, is that "there are often latent errors that occur at the 'blunt end' of the health care system, potentially affecting large numbers of patients if not corrected."

In an interview with InformationWeek Healthcare, Sittig, a professor at the University of Texas Health Sciences Center in Houston, explained that problems in a health information system are usually caught fairly soon. But, because they may affect an entire hospital or a multi-hospital system, they can cause a lot of harm in a short time, he said.

Here is the formal abstract from the Archives

HEALTH CARE REFORM

Defining Health Information Technology–Related Errors

New Developments Since To Err Is Human

Dean F. Sittig, PhD; Hardeep Singh, MD, MPH

Arch Intern Med. 2011;171(14):1281-1284. doi:10.1001/archinternmed.2011.327

Despite the promise of health information technology (HIT), recent literature has revealed possible safety hazards associated with its use. The Office of the National Coordinator for HIT recently sponsored an Institute of Medicine committee to synthesize evidence and experience from the field on how HIT affects patient safety. To lay the groundwork for defining, measuring, and analyzing HIT-related safety hazards, we propose that HIT-related error occurs anytime HIT is unavailable for use, malfunctions during use, is used incorrectly by someone, or when HIT interacts with another system component incorrectly, resulting in data being lost or incorrectly entered, displayed, or transmitted. These errors, or the decisions that result from them, significantly increase the risk of adverse events and patient harm. We describe how a sociotechnical approach can be used to understand the complex origins of HIT errors, which may have roots in rapidly evolving technological, professional, organizational, and policy initiatives.

This can be found here:

http://archinte.ama-assn.org/cgi/content/abstract/171/14/1281

If you have access via an academic library or CIAP the full text is available from this link.

The last paragraph of the conclusion really says it all.

“In conclusion, rapid advances in HIT development, implementation, and regulation have complicated the landscape of HIT-related safety issues. Erroneous or missing data and the decisions based on them increase the risk of an adverse event and unnecessary costs. Because these errors can and frequently do occur after implementation, simply increasing oversight of HIT vendors' development processes will not address all HIT-related errors. Comprehensive efforts to reduce HIT errors must start with clear definitions and an origin-focused understanding of HIT errors that addresses important sociotechnical aspects of HIT use and implementation. To this end, we provide herein a much needed foundation for coordinating safety initiatives of HIT designers, developers, implementers, users, and policy makers, who must continue to work together to achieve a high-reliability HIT work system for safe patient care.”

It seems to me the bar has been dramatically raised on our expectations of what Health IT can deliver and how well designed and delivered it must be.

Those rushing to deliver the PCEHR should understand - they have been warned that doing what they are attempting is a great deal harder than it might initially appear. It also seems likely that pretty much no-one has got it fully right - or even close - just yet!

David.

Will This Be the Fate of the PCEHR? The Way It Is Going I Would Not Be Surprised.

The following report appeared a few days ago.

MPs blast government IT failures

28 July 2011 Lyn Whitfield

The Commons’ public administration committee has concluded that the government’s lack of IT skills and over-reliance on an “oligopoly” of large contractors is a “recipe for rip-offs.”

In a report that echoes the findings of successive spending watchdog investigations into government IT, the committee says that the “overall record of developing and implementing new IT systems is appalling” despite an “obscene” amount of public spending.

Although it did not take evidence from the Department of Health, the committee’s verdict that “IT procurement has too often resulted in late, over budget IT systems that are not fit for purpose” sounds very like the latest National Audit Office verdict on the National Programme for IT in the NHS.

In its third report on the project, which focused on detailed care record systems, the NAO concluded that successive contract negotiations had delivered less functionality to fewer trusts for hardly any less money; so the programme had not delivered value for money and was unlikely to do so.

Committee chair Bernard Jenkin said: “The government has said that it is overly reliant on an ‘oligopoly’ of suppliers; some of our witnesses went further and described the situation as a ‘cartel’.

“Whatever we call the situation, it has led to an inexcusable situation that sees government waste an obscene amount of public money.”

The PASC acknowledges that while successive governments have failed at large IT projects, they have also tried to find out what keeps going wrong. Its report says the NAO found 30 major cross-government policies, reviews and strategies of IT from 2000 to 2010.

It also finds that most of these reviews identified common problems; such as projects being: too big; open to only a limited range of suppliers; duplicating work that had already been done elsewhere; not interoperating with other systems; being poorly managed; and failing to engage users.

The PASC also accepts that the present government has tried to address these problems; for example by: “creating a presumption against projects having a lifetime value of more than £100m”; creating an asset register and cross-public sector app store; promoting open source software and open standards; and trying to hold ministers and senior responsible owners to account.

The Cabinet Office, under its minister Francis Maude, has been leading on these efforts, and is known to be taking an active interest in the NPfIT local service provider contract that still has to be decided for the North, Midlands and East of England, where CSC has missed a number of deadlines to deliver Lorenzo to trusts.

However, the PASC says that it is still not clear that the government has “grasped the fundamental causes of failure or simply listed its systems.”

More here:

http://www.ehi.co.uk/news/EHI/7058/mps-blast-government-it-failures

The real key paragraph is this one.

“It also finds that most of these reviews identified common problems; such as projects being: too big; open to only a limited range of suppliers; duplicating work that had already been done elsewhere; not interoperating with other systems; being poorly managed; and failing to engage users.”

Now, thinking of the PCEHR program.

- Too Big - Tick

- Open to Limited Suppliers - Tick

- Duplicating Work Already Done Elsewhere - Partly

- Not Interoperable - Think Wave 1 and 2 Projects

- Poorly Managed - Think IHI service and NEHTA’s implementation capabilities

- Failing to Engage Users - Public and Docs really don’t know what is going on.

There is little doubt we are setting ourselves up to fail. Especially with no real decent scale piloting and doing things in a politically set rush!

How sad is this when we could have done so much better for the money?

David.

DoHA / NEHTA Provides Some Analysis on the Submissions Regarding the Draft PCEHR Concept of Operations.

The following appeared in the Google Cache a day or so ago.

Here is the link:

[PDF] PCEHR Concept of Operations Public Consultation Submissions ...

www.yourhealth.gov.au/.../...

File Format: PDF/Adobe Acrobat - View as HTML

PCEHR Concept of Operations Public Consultation Submissions Process: Analysis of Key Themes. 3. 1 Introduction. In the 2010/11 Federal Budget, ...

The full text is currently viewable using the View as HTML link.

PCEHR Concept of Operations Public Consultation Submissions Process: Analysis of Key Themes

Here is the table of contents.

Table of Contents

1 Introduction ............................................................................................ 3

2 Analysis of submissions ........................................................................... 5

2.1 Overview .............................................................................................. 5

2.2 Acknowledgement of submissions ...................................................... 6

3 Process review ........................................................................................ 7

3.1 Overview of the ConOps submissions review process ........................ 7

4 Common themes .................................................................................... 9

4.1 Summary view of themes ................................................................. 10

4.2 Access control, security and privacy ................................................. 11

4.3 General design suggestions .............................................................. 12

4.4 Information model ............................................................................ 13

4.5 Long term governance and sustainability ......................................... 14

4.6 Administrative overhead of PCEHR and remuneration provisions .... 15

4.7 Policy and legislation ......................................................................... 16

4.8 Adoption of the ‘opt in’ model .......................................................... 17

4.9 Implementation planning and road map ........................................... 18

4.10 Rural, aged care, disability and mental health provisions ............... 19

4.11 Secondary use of data ..................................................................... 20

4.12 Legal and liability.............................................................................. 21

4.13 Education of stakeholders ............................................................... 22

4.14 Interest to be more involved with delivery of the e-health System . 23

4.15 Accessibility / Considerations for people with limited or no

access to a computer ............................................................................. 24

4.16 Integration with existing healthcare systems ................................ 25

4.17 Platform mobility .......................................................................... 26

5 Next Steps .......................................................................................... 27

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In terms of frequency of matters raised we had:

Access control, security and privacy - 17.6%

General design suggestions -11.2%

Information model - 9.8%

Long term governance and sustainability -8.1%

Administrative overhead / PCEHR and remuneration provisions -7.2%

Policy and legislation - 6.2%

Adoption of the ‘opt in’ model - 5.8%

Implementation planning and road map - 5.8%

Rural, aged care and mental health provisions - 5.3%

Secondary use of data 4.5%

Legal and liability concerns - 4.5%

Education of stakeholders - 4.3%

Interest to be more involved with delivery of the e-health system - 4.2%

Accessibility / Considerations for people with limited or no access to a computer - 3.3%

Integration with existing health care systems -1.7%

Platform mobility - 0.6%

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So far so good and there are useful things reported under each heading.

What may give a little more pause is this:

5 Next Steps

The draft ConOps document will be revised to incorporate changes based on the themes and key points identified in the public consultation process. The ConOps document is expected to be finalised in August 2011.

Numerous points raised during the ConOps consultation process have been identified as being change and adoption issues. These points will be taken in to consideration by the National Change and Adoption Partner and incorporated into the work being undertaken to plan, design and develop training, guidance and tools in collaboration with healthcare providers and software providers.

Many points also related to the detailed implementation of the PCEHR system, and will be considered as part of the work that is currently being done on the design of the PCEHR’s detailed requirements, and also the work that will be performed by the National Infrastructure Partner. It is anticipated that the lessons learnt from eHealth sites will also be taken into consideration in the detailed design of the PCEHR system.

DoHA and NEHTA will continue to actively engage in a process of ongoing consultation with key stakeholder groups, including consumers, healthcare providers, the ICT industry, and state and territory governments. As part of this process, the PCEHR System: Legislation Issues Paper has been released for public comment and feedback. The paper covers issues such as participation in the system by individuals, healthcare providers and system operators, access controls, privacy, security and governance. Submissions on the PCEHR System: Legislation Issues Paper will be accepted until 5 p.m. AEST Wednesday, 3 August 2011.

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One just wonders just how much of all this is really just ‘kicking the can down the road’ rather than actually changing the overall ConOps to address needed changes. The end of August will tell us I guess.

I note my submission is not mentioned despite the submission e-mail explicitly saying it could be used - it is however on the www.yourhealth.gov.au site. I wonder why it was not mentioned?

I also wonder why the .pdf has disappeared? It was clearly there at one point for the Google Spider to find it!

Enjoy reading the detail at the link above.

David.

Weekly Australian Health IT Links – 01 August, 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

The first article concerns an apparent technology innovation which, if true, will certainly have a major impact on the NBN build out and does demonstrate the broader lesson that picking ‘technological winners’ is a fool’s game. This is a perfect example of why this is the case.

This is certainly a story to watch!

What follows is links to all sorts of interesting stuff that really seems to show we have a small groundswell of activity happening the e-Health space. A good thing.

All in all not a boring week at all!

Late Note: The results for the Infrastructure Partner for the PCEHR will be announced very soon. Only a few legal issues to be sorted I am told. Watch this space!

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http://www.theaustralian.com.au/national-affairs/wireless-challenge-to-future-proof-nbn/story-fn59niix-1226104623595

Wireless challenge to 'future-proof' NBN

• Mitchell Bingemann
• From: The Australian
• July 30, 2011 12:00AM

A TECHNOLOGY guru who has been described as the Thomas Edison of Silicon Valley claims to have developed a new wireless technology that could one day rival the download speeds on the National Broadband Network.

The new technology, called DIDO, allows internet users to access download speeds up to 1000 times faster than possible on conventional wireless networks, without any fall in speed as more users get on to the network.

Opposition communications spokesman Malcolm Turnbull said the wireless breakthrough underlined the importance of being "technology agnostic" when it came to choosing broadband solutions to meet the nation's needs.

The federal government has pledged to spend $36 billion to roll out a fibre-to-the-premises network to 93 per cent of the nation over the next 10 years. The remaining 7 per cent will be served with a mix of wireless and satellite broadband technologies.

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http://www.smh.com.au/technology/technology-news/thousands-of-privacy-breaches-going-unreported-20110727-1hzes.html

Thousands of privacy breaches going unreported

Asher Moses

July 27, 2011 - 12:49PM

Privacy breaches affecting Australians are flourishing but laws provide inadequate protections.

There has been a 27 per cent jump in the number of incidents of stolen or lost personal information reported to the Privacy Commissioner in the past year but inadequate laws mean thousands of incidents go unreported.

At a seminar held this morning by the International Association of Privacy Professionals, the Privacy Commissioner, Timothy Pilgrim, revealed his office had received 56 data breach notifications in the year to June 30 - up from 44 in the previous year.

However, Pilgrim warned that this only included responsible companies that voluntarily owned up to losing personal information as the government had failed to introduce mandatory data breach notification laws.

The worst offenders often got away with little accountability and forensic investigators say almost all incidents they investigate on behalf of companies are not made public.

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http://www.brisbanetimes.com.au/opinion/society-and-culture/the-truth-that-sets-us-free-20110729-1i44u.html

The truth that sets us free

Frank Moorhouse

July 30, 2011

Opinion

Illustration: Michael Mucci

Revealing more about our lives helps break down stigma. Privacy law threatens to reinforce it.

I think we would agree - in some hazy way - that privacy as a value, and behaviour surrounding the idea of privacy, are considered fundamental in a good society and to our sense of self. But the more I've thought and conversed about this haziness the more I have had reason to be fearful about the enterprise of legal codification of privacy and have, ultimately, come to oppose it.

Some of my thinking is also, I suspect, wishful thinking springing from my own unorthodox values about candour, but even wishful thinking is part of the ethos-making process. The word ''privacy'' is a conceptual and semantic labyrinth and while, in some relatively rare situations, it can be used precisely, its use generally requires much discourse to establish that precision.

The report by the Australian Law Reform Commission on privacy laws was delivered to Parliament in 2008 and it has taken a long time to gain wider public attention but even there it is stalled by complexity. The defeating complexity is illustrated by the physical report itself. The result of two years' research, consultation and analysis, it runs to 2700 pages in three volumes and put forward 295 recommendations for change. In 2009 the Federal Government accepted 141 of the recommendations - 34 with qualification - and two others were noted. Acceptance does not mean that action will be taken. That is, less than half of the recommendations were accepted, which itself illustrates how far we are from clarity or a consensus on the questions of privacy.

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http://www.australiandoctor.com.au/articles/96/0c071d96.asp

GPs top health website referrers

28-Jul-2011

David Brill

GPs are ahead of other Australian health professionals when it comes to embracing websites as a source of information for their patients, research finds.

A new survey reports that 86% of GPs routinely recommend a health website to their patients -- a higher proportion than psychiatrists, pharmacists, dietitians, social workers or chiropractors.

And just 42% of physiotherapists and 33% of optometrists typically recommend websites to their patients -- making these the most reluctant groups to recommend websites, the study found.

HealthInsite was the top site recommended by GPs, followed by the beyondblue and Diabetes Australia websites. Psychiatrists, meanwhile, favoured the Black Dog Institute, beyondblue and MoodGYM websites.

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http://www.computerworld.com.au/article/395251/australian_it_health_spending_tipped_reach_2_1_billion_ovum/

Australian IT health spending tipped to reach $2.1 billion: Ovum

Technology infrastructure development will drive growth by 2016, says analyst firm Ovum

• Hamish Barwick (Computerworld)
• 28 July, 2011 15:26

Local IT health expenditure is expected to reach $2.1 billion by 2016, according to a report by analyst firm Ovum, which is driven by increased spending on electronic health records (EHRs), picture archiving and telehealth services.

In the firm’s latest IT healthcare market forecast, the drive to cut costs in the sector, as well as improve patient services were highlighted as key reasons for increased spending.

Ovum analyst, Cornelia Wels-Maug, said telehealth services, such as the monitoring of conditions via telecommunications technology and EHR, were predicted to provide the strongest growth.

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http://www.smh.com.au/entertainment/tv-and-radio/q--pay-thats-the-answer-20110730-1i5k5.html

Q & pAy, that's the answer

Andrew Taylor and Jim O'Rourke

July 31, 2011

TONY JONES, host of the ABC program Q&A, is being paid to run mock versions of his influential discussion show at business conferences.

Prominent figures in the healthcare and information technology industries, as well as senior federal government bureaucrats, will be at the ''HIC 2011 Q&A with Tony Jones'' - promoted as one of the premier events at the conference on e-health opening in Brisbane tomorrow. Jones hosted a similar Q&A at the HIC 2010 conference in Melbourne last August.

The ABC, which gave Jones permission to conduct the sessions, says the moonlighting does not amount to media training or breach any of its editorial policies covering independence and conflict of interest.

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http://www.6minutes.com.au/news/pcehr-targets-unrealistic-say-software-companies

PCEHR targets unrealistic, say software companies

• By Gemma Collins on 28 July 2011

It is unrealistic to expect the government’s planned Personally Controlled Electronic Health Record system (PCEHR) to be up and running by next year, according to medical software makers.

The Medical Software Industry Association says it is a “very tight” timeframe to expect the system to be introduced by July 2012 and immediate action is needed to ensure more “appropriate” timeframes are developed.

In a submission to the consultation on the PCEHR system, (link) the MSIA criticises the government’s draft proposal which it says does not cover some key matters including how it intends to educate Australians about the benefits of the system.

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http://www.computerworld.com.au/article/395081/info_sa_hospital_inpatients_online/

Info on SA hospital inpatients online

Shows information on bed occupancy, length of stay and number of surgical or critical care patients

• AAP (AAP)
• 27 July, 2011 11:08

Real-time information about the number of patients being treated in South Australia's metropolitan hospitals is now available online.

South Australian health minister John Hill said the inpatient dashboard featured on the SA Health website provides information on the number of patients at each hospital.

The link which is updated every thirty minutes, includes information on bed occupancy, average length of stay, as well as the number of patients in each area of the hospital including surgical or critical care.

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http://ehealthspace.org/news/telehealth-gets-racgp-partner-boost

Telehealth gets RACGP partner boost

Posted Tue, 26/07/2011 - 10:33 by Josh Gliddon

The Royal Australian College of General Practitioners (RACGP) has met with leading telehealth providers to discuss telehealth opportunities for its members.

The College met with a range of organisations including IBM, Medibank, Microsoft, Telstra and Optus. NEHTA clinical lead and federal government broadband champion, Mukesh Haikerwal, chaired the meeting.

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http://www.racgp.org.au/standards/telehealth

RACGP Telehealth standards project

The Royal Australian College of General Practitioners (RACGP) recognises that telehealth provides considerable opportunities to improve health outcomes and access for patients to 'attend' a consultation without some of the personal inconvenience and personal or travel costs ordinarily involved in a typical face-to-face consultation.

To guide GPs through telehealth consultations and provide a safety and quality framework for patients and GPs, the RACGP is working on a number of telehealth initiatives, including the development of standards for general practices offering video consultations and an online training and education module on video consultations that will be available next year.

The College is pleased to announce that the Department of Health and Ageing has engaged the RACGP in a project to develop standards for general practices offering video consultations.

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http://www.theaustralian.com.au/australian-it/opinion/time-to-use-nbn-to-deliver-better-cheaper-e-health/story-e6frgb0o-1226101599483

Time to use NBN to deliver better, cheaper e-health

• ACS: Anthony Wong
• From: The Australian
• July 26, 2011 12:00AM

AS the infrastructure for the National Broadband Network rolls out across the nation, work is ramping up on the applications that will leverage the power of high-speed broadband to drive economic growth and improve our quality of life.

Of these applications, one of the most critical is e-health, which promises to reduce the cost of healthcare while improving access to health services for all Australians, regardless of location.

The risks, and need for diligence around implementing e-health systems, are high in light of recent failures both locally and overseas.

According to the Australian Bureau of Statistics, annual health expenditure grew by 45 per cent between 1997 and 2007 to reach $4507 per person. With the rising incidence of chronic conditions such as heart disease, cancer, asthma, obesity and diabetes, combined with our ageing population, heath costs are set to soar.

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http://www.medicalobserver.com.au/news/data-danger

Data danger

25th Jul 2011

The blueprint on how the national e-health records scheme will be stored and managed is a minefield of medico-legal concerns, writes Leigh Parry. Leigh Parry

IN JUST one year, your patients will have unprecedented access to their medical records – not only will they be able to view their records online, but they will be able to control who sees them, and even add their own notes.

In theory, the personally controlled electronic health record (PCEHR) scheme will drive safer, more efficient and better quality healthcare – as Health Minister Nicola Roxon says, “Patients will no longer have to remember every immunisation, every medical test and every prescription as they move from doctor to doctor.”

Doctor groups are generally supportive of the scheme, which aims to address the fragmentation of medical records that exist across a vast array of different systems.

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http://www.6minutes.com.au/news/gp-software-gets-nehta-accredited

GP software gets NEHTA accredited

• By Gemma Collins on 25 July 2011

Plans for the $467 million personally controlled e-health record system are getting under way as a GP practice software becomes NEHTA accredited.

iSOFT which runs the practiX GP software says it is the first NEHTA conformant desktop software (link) as part of the implementation personally controlled e-health record (PCEHR) system.

It says the software will enable communication between GPs and hospital-based doctors, by allowing the exchange of clinical information through discharge summaries, specialist letters, referrals, health summaries and medications management.

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http://ehealthspace.org/news/racgp-inks-precedence-ehealth-deal

RACGP inks Precedence ehealth deal

Posted Mon, 25/07/2011 - 10:30 by Josh Gliddon

The Royal Australian College of General Practitioners’ (RACGP) business arm, RACGP Oxygen, has inked a deal with clinical software provider Precedence that will see it offer the cdmNet online service to GPs treating chronically ill patients.

According to RACGP Oxygen chief executive Mark Donato, the new software will make it easier for GPs to interact with other members of the patient’s care team along with the patient.
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http://www.australiandoctor.com.au/articles/af/0c071daf.asp

Medicare Local in ASIC probe

28-Jul-2011

Paul Smith

ONE of the Federal Government's Medicare Locals appears on the brink of collapse after the Australian Securities and Investment Commission was called in to investigate a planned merger between two divisions to create the new organisation.

Murrumbidgee General Practice Network was to merge with the Riverina Division of General Practice to create one of the 19 new Medicare Locals due to be launched on 1 July. The current chair of Riverina is Dr Tony Hobbs, former AGPN leader and who is considered the architect of the government’s $460 million Medicare Local reforms.

But the board of Murrumbidgee claimed in a statement this morning there were "apparent failures in due process and inadequate disclosure of information by certain parties on matters of material significance to the merger".

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http://www.smh.com.au/technology/security/software-takes-brain-power-out-of-hacking-20110727-1i076.html

Software takes brain power out of hacking

Asher Moses

July 28, 2011

Self-taught hacker driven by ego

The Federal Government is warning businesses to better protect themselves after a man was charged with allegedly hacking into the National Broadband Network.

EVEN if David ''Evil'' Cecil is guilty, he is not necessarily a hacking mastermind. Computer security professionals say breaking into websites and computer networks is now as simple as downloading free software, selecting a target and hitting ''run".

Even without a specific target in mind, a method called ''Google hacking'' allows hackers to find target servers running vulnerable software using just the search engine.

''If an attacker wants to get in, it's just a matter of time really,'' Ty Miller, the chief technology officer at Pure Hacking, said.

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http://www.theaustralian.com.au/national-affairs/electronic-health-files-secure-despite-nbn-hacking-minister-insists/story-fn59niix-1226103013428

Electronic health files secure despite NBN hacking, minister insists

• Sean Parnell and Ben Packham
• From: The Australian
• July 28, 2011 12:00AM

THE Gillard government has moved to assure Australians, and the booming e-health industry, that even if the National Broadband Network is hacked, sensitive medical records will be safe.

The NBN has long been promoted by its backers and the government as a potential driver of e-health initiatives, such as telemedicine and the Personally Controlled Electronic Health Record System (PCEHRS), due to be delivered next year.

But the hacking case now before the courts has reignited privacy and security concerns and raised doubts over the National E-Health Transition Authority's commitment to resolve such problems.

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http://www.ehi.co.uk/news/ehi/7059/morecambe-bay-says-lorenzo-works

Morecambe Bay says Lorenzo works

28 July 2011 Shanna Crispin

University Hospitals of Morecambe Bay NHS Foundation Trust appears to have turned the corner with its troubled implementation of Lorenzo as part of the National Programme for IT in the NHS.

In an update on the single patient record project, delivered to the trust’s board last week, head of informatics Steve Fairclough, headed the ‘key messages’ slide of his presentation: “It works!”

He also said that staff feedback was “encouraging” although there is still work to be done, and further improvements in performance and usability are planned.

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http://www.theaustralian.com.au/business/world/european-study-sees-no-mobile-phone-cancer-link/story-e6frg90o-1226103330514

European study sees no mobile phone-cancer link

• Gautam Naik
• From: The Wall Street Journal
• July 28, 2011 11:34AM

A EUROPEAN study involving nearly 1000 participants has found no link between mobile phone use and brain tumours in children and adolescents, a group that may be particularly sensitive to phone emissions.

The study, published in the Journal of the National Cancer Institute, was prompted by concerns that the brains of younger users may be more vulnerable to adverse health effects -- such as cancer -- from mobile phones.

In the past two decades, mobile phone use has soared among children in developed countries, with one study suggesting that most youths start to use mobile phones by age 9 or 10. Children have a developing nervous system, and cellphone emissions penetrate deeper into their brains. Studies have indicated that the outer brain tissue of children ages 5 to 8 may absorb twice the amount of cellphone energy absorbed by adult brains.

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Enjoy!

David.

AusHealthIT Poll Number 81 – Results – 1 August, 2011.

The question was:

Is Senator Boyce Correct In Calling for a Pause and Review of the PCEHR Program?

Definitely

- 29 (58%)

Probably

- 6 (12%)

Probably Not

- 9 (18%)

Definitely Not

- 6 (12)

With 70% leaning to the need for a pause and review of the PCEHR Program a pretty clear outcome!

Votes : 40

Again, many thanks to those that voted!

David.