Quote Of The Year

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

or

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

Thursday, September 08, 2011

Looks Like A Leaking Campaign Is Underway From Queensland Health’s IT Division. At Least E-Health Is Getting Discussed Up North!


Two leaks in two days seems to be a bit of a trend one would have to say.
Here is the press release
Mark McArdle MP
Shadow Minister for Health
LNP Member for Caloundra
8 September 2011

Leaked audit slams health IT systems

The Bligh Labor Government’s attempts to downplay problems with Queensland Health’s IT program have been blown apart by a freshly leaked independent audit report.
The leaked partial Queensland Audit Office report “ICT Governance Queensland Health 2010/11” follows the State Opposition yesterday releasing a secret risk report card that warns IT problems were spreading from health payroll to patients.
In State Parliament today, the LNP tabled the leaked audit report which found:
·         Queensland Health did not know the full ICT spending across its portfolio and was therefore in breach of the Bligh Labor Government’s own IT planning standards
·         ICT Risk Management was inadequate for a department of Queensland Health’s size
·         There was no robust and independent oversight of the ICT program
·         As of August 2010, the ICT Portfolio Risk Register contained just two risk entries – (the most current version tabled in State Parliament yesterday contained seven entries with major to extreme consequences)
·         Queensland Health’s ICT program was in breach of ‘Principle 3’ of the Bligh Government’s own ‘ICT Resources Strategy Planning (IS2)’ planning standard
LNP Shadow Minister for Health Mark McArdle said the audit was yet another report sounding alarm bells over the Bligh Labor Government’s management of health IT systems.
“It’s time for Anna Bligh and Geoff Wilson to come clean over the systemic waste and mismanagement that has been allowed to fester in Queensland Health,” said Mr McArdle.
In Parliament, the Premier failed to ease fears that the Department is not complying with the QAO recommendations.
“The report confirms Queensland Health have got it wrong from day one,” said Mr McArdle.
“Anna Bligh has admitted that even the most basic risk management strategies had not been in place while the government spent over $300 million on ehealth since 2007 and wasted $220 million to fix the health payroll system.”
In Parliament today, the Health Minister said he expected recommendations by independent bodies such as the QAO to be fully implemented, yet the leaked report showed the department rejected the QAO’s recommendations for more robust and independent oversight.
“The department is clearly ignoring any proper oversight - and it is clear Geoff Wilson has totally lost control of Queensland Health,” said Mr McArdle.
“The reality is hundreds of millions of dollars have been wasted fixing up Labor’s health payroll debacle, hundreds of millions of dollars more will need to be spent to ensure patients’ records are accurate and this new report raises more questions over Labor’s IT processes.”
Mr McArdle said there was an embedded culture of waste, mismanagement, and denial within Queensland Health under Labor.
“Both Paul Lucas and Geoff Wilson are culpable for Queensland Health’s multiple IT deficiencies yet the Anna Bligh continually refuses to hold any Minister accountable,” he said.
“The LNP will be open and accountable. We’ll save you money and deliver more by getting action on the basics and cutting waste.”
----- End Release.
Here is a link to the document:
And here is a link to the document mentioned in a blog yesterday.
It can only be a good thing e-Health is getting some discussion in parliament. I will leave an assessment of each of the documents to the reader.

It would be good to hear from some QH ICT people regarding their objectives and concerns.
Enjoy!
David.

Wednesday, September 07, 2011

Queensland Health Feels There A Few Major Risks to Ongoing IT Service Delivery For Their Health System. Wants More Money!


The following release was sent to me today.
Press Release
Mark McArdle MP
Shadow Minister for Health
LNP Member for Caloundra
7 September 2011

Labor’s health IT bungles spread from payroll to patients

The Bligh Labor Government’s health IT bungling has spread from payroll to patients and could cost another half a billion dollars to fix, a secret Queensland Health ‘risk report card’ obtained by the State Opposition reveals.
In State Parliament today, the LNP tabled a leaked extract from Queensland Health’s ICT Portfolio Plan 2011 – 15 which identified IT “risks” resulting in “major” to “extreme” consequences for patients and the State Government.
These included:
·         That the discontinuation of the current Patient Administration System could result in “the inability to register, admit, transfer and discharge patients as well as effectively manage clinical and financial patient information”.
·         The “inability to provide quality information to support quality of care”.
·         “Insufficient funding for business-as-usual activities and change programs” including the new local hospital networks being established under Federal health reforms and the health payroll overhaul recommended by the Ernst and Young report.
·         “Inability to acquire suitable workforce capability”.
Labor’s secret health IT risk report card reveals it would cost $438.8 million to upgrade or replace the current Patient Administration System, and work needs to start from July 2012.
This is on top of the $307 million budgeted for the eHealth Strategy and the $220 million needed to fix the health payroll debacle.
LNP Shadow Minister for Health Mark McArdle said Labor’s secret risk report card was a damning assessment of Labor’s chaotic management of Queensland Health’s IT program.
“The systemic leadership and management failures of the health payroll system have spread to the entire Queensland Health IT program under Health Minister Geoff Wilson,” said Mr McArdle.
“Put simply, patients’ lives could be put at risk because Labor has failed to properly plan and deliver health IT infrastructure.
“Hundreds of millions of dollars have been wasted fixing up Labor’s health payroll debacle, and now we learn hundreds of millions of dollars more will need to be spent to ensure patients’ records are accurate.”
Mr McArdle said the report would also spark fears Queensland could miss out on Federal funding because the State Government was not fully prepared for the changes required under the National Health and Hospital Networks Program.
“This damning report reveals that the Bligh Labor Government is struggling to ensure that the new hospital networks have the IT infrastructure in place in time, and that the health payroll overhaul actually happens,” Mr McArdle said.
“The Queensland Health IT debacles that started under Paul Lucas continue under Health Minister Geoff Wilson, who has now been in the job 200 days.
“Both Paul Lucas and Geoff Wilson are culpable for Queensland Health’s multiple IT deficiencies.
“Every Queenslander has the right to ask when will this tired, 20 year old Labor Government finally fix their bungled IT systems?
“The LNP will save you money and deliver more by getting action on the basics and cutting waste. We’ll forward plan, not live for the moment.
----- End Quote:
I have seen the extract from “ Commercial in Confidence - ICT Portfolio Plan 2011-15 Part A v1.0 FINAL” Page 22 of 83 on which the quotes in this release are based and what is quoted is mild. Clearly some worried Queensland Health Staff are wanting a great deal more money to operate and are using some interesting tactics to try and raise interest! Go for it is all I can say - but spend sensibly. I note in the part I saw the PCEHR does not get a gurnsey!
Fun stuff and I look forward to someone sending me the full report!
David.

NEHTA Has Just Published a Swag of Detailed Clinical Specifications - There Are A Few Questions That Arise.


We have had a dump of material delivered late last week. Here are the links to the files
The seven actual documents are all pretty imposing and complicated and extend to 100+ pages each not that there is not a heap of boilerplate within each.
I wondered just what these specifications were for and who was expected to use them.
Going to the NEHTA Site makes things a lot clearer:

Data Specifications

The data specifications aim to standardise the information structure and language that names and describes clinical concepts, and to provide a basis for the development of further, context-targeted specifications that can be implemented by system designers.
They are not intended to be software or messaging design specifications. Instead, they represent the clinical information requirements for data collection and information exchange to facilitate safe and effective continuity of care across healthcare for example, General Practice and Acute Care.
Intended Audience
This resource is targeted at:
  • jurisdictional ICT managers
  • clinicians involved in clinical information system specifications
  • software architects and developers, and
  • implementers of clinical information systems and other relevant applications in various healthcare settings.
The content is reasonably technical in nature and expects the audience to be familiar with the language of health data specification and have some familiarity with Australian Standards for health messaging, and/or repositories of data specifications.
This information is found here:
Looking at the actual files I note, for example, the Pathology Detailed Clinical Model first appeared as Version 1.0 on 29 May, 2007.
Some 4.25 years later we get a recast version 2.0.
The questions which rush into my mind are:
Who is actually using and implementing these specifications after 4 years?
If anyone has implemented what value have they seen from implementation and use?
Why might software developers choose to use them in isolation - as there does not seem to be any ongoing plan for them?
How will these specifications be maintained over time and who takes over if NEHTA is not funded in perpetuity?
Is sematic interoperation achievable without an agreed data model and is that model part of these specifications? I do understand the need for data and information clarity if information is to be exchanged between systems but with SNOMED -AU and AMT both in a less than finalised state where does this all fit?
It is by no means clear to me just what the underlying data-model for all this is, who owns it and maintains it etc.
With PCEHR software being sourced internationally just where do these data group etc. fit?
Overall, thus far, there seems to have been a lot of work done for no obvious outcome. I look forward to having all this explained to me.
I do note that talking about Detailed Clinical Models (DCMs) NEHTA says:
“The collaboration process in the NEHTA Clinical Knowledge Manager (CKM) will result in a library of archetypes (initially openEHR archetypes) based upon requirements identified by Australian clinicians and other health domain experts, and drawing from comparable work overseas. To create the DCMs, these archetypes will be transformed into platform and reference model agnostic models (based upon ISO 11179). They will then be uploaded to the National Information Component Library that NEHTA is in the process of building.
Initially, the DCMs will be available only in human-readable PDF format. In the medium term we intend to make them available in a number of machine-readable formats, and we will consult the community to determine what formats are required. CKM is being used to gather and formalise requirements for the DCMs and to support the life cycle management of each DCM through a collaborative, online review process. This provides an important vehicle for clinicians and domain experts to validate that the clinical requirements have been met, and warrant that the resulting published DCMs are safe, high quality and fit for purpose. They will then be uploaded to the National Information Component Library that NEHTA is in the process of building.”
More here:
I wonder is the National Information Component Library the data model that seems to be missing to underpin all this - and a range of other initiatives or is there something else at a more structured level?
I suspect we are yet to see the full picture of where this is all headed. I am happy for all brief explanations as to what these really mean and who will actually deploy them.
David.

Tuesday, September 06, 2011

The Sorry State of Listed Health IT Companies in Australia. Pretty Sad!


It really has been a pretty bad time for large Health IT companies in Australia.
First we had the well-known collapse of iSoft and its purchase by CSC.
Then, right as the death knell of the Australian Listed Companies reporting season we have had the following news:

Global Health narrows FY11 loss to $223k

Healthcare software firm Global Health (ASX:GLH) slashed $500k from its FY11 loss, and lifted its core revenue for the period by 12 per cent
Healthcare software and services company Global Health (ASX:GLH) narrowed its FY11 loss by over $500,000, due to improving core revenue and lower costs.
The company reported a net loss for the year of nearly $223,000, from an $812,000 loss in FY10.
EBITDA swung to a positive $170,000, from a $723,000 EBITDA loss a year earlier.
Core revenue from the supply of software systems to hospitals and health care providers grew 12 per cent to $4.9 million. International revenue more than doubled to about $519,000.
More here:
The losses have been happening for a while

Global Health 1H loss widens to $511k

Global Health, (ASX:GLH), a e-health solution provider, said its loss widened to $511k in the first half as a result of the strong Australian dollar
Lots more here:
The annual basics here are a Net Loss of $223,000
Total Revenue about $5 Million and of that $1.3Million was General and Admin costs.
We don’t have the full report but last year the company spent $750,000 on executive salaries while having a loss of a little over $800,000 for 2010.
It will be very interesting to see how much of this is trimmed in this year’s final report.
It is hard to understand just why this company is actually listed, other than as a source of public funds for the directors to then loose.
Both the accumulated losses and the contributed equity are about $19,000,000. The chances of this ever being recovered would have to be remote!
Following all this we had news from the long deceased, in Australia, ICSGlobal.

ICSGlobal reports maiden $204k profit

IT consulting and e-business company ICSGlobal (ASX:ICS) said solid growth in the UK helped the company move to an FY11 profit
IT consulting and e-business services company ICSGlobal (ASX:ICS) swung to a maiden profit of $204,000 in FY11.
The company lifted its revenue from continuing operations by 35.6 per cent to $1.7 million, led by a 69 per cent increase in revenue from the UK in local currency terms. The contribution would have been higher were it not for an 18 per cent increase in the value of the AUD against the pound sterling during the year.
In its financial report, ICSGlobal said it is well-placed to expand its UK business this financial year.
In Australia, the company concentrated on streamlining its operations, and now no longer employs any full-time executives here.
Earnings were also lifted by the first proceeds from the sale of ICSGlobal's Australian Thelma e-health business, worth up to $1.25 million.
More here:
This report is great fun. The Australian business has been closed down, the former CEO who managed accumulated losses of near to $32,000,000 has returned to the board as a Non Exec Director and directors fees have been well over ½ of the profit.
It is just impossible to conclude either of these companies are being run for the benefit of shareholders in any way at all. Key advice is not invest in sub-par money loosing enterprises like this if you value your savings.
At the other end of the scale we have ProMedicus (ASX:PME).
Here is their release:

Pro Medicus Limited full-year results

Friday 26 August 2011
Leading e-health company Pro Medicus Limited [ASX: PME] today announced its full-year results for the year to 30 June 2011.
·         Revenue – $14.07m, 27.7% lower than last year’s revenue of $19.46m
·         Gross profit – $13.61m, 23.0% lower than last year’s gross profit of $17.68m
·         Net profit – $0.50m, 87.2% lower than last year’s net profit of $3.92m
·         Cash reserves – $3.26m
·         Company remains debt-free
Pro Medicus Chief Executive Officer, Dr Sam Hupert, said the full-year result was in line with guidance made to the Australian Securities Exchange on 20 May 2011 with revenue affected by fewer new sales than anticipated. Profit was further impacted by several factors including a number of one-off payments and the strong Australian dollar with foreign exchange fluctuations reducing the company’s profit by more than $1.1m. As a result, no dividend was declared in the 2nd half.
“The past year has been a difficult one – but I am confident that Pro Medicus is turning the corner,” Dr Hupert said. “We have cleared the decks and taken some financial hits and are now in better shape. We believe that last year will represent the bottom of the cycle for us and we will move up from here.”
Dr Hupert said Pro Medicus continues to invest in new product development and will release its new RIS technology platform before the end of the year.
“This is a new product which we think will reposition us as market leaders,” he said. “Importantly, with our new offering, we are able to configure business-specific workflow and rules to suit clients’ needs without needing to customise the program for each client. This will make a huge difference to both us and our clients. This is a new concept, and a significant advance on what is currently in the market. Unfortunately, like many large scale development projects, it has taken longer to complete than expected but it will be worth it.”
----- End Extract
Full release is here:
A vastly different picture with both cash in the bank, no debt and profits! What a change.
Lastly we must not ignore Primary Health Care (ASX:PRY). They own a health technology division which was the old HCN and which owns Medical Director.
There are still doing OK with revenues about $50M per annum but the revenue is flat and the profit margin is dropping. They failed to sell the division recently due to no-one wanting to pay the asking price apparently.
See here:
All in all it is a pretty sorry sight. We really should be doing better than this is a sector with a pretty good health system and some pretty good IT developers. I guess most of the better and more useful action is in the smaller unlisted sector (think Best Practice, Medical Objects, Pen Computing and so on).
David.

The Department of Health and Ageing (DoHA) Updates The PCEHR Web Site - What do We Now See?


I checked to see if the new release of the PCEHR ConOps was available today.
The website has been updated.

Personally controlled electronic health records

Like many other countries, Australia’s health care system is facing increasing challenges to the sustainability of current health care practices.
The personally controlled electronic health record (PCEHR) system is being developed as part of the national e-health program to help meet these challenges and bring consumer-focussed electronic health capabilities to the Australian health system to drive improvements in quality, safety and access to health and medical care.

What is a PCEHR?

A personally controlled electronic health record (PCEHR) will be a secure, electronic record of your important health information.
The PCEHR will bring key elements of your health information together in a unified record. Your information in the PCEHR system will be accessible only by you and your authorised healthcare providers. This information will allow healthcare providers to make better, more efficient decisions about your health and treatment.
The PCEHR will not hold all the information in your healthcare providers’ records, but will detail key and frequently used health care information. As PCEHRs become more widely used and the PCEHR system matures, you will be able to access your own health information online — anytime, anywhere—and so will your authorised healthcare providers. Your health care information will be protected and secure through a combination of governance arrangements, supported by information privacy and system security measures.
You will also be able to nominate which members of your family (or carers) have access to your information. For example, if you are mature-aged or chronically ill, you can nominate your partner (or a trusted person), to have access to your PCEHR.
Update is dated 5 Sept, 2011
The earlier version mentioning an August, 2011 release is here:
I have checked the downloadable document and it is dated April, 2011.
I note NEHTA’s front page still has the August delivery date. I wonder when that will change?
Looks like we all have to wait some more!
David.

Monday, September 05, 2011

Weekly Australian Health IT Links – 5th September, 2011.


Here are a few I have come across this week.
Note: Each link is followed by a title and a few paragraphs. 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

Really a very quiet news week. The most exciting thing is that we are promised a new revised PCEHR ConOps. It was to be delivered during August, but seems to have been delayed. That can’t be helping those delivering the system!
On another front I note that as late as Thursday September 1, 2011 we have yet to see a contract finalised between DoHA and Standards Australia to progress E-Health Standards including some involved PCHER.
To quote “I have discussed the situation with xxx, Senior Portfolio Manager. xxx has informed that unfortunately SA and  DOHA have not yet executed the contract so SA are unable to facilitate any meetings at this stage. With regard to the proposed new date, the decision is given below.”
Oh dear, seems to be getting a bit messy here. We need all involved to get moving on this if we are to see anything useful happen with the PCEHR in the next decade or so .
-----

Govt leadership key to e-health success

The committee found that while the NBN will improve e-health implementation, a national leadership strategy is needed to implement initiatives across the entire sector
Increased government leadership is needed to successfully implement e-health initiatives across the entire healthcare sector, as opposed to individual providers, a House of Representatives committee has found.
In its report into the role and potential of the National Broadband Network (NBN), the infrastructure and communications committee found that while the NBN will play a significant role in improving the implementation of e-health systems, challenges remain in gaining wider change.
The report cites comments made by the Broadband Commission for Digital Development that the key reason behind e-health implementation delays is the benefits reaching society as a whole, as opposed to immediate positive consequences for the commercial aspects of healthcare.
-----

NEHTA grabs half of $400m records spend

THE National E-Health Transition Authority has collared an estimated $200 million so far for the 18-month run-up to the Gillard government's personal e-health records launch next July 1, with more money to come.
The Transition Authority received some $110m in base funding for e-health standards work between January 2011 and June 2012, plus separate Personally Controlled Electronic Health Record contracts worth $90m from the Department of Health.
A third tranche of these funds is due in October.
This contrasts with just under $200m for four private-sector projects including the building of the system, three lead implementations and nine e-health pilots to be finished in the same period.
Only $2.3m has been allocated to help local software providers redevelop their products through the Transition Authority's GP desktop panel.
-----

Sceptics change tune on electronic records

Mark Metherell
September 1, 2011
THE Facebook era is spurring an about-turn in the attitudes of those once anxious about the ''big brother'' implications of electronic health records.
Consumer health leaders have reversed their demand for the government to require individuals to choose to be part of the system that will enable the electronic storage and transfer of patient records.
At a meeting on medicines policy in Canberra this week, 50 consumer health advocates unanimously backed the introduction of an ''opt-out'' process under which individuals would be automatically connected unless they took the conscious step to stay out.
The Consumer Health Forum says the change reflects a transformation in attitudes among many health activists who are now more comfortable with electronic records and have become more convinced of the potential benefits of e-health to patient care and safety, and to streamline health services.
-----

Patients divided on GP sign-up schemes

THERE could be a snag lying in store for attempts to improve care through a voluntary system encouraging patients to register with a particular general practice.
It seems the patients themselves are not too keen.
Newspoll research conducted for Inquirer shows slim majority support for registration, at 51 per cent, even after it's been explained to respondents that the move should give them better quality healthcare.
Support for registration dipped to 45 per cent in the 18-34 age bracket, suggesting a bumpy road ahead for efforts to bring in registration if this lack of enthusiasm reflects a generational attitude.
Support in the over-50s, who are much more likely to have the chronic conditions such as diabetes for whom such schemes are most relevant, was only slightly higher, at 55 per cent.
-----

GP Council kickstarts patient data website

The General Practice Data Governance Council has launched a website that provides tools for health professionals looking to ensure data generated by consultations with patients is handled properly.
Dr Mukesh Haikerwal, independent chair of the General Practice Data Governance Council, said this secondary use of data could be as varied as clinical research, disease events and health planning.
.....
The new website can be found at: www.gpdgc.org.au
-----

Watchdog determined to grow some teeth

It was the third scathing assessment of the Therapeutic Goods Administration delivered this year to new TGA national manager Rohan Hammett, a clinical and academic physician.
"The TGA has for a long time been an easy beat-up and I think much of it has been deserved, frankly. We're trying to change that," he says.
Hammett tells Weekend Health his wish list includes beefed up post-market surveillance of medical devices, backed by the power to impose new civil penalties on companies breaching TGA regulations.
-----

Q&A: Paul Jurman, director of IT, Southern Health

We take a look at what an average day for Jurman looks like, as well as what's next on his IT agenda
With around 13,000 staff working across more than 40 sites, Southern Health is the largest health service in Victoria. The organisation covers parts of metropolitan Melbourne, as well as sites at Monash, Greater Dandenong, Casey, Cardinia, Kingston, Glen Eira, Frankston, Knox and Bayside.
The organisation’s director of information technology, Paul Jurman, sat down with Computerworld Australia to discuss what an average day involves for him.
-----

Pharmacy's peak bodies differ on e-health records: AMA

Leading pharmacy organisations appear to be on different pages when it comes to the introduction of Personally Controlled Electronic Health Records (PCEHRs), the AMA believes.
Responding to claims by Kos Sclavos, Pharmacy Guild of Australia national president, that the AMA would seek to lock other health professionals out of the PCEHRs, Dr Steve Hambleton (pictured), AMA president, suggested the Guild consult the PSA on the issue.
In his fortnightly opinion piece in Pharmacy News, Mr Sclavos expressed concerns medical organisations including the AMA would seek to freeze other health professionals out of having input into PCEHRs, giving total control to doctors.
"In my view some of the negativity comes from medical organisations questioning controls in the system, and by default reducing consumer confidence," he said.
"The AMA has again predictably run interference stressing their desire that the system must be doctor-centric, with the doctor controlling every step.
-----

PSA backs collaboration on e-health record

Working with doctors on personally controlled electronic health records (PCEHRs) will provide the best outcomes for patients, the PSA believes.
Following claims by Kos Sclavos, Pharmacy Guild of Australia national president, that the AMA was running "interference" to create a doctor-centric PCEHR system, Grant Kardachi, PSA national president, told Pharmacy News that collaborating with GPs was essential to ensue quality use of medicines (QUM).
"PSA’s position has always been to act in the best interests of patients, especially in the area of patient safety, following QUM principles with respect to medicines," Mr Kardachi said.
"Working with our colleague GPs will be essential to ensure medicine safety for our patients, and the PCEHRs will support that.
-----

PHARMEDIA: PCEHR - A Fight for Control?

Squabbles are breaking out in respect of who is going to manage Person Controlled Electronic Health Records (PCEHR) with the Australian Medical Association (AMA) and the Pharmacy Guild of Australia (PGA) being the most vocal.
This against a backdrop of a contract being awarded to Accenture and their alliance partners, Oracle and Orion to develop the system on behalf of the Australian government.
Health Minister Nicola Roxon has said Accenture would receive $47.8m to develop the personally controlled e-health record system.
The department will also pay $17.8m to Oracle in licence fees for access to e-health records stored within all PCEHR repositories, and $11m in fees to Orion for operating a portal.
-----

Telstra, Accenture don the lab coats to develop Cloud services

Cloud product innovation laboratory opened in Melbourne, aimed at enterprise and government customers
The move to Cloud will be accelerated for Telstra’s (ASX:TLS) enterprise customers following the opening of a product innovation lab with its US-based consulting partner, Accenture, in Melbourne this week.
The lab is designed to become an Australian innovation hub, with Cloud-based technologies to be developed for both enterprise and government organisations. It is part of an $800 million, five-year investment in Cloud services announced by Telstra in June this year.
According to Telstra’s chief technology officer, Dr Hugh Bradlow, the lab will show businesses how Cloud computing technologies could improve their business performance.
-----

Older people fall for internet scams

Older people often fall for internet scams and then are too embarrassed to report the fraud, a study has found
  • AAP (AAP)
  • 29 August, 2011 08:30
Older people often fall for internet scams and then become too embarrassed to report the fraud, a study has found.
The over-55 age group accounts for 40 per cent of victims even though their age group is less likely to use the internet, a study by the Australian Institute of Criminology (AIC) has found.
The study surveyed 202 Victorians who had sent money to Nigeria to determine why they had responded to unsolicited contact and the impact of the fraud on their lives.
Federal justice minister, Brendan O'Connor, said many victims were too embarrassed to report the fraud to authorities.
-----

Flying Doctors fear NBN will bypass bush

  • From: AAP
  • September 02, 2011 7:42PM
THE Royal Flying Doctors' Service (RFDS) says health services in Wilcannia in western NSW could suffer if the national broadband network (NBN) fibre rollout bypasses the area.
RFDS southeastern section executive director Clyde Thompson says rural and remote areas need far better internet services than they now have.
"If we are going to have an NBN ... please make sure that the capacity of the NBN in remote areas, particularly in the satellite uplinks, meets the requirements of remote communities," he told ABC Television today.
-----
Enjoy!
David.

AusHealthIT Poll Number 86 – Results – 5th September, 2011.


The question was:
Should Investment Continue in The Present Contentious Design of The PCEHR as It Is Rather Than Fixing The Design Flaws First?
Just Steam On
- 7 (20%)
Make Some Minor Changes
- 1 (2%)
Make Major Change But Push On
-  0 (0%)
Regroup To Fix Flaws And Then Proceed
-  26 (76%)
Votes 34
A stunningly clear cut vote. This project needs a careful and in depth rethink seems to be the large majority view!
Again, many thanks to those that voted!
David.

Sunday, September 04, 2011

I Wonder What Is Going On With the Terminology Function At NEHTA?


First we had this appear.
Subject: NEHTA - National Clinical Terminology & Information Service - AMT monthly releases between August and December 2011
Date: Thu, 25 Aug 2011 09:30:17 +1000
From: "NCTIS ServiceDesk" <nctis.servicedesk@nehta.gov.au>
NEHTA - National Clinical Terminology & Information Service - AMT monthly releases between August and December 2011
Since 2007 the NCTIS has been issuing monthly national releases of the Australian Medicines Terminology (AMT) incorporating new items registered with the TGA.
While the AMT has been implemented in clinical systems in Australia, NCTIS has been consulting with software vendors and the terminology community about how we can increase uptake. As a result of this consultation and our recent AMT license holder’s survey we have identified a range of materials that would assist people implementing AMT. These materials will be defined in an AMT Implementation Plan that will be published on NEHTA’s website shortly. The AMT Implementation Plan will set out pathways to implement AMT, including integration guidance and include timeframes for deliverables such as AMT v3.
In order to respond to the market and deliver material requested by implementers over the coming months, NCTIS is pausing AMT monthly releases until December 2011. This decision has come following consultation with healthcare organisations and vendors that have already completed large scale AMT implementations, and have confirmed their operational use of AMT in clinical settings will not be impacted by this action.
We look forward to continuing our work with you to use AMT throughout the healthcare sector to support consistent terminology in medications management. Should you have any questions, comments or feedback, please direct these to terminologies@nehta.gov.au.
Regards,
NCTIS Service Desk
National Clinical Terminology & Information Service
nehta - National E-Health Transition Authority
PO Box 5190
West End, Queensland 4101 
Then a day or so ago we had a follow-up.
Subject: Request for feedback - SNOMED CT-AU
Date:        Thu, 1 Sep 2011 13:00:03 +1000
From:       NCTIS ServiceDesk
To:             undisclosed-recipients:;
Request for feedback on your dependency on SNOMED CT-AU release date
NCTIS released the first national release of SNOMED CT-AU in December 2009 and has been following a six monthly release cycle since then. To support the national Personally Controlled Electronic Health Record, NEHTA is undertaking additional development of detailed clinical models and associated SNOMED CT-AU reference sets.  At the same time, we are also investing resources in the development of AMTv3 which will more closely align with SNOMED CT-AU, and to develop other implementation resources to help vendors and implementers use AMT.
To allocate NEHTA resources to this work, the NCTIS is considering delaying the November 2011 release. We are also investigating aligning Terminology releases with other Specification releases, such as Specialist letters, to provide a more integrated release to implementers. While we need to consult with users of NEHTA’s specifications and terminology to determine the viability of this, we can confirm that the next SNOMED CT-AU will be no later than May 2012.
In order to evaluate the significance this may have we are now writing to license holders to determine whether a delay would have an impact on any clinical application using SNOMED CT-AU. We have already written to all license holders who downloaded any of our last three releases, and have not had received feedback that any clinical application would be impacted, and the results of our recent user survey indicate this is not the case more broadly with other license holders. However, we would like to confirm this directly with you.   
If you have implemented SNOMED CT-AU in a clinical setting and would be impacted by a delay in the November release, please advise us by COB Tuesday 6th September at terminologies@nehta.gov.au or 07 3023 8400.
We look forward to continuing our work with you to use SNOMED CT-AU throughout the healthcare sector to support consistent terminology in clinical management.
Regards,
NCTIS Service Desk
National Clinical Terminology & Information Service
nehta - National E-Health Transition Authority
PO Box 5190
West End, Queensland   4101 
What NEHTA seems to be saying here is that we can’t actually walk and chew gum and so do you mind if we stop chewing so we don’t fall over.
More amazingly it seems after working for at least six years on the Australian Medicines Terminology only now have they discovered a need to actually have an implementation plan!
Surely an organisation that is being funded as well as NEHTA is can continue its ‘business as usual’ functions while undertaking some planning and improved service delivery changes?
It is interesting that Sept 1, 2011 the Health Minister announced some updates to the Pharmaceutical Benefits Scheme Coverage:
See here:

Erbitux, Gilenya and Other Medicines Listed on the PBS

More than 400,000 Australians will benefit from new subsidised medicines from 1 September 2011, including patients suffering multiple sclerosis, cystic fibrosis and various forms of cancer.
.....
In all, twenty-one (21) new listings on the PBS come into effect from 1 September. More detail on these is available on the PBS website at www.pbs.gov.au.
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So already the current AMT is way out of date!
Also remember that SNOMED-CT is also meant to be the terminology underpinning the PCEHR - but it is now on hold until the end of the year apparently. I suspect that will need an implementation plan as well!
Bottom line is that under NEHTA’s management we see major initiatives such as clinical terminology simply floundering and not being used as might have been hoped.
(Of course we all know there are a few fundamental issues with SNOMED-CT - I wonder how that fits into this ‘pause’? See here:
I wonder when the powers that be will notice all this is not exactly going as planned?
Soon I hope!
David.