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, September 20, 2011

And Now For A Little Government Procurement Fun. You Be The Judge!

The following report appeared today in the Courier Mail.

Opposition claim of IT contract bias

QUEENSLAND Health bureaucrats ordered changes to an independent report to guarantee an IT supplier a multi-million-dollar government contract, the State Opposition says.
The troubled department last night vehemently rejected allegations it deliberately changed the report's scope to favour software company Cerner Corporation.
Queensland Health is now in negotiations with the US-based Cerner to build a $243 million electronic medical records system in Queensland hospitals.
Documents obtained by the Opposition under Right to Information laws show a public servant asked that extra information be added to the findings of a 2009 external investigation into potential suppliers.
Opposition health spokesman Mark McArdle said the emails, marked "confidential", asked that Cerner be highlighted as the only company with systems already in Australia. He said the change may have unfairly excluded other potential competitors.
It is the latest in a series of IT headaches for the Bligh Government, which is still battling to fix its disastrous health payroll system and was this month embarrassed by leaked reports detailing risks within other health technology projects.
In a statement last night, chief information officer Ray Brown rejected the latest claims as "categorically untrue".
He said an independent probity adviser had reviewed the process and found no reason to believe Cerner was treated with undue bias.
More here:
For your reading pleasure we are lucky to have the actual e-mails - so readers can be the judge if there was any issue with what was apparently going on behind the scenes.
The e-mails were made available under FOI so they are free for all to browse:
It will be interesting to see how this now plays out. Regular readers will know that implementations in NSW and Victoria of Cerner software have not been problem free but it also needs to be recognised that Cerner globally has been very successful in delivering working hospital systems elsewhere. Where any blame lies for issues in particular implementations is really not something that can be known without individual case analysis!
My suspicion, on the basis of the obvious evidence of a large number of successful implementations globally is that there is a need to closely examine how large scale, state-wide implementations are undertaken in Australia to see if there are major problems with that approach.
Others have also suggested that there are some software flaws and certainly few systems of the complexity of the Cerner product are likely to be ‘bug free’!
I keep an open mind but suspect there are a mix of causes!
We can all watch what happens now with interest!
David.

Monday, September 19, 2011

AusHealthIT Poll Number 88 – Results – 19th September, 2011.

The question was:
Have NEHTA / DoHA Responded Adequately And Fully To The PCEHR Submissions With the New PCEHR ConOps?
No Way
- 14 (56%)
Some Minor Progress
- 9 (36%)
Major Progress
-  2 (8%)
Full And Adequate Response
- 0 (0%)
Votes 25
A stunningly clear cut vote. DoHA and NEHTA are just not listening!
Again, many thanks to those that voted!
David.

Weekly Australian Health IT Links – 19th 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

No doubt the big news of the week has been the release of the ‘Final’ Concept of Operations for the PCEHR.
Two other bits of news - the announcement of the Draft Telehealth Standards and the DoHA data warehouse have rather slipped between the cracks!
Setting up these warehouses to be data-mined for quality, performance and cost information may indeed turn out the be a much larger step than most are recognising right now!
The Draft Telehealth Standards are found here:
There is a lot of information - but it is not clear to me exactly what is being standardised at a technical level. Comments welcome on this one!
Certainly the control and governance of this information needs to be very closely watched.
Lots of other interesting stuff - including the rather sad note that one of our medical technology companies has hit a rather nasty bump on the road. This country produces only so many major successes of a technical kind and it is to be hoped this ship can be quickly righted.
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DoHA gets data warehouse in order

Enterprise data warehouse project will help facilitate the National Health Reform initiative
  • Tim Lohman (Computerworld)
  • 16 September, 2011 09:36
Australia’s National Health Reform (NHR) initiative has taken a step forward with the announcement that it will shortly begin the enterprise data warehouse (EDW) overhaul component of the initiative.
The NHR initiative seeks to unify the Commonwealth, states and territories in a nationwide health and hospital system overhaul.
The EDW program, one of many elements, will ensure the data collection and storage facilities for a range of key health-related data sets are in place to support the NHR.
The EDW will also provide access to key common and agency specific data collections; provide the tools for a range of data analysis, modelling and forecasting activities; and ensure activity based funding-related data transfer between the relevant national, state and territory agencies. The data sets involved in the data warehousing program are sizable.
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Ceasefire over e-health standards

NEHTA standards head made redundant.

The Department of Health and Ageing has agreed to resume the funding required to develop the technical standards that underpin its $466.7 million personally controlled electronic health record initiative.
The department had reportedly cut funding to an e-health standards development program by Standards Australia over the current financial year.
Negotiations around funding for Standards Australia's work continued well into August. A spokesman for the national body said an agreement had since been reached.
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Gillard government's health records rollout 'lacking in standards'

THE Medical Software Industry Association has warned that the Gillard government's $500 million e-health records rollout is a "standards-free zone" that will lead to massive costs and risks sinking local e-health providers.
The revised concept of operations for the personally controlled e-health record system, currently under implementation at 12 lead sites, was released by Health Minister Nicola Roxon in Canberra yesterday.
But the document reveals that a swag of technical standards needed for the build are yet to be decided. Instead, private contractors will have to rely on "specifications" developed by the National E-Health Transition Authority, which will ultimately progress these for acceptance by Standards Australia.
An MSIA spokeswoman said there was little point in having a dozen projects and a national repository for patient records if the work was being done without reference to appropriate standards.
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6minutes Online Video - the PCEHR

  • 15 September 2011
The final plans for the personally-controlled e-health record (PCEHR) have been released by health minister Nicola Roxon. However, medical groups such as the AMA say the government has not listened to the practical suggestions put forward by doctors for the scheme, which is due to start in July 2012. Michael Woodhead reports on what the scheme will look like.
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E-health push to give stars false IDs

  • Natasha Bita, Consumer editor
  • From: The Australian
  • September 16, 2011 12:00AM
CELEBRITIES, politicians and victims of domestic violence will be given fake identities to prevent hacking into their medical records stored in the federal government's new electronic health database.
The government has decided to let patients who "fear exposure due to the public nature of their work" use pseudonyms when they sign up for the $467 million e-health system, which will begin storing medical records in a central database from July next year.
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AMA pours cold water on PCEHR, again

The Australian Medical Association (AMA) has renewed its concerns about the structure of the PCEHR following the federal government’s launch of the final version of the Concept of Operations today.
In particular, the AMA has raised concerns about the ability for patients to excise aspects of their medical records from the record as something that could have serious consequences in an emergency situation. The AMA has repeatedly questioned aspects of the PCEHR’s operation in public and private forums.
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PCEHR needs fine-tuning: RACGP

The Royal Australian College of General Practitioners (RACGP) has welcomed the final Concept of Operations document for the personally controlled electronic healthcare record (PCEHR), with a caveat.
The peak organisation for GPs stated not all of its concerns had not been addressed, the plan did provide the clarity needed to get the record underway.
“The RACGP is pleased that the final plan for the PCEHR has been released and whilst not all our previously raised issues have been addressed, it is important that Australia gets underway with the implementation of the PCEHR,” said Dr John W. Bennett, chair of the RACGP National Standing Committee – ehealth, in a statement.
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Slow uptake better for e-health: Roxon

By Josh Taylor, ZDNet.com.au on September 13th, 2011
Slow uptake of the government's planned personally controlled e-health records (PCEHR) will be better for the system, according to Health Minister Nicola Roxon, who said that it may not be able to cope with 100 per cent adoption on day one.
At the unveiling of the government's final concept of operations report for the PCEHR system in Canberra yesterday, Roxon refused to be drawn on what level of take-up for the opt-in system she was expecting from the launch on 1 July 2012, instead saying that it will be better if fewer people sign up for the system on day one.
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Roxon defends opt-in system for e-health records

13th Sep 2011 AAP
FEDERAL Health Minister Nicola Roxon has hit back at critics of the opt-in system for setting up individual electronic health records, saying people shouldn't have to make the switch before they are ready.
Every Australian has been assigned a 16-digit identification number, but they won't automatically get an e-health record when the system starts in mid-2012.
Instead, they'll have to choose to participate.
Doctors say that's a mistake, saying an opt-out system would be better.
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E-health rebates ruled out

  • Karen Dearne
  • From: Australian IT
  • September 13, 2011 9:08AM
HEALTH Minister Nicola Roxon has flatly ruled out paying for doctors to create and maintain electronic health records on behalf of their patients.
In a doorstop interview at the launch of a model e-health display in Parliament House yesterday (MON), Ms Roxon replied "no" when asked if there would be a special Medicare rebate for doctors using a new $500 million nationwide patient electronic record system due to start next July 1.
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No rebate for PCEHR adoption

The government has ignored advice from medical groups on the PCEHR,  with health minister Nicola Roxon ruling out any special rebate to cover the costs of adopting the new system.
In an interview yesterday she said GPs were already using computerised systems and would see the value in switching to a new and better record system.
“The government's commitments are to fund the infrastructure that's required so that the system can talk to each other. It's not to fund each and every bit of a general practice or a health practice of any type which is going to constantly update itself and want to keep up with modern technology,” she said.
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No rebates for setting up e-health records

13-Sep-2011
Paul Smith
There will be no new MBS items to fund the time GPs spend setting up the Federal Government’s $467 million e-health record system.
Yesterday saw the release of the government’s final blueprint, detailing how the records will work, the clinical information they will hold, the extent of a patient’s control over their content and the role of the GP.
GPs will be expected to become the so-called “curators” of patients’ shared health summaries, the part of the e-health record that will list diagnoses, medications, allergies and basic biographical details.
But Federal Health Minister Nicola Roxon, when asked by reporters if there would be special Medicare rebates for setting up the records, said: “No. Look, we are not contemplating that there will be a special rebate. I’m sure that over time there’ll be all sorts of different options and requests and they will be considered as they come.
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Issues still to be resolved on e-health records program

THE revised concept of operations for the Gillard government's $500 million e-health records program fleshes out some details but many of the ticklish issues around funding, governance and medico liability remain "out of scope".
Consultations threw up concerns that as yet, there are no arrangements for long-term management of the personally controlled e-health record (PCEHR) program and related services, that there is no ongoing funding beyond its July 1 startup date, and that there is no money on the table to compensate doctors for the creation and maintenance of uploaded patient information.
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Govt releases e-health plan for July 2012

Australians are a step closer to accessing their medical records from July 2012 after the government issued the blueprint for national electronic health records.
The government released the concept of operations for the personally controlled electronic health record (PCEHR) system on Monday.
Health and Ageing Minister Nicola Roxon said the plan would help build the core parts of the system in the move from paper-based records to secure e-health data.
"Ehealth will help us provide better care, save lives and save money," Ms Roxon said in a statement on Monday.
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Health System To Benefit From After Hours Video Conferencing

By Computer Daily News | Monday | 2011-09-12
The Federal Government has released a new blueprint for the deployment of its e-health project. The blueprint includes a timeline for the rollout of its e-health program, as well as development of personally controlled e-health records (PCEHR in Canberra-speak) and telehealth initiatives.
The Government has set out how it will meet 45 percent of efficient growth funding from July 2014, and 50 percent of efficient growth from July 2017 at an initial cost of $467 million.
It plans to have the national infrastructure for the PCEHR in place in the first quarter of 2012, with further enabling legislation ideally set to pass in March or April.
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Roxon strips final veil from ConOps

Five months to the day after releasing its draft concept of operations (ConOps) document regarding the use of personally controlled electronic health records (PCEHR), the Federal Government has unveiled the final version. The ConOps explains how the nation’s e-health system will be structured, how it will work, and what security and privacy principles will be embraced.
According to the minister for health and ageing Nicola Roxon; “The Concept of Operations will be used by our infrastructure partners to build the system to allow all Australians to sign up from July next year.” Despite multiple concerns raised during the consultation phase the regime remains opt-in, meaning that only those Australians that want a PCEHR will get one.
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Health allows for access to patient records in emergencies

Healthcare providers get unlimited "break-glass" access to patient records.

Healthcare providers will have access to all clinical documents and records in an emergency situation under a revised concept of operations released by the Department of Health and Ageing today.
The "no access" provision was proposed in the draft document in May as one of three document security levels that allowed users to fine-tune access to their personally controlled electronic health record, due to be available from July 1 next year.
It came in addition to the "general access" and "limited access" levels, the latter of which restricted access to some documents for nominated healthcare providers.
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E-health gets last-minute access change

By Michael Lee, ZDNet.com.au on September 12th, 2011
The Australian Government has finalised its plans for its personally-controlled electronic health record (PCEHR) system with the release of a final Concept of Operations report, which contains significant alterations to how the proposed system will work, including a change in how health providers will be able to access medical information.
The final plans (PDF) for the health record system, which is expected to be made available to the general public in July next year, were released by the Minister for Health and Ageing, Nicola Roxon, today.
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E-health uptake will be gradual: Roxon

Federal health minister, Nicola Roxon, has hit back at critics of the "opt-in" system for individual electronic health records
  • AAP (AAP)
  • 13 September, 2011 08:27
Federal health minister, Nicola Roxon, has hit back at critics of the "opt-in" system for setting up individual electronic health records, saying people shouldn't have to make the switch before they are ready.
Every Australian has been assigned a 16-digit identification number but they won't automatically get an e-health record when the system starts in mid-2012.
Instead, they'll have to choose to participate.
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Southern Health rolls out iPads, BYOT, wireless network

Plans to expand wireless in the works
The rollout of iPads, a 'bring your own' technology (BYOT) policy and the trial of an internal wireless network have given Southern Health staff members greater access to patient information while on the move.
Southern Health CIO, Dr Philip Nesci, said that the largest public service provider in Victoria began to trial wireless internet at Casey Hospital earlier this year.
“We decided to go fully wireless in Casey Hospital, basically as a pilot to really understand not just wireless but technologies and the impact they can have on personal care,” he said.
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Online mental health services a step closer

A committee of mental health professionals, social media experts and carers has been appointed to oversee rollout of new services.
Access to online mental health services is a step closer after the federal government appointed a committee to oversee their rollout.
The committee comprises a mix of mental health professionals, social media experts and consumer and carer representatives.
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Electronic register could cut drug abuse

SOFTWARE under trial that warns pharmacists not to dispense addictive medication to drug addicts if they have been given such medication just days before could bring addictions under control if introduced.
West Australian Coroner Alastair Hope earlier this week called for a central register to monitor the sale and use of the addictive medicines after a 40-year-old mother of seven died from an overdose of methadone while being treated for an addiction to prescription drugs.
The Pharmacy Guild of Australia says it is working with the government on a real-time recording system that captures data on the dispensing of controlled Schedule 8 drugs such as codeine, methadone, oxycodone and pethidine.
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Doctors back push for drugs register

COLLEEN EGAN and ANDREW TILLETT, The West Australian September 14, 2011, 5:14 am
Doctors need a live computer database system if they are to keep up with trends in the black market prescription drug trade, according to the Australian Medical Association.
AMA WA president Dave Mountain said yesterday there was "a significant number" of people who made a living from visiting GPs and pharmacists for pills which they then sold for $30 to $50 each.
Dr Mountain said painkiller oxycodone and sedative Stilnox were "flavour of the month" in Perth because they had a reputation as party drugs, often when mixed with alcohol and other substances.
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Cochlear facing six-year low in earnings

COCHLEAR'S voluntary global recall of its unimplanted Nucleus 5 hearing device could see the company post its weakest full-year earnings in six years as sales decline.
The world's largest hearing implant maker began the recall on Monday after an increase in the number of failures, and has ceased manufacturing the unit while it investigates the cause of the "shut down", which it says does not injure users.
While Cochlear plans to increase production of the device's predecessor, the Nucleus Freedom, the company could not forecast the financial impact of its first major product recall or how long it would take for the device to re-enter the market.
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Kevin Rudd guru Joshua Gans slams NBN monopoly as deal 'will harm consumers'

KEY planks of the National Broadband Network business case are anti-competitive and will send Australia backwards, one of Kevin Rudd's "best and brightest" economic brains has warned.
In a blistering critique, economist Joshua Gans, who in 2008 was hand-picked to attend the then prime minister's 2020 summit to discuss productivity, has criticised plans to subsidise the rural NBN rollout through the prices that urban consumers pay.
The promise to put a cross-subsidy in place so that regional areas pay the same access prices for the NBN as people in the city was a key promise to the regional independents Tony Windsor and Rob Oakeshott that helped Labor form a second-term government.
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Aging population could benefit most from NBN

Digital business partner says technology can improve quality of life for aged care residents
The opportunity to help Australia's aging population with relevant technology must be taken account for in the rollout of the National Broadband Network (NBN), a KPMG digital business national managing partner has argued.
Speaking at an Enterprise Ireland trade mission in Sydney, Malcolm Alder, said that aged healthcare was a "burning issue" and the infrastructure provided by the NBN would deliver technological advances that could help aged care.
Alder shared the findings of an e-health pilot that he was involved with at a rest home in Foster, NSW, this year.
"The staff had been there 15 to 20 years and were not overly computer illiterate," he said "The thought that a whole bunch of [e-health] technology was going to descend on them was scary."
However, when the staff discovered that the technology was going to make their life easier and the quality of the residents that they were caring for better, their attitude changed, he said.
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Uncertain future for AGPN and SBOs

AGPN board members are to become the founder members of a new Medicare Local National Body, but a question mark remains over the future role  - if any - of the AGPN and GP division state-based organisations (SBOs).
A communiqué (link) from the AGPN Board says health minister Nicola Roxon has made it clear that SBOs will not continue in their current form when the Medicare Local National Body is formed
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Diagnosis? Elementary, with help from ‘Watson’

15th Sep 2011 Mark O’Brien
THE IBM supercomputer most famous for beating two former champions of American game show Jeopardy! earlier this year will soon be helping US physicians identify treatment options, under an agreement announced last week.
US healthcare company WellPoint has signed a deal for the first commercial applications for the IBM ‘Watson’ technology, which was designed to rival a human’s ability to answer questions posed in natural language.
The system can sift through an equivalent of about one million books or roughly 200 million pages of data, analyse the information and provide precise responses in less than three seconds.
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Objective-C, C#, D language: Winners in programming popularity

Java remains the longtime top-ranked language in the Tiobe Programming Community index
Objective-C, used for developing Apple iOS applications, climbs to No. 6 in the monthly Tiobe Programming Community index for most popular programming languages, after being ranked at number 8 a year ago. Also posting gains, C# rose to No. 4, a jump of two spots a year ago, while PHP dropped from No. 4 at this time last year to No. 5.
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Why be a pirate? Use open source software instead

Business decision-makers who get their proprietary software illegally need to wake up and check out the free alternatives.
Close to half of all computer users around the world tend to get their software illegally, and business decision-makers are no exception.
That's one finding from a recent survey commissioned by the Business Software Alliance (BSA) lobby group, which reported the results in a blog post last week.
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Enjoy!
David.

Minister Roxon Talks About the PCEHR on The Health Report This Morning.


You will be able to hear the conversation which is mostly about the PCEHR from this link later today.
The Minister for Health and Ageing, Nicola Roxon, talks about Australia's position at the United Nation's meeting on non-communicable diseases, which starts today.
The conversation is 1 minute about the advertised topic and 3-4 minutes about the PCEHR.
David.

Sunday, September 18, 2011

The Health Minister is Playing A Very Risky Game With the PCEHR. She Needs To Change Tack or She Will Fail!


On Friday we had an intervention in the PCEHR conversation by the Health Minister.

Pulling E-Health Together, Not Tearing it Apart

Article by Minister for Health and Ageing Nicola Roxon and published on 6 Minutes.
16 September 2011
The following article by Minister for Health and Ageing Nicola Roxon was published on 6 Minutes.
This week we took eHealth to the Federal Parliament, demonstrating to politicians how records will make a real difference to patient care in the hospitals, GP surgeries and pharmacies in their electorates.
The same demonstration will soon travel to different parts of the country, helping clinicians, consumers and others in the health system understand how connecting the patient journey will make a real difference.
What we were able to show to politicians is that this is not a technology system – it is a health system. It will improve care for patients, reduce medication errors and avoid unnecessary tests.
The display also demonstrates how eHealth is real, and no longer a vague plan for the future. We now have over a million healthcare identifiers downloaded to be used, lead implementation sites underway, secure messaging being used and patient consultations being undertaken through videoconferencing.
And from next July, Australians will be able to register for an eHealth record.
Yesterday we released the finalised plans for the service which will be built by our infrastructure partners. These were released following long and detailed consultation with clinicians, health consumers and ICT industry professionals across the country.
Now that we’re getting on with the job, it is important that people who want eHealth to be delivered get behind the program. I am buoyed by the enthusiasm that there is for eHealth across the spectrum of professional groups and the community.
Over the past decade of inaction it was easy for everyone to agree – because since nothing was being done, no decisions had to be made.
But now that the Gillard Government is actually getting on with the job – it creates the environment in which differing interest groups want to get their hands on the steering wheel. That’s obviously impossible.
For instance, we’ve seen the AMA saying we’re not listening to doctors. This couldn’t be further from the truth. They should try telling that to the College of GPs that has endorsed the plan, the leaders of the program include former Presidents of the AMA and RACGP, and the over 50 clinical leads that are closely engaged in the program.
The truth is that while the AMA haven’t won every single discussion about how the records will work, we agree on most of the design of the system. We’ll never be able to agree on every single detail because the Government has to take all the right advice and make decisions that are in the overall interest of the community and patients, not one professional group.
What the AMA needs to consider is whether they will be a partner to deliver eHealth, or whether they will act in opposition and miss this once in a generation opportunity.
By working for the collective good, everyone can help us deliver a solution to benefit patients and clinicians. The alternative option is to try and tear apart consensus on this program and leave a legacy of mountains of paper in hospitals and GP surgeries – unconnected and stuck in a luddite time warp.
It would be a waste to miss this opportunity to transform our health system.
For our part, we will continue to push ahead with this program in a way that engages our hard working clinicians, but unapologetically also making sure that this is a system that has patients at its heart.
The press release is found here:
The original publication in 6minutes.com.au is found here:
There was a report of the intervention here:

Minister urges AMA not to reject PCEHR

Health minister Nicola Roxon has rejected AMA claims that the government has failed to listen to doctors in the design and implementation of the PCEHR.
In an opinion article in today’s 6minutes, the minister says compromise is essential in a project that involves so many different groups, and she urges the AMA to come on board as a partner rather than “tear apart consensus” and leave medical records in a Luddite time warp.
.....
The Rural Doctors Association of Australia also said it supported the PCEHR program but was disappointed that no special rebate will be paid to doctors.
“Many rural doctors are already working long hours and struggle to keep their practices economically viable. Given this, they may be reluctant to participate in the PCEHR system without appropriate incentives for the time they will have to spend creating and updating the electronic records,” said RDAA president Dr Nola Maxfield.
This article is found here:
Miss Roxon was presumably reacting to this release from the AMA.

Medical advice missing from e-health records plan

AMA President, Dr Steve Hambleton, said today that the AMA was disappointed that the Government has failed to heed medical advice in finalising its Concept of Operations for the personally controlled electronic health record (PCEHR).
Dr Hambleton said the proposals could ‘de-medicalise’ electronic patient health information.
“Little has changed from the draft plan despite the sound advice provided by many medical groups, including the AMA, about what should be included on a patient’s health record.
“The Government has caved in to minority consumer groups.
“Under the proposed arrangements, people will be able to alter their health record without consultation with their doctor.
“Patients could entirely remove from their record clinical documents that they had previously considered worth sharing with healthcare providers.
“This is a very dangerous precedent that could undermine all the potential benefits of an electronic health record.”
Dr Hambleton said that the AMA would prefer the system to be opt-out, not opt-in.
“The opt-in system has resulted in incredibly complex rules for patients to give their doctors access to their PCEHR,” Dr Hambleton said.
“And there are still concerns around medico-legal liability associated with the electronic health record.
“The AMA is a huge supporter of e-health and the benefits it can bring to the health system, but we cannot support aspects of the system that do not improve on what we have now and which potentially create risks to patient health.
“We will have a system that doctors and other health practitioners are keen to embrace but won’t be able to because their patients haven't yet given them access to their records.
“Australia has the opportunity to be a world leader in electronic health but it won’t happen with the very complex health record announced today,” Dr Hambleton said.
The release is here:
We have also had the Rural Doctors Association of Australia react.

Patient controlled e-health records: Better support needed to ensure rural uptake

The Rural Doctors Association of Australia (RDAA) has warned that rural practices will need adequate support to ensure the success of a Patient Controlled Electronic Health Records (PCEHR) system in the bush.
RDAA was responding to comments made this week by the Federal Health Minister, Nicola Roxon, that at this stage no special rebate will be paid to doctors to cover their time in creating health summaries for PCEHRs.
RDAA wrote to the Minister earlier this month advising that, without such a rebate, many rural practices will find it difficult to meet the challenges associated with implementing a PCEHR system.
“RDAA supports the PCEHR as a means of making important patient information available to doctors working in different locations and with different systems” acting RDAA President, Dr Nola Maxfield, said.
“This is particularly relevant for rural patients who are most likely to be transferred away from their local community in the event of a medical emergency or serious illness.
“However, we have a number of concerns about the likely uptake of the PCEHR system in rural and remote areas.
“Many rural doctors are already working long hours and struggle to keep their practices economically viable. Given this, they may be reluctant to participate in the PCEHR system without appropriate incentives for the time they will have to spend creating and updating the electronic records.
Full release is here:
In the presence of this response I find two sections from the Minister very worrying:
First:
“For instance, we’ve seen the AMA saying we’re not listening to doctors. This couldn’t be further from the truth. They should try telling that to the College of GPs that has endorsed the plan, the leaders of the program include former Presidents of the AMA and RACGP, and the over 50 clinical leads that are closely engaged in the program.
The truth is that while the AMA haven’t won every single discussion about how the records will work, we agree on most of the design of the system. We’ll never be able to agree on every single detail because the Government has to take all the right advice and make decisions that are in the overall interest of the community and patients, not one professional group.”
The Minister is assuming here she can undertake the implementation of the PCEHR without at least tacit support from the AMA and the RDAA. She clearly does not have that support at present and she surely can’t imagine she is on a winner without such support. What is happening here is she is trying to ‘verbal’ the AMA etc. to support a plan they know is flawed. That is a looser of an approach if I have ever seen one!
“What the AMA needs to consider is whether they will be a partner to deliver eHealth, or whether they will act in opposition and miss this once in a generation opportunity.
By working for the collective good, everyone can help us deliver a solution to benefit patients and clinicians. The alternative option is to try and tear apart consensus on this program and leave a legacy of mountains of paper in hospitals and GP surgeries – unconnected and stuck in a luddite time warp.
It would be a waste to miss this opportunity to transform our health system.
For our part, we will continue to push ahead with this program in a way that engages our hard working clinicians, but unapologetically also making sure that this is a system that has patients at its heart.”
What the Minister should be considering here is that the PCEHR she has been advised to try and implement is by no means the best approach to this mythical ‘e-health’ she is conceptualising at a remarkably simplistic level.
I am perfectly sure both the AMA and the RDAA would be thrilled to work with Government in implementing a practical workable e-Health Strategy and but sadly the present ConOps is just not it!
The bottom line is that the RACGP thinks the PCEHR needs some work according to their most recent release:
See here:
 “Dr Bennett pointed out however, that some aspects of the plan still needed to be worked out.
“As highlighted in previous College submissions, we would have preferred to have a default option of the patient’s usual GP being the nominated healthcare provider. However, the College acknowledges that in some very remote areas without full-time general practice services, this role is best filled by a healthcare provider other than a GP.
The RACGP is also concerned that the current plan doesn’t offer any incentives for GPs and urges the Government to consider how this additional effort will be acknowledged.
“We would like to see amendments to the Medicare Benefits Schedule to recognise the additional workload GPs will undertake in consultations initiating and maintaining the patient’s shared health summary and other elements of the PCEHR,” Dr Bennett said.”
Full release here:
- and the AMA and the RDAA are pretty convinced it is not a goer in its present form.
Sorry Minister you have a lemon here of the same sort as a number of other Labor plans.
I hope your advisers are brave enough to tell you that without medical profession support this will be a huge unused white elephant!
David.