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."

Wednesday, March 28, 2012

The Health Minister Decides GPs Need To Be Paid for PCEHR Services, Restricts Ambition Dramatically and Sanity Finally Prevails!

Here is the transcript of the speech given today.

TO HEALTH E-NATION CONFERENCE

Gold Cost
28 March 2012
______________________________________________________________
I would like to acknowledge the traditional owners of the land on which we meet today, the Bundjalung people and pay my respects to elders past and present.
I am delighted to be here at the Health-e-Nation conference.  eHealth is an exciting area of innovative health practise and of industry collaboration.  I imagine we’re all pretty excited about the health benefits eHealth can deliver.

The Health And eHealth Reform Agenda

But in eHealth, as in our health reforms more broadly, two questions drive my approach to the Health Portfolio -
- is it good for patients? and
- of all the competing demands for the health dollar, is this the best thing we can do with our investment?
The case for eHealth needs to be made with both these questions in mind.
The anecdotal benefits of eHealth are obvious.  I heard from a doctor recently, married to another doctor, whose father-in-law lived with them.
The father-in-law collapsed in a shopping centre from a perfectly preventable negative interaction between medicines after his GP and gerentologist changed his medication without knowing what the other had done.
Each year around Australia there are more than 15,000 hospital admissions because of medication errors due to poor patient information.  eHealth will help to reduce such errors.
eHealth will also mean:
- better co-ordinated care for patients with chronic or complex illnesses;
- reduced duplication of testing;
- less of a need for patients to retell their story every time they see a healthcare professional; and
- a more efficient use of time, staff and funding.
These benefits were recognised by health ministers from across the country back in October 2008 through the National eHealth Strategy.
The Strategy details the shared commitment of all governments to developing electronic medication management, secure electronic messaging between healthcare providers, the use of healthcare identifiers for patients and providers, digital authentication, and a national eHealth records system.

eHealth Achievements So Far

Any change so large and so complex, any infrastructure investment so significant, needs solid foundations.
Our progress on the foundation elements of an eHealth system has been strong.
In 2010 the Healthcare Identifiers Service commenced operation.  And already more than 1.7 million Individual Healthcare Identifiers have been matched and downloaded from the Service.  This is an essential part of the preparation for the roll out of the eHealth records system, as it allows healthcare professionals to accurately identify patients so they can safely exchange their records.
We’re also seeing around 70% of community pharmacies now using ePrescribing.  One prescription exchange service reported 4.2 million prescriptions dispensed in the week before Christmas last year alone.
We’ve also developed specifications for the clinical software that healthcare professionals use that allow them to contribute to and access a patient’s eHealth record, including shared health summaries, event summaries and discharge summaries with their patient’s permission.
And of course we are currently building the foundations of a national eHealth records system.

The National eHealth Records System from 1 July

The national eHealth records system will be a cornerstone of eHealth in Australia…
…and from 1 July this year the Federal Government will start to roll it out.
From 1 July, patients will be able to register for their own eHealth record through Medicare shopfronts and over the phone.  And mums and dads will be able to register for their kids.
When they’re registered, patients will be able to go online to view their record and add a range of basic health information, including emergency contact details, the location of their advanced care directives, any allergies they have or medication they’re on.
Patients will also be able to create their own private ‘diary’ area of the eHealth record, where they can enter their own health-related notes.
Powerful patient privacy controls are a critical part of the eHealth record.
From the start, patients will also be able to set these privacy controls to determine who can access which information.  For extra security, patients will also be able to see an access log that shows them every time their record has been a viewed or edited.

1 July – The First Step Of Many In A Gradual Roll Out

This is a big and exciting project, but I’m determined not to rush it.
This isn’t a matter of ‘flick a switch’ on 1 July and away you go.
We’ve always said the rollout of the national eHealth system would be in gradual, carefully managed phases.  That is the sensible, responsible way to deliver this reform.
The initial step we’ll take on 1 July has always been about two key things…
…firstly, delivering the core national eHealth system – the building blocks…
…and secondly, allowing the first patients to register.
   And both are on track.
Over time, as patients and doctors register, more detailed and sophisticated features will be available as part of an eHealth record.
Eventually things like immunisation records, Medicare and pharmaceutical benefits information, organ donation details, and hospital discharge papers will be able to be added.
And healthcare professionals will start to integrate patient eHealth records with the software they use in their practices…
…so they’ll easily be able to add new information to a patient’s record.
The Northern Territory introduced a form of eHealth records a few years ago.
What that example shows us is that take up tends to be slow in the first couple of years, but that as the system matures take up accelerates.  We expect that to be the case for the national eHealth records system too.
This project has been talked about for a decade, so naturally there is a high degree of interest and excitement now that it’s becoming a reality.
The roll out of eHealth will eventually change the way patients are cared for, starting first with the highest users of health services.
Just as the Snowy Scheme took years to build, and moved, over time, from simply an irrigation project to a renewable energy project that today powers the morning and evening rush hours of Sydney, Brisbane, Canberra, Melbourne and Adelaide.
This didn’t happen overnight, nor was the full potential of the project realised on the day the water started flowing.  The national eHealth records system will grow and evolve in a similar way.
Labor governments are nation building governments.
Labor governments invest in infrastructure.
And we’ve committed to building and investing in an eHealth records system because it’s the 21st Century digital infrastructure that will help revolutionise healthcare in Australia.

Support For Healthcare Professionals

For healthcare professionals, eHealth records will mean easier and faster access to more patient information. This is good news for all clinicians — perhaps for GPs more than most, because they see such a large number, and wide variety, of patients.
We know clinicians will be central to the smooth and effective operation of the national eHeath records system.
That’s why the Government has supported GPs to prepare for eHealth through Practice Incentive Payments.
In 2010-11 the Government invested around $85 million in the Practice Incentives Program eHealth incentive, with around 4200 general practices receiving up to $50,000 each.
These Practice Incentive Payments have ensured that over 95% of GP are using computers and the Internet.   Australian GPs are, in fact, the fifth most computerised general practice workforce in the world.
And today I’m in a position to detail additional support for GPs.
I am pleased to confirm MBS consultation items will be available to GPs as part of providing continuity of care to a patient, and if they are creating or adding to a shared health summary on an eHealth record which involves taking a patient’s medical history as part of a consultation.
The Level B, $35.60 benefit will be available for consultations that involve taking a medical history for less than 20 minutes.
The Level C, $69 benefit will be available for consultations that involve taking a detailed medical history for more than 20 minutes.
And the Level D, $101.55 benefit will be available for consultations that involve taking a more extensive medical history for more than 40 minutes.
I want to confirm that the use of the longer consultation items will be seen as appropriate by the Medicare Australia Practitioner Review Process and the Professional Services Review in circumstances where there is clear evidence of patient complexity and there is documentation of a substantial patient history.
I understand that issues surrounding the use of MBS items have caused some uncertainty in the profession, so I am happy to offer these clarifications today.

A Genuine Partnership

I am committed to a genuine partnership between our Government, patients, healthcare professionals and the IT sector to deliver this important reform.
Our 12 eHealth pilot sites are an example of this collaboration in action.  I visited one of these pilot sites in Brisbane a couple of weeks ago – Metro North Brisbane Medicare Local.
I saw for myself the innovative new technologies being trialed and the strong partnerships being forged between healthcare and IT professionals for the good of patients.  These pilot sites are breeding grounds of best practice that we can learn from and weave into the roll out of the national system.

Conclusion - Making a real difference for patients

But it’s not just the pilot sites that are adopting these new opportunities with vigour.
Earlier this year I was impressed by Professor John Wilson’s telehealth project and the potential for expanding in-home services for patients in remote areas or those who find travel difficult.
A few weeks ago I visited Shell Cove Family Practice – one of our GP Super Clinics – and saw their ability to integrate patient data – to look for smokers or diabetics or young mums to proactively offer better services or interventions.
A growing number of Australians will come to see and enjoy the value of a national eHealth records system as functionality increases and access improves.
They will see the benefits in managing their own health care and that of their family, and in creating a safer, more efficient and effective healthcare system.
Take the case of Vietnam veteran Peter Ryan, who was rushed to hospital on a Sunday afternoon with what turned out to be renal failure.  Before he was diagnosed, the emergency medics were forced to waste valuable time trying to contact his GP to find out what medication he was taking.  ‘I could have died while the hospital staff were chasing my medical history,’ Peter says.
With a national eHealth records system, a frightening situation like that could eventually be a thing of the past.
Technology has long been a driver of significant advances in health care in Australia — of our ability to detect and treat injury, illness and disease, and of our ability to protect and preserve life.
The great majority of our healthcare professionals — GPs, specialists, pharmacists, and allied professionals such as physiotherapists and psychologists — use computers regularly in their daily practice.  And most of us have internet access at home.
The problem has been that up to now, all these computers have not been talking to each other.
But the Government’s national eHealth records system will enable secure and consistent information sharing.
Government has worked with the health profession and the IT industry to develop the common language and secure information transfer needed to make a real difference where it matters most - for patients in clinics, hospitals and homes across our nation.
ENDS
-----
All I can say is that this is the most sensible speech on e-Health I have heard for a good while. It recognises it is long and hard, sets way more sensible objectives for July 1, and makes it clear this will be years in the making.
Recognition of the e-prescribing services and so on that are already operating is a welcome change indeed.
Minister Plibersek gets high marks indeed in my view for this resetting, recalibration and recognition she needs the GPs to have e-Health work.
Good on her.
Is my job done here?
David.

Tuesday, March 27, 2012

At Least Some Small Proof There Is E-Health Beyond the PCEHR! Good News Indeed.

The following article appeared today.

E-medical records help streamline Sydney's new cancer centre

LOCAL oncology software developer Charmhealth will supply a $5 million e-medical record system for the $230m Lifehouse cancer treatment and research facility under construction in Sydney.
Cancer patients are typically treated by a diverse team of medical specialists, and the oncology-based e-medical record (EMR) system will support secure sharing of patient information across the facility.
Chief executive Tim Dugan said Lifehouse had signed a multi-year contract with Charmhealth after an implementation study showed its solution would deliver significant clinical and business benefits.
"The fully integrated ICT system will be one of the cornerstones supporting the Lifehouse vision," Mr Dugan said.
"The expected efficiencies will enhance the patient experience, making it safer and simpler."
Charmhealth's unified EMR suite will streamline patient appointment bookings, provide advanced clinical decision support, create treatment orders and handle medication management, including the procurement of medicines.
Lifehouse recently signed up TechnologyOne to provide OneHealth -- its pre-configured suite of financial, asset management, planning and customer relationship modules -- as the facility's core corporate system.
Lots more here:
Usefully I also had an e-mail today from Alicia Cook who is the Clinical Systems Project Manager for the clinical aspects of the project. She sent me a release and some other material.
Here is a release on the planned system:

Charmhealth preferred vendor for Lifehouse Oncology Information System

Charmhealth - Australia's leading developer of oncology information technology solutions, today announced it has been named as preferred vendor to provide to deliver the Lifehouse Oncology Information System - a comprehensive oncology electronic medical record (EMR) solution to The Chris O’Brien Lifehouse at Royal Prince Alfred Hospital, Sydney, Australia.

Comprehensive EMR

The Chris O’Brien Lifehouse at RPA (Lifehouse) is due to open mid 2013 and will be a world-class cancer treatment and research facility providing integrated care and support services to public and private patients.
Lifehouse have now finalised contract negotiations with charmhealth for a multiyear contract to supply a comprehensive EMR solution after the preliminary implementation planning study completed in December 2011 identified significant clinical and business benefits that will be delivered by the charmhealth solution.
The expected efficiencies have direct flow-on effects that will enhance the patient experience - making it safer and simpler.
Charmhealth will provide a comprehensive, unified EMR that supports the accurate and efficient creation of treatment orders; facilitates and streamlines patient bookings for treatment; supports the manufacture, purchase, prescribing and administration of medicines and provides advanced clinical decision support, an intuitive user interface and effective tools to enhance the collection and sharing of information across the continuum of care.
Patients and their families can expect:
·         Enhanced safety in relation to medication prescribing and administration with a closed-loop electronic medication management system
·         Reduced waiting times due to efficiencies in scheduling
·         Improved communication between care providers through access to a unified patient record
·         Increased involvement in care via a patient portal giving access to the nominated care coordinator and information important for patient wellbeing
·         Expanded geographical reach of services due to the use of appropriate technology
·         A seamless experience throughout the entire patient journey from diagnosis to survivorship

Tim Dugan, Lifehouse Chief Executive Officer, said “Our patients are the focal point of our care philosophy and the fully-integrated ICT system will be one of the cornerstones supporting the Lifehouse vision.  As a centre for excellence, it is essential for us to select a solution that delivers a standards driven platform that aligns with Australia’s contemporary E-Health Strategy.”
Anne-Marie Hadley, Chief Information Officer of Lifehouse, said “The charmhealth solution has been designed on best-practice principles both in software architecture and health informatics. It offers a seamless experience for patients, families and staff across the entire patient journey and the unified patient record will support effective communication for safer patient care.”
"We are putting a large effort into the change management aspect of the project and expect this focus will enable new users to have a seamless transition when the system goes live," she added.
Janine Garrett, CEO of charmhealth, said: “The charmhealth team is committed to a long term partnership with Lifehouse that will deliver improved service and quality outcomes for the integrated cancer centre and its patients. 
Our solution incorporates the latest Microsoft technologies and will complement the state-of-the-art facility and services by offering the most advanced functionality of any oncology EMR solution on the Australian market today.” 
----- End Release
For those interested in the technology base I was given this description:
"The Lifehouse CHI EMR/EMM solution leverages and builds on charmhealth’s existing CHARM-ONCOLOGY solution platform, introducing a web based interface layer built using Microsoft .NET technologies and Silverlight. The emphasis is on providing a seamless user experience across all layers, while ensuring ease of access is balanced with security at all levels. The solution is scalable and growth can be accommodated as non-traditional care models, like telehealth and video consultations, are introduced.  Moving forward the CHI solution will form the technology platform for all charmhealth clinical applications. It uses the .NET Framework 4.0 making full use of the new user experience technologies of Silverlight 4.0 and ASP.NET 4.0.  CHI takes full advantage of features offered in SQL Server 2008.  The solution design and build has taken a standards based approach and incorporates many features of the Microsoft Common User Interface, as designed with the NHS in the UK."
She also kindly provided me with a link to a (high-level) video on what was being planned.
Here is the link:
For those that do not know the company their site provides a lot of useful information. See here:
What to say other than to encourage Lifehouse to take a path less travelled with a system tailored specifically to meet the needs of their type of care delivery.
The only risk I see is in the development of some core modules such as PAS which are not presently in the suite against a fairly tight timeline. I am sure they have the problem covered - but such systems are not quite as simple as they may appear sometimes.
To offset that risk there does seem to be a pretty good development and implementation track record.
It is, however, really good to see that delivery of useful speciality e-Health has not been totally drowned out by all the fuss around the PCEHR!
Great to have what seems to be a very good news story to write about!
David.

Monday, March 26, 2012

Weekly Australian Health IT Links – 26th March, 2012.

Here are a few I have come across the last week or so.
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

-----
Well last week was a ripper. Firstly we had a report on the PCEHR from the Senate, which despite the spin from NEHTA and DoHA, was pretty critical of how the PCEHR Program had been managed.
Secondly we have now had the Opposition has declared its position. This has to mean there is now considerable uncertainty with respect to the future of the PCEHR Program.
-----

Disarray surrounds database

  • by: Sue Dunleavy and Karen Dearne
  • From: The Australian
  • March 24, 2012 12:00AM
THREE months before the latest holy grail of the health system is launched, Labor's Personally Controlled e-Health Record is beginning to look like a pub with no beer, or an electronic health record with no clinical details.
The program is $300 million over budget and the list of significant technical, security and organisational flaws is growing, as is the likelihood it will go the way of Britain's $18.4 billion version of the PCEHR. It was dismantled last September after just 8.25 million people out of 60 million opted in and only 1203 GP practices loaded records on to the program.
This week government members on a Senate inquiry into the PCEHR reported concerns the system may not be ready on July 1. Coalition members called for it to be delayed for 12 months.
-----

E-Health start faces delay says Opposition Senator Sue Boyce

OPPOSITION Senator Sue Boyce says the Gillard government’s personally controlled e-health system will not start on July 1, as its enabling legislation has just vanished off the face of the earth”.
“The government has not put up its PCEHR Bills for debate in the Senate in this last sitting session before the Budget,” she said in a statement.
“The very earliest the Bill can be passed now is the week of May 8 to 10, just seven weeks before the PCEHR program is due to start.
“Coalition members have been warning the government for more than 12 months that their start-up date was too ambitious.
-----

Rules for personally controlled e-health record system released

  • by: Karen Dearne
  • From: Australian IT
  • March 21, 2012 11:35AM
THE proposed rules and regulations for the operation of the personally controlled e-health record system by the federal Health department have been released two days after a Senate inquiry into the PCEHR legislation reported its findings.
The head of Health's e-health division, Fionna Granger, invited public comment on the PCEHR System: Proposals for Regulations and Rules paper, by April 11.
"The Personally Controlled E-Health Records Bill 2011, currently before Parliament, provides the legislative framework for the operation of the PCEHR system but not the particular operational detail," she said.
-----

Concerns raised over e-health plan

  • by: Karen Dearne
  • From: Australian IT
  • March 20, 2012 10:28AM
THE results of a Senate inquiry into the Gillard government's Personally Controlled E-Health Record Bills have split along party lines, with the Labor majority recommending the bills be passed and Coalition senators calling for a delay until July 1 next year so that unresolved issues can be addressed.
In "additional comments" on the main report, the Greens have recommended five amendments to enhance the legislation, including greater privacy protections.
The PCEHR Bills will now be debated in the senate, following their passage in the lower house last month.
-----

Senate Committee qualifies e-health approval

Coalition Senators seek pushback.

A Senate committee examining proposed legislation for the Government's e-health records scheme has recommended the bills be passed as long as their operation is reviewed in 2014.
Senators on the committee approved the bills' passage without amendment, although they accepted a range of shortcomings raised in the evidence given to the committee.
The Greens sought four amendments, including around data protections. 
-----

Conflicting recommendations spur hot debate over PCEHR

21st Mar 2012
LEGISLATION enabling the personally controlled electronic health record (PCEHR) system is set to be hotly debated in the Senate after a parliamentary inquiry splintered into conflicting recommendations from government, Greens and Coalition senators.
Government senators on the Community Affairs Committee recommended the bills enabling the system be passed and reviews of the governance structure and a possible transition to an ‘opt-out’ model be conducted after two years.
An opt-out model would provide every Australian with an e-health record by default, rather than requiring them to sign up of their own accord.
-----

GPs key to e-health success: Plibersek

  • by: Karen Dearne
  • From: Australian IT
  • March 22, 2012 5:30AM
HEALTH Minister Tanya Plibersek wants GPs to take a lead role in reforming healthcare through the adoption of e-health systems.
"E-health is an important area with great potential to improve the convenience and quality of care for patients," she told a conference for GPs in Canberra.
"It's also an area where the government is keen for GPs to take a lead role."
Ms Plibersek said the government would start to roll out the personally controlled e-health system from July this year.
-----

Patients will have to pay for eHealth

 PATIENTS will have to pay up to $280 out of their own pockets if they want a personally controlled eHealth record from July because there is no Medicare rebate available to cover the cost of a doctor setting it up.
A Senate committee last night also raised concerns the government's $470 million eHealth scheme may not be ready to go on its proposed starting date of July 1.
The Senate community affairs legislation committee said the government should rethink the key design principle of the system and consider switching from a model where patients have to opt in to one where they must opt out.
The committee received evidence from consumers and doctors that the system might not fly if not enough patients decided to opt in. It says when the scheme is reviewed in 2014, the government should consider switching it to an opt-out model.
-----

DoHA secretary signals future for NEHTA

Department of Health and Ageing secretary Jane Halton has moved to ease concerns about NEHTA’s future, stating the organisation will continue to function into the second half of this year.
The current round of funding for the National Ehealth Transition Authority expires after June 30. However, Ms Halton has revealed the government’s lead ehealth organisation will continue to function beyond that deadline as it continues to work on the government’s Personally Controlled Electronic Health Record (PCEHR) project.
-----

DoHA expects ‘measured’ PCEHR adoption rate

The federal government’s incoming ehealth System Operator has revealed she is expecting consumers will not rush to sign up for personally controlled electronic health records, and has not set target rates for adoption.
Jane Halton, secretary at the Department of Health and Ageing and PCEHR System Operator from July 1, pending legislation, also said more than 1.4 million consumer identities were registered in the PCEHR system via the wave sites where the ehealth system is being trialled.
Speaking exclusively to eHealthspace.org ahead of her appearance at Health-e-Nation 2012, Ms Halton said: “I do not expect that the entire nation will opt in on 1 July, and actually we don’t want that.”
-----

Concerns raised over e-health records for elderly

NEHTA conceded that the system may not be "senior friendly"
The suitability and accessibility of the Federal Government’s Personally Controlled Electronic Health Record (PCEHR) system for the elderly has been brought into question by a Senate committee investigating cyber safety for senior Australians.
The committee voiced concerns to the National E-Health Transition Authority (NEHTA) — the body charged with the rollout of the PCEHR — around just how “senior-friendly” and easy to use the system would be for the demographic.
-----

NEHTA to front Senate cyber safety hearing

NEHTA is taking steps to reassure government and health industry stakeholders that it is comprehensively addressing a range of ehealth privacy and security concerns.
Industry groups including AusCERT have questioned the efficacy of the ehealth agency’s standards and technologies for protecting the Personally Controlled Electronic Health Record (PCEHR).
-----

NEHTA rejects claims of mismanagement

By Josh Taylor, ZDNet.com.au on March 19th, 2012
The Nation E-Health Transition Authority (NEHTA) has issued a 21-page rebuke to claims from the Medical Software Industry Association (MSIA) that the $466.7 million e-health program is being mismanaged by the government authority.
At a Senate inquiry into e-health legislation last month, MSIA made a number of claims that the specifications for the individual health identifier (IHI) — which links a person to their personally controlled e-health record — risk patient safety, because when a person changed gender or birth date information, they would be issued with a duplicate health identifier.
-----

Delay launch of PCEHR for a year - Senators

20 March, 2012 Michael Woodhead
With only three months to go before the launch of the PCEHR, opposition Senators say the rushed program faces too many problems and unanswered questions and should be delayed for a year.
A Senate inquiry into the PCEHR program has divided along party lines, with the Opposition saying the short timeframe for implementation is unrealistic and that there are still unresolved issues around patients being unable to control who has access to their records,  governance and the complex infrastructure of the system.
-----

Coalition calls for e-health launch delay

By Josh Taylor, ZDNet.com.au on March 20th, 2012
The Coalition has called for the Federal Government to delay the launch of personally controlled e-health records (PCEHRs) for all Australians by one year until 1 July 2013.
The Senate committee investigating the legislation required for the implementation of the $466.7 million PCEHR system yesterday called for the passage of the Bills in its report handed to the Senate yesterday. However, a dissenting report from coalition senators Sue Boyce and Bridget McKenzie noted that the majority of participants in the inquiry are extremely concerned about the launch date being just four months away.
-----

E-health records sign onto australia.gov.au

Whole-of-government sign-on system gains second member.

The Department of Health and Ageing has settled on the Federal Government’s single sign-on portal as the primary method of accessing consumer e-health records when they are made available later this year.
Consumers who opt for a personally controlled electronic health record from July 1 will be required to link their record to their login credentials on the australia.gov.au online portal in order to access the record online.
The e-health records portal itself will be hosted by the department, the designated systems operator for the project.
-----

Call to consider 'opt-out' e-records

20 March, 2012 Paul Smith
An inquiry into patient controlled e-health records is calling on the Federal Government to rethink its plan for patients to opt into the $467 million system and consider an opt-out scheme instead.
There have been long-running concerns that the success of the initiative will be undermined by low patient take up when it goes live in July.
On Monday night the Senate's community affairs legislation committee released its report recommending the current bill to create the personally controlled e-health records (PCEHR) system be passed.
-----

NBN key for Royal Children's Hospital

By Josh Taylor, ZDNet.com.au on March 22nd, 2012
Although the new Royal Children's Hospital in Melbourne is already equipped with a fibre backbone, director of ICT architecture Brendan Kelly says "thank god" for the National Broadband Network (NBN).
The new 357-bed Royal Children's Hospital in Melbourne was opened by Her Majesty The Queen on 26 October 2011.
The hospital has a 10-gigabit fibre backbone; 108 fibre joins the hospital with two other hospitals in the area. Kelly told journalists at CiscoLive! in Melbourne today that it was a "sparkly new facility".
-----

Aussie to webcast rare surgery

By Luke Hopewell, ZDNet.com.au on March 20th, 2012
Medical pioneer and self-professed evangelist professor Andrew Renaut will once again broadcast live, unedited footage of a rare surgical procedure over the internet to medical students and professionals. Renaut, however, is being cautious not to turn his educational webcast into a reality show.
Renaut has been broadcasting his surgeries for the past five years, with the last procedure aired in 2010. The professor is now gearing up for another webcast on Thursday that will see an unedited laparotomy, colectomy, ileorectal anastomosis and repair of ventral hernia broadcasted online with the support of the Australian Institute of Medical Education.
-----

eHealth display rolls out

By Karen Keast | Date of Posting: 20-03-2012
Allied health professionals, nurses and other healthcare providers across Australia will receive a first-hand look at how the new eHealth system will operate.
An innovative, interactive mobile display is touring Australia to showcase the Federal Government’s $465.7 million national Personally Controlled Electronic Health Record (PCEHR) system, which will be available from July 1.
Now touring Australia, the National E-Health Transition Authority’s (NEHTA) Model Healthcare Community truck has been designed to outline the eHealth story and its initiatives, ranging from reception to consultation, specialists, pharmacy, diagnostics and hospital.
-----

ACMA calls for improved senior citizen cyber safety education

Face-to-face programs preferred over online sessions, according to ACMA research
Improving cyber safety education of senior citizens through more targeted programs would greatly improve their confidence and get more elderly Australians online, according to an Australian Communications and Media Authority (ACMA) submission to a Senate committee investigating cyber safety for senior Australians.
Speaking at the Senate hearing in Sydney, ACMA digital economy division general manager, Andrea Wright, said that most cyber safety programs are aimed at young people and the Authority is trying to change this.
During Safer Internet Day in 2012, for example, ACMA targeted grandparents with face-to-face presentations across Australia.
-----

Safety of older net users in spotlight

THE Health Department will give evidence on the security of the personally controlled e-health record system at a Cyber-Safety for Seniors hearing on Wednesday.
Joint select cyber-safety committee chairwoman Catryna Bilyk said the hearing would examine the benefits of moving vulnerable people, including "the fragile elderly", to the system when it launches on July 1.
-----

PCEHR operational blueprint in final draft: DoHA

Written by Kate McDonald on 19 March 2012.
An operational blueprint that will set out how the PCEHR will be managed after the system is launched on July 1 is in its final draft, according to the Department of Health and Ageing (DoHA).
In a response to questions put on notice during a Senate committee hearing into the PCEHR last month, DoHA said the operational blueprint was being developed by administrative design company ThinkPlace.
-----

HealthLink launches electronic pathology ordering

Written by Kate McDonald on 21 March 2012.
HealthLink has launched its eLab electronic pathology ordering system on the Australian market.
eLab was originally developed as part of an international collaboration between HealthLink and Danish company Danish Medical Data Distribution (DMDD).
Called WebReq in Denmark, it has been up and running there for six years and is now used by all community-based practices and some hospitals to order more than 600,000 orders per month.
-----

Electronic medical records: why we should seek a second opinion

December 19, 2011
Opinion
There are fears that the US's overreach in Iraq and Afghanistan, in combination with its tenuous financial state, may spell the end of its global hegemony. But the superpower's downfall is just as likely to be caused by the cost of MRI scans as it is by defence spending.
Health remains the greatest non-security challenge Western governments face. The task of managing an ageing population, whizbang technologies and a demanding public is awesome.
Australia is not quite in the budget quagmire on health, but there is every chance its proportion of gross domestic product costs will continue to rise above the current 10 per cent. One of the great potential contributors to efficiency in what is notoriously the most inefficient of sectors is the electronic patient record. By allowing for more efficient sharing of information, health records stored as a transferable entity in digital form could transform the entire sector.
-----

Government kicks off NBN video conferencing pilot

The trial aims to increase access for rural Australians to services such as Centrelink and Medicare
The Federal Government has kicked off a video conferencing pilot over the National Broadband Network (NBN) which aims to give regional Australians increased access to services such as Medicare and Centrelink.
The trial will offer customers access to services under the Department of Human Services (DHS) portfolio which is part way through consolidating Centrelink, Medicare and the Child Support Agency.
-----

NBN trial sites to roll out e-health, education projects

Home monitoring of type two diabetes patients in Townsville, local government video services planned by Department of Broadband, Communications and the Digital Economy
National Broadband Network (NBN) trial sites inTownsville, Queensland and Armidale, New South Wales are in the process of rolling out separate trials over the NBN designed to help Townsville type two diabetes sufferers and, in Armidale, offer remote access to TAFE courses.
Speaking at the Cisco Live conference in Melbourne, Department of Broadband, Communications and the Digital Economy First Assistant Secretary, Keith Besgrove, said the Townsville trial, which is scheduled to run for 18 months, would involve in home monitoring via video of the type two diabetes patients in collaboration with the Queensland Department of Health. The trial is due to commence within the next two months.
-----

Out with passwords, in with cognitive fingerprints

Randall Stross
March 19, 2012 - 12:14AM
We are moving to a world where you sit down at a console, you identify yourself, and you just start working, and the authentication happens in the background.
Imagine sitting down at your work keyboard, typing in your user name and starting work right away - no password needed.
That's a vision the Defence Advanced Research Projects Agency, part of the Defence Department, wants to turn into a reality. It will distribute research funds to develop software that determines, just by the way you type, that you are indeed the person you say you are.
-----
Enjoy!
David.

AusHealthIT Poll Number 114 – Results – 26th March, 2012.

The question was:
What Impact Will The Senate Report On The PCEHR Have On The Future Of E-Health In Australia?
None
-  11 (52%)
Minor
-  7 (33%)
Major
-  1 (4%)
Transformative
-  2 (9%)
Votes: 21
A crystal clear outcome - readers think there will be no difference made. This is the first poll in a long time where I think the majority has it wrong. I really think the impact will be pretty large - especially on NEHTA.
The bad blood and relationships between NEHTA and DoHA is well understood by the political insiders (the Senators) and they clearly have sided with DoHA in their report. What this will mean for NEHTA is unlikely to be good.
Again, many thanks to those that voted!
David.

Sunday, March 25, 2012

The Future Of the PCEHR Program Is Now Really Up In The Air. Politics Will Now Play A Major Role In What Happens.

The following report appeared a couple of days ago.

E-Health start faces delay says Opposition Senator Sue Boyce

OPPOSITION Senator Sue Boyce says the Gillard government’s personally controlled e-health system will not start on July 1, as its enabling legislation has just vanished off the face of the earth”.
“The government has not put up its PCEHR Bills for debate in the Senate in this last sitting session before the Budget,” she said in a statement.
“The very earliest the Bill can be passed now is the week of May 8 to 10, just seven weeks before the PCEHR program is due to start.
“Coalition members have been warning the government for more than 12 months that their start-up date was too ambitious.
“Now it looks as though Health Minister Tanya Plibersek secretly agrees.”
On Monday, the Senate Community Affairs committee reported its inquiry into the PCEHR had uncovered a wide range of concerns and unresolved issues, but the Labor majority recommended passing the bills.
However, the Coalition members called for a one-year delay of the program’s commencement, in a dissenting minority report.
Senator Boyce said the PCEHR project was “just another example of Labor’s shambolic and systemic mismanagement”.
“The government makes a big deal of announcing a date and then scrambles ineptly to meet the deadline, irrespective of the quality of their programs,” she said.
“The Coalition has argued the July 1 deadline is foolish, and even dangerous.
“Expert evidence from clinicians, privacy organisations and the medical software industry is that neither the processes nor the systems have been adequately tested before being unleashed on the public.”
Senator Boyce said the inquiry had showed there were “a huge range of problems” still to be ironed out.
Lots more here:
In the same article there is also evidence the Health Minister is working to lower expectations.
“Earlier this week, Ms Plibersek confirmed that the government would commence its PCEHR rollout from July this year.
Over time, the system will join the dots electronically between GPs, pharmacists, specialists, allied health professionals, hospitals and patients,” she told a conference for GPs in Canberra.”
You can read the full press release from Senator Boyce here:
So where are we?
As I read it the Opposition is by no means convinced regarding the PCEHR Program and the Government is realising that the program will take years and years.
In this situation it has to be virtually certain that a change of Government - which on present polling seems likely in the next 18 months - would result in some very detailed and thorough review of what has been delivered and just what value for money has been realised. The outcome of that review is unlikely to be very positive in terms of either adoption or clinical benefits obtained I would suggest.
We also know the Paul Madden the DoHA CIO sees the PCEHR as an 8-10 year program. See here:
In that situation, and with the Opposition view being that things need, at the very least a 12 month pause, I would suggest scrutiny will be coming pretty soon and I also predict that with that scrutiny will come a recognition that there were some much better options that might have been pursued.
I note with interest even NEHTA, in its flashy brochure for consumers, is making it clear thing like e-diagnostics will not be done for a couple of years (at least).
See here:
This document is really 2 pages of content and 14 pages of NEHTA Paid Models smiling a lot! What a waste of paper and ink.
I really wonder just how long this charade can go on for before it becomes clear that we are heading for a really awful e-Health train-wreck and that sanity can only be regained by a major pause and review.
To just steam on towards the iceberg is plain idiotic.
Especially when the Senate Inquiry has provided a long list of  the issues to be addressed as well as the political cover for the Government to go ahead and actually pause and sort things out.
David.