The Canadian Medical Journal Suggests the NEHRS (PCEHR) Is A Crock. The World Is Starting To Notice.

The following appeared a few days ago in Canada.

NEWS

April 30, 2012

Bloom fading from e-health golden wattle

It sounded like a great idea in 2010: a personally controlled electronic health record that would allow Australians to access and share medical records in a nationwide database. The system, it was argued, would support better medical decision-making, reduce errors and save time and money.

To that end, the government set aside A$467 million and targeted an ambitious launch date of July 1, 2012.

Medical groups such as the Australian Medical Association lauded the notion, asserting that a shared electronic health record would help doctors deliver better care as they’d have access to a patient’s full clinical records no matter where he was treated. Health and consumer advocates were equally effusive. The proposed system would yield improved health outcomes, reduce medical mistakes and provide confidential health records.

But as details emerge and the launch date nears, the supposed charms of a Personally Controlled e-Health Record (PCEHR) appear to be fading, much as the bloom eventually withers on Australia’s national flower.

“E-health in general is a good idea, but you need some other infrastructure and you need it to be comprehensive,” says Robert Wells, director of the Australian Primary Health Care Research Institute. “In my view, it’s a complete waste of money and I’m not sure what they hope to achieve from it.”

What has changed so dramatically in a few scant years?

As now envisioned, patient interaction with the system will be much more limited. The federal Health Department has admitted there will be privacy risks in the transfer of patient data. And a recent Senate inquiry indicated that the software, as well as the architecture that will allow patients and clinicians to join the network and share data, may not be ready on time.

“There is still some very significant development work to be done on the PCEHR functionality,” Rosemary Huxtable, deputy secretary with the Department of Health and Ageing, told parliamentarians.

Because of that lack of “functionality,” the Australian Medical Association and the Health Care Consumers’ Association have expressed consternation about the timing of the system’s rollout, while a coalition of senators is urging that the venture be delayed for 12 months.

.....

As for privacy concerns, Australian security experts are warning that insufficient security protections could leave the system open to hacking.

The health department insists clinical data will be encrypted during transmission but acknowledges that it could be compromised at the personal computer level. To combat that, the department says it will issue instructions to users as to how to protect themselves from security threats.

Others are now struggling to comprehend whether the system, as currently envisioned, will have any benefits.

.....

An ideal e-health plan would reduce costs for funders, reduce liability risks for physicians and bolster a patient’s ability to share in the management of his health records, says Klaus Veil, vice president of the Australasian College of Health Informatics.

But as currently configured, the personally controlled electronic health record that will become operational in July is not capable of “doing the job,” Veil says. “Core bits are missing. We don’t know if and when this functionality will actually be in the PCEHR.”

DOI:10.1503/cmaj.109-4180

— Tanalee Smith, Adelaide, Australia

Full article is found here:

http://www.cmaj.ca/site/earlyreleases/30april12_bloom-fading-from-e-health-golden-wattle.xhtml

Looks like the news is starting to turn on the NEHRS as more and more local expert decide to speak out to point out the legion of flaws they now seem to be seeing in the PCHER.

In December 2010 this blog was pointing out a major set of issues:

See here:

http://aushealthit.blogspot.com.au/2010/12/it-isnt-only-wikileaks-that-can-cause.html

and here:

http://www.aushealthit.blogspot.com.au/2010/12/it-is-now-clear-pcehr-is-nothing-but-pr.html

and even earlier we had more here:

http://www.aushealthit.blogspot.com.au/2010/07/nehta-and-doha-are-heading-in-wrong.html

Funny it seems to have taken so long for people to realise just what a crock this is.

Indeed see here a full 18 months earlier:

“I previously provided a Submission on the PCEHR proposal to NHHRC in May, 2009 and the views expressed in that submission remain my position despite the work undertaken by DoHA and NEHTA since.

This submission is available here:

http://www.health.gov.au/internet/nhhrc/publishing.nsf/Content/309-interim/$FILE/309%20-%20Submission%20-%20Dr%20David%20More.pdf”

Sadly they stubbornly pressed on and now we see the result. Next Tuesday (Budget Night) will tell us all just how stubborn they will really be!

David.

Is This Another Evidence Free Intervention From DoHA? It Might Not Be But More Work Is Needed To Be Sure.

The following appeared a little while ago.

Consider broad telehealth benefits

A NEW US study which showed “underwhelming” clinical outcomes from telemonitoring still adds to the knowledge base about telehealth and should not dissuade doctors from its benefits, according to Australian experts.

Professor Len Gray, director of the Centre for Online Health at the University of Queensland, said the study, published in Archives of Internal Medicine, was well designed but examined only clinical outcomes, when there were many other potential benefits of telehealth. (1)

In the trial, 205 older adults with multiple illnesses were randomly allocated to receive usual self-directed care, or daily sessions of telemonitoring for assessment of symptoms and measurement of biometrics such as weight, blood pressure, blood glucose levels, oximetry and peak flow, with the use of videoconferencing.

In the 12 months following enrolment there were no differences in rates of hospitalisation and emergency department visits between patients receiving telemonitoring and those receiving usual care.

The study authors said the results provided “further evidence of a lack of efficacy of telemonitoring on hospitalisations and ED visits”.

“Given the potential costs of telemonitoring and the lack of efficacy, it may be important for physicians and funding organizations to evaluate which patient groups might be most responsive and which implementation strategies will be most useful”, they said.

Professor Gray said telehealth came in many forms and had an array of outcomes other than clinical, such as lowering costs for patients and allowing doctors to be more efficient, which were not measured by this study.

He said that in Australia the goals of telehealth were not necessarily confined to clinical improvements but were also about providing health services to rural and remote communities and increasing efficiency for doctors.

More here:

http://www.mjainsight.com.au/view?post=Consider+broad+telehealth+benefits&post_id=8934&cat=news-and-research

One really has to wonder what is going on here - if we are not doing things for overall clinical benefit just what are we on about?

Clearly we need to consider just what all this means. I fear we might be a bit trapped in a definitional mess.

The Government announced a $620 Million Telehealth Initiative in June 2011.

Here is the release.

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr11-nr-nr127.htm?OpenDocument&yr=2011&mth=06

The abstract reports a rather limited type of telehealth - and certainly does not address some issues of concern in far-flung rural Australia.

A Randomized Controlled Trial of Telemonitoring in Older Adults With Multiple Health Issues to Prevent Hospitalizations and Emergency Department Visits

Paul Y. Takahashi, MD, MPH; Jennifer L. Pecina, MD; Benjavan Upatising, MSIE, PhD; Rajeev Chaudhry, MBBS, MPH; Nilay D. Shah, PhD; Holly Van Houten, BA; Steve Cha, MS; Ivana Croghan, PhD; James M. Naessens, ScD; Gregory J. Hanson, MD

Arch Intern Med. Published online April 16, 2012. doi:10.1001/archinternmed.2012.256

Background  Efficiently caring for frail older adults will become an increasingly important part of health care reform; telemonitoring within homes may be an answer to improve outcomes. This study sought to assess differences in hospitalizations and emergency department (ED) visits among older adults using telemonitoring vs usual care.

Methods  A randomized controlled trial was performed among adults older than 60 years at high risk for rehospitalization. Participants were randomized to telemonitoring (with daily input) or to patient-driven usual care. Telemonitoring was accomplished by daily biometrics, symptom reporting, and videoconference. The primary outcome was a composite end point of hospitalizations and ED visits in the 12 months following enrollment. Secondary end points included hospitalizations, ED visits, and total hospital days. Intent-to-treat analysis was performed.

Results  Two hundred five participants were enrolled, with a mean age of 80.3 years. The primary outcome of hospitalizations and ED visits did not differ between the telemonitoring group (63.7%) and the usual care group (57.3%) (P = .35). No differences were observed in secondary end points, including hospitalizations, ED visits, and total hospital days. No significant group differences in hospitalizations and ED visits were found between the preenrollment period vs the postenrollment period. Mortality was higher in the telemonitoring group (14.7%) than in the usual care group (3.9%) (P = .008).

Conclusions  Among older patients, telemonitoring did not result in fewer hospitalizations or ED visits. Secondary outcomes demonstrated no significant differences between the telemonitoring group and the usual care group. The cause of greater mortality in the telemonitoring group is unknown.

Here is the link to the abstract.

http://archinte.ama-assn.org/cgi/content/short/archinternmed.2012.256

But this report needs to be considered in the light of this work from the UK:

UK telehealth saves lives and money

Posted Thu, 26/04/2012 - 11:35 by Will Turner

The results are in on how the UK is doing telehealth, and the numbers are staggering. Will Turner reports.

The Challenge: One quarter of the UK population living with long term chronic illness.

The Approach: A trial of 6,000 patients involving biometric monitoring where patients take and transmit health readings through to clinicians who then monitor and advise the patient.

The Outcomes: Major reductions in mortality rates and hospital admissions.

The Lessons Learned: Upfront investment in telehealth based prevention saves public health dollars and improves patient quality of life.

The Upside for:

Clinicians: Better able to focus on work requiring their clinical expertise.

Patients: Empowered to better manage their own health and greater confidence in their access to care that keeps them out of hospital.

The Organisation: A more cost effective model of primary and secondary care that at the same time delivers better quality of care in a sustainable manner.

In Australia the term telehealth typically refers to video consultation: doctors talking to doctors, doctors talking to patients. By contrast telehealth in the UK is more about biometric monitoring: patients taking personal device readings in their own homes, transmitting them through to clinicians who then monitor and advise the patient.

Lots more here:

http://ehealthspace.org/casestudy/uk-telehealth-saves-lives-and-money-0

I suspect the last paragraph is the clue here. Defining Telehealth, Telemonitoring and so on is the only way to compare with apples with other apples and not oranges. The two trials look quite similar, but quite different to what is being funded here in OZ.

I think we need to wait for the evaluations of what is being done here and to see more studies in the telemonitoring area (given the different US and UK experiences) before clear conclusions can be drawn.

Bottom line, you have to be sure what you are talking about!

David.

NEHTA Looks To Be Suffering A Major Funding Cut From June 30, 2012. Duck and Cover!

We had the 2012/13 Victorian Budget announced today.

See http://www.budget.vic.gov.au/budget.html

NEHTA got a mention I am told.

On the latest figures Victoria has the following proportion of the Australian Population.

Population breakdown of Australia is 5 640.9 (Victoria) of 22960.0 (Total OZ) Individuals X 1000 - This means the ratio .245 of the national population (Source ABS 29/03/2012).

See here:

http://www.abs.gov.au/ausstats/abs@.nsf/mf/3101.0

Here is the mention and quote.

The Victorian Government plans to spend $16.6M over 2 years on NEHTA.

“$16.6 million over 2 years to enable the National E-Health Transition Authority (NEHTA) to the development and maintenance of national e-health foundations” - From Victorian Budget Papers today. (Source VHA Members Bulletin)

This implies an annual contribution of $8.8M.

This means a proportional total Jurisdictional Contribution of $35.918M

Add the Commonwealth 50% and we arrive at say $72M per annum.

Here are the totals for the last 2 years - Source Annual Reports:

Member provided revenue (which I believe is separate from the special funding for PCEHR delivery etc. - but how can you be sure?):

 2011 $122,392,640 (- $50M from this level.)

 2010 $95,635,311 (- $23M from this level.)

Looks like the contractors and temporary staff will be out on the streets with this level of cut.
Seems like (at say even $200,000 per head)  between 100 and 200 staff out the door.

Maybe the PR Department could become a single secretary, we could do without paid spruikers and the CEO could look at a pay cut since there will be a smaller organisation to run?

The implications for the Federal Budget and the NEHRS (PCEHR) are obvious. Slow down to stop mode will most likely be in place.
Please note: I am really sorry for the high quality and dedicated people who may be affected by the rather nasty cut if I am right. They deserved much better management to deliver much more skilfully so their future was much more secure.

David.

An Interesting Pair Of Articles On IT Project Failure. There Is Considerable Relevance To The NEHRS.

The following pair of articles appeared a little while ago. There seems to be a lot of relevance to what we have seen in the NEHRS (PCEHR) Program in what is said.

Who's accountable for IT failure?

By Michael Krigsman | April 16, 2012, 4:45am PDT

Summary: IT failures are a management crisis of serious proportions that have been largely ignored. Here’s what senior executives need to know - and do - right now.

This two-part series presents a structure for understanding why IT projects fail, in a way that goes far beyond project management alone. Part one elaborates the problem while part two discusses the need for greater accountability on the part of senior management.

It’s a sobering statistic: nearly 70 percent of IT projects fail in some important way, putting the economic impact worldwide at three billion dollars, which corresponds to 4.7 percent of global GDP. And it’s a universal problem: setbacks span the public and private sectors, occur in all industries, and often result in substantial economic and productivity losses.

Read Also:
Annual cost of IT failure: $6.2 trillion
Worldwide cost of IT failure: $6.2 trillion
Critique: $6.2 trillion global IT failure stats
Worldwide cost of IT failure (revisited): $3 trillion

Just look at these CRM failure statistics for the years 2001-2009 - the numbers tell a story of significant problems related to IT project delivery:

• 2001 Gartner Group: 50%
• 2002 Butler Group: 70%
• 2002 Selling Power, CSO Forum: 69.3%
• 2005 AMR Research: 18%
• 2006 AMR Research: 31%
• 2007 AMR Research: 29%
• 2007 Economist Intelligence Unit: 56%
• 2009 Forrester Research: 47%

In virtually every case of failure, management fails to anticipate serious problems. Even in cases where challenges are likely, IT failure is too often considered business-as-usual, with executives throwing their figurative hands in the air, in surrender to chance or bad luck.

IT failures happen when managers exercise insufficient judgment, possess too little experience, hire the wrong people, ignore warning signs and, crucially, fail to involve affected employees in a way that eases the path to success.

WHY IT PROJECTS FAIL

Although tempting to blame project managers for failure, we must point attention to senior executives for allowing the conditions for failure to exist in the first place. The underlying reasons fall into three categories:

1. Unrealistic and mismatched expectations
2. Conflicts of interest among customers, vendors and integrators
3. Corporate organization structure that conspires toward failure

Lots and lots more is here:

http://www.zdnet.com/blog/projectfailures/whos-accountable-for-it-failure-part-one/15451

The link to Part 2 is in the text above.

I especially like this idea presented a little further down about the ‘Devil’s Triangle’

“The Devil’s Triangle principle explains that:

Three parties participate in virtually every major software deployment: the customer, system integrator or consultant, and the software vendor. Since each of these groups has its own definition of success, conflicts of interest rather than efficient and coordinated effort afflict many projects.”

The NEHRS program has this in spades and even worse than that ‘the customer’ (i.e. the public) is the one left without essentially any voice and is being given something there has simply been no demand for in the shape it is proposed.

Point 3 also has spectacularly high relevance as we consider the utterly broken governance and leadership of the program with two distinct centres of power (DoHA and NEHTA) and the consumer essentially out of the loop.

All the issues about NEHTA being not really able to understand who the customer is and how the different stakeholder groups will see things also rings true.

Any expectation this will all turn out well seems to be extraordinarily optimistic based on this analysis.

As for who should be accountable it has to be DoHA who have taken the running and really don’t still know what they don’t know who take most of the blame and NEHTA to a lesser extent for not telling the DoHA team they were asking for a lemon. I know there are current and former NEHTA staff who have had this view for ages.

Do read the full article - they should be inscribed on tablets in every IT Department.

David.

Weekly Australian Health IT Links – 30th April, 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

An interesting and rather varied week.

The way I read it we are seeing increasing clarity in the views of the various interest groups as the start-up date approaches, and a recognition that this might be coming ‘ready or not’ and that there are still a considerable number of rough edges that need to be smoothed.

The blog posted on Friday and found here has excited one reader:

http://www.aushealthit.blogspot.com.au/2012/04/serious-commentator-makes-some-smart.html

The point I was trying to make is that patients need to be in control and  consent to what happens to them. They should also be able to - as they do now - be able to know what information is held about them. As for controlling what their carer records to assist in delivering their care - and for a host of other reasons - I see this as a professional responsibility and not something the patient should be controlling. Of course the carer has a responsibility to protect the information - keep it safe and only disclose it to anyone other than the patient when given permission and consent. As I say in the comments we have a preferred model of care delivery - based on a primary care driven model - and our Health IT should optimally support that. The PCEHR does not do that in my view.
It is also interesting the Allscripts seem to have hit a bit of a speedbump in the US. Given they support and are implementing in WA and SA there is some concern about how things will play out.

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http://www.cso.com.au/article/422310/security_concerns_over_australia_e-health_records_/

Security concerns over Australia’s e-health records

Medicos blame NEHTA’s "unreliable performance". But enough with lost data! Let’s criminalise negligent data breaches.

• Stilgherrian (CSO Online (Australia))
• — 23 April, 2012 11:34

As Australia grinds ever-closer to putting our health records online from (allegedly) 1 July, disturbing news is emerging. US hospitals are seeing more data breaches, and Australian medical experts warn that patient safety could be put at risk.

“It is not yet possible to make any definitive statement about whether the personally controlled electronic health record is safe or not," wrote three experts in the latest subscriber-only Medical Journal of Australia.

According to News-Medical.Net, the new e-health system has been subject to growing criticism based on privacy and security concerns, and that's down to the unreliable performance of the National E-Health Transition Authority (NEHTA).

There are "accusations of ineffective oversight and failure of administrators to acknowledge design flaws" and "warnings that the system will not succeed because its implementation has been ill-considered and rushed," according to the report — although NEHTA has pulled back the pace.

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http://www.news.com.au/news/are-online-medical-records-safe/story-fn6ja1a0-1226340945520

Are online medical records safe?

• Leanne Hudson
• National Features
• April 28, 2012 7:00PM

THE Government wants to put your health records in cyberspace and you’ve already been given an ID. Leanne Hudson asks if it’s entirely safe.

Imagine if any medical practitioner could access your healthcare records at the click of a mouse. The emergency department could treat you more quickly, specialists could compare test results instantly and you wouldn’t have to remember the last time you had a tetanus shot.

Welcome to the world of eHealth, a program the  Government has invested $466 million in. Its aim is to create PCEHRs (Personally Controlled Electronic Health Records) that centralise a patient’s healthcare information and, with their permission, present it to registered healthcare providers.

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http://www.medicalobserver.com.au/news/exposed-ehealth-logon-security-risk

Exposed: E-health log-on security risk

26th Apr 2012

Mark O’Brien

GPs and other practitioners have been using their unique e-health identifying number as a log-on for the AHPRA website since 2010 without being given any advice on security provisions or even warned the two numbers are the same.

Practitioners will use their Healthcare Provider Identifier (HPI-I) number to access patient information under the personally controlled e-health records system (PCEHR) and the number will be used to track each practitioner’s use and access of that information.

An AHPRA spokesperson confirmed their website log-on was comprised of the last 10 digits of a practitioner’s HPI-I. The first six digits of the HPI-I are common to every AHPRA registered practitioner.

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http://www.australiandoctor.com.au/news/latest-news/test-cases-for-e-health-pay-revealed

Test cases for e-health pay revealed

24 April, 2012 Paul Smith

Details of what MBS items doctors can claim for creating and curating shared e-health summaries were released by the RACGP on Tuesday.

Under the $467 million Personally Controlled Electronic Health Record (PCEHR) system, doctors will be expected to create shared health summaries listing patient’s diagnoses, medications, allergies and adverse reactions and immunisations.

The system is being rolled out from July. But there has been a protracted debate over the circumstances in which level B, C and D attendance items can be claimed by doctors for creating the summaries — summaries which will be shared with hospitals, doctors and other health providers who sign up to the initiative.

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http://www.australiandoctor.com.au/news/news-insight/working-with-e-health-on-the-front-line

Working with e-health on the front line

17 April, 2012 Paul Smith

Dr David Guest is one of the doctors trialling key aspects of the personally controlled
e-health records system through the Improvement Foundation eCollaborative. He has prepared shared health summaries for about 100 of his patients.

At his practice near Lismore he creates a draft version of the health summary drawn from his patient records, asking the patient to read through the information in the waiting room before correcting the summary in the consultation.

“Going through the patient information and tidying it up before it gets uploaded onto to the PCEHR does involve some work,” he says. “For new patients with a long list of problems, it could take 30 minutes ... It’s about determining what is relevant to the patient’s ongoing care. My practice consists of a lot of elderly patients with chronic disease, [such as] diabetes and heart disease patients. So they can be fairly complex."

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http://www.ntnews.com.au/article/2012/04/29/301161_ntnews.html

Doctors worry about patient data control

ELLIE TURNER   |  April 29th, 2012

DOCTORS have raised concern over joining the Territory's original e-health revolution with a new national database.

The Personally Controlled e-Health Record "opt in" scheme will allow people to enter and control their own medical data from July 1.

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http://www.lexology.com/library/detail.aspx?g=1eb0438b-10c8-4de1-bc00-7f83dddd4858

When will ehealth record legislation be passed?

• Thomsons Lawyers
• Ruth Hood
• Australia
• April 13 2012

On 25 November 2011, on the recommendation of the Selection of Bills Committee, the Senate referred the provisions of the Personally Controlled Electronic Health Records Bill 2011 and the provisions of the Personally Controlled Electronic Health Records (Consequential Amendments) Bill 2011 to the Community Affairs Legislation Committee for inquiry and report by 29 February 2012. On 28 February the Senate extended the reporting date to 13 March 2012. The reporting date was again extended to 15 March and then 19 March 2012.

The report was tabled on 19 March 2012. With recommendations to review after two years of operation, the Community Affairs Legislation Committee has recommended that the Bills be passed – click here for the report.

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http://ehealthspace.org/news/glancing-forward-prof-david-glance

Glancing forward: Prof David Glance

Posted Mon, 23/04/2012 - 14:50 by Josh Gliddon

Professor David Glance, the director for software practice at the University of Western Australia, had some reservations. He was on the phone, straddling time zones, telling eHealthspace.org he is doubtful the summary care record in the PCEHR will make any real difference to Australian health consumers.

“Globally, there’s no evidence [a summary care record] will improve health outcomes,” he said.

Professor Glance has an extensive background in ehealth, heading the development of MMEx, a clinical software package. He’s also researched text analysis of clinical data, and the implementation of software in clinical settings.

The problems with a summary care record, said Prof. Glance, are myriad. If someone comes into an emergency department, there are a whole set of preconditions associated with getting a health care record to work properly.

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http://www.theaustralian.com.au/australian-it/delayed-choice-for-prescription-alert-platform/story-e6frgakx-1226336572114

Delayed choice for prescription alert platform

• by: Karen Dearne
• From: The Australian
• April 24, 2012 12:00AM

HEALTH Minister Tanya Plibersek's $5 million plan to crack-down on prescription painkiller abuse, which was announced in February, was originally funded under the fifth community pharmacy agreement with the Pharmacy Guild in 2010.

However, a decision on the platform was reached only late last year.

Ms Plibersek was responding to calls from a Victorian coroner for action on real-time prescribing and dispensing monitoring systems for controlled (Schedule 8) drugs, including the ability to alert doctors before new scripts are issued.

In February, coroner John Olle found James, a 24-year-old Melbourne man, had committed suicide by overdosing on morphine and diazepam; in the three years before his death, James had obtained S8 scripts from 19 doctors and medications from 32 pharmacies.

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http://www.computerworld.com.au/article/422918/bionic_eye_patient_tests_planned_2013/

Bionic eye patient tests planned for 2013

UNSW launching new bionic vision labs

• Diana Nguyen (Computerworld)
• 27 April, 2012 10:49

Bionic vision researchers intend to test a functional bionic eye on patients next year.

“Our primary aim is to complete the first prototypes of the bionic eye so they can be tested in human recipients in 2013,” said Gregg Suaning, a professor from the University of New South Graduate School of Biomedical Engineering, in a statement.

Suaning is also the leader of Bionic Vision Australia’s wide-view device, the first of two prototypes designed to restore vision in people with degenerative retinal conditions.

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http://www.medicalobserver.com.au/news/soldiers-need-ehealth-records-review-finds

Soldiers need e-health records, review finds

24th Apr 2012

AAP

ELECTRONIC health records are needed to stop Australian soldiers wounded in war zones from falling through the cracks of bureaucracy during their rehabilitation, a review says.

A review by KPMG found the Defence system failed when it came to rehabilitation, transition to normal life, and compensation for soldiers wounded in Iraq, Afghanistan and other warzones.

But it was good at providing immediate medical care to wounded troops, the 280-page review released on Monday afternoon revealed.

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http://www.mjainsight.com.au/view?post=Consider+broad+telehealth+benefits&post_id=8934&cat=news-and-research

Consider broad telehealth benefits

A NEW US study which showed “underwhelming” clinical outcomes from telemonitoring still adds to the knowledge base about telehealth and should not dissuade doctors from its benefits, according to Australian experts.

Professor Len Gray, director of the Centre for Online Health at the University of Queensland, said the study, published in Archives of Internal Medicine, was well designed but examined only clinical outcomes, when there were many other potential benefits of telehealth. (1)

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http://www.smh.com.au/digital-life/hometech/geeks-use-computer-power-to-cure-cancer-20120403-1w9y2.html

Geeks use computer power to cure cancer

Anthony Agius

April 26, 2012 - 8:07AM

Technology enthusiasts are using the power of their computers to join the fight to cure diseases such as cancer, Alzheimer's and Parkinson's.

The human race agrees cancer is awful. Nobody wants it and nobody likes it. Cancer's impact also spreads to the minds of families and friends of those with the disease, who watch their loved ones try to cope with their own bodies trying to kill them.

The same applies for diseases like Alzheimers and Parkinsons. As people are touched by the effects of these diseases, they want to help. Some become scientists, doctors or nurses, actively working in the front lines to cure, treat and assist. The majority of us contribute to charities, either directly, by volunteering, or indirectly, by giving money, or raising awareness.

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http://www.computerworld.com.au/article/422311/privacy_act_reforms_implications_digital_environment/

Privacy Act reforms — the implications for the digital environment

The Privacy Act reforms to create greater protection for online users

• Stephanie McDonald (Computerworld)
• 23 April, 2012 12:17

As Privacy Awareness Week kicks off this week, the Federal Government’s reforms to the Privacy Act, which began in 2006, seem to have fallen off the radar.

Roger Clarke, principal at Xamax Consultancy, attributes the slow government response to “complete apathy” and says the reason the inquiry began in 2006 was to “quieten down the backbenchers” around problems which had been identified in parliament surrounding privacy issues.

“They progressed extraordinarily slowly and they still haven’t really reached any point of resolution, and one has been brought forward from the second tranche, opportunistically and quite recently, but that one also seems to have stalled in the last few months as well,” Clarke says.

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http://www.theage.com.au/technology/technology-news/woman-in-divorce-row-loses-job-fight-20120425-1xlk7.html

Woman in divorce row loses job fight

Natasha Rudra

April 26, 2012

A WOMAN who used Australian Federal Police databases to dig up dirt on her former husband during a bitter divorce has lost a claim for unfair dismissal.

Fair Work Australia heard the woman, who worked as a financial analyst for the AFP, also tried to rope colleagues into her battle against her former husband but was sacked in April last year after he hired a private investigator and complained to police.

She was found to have breached the AFP code of conduct after getting a co-worker to send her records on her former husband's businesses, which she described as ''gold'' and forwarded on to her mother.

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http://www.theaustralian.com.au/business/mergers-acquisitions/technology-in-the-driving-seat-as-boschs-growth-accelerates/story-fn91vdzj-1226336587571

Technology in the driving seat as Bosch's growth accelerates

• by: Damon Kitney
• From: The Australian
• April 24, 2012 12:00AM

THE $1 billion Australian business of Robert Bosch, the world's biggest automotive parts supplier, is evaluating several strategic acquisitions and launching a range of hi-tech growth initiatives to help it achieve its ambition to double in size in the next decade.

Bosch is renowned for its automotive components, power tools and household appliances, but Australian president Gavin Smith says the recent launch of new softwear and business outsourcing operations in Australia, as well as initiatives in solar energy and e-health, will underpin the extensive growth ambitions of the local operation.

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http://www.theaustralian.com.au/australian-it/swiss-scientists-show-off-mind-controlled-robot/story-e6frgakx-1226337687934

Swiss scientists show off mind-controlled robot

• From: AP
• April 25, 2012 8:08AM

SWISS scientists have demonstrated how a partially paralyzed person can control a robot by thought alone.

It is a step they hope will one day allow immobile people to interact with their surroundings through so-called avatars.

Similar experiments have taken place in the United States and Germany, but they involved either able-bodied patients or invasive brain implants.

On Tuesday, a team at Switzerland's Federal Institute of Technology in Lausanne used only a simple head cap to record the brain signals of Mark-Andre Duc, who was at a hospital in the southern Swiss town of Sion 100 kilometers away.
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http://www.cebit.com.au/ehealth/2012/interview-denis-tebbutt-vendor-engagement-national-e-health-transition-authority-nehta

Interview: Denis Tebbutt, Vendor Engagement, National E-Health Transition Authority (NEHTA)

Posted on April 23, 2012 by Neerav Bhatt

Denis Tebutt is an adviser to the National E-Health Transition Authority (NEHTA). Denis has spent the last 40 years in high technology businesses with over 30 in the growing information technology sector working across the globe in manufacturing, finance and for the past 10 years in healthcare.

He is a dynamic leader with strong strategic and business development skills founded on a deep understanding of the technology and its role in supporting the development of a more agile and innovative business model for the industries that he has served. The challenge faced by the healthcare sector brings together the experiences and lessons of earlier industries.

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http://www.healthdatamanagement.com/news/allscript-stock-financial-performance-software-vendor-44372-1.html

Financial Decline, Departures Roil Allscripts

Joseph Goedert

APR 27, 2012 11:44am ET

The stock price of physician/hospital software vendor Allscripts dropped 40.6 percent at the open of trading on April 27 after the company announced poor first quarter financial results, lowered expectations for the rest of 2012, and announced the departure of its chief financial officer and four board members including Chairman Phil Pead.

Pead was terminated and three board members opposing the decision resigned. CFO Bill Davis will leave in May to join another company outside the industry. Allscripts has named Dave Morgan, senior vice president of finance, as interim CFO.

Nearly 45 million shares traded hands during the first hour of trading on April 27, compared with a daily average of about 3 million shares. The stock had lost up to 45 percent of its value during extended trading after the market closed on April 26.

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http://www.healthcareitnews.com/news/allscripts-skid-mode-shares-plunge-chairman-ousted

Allscripts in skid mode as shares plunge, chairman ousted

By Bernie Monegain, Editor

Created 04/27/2012

CHICAGO – It was no ordinary quarterly meeting Thursday for Allscripts. Its chairman Phil Pead was, by many accounts, forced out. Three board members apparently resigned in protest. And this morning, the EHR vendor's shares have plunged almost 43 percent to $9.15.

The company also reported that CFO Bill Davis would be exiting May 18 for another position outside the healthcare sector, leaving analysts downgrading the firm's stock from “buy” to “neutral.”

Sean Wieland, senior analyst from Piper Jaffrey was among those downgrading.

“Any one of these items would be a concern, but all three happening simultaneously leads us to question what else is there that we don't know,” he wrote in an analyst brief today. He added that a rule of thumb is to downgrade on any CFO turnover.

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http://www.zdnet.com/blog/projectfailures/whos-accountable-for-it-failure-part-one/15451

Who's accountable for IT failure?

By Michael Krigsman | April 16, 2012, 4:45am PDT

Summary: IT failures are a management crisis of serious proportions that have been largely ignored. Here’s what senior executives need to know - and do - right now.

This two-part series presents a structure for understanding why IT projects fail, in a way that goes far beyond project management alone. Part one elaborates the problem while part two discusses the need for greater accountability on the part of senior management.

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Enjoy!

David.

AusHealthIT Poll Number 119 – Results – 30th April, 2012.

The question was:

Who Is Most To Blame For The Present Slow Rate Of Progress In E-Health In Australia?

DoHA

-  15 (39%)

NEHTA

-  18 (47%)

The Private Sector

-  0 (0%)

The State Jurisdictions

-  3 (7%)

Other

-  2 (5%)

Votes: 38

An interesting outcome with national bodies getting most of the blame, the states a tiny proportion and the private sector being seen as being guiltless.

Enough said.

Could the 2 other voters please leave a comment to tell us what other actually is? Please.

Again, many thanks to those that voted!

David.

I Wonder What This Outcome Means? It Does Not Look Good for E-Health In OZ.

This was released yesterday.

Media Releases and Communiques

Standing Council on Health - Communique - 27 April 2012

27 April 2012

Australian Health Ministers and the New Zealand Health Minister met in Canberra today to discuss a range of national health issue including workforce, eHealth, Indigenous health and aged care. The meeting of the Standing Council on Health was chaired by WA Minister for Health, Dr Kim Hames.

Issues discussed today included:

MyHospitals – New cancer surgery and quality and safety data added

Ministers agreed that following the recent release of cancer treatment services information in March 2012 on the national MyHospitals website, information will also be published on cancer surgery waiting times from May 2012. Initially raw data will be provided with an accompanying narrative about variations in types of cancers along with information about numbers of reporting hospitals, until national benchmarks are developed.

Providing more information about the range and location of cancer-related treatment services and waiting times on MyHospitals enables patients to find out more about local services and helps to drive improvements in hospital performance.

Dementia – a National Health Priority

The meeting was addressed by the Federal Minister for Health, Tanya Plibersek who gave notice to the Council that the Commonwealth will be proposing that dementia be designated as a National Health Priority.

Ms Plibersek said the projected growth in the number of people with dementia will result in many challenges for the health sector. Making dementia a National Health Priority Area would help focus attention and drive collaborative efforts aimed at tackling dementia at national, local and state and territory levels.

The Commonwealth intends to formally bring a paper on this issue to the August 2012 meeting, at which the Commonwealth Minister for Mental Health and Ageing, Mark Butler, will join a substantive discussion on this issue.

Model of care for privately practicing midwives

Ministers today considered a West Australian proposed model of care for privately practicing midwives to provide Medicare-eligible services as part of planned homebirth for low risk women.

Ministers agreed to further discussion on this issue at their next formal meeting in August 2012.

Health Workforce 2025: Doctors, Nurses and Midwives

Health Ministers considered the Health Workforce 2025 Report, which models expected workforce demand and supply for doctors, nurses and midwives to 2025.

While there may be debate over the modeling in this report it identifies indicative broad trends well into the future and without strong reform intervention these estimates will mean services may be unsustainable.

Ministers agreed that the report presents the need for essential coordinated, long term reforms by Governments, professions and the higher education and training sector.

All Governments have made substantial investments in Australia’s health workforce and delivered more doctors and nurses than ever before. These investments have been significant; however, it is clear from the report that we must look further then just adding to the existing workforce profile. Other more innovative solutions are required. Looking further means new ways of thinking, new models of care and new roles and functions across the health workforce.

Aboriginal and Torres Strait Islander Health Worker Final Report – Growing Our Future

Ministers noted the Final Report on the Aboriginal and Torres Strait Islander Health Worker project being delivered by Health Workforce Australia. This report is timely because as of 1 July 2012, Aboriginal and Torres Strait Islander Health Practitioners will join the National Registration Scheme for the first time.

There is significant variability in the roles, functions and title of Aboriginal and Torres Strait Islander Health Workers across Australia and this report proposes a nationally consistent definition for Aboriginal and Torres Strait Health Workers which has been broadly supported by Aboriginal and Torres Strait Islander stakeholders.

The report provides a total of 27 recommendations which will help to inform the development of policies and strategies that will strengthen and sustain the Aboriginal and Torres Strait Islander Health Worker workforce to deliver care in response to the known burden and distribution of disease in the Aboriginal and Torres Strait Islander population.

The COAG National Action Plan on Mental Health 2006-2011 Fourth Progress Report Covering Implementation to 2009-10

Ministers endorsed the Report and agreed that it be submitted to COAG for final endorsement and public release. The report presents updated information on 11 of the 12 progress indicators, and provides details on changes in key areas targeted for reform.

Donate Life Network Progress Report

Ministers reviewed the organ and tissue donation and transplantation outcomes which showed a significant lift in organ donation rates last year.

In 2011 there were 337 donors who made a life changing difference to 1001 transplant recipients.

Ministers agreed on the national and jurisdictional donation targets for 2012 and the projected donation and transplant growth trajectories to 2018.

National Strategic Framework for Rural and Remote Health

Ministers released the new National Strategic Framework for Rural and Remote Health, the product of significant collaboration between the Commonwealth, States and the Northern Territory governments and community stakeholders.

The Framework is an important guide for all levels of government to enable a more consistent and coordinated approach for rural and remote health. The Framework aims to reduce the inequities in health outcomes and service delivery currently experienced by rural and remote Australians. The Framework will be publicly available at www.ruralhealthaustralia.gov.au.

The communique is found here:

http://www.health.gov.au/internet/main/publishing.nsf/Content/mr-yr12-dept-dept270412.htm

What on earth are we to make of this?

All the issues mentioned in the introduction were discussed and outcomes were reached except for e-Health. Does this mean e-Health was discussed and no agreement could be reached to get a line or two in the communique or was the matter mention as being on the agenda but not actually discussed?

And why was the topic mentioned in the communique if there was nothing to say?

I think the most likely meaning is that e-Health was discussed and that either there were some budget implications so no comment was made or it was discussed and no agreement could be reached.

In that context this is interesting:

Health ministers warn of 'unsustainable' services

April 28, 2012

AUSTRALIA'S dependence on imported doctors and nurses - which faces rising international criticism - will continue to grow without reforms in supply and use of local graduates, the first national report on the health workforce says.

The report by HealthWorkforce Australia shows in recent years Australia has imported more doctors than it has produced local medical graduates.

That is despite endorsement eight years ago by health ministers of the goal of ''national self-sufficiency'' in health workforce supply.

The report was released after yesterday's meeting of state and federal health ministers, who warned that ''without strong reform intervention these estimates will mean services may be unsustainable''.

The ministers gave their support to the prosect of big changes in the working scope of doctors and nurses which is likely to include increased use of assistants and technology such as ehealth.
.....

Reforms may include greater use of assistants, the introduction of ''new workforces'' and broader application of technologies such as ehealth and telehealth (the use of telecommunications for consultations, diagnosis and procedures).

.....

More here:

http://www.smh.com.au/opinion/political-news/health-ministers-warn-of-unsustainable-services-20120427-1xqei.html

It is interesting to see e-Health pointed out as a workforce issue in the taskforce report to Ministers.

I guess what is going on will all become clearer just 8 days from now if the fiascos around Mr Slipper and Mr Thomson are contained to the extent that the ‘dark clouds’ over the parliament as described by Ms Gillard today have lifted sufficiently to permit near normal operations to re-commence.

We really do live in interesting times!

David.