Quote Of The Year

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

or

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

Tuesday, June 19, 2012

Breaking News - The Opposition Is Supporting the NEHRS Legislation. So Apparently A Done Deal.

In the Senate in the last hour we have had the Opposition provide a very long list of problems with the program (over about 15 minutes) and then go on to say - with some minor amendments - they are backing what they agree is rather poor and incomplete legislation.
I give up frankly having any hope in our democracy when this is the way things happen.
In the meantime the Greens are apparently thrilled with things and want it to rush ahead.
Separately I am now hearing from inside sources the following request.
“Can you please ask why the Minister and staff are not providing clarification to anyone - even the implementation team - about what the actual roll out timeline for the PCEHR is, with only 2 weeks to go. They've floated some speculative reports in the media, but no one actually knows anything solid.”
So we have the teams doing the work in the dark and the Senate off on a frolic not knowing what it does not know!
When there is the Hansard on what was said I will make sure it is available
This is really pretty sad.
David.

Debate In Senate Now Running

Enjoy

David

Senate Debate on NEHRS / PCEHR On Today After 12.30pm

See yesterday's post for how to watch.

David.

Monday, June 18, 2012

Senate Can't Find Time For E-Health On June 19, 2012

Maybe they will get to it tomorrow.

Having listened to the debates the banality, repetitiveness, and political point scoring is just horrible.

These ratbags (The Senators) are just obsessed by the sound of their own voices and offer close to zero real intellectual value - pretty sad this.

David.

Weekly Australian Health IT Links – 18th June, 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

As we run down to what will be the biggest ‘non-launch’ in history we are now seeing all the nonsense that has gone on in the last two years being exposed. I suspect we are going to see a run of such ‘confessions’ as to delivery failure over the next little while.
For the present there is little else to highlight but, of course, there are always a few interesting things to browse. Certainly what is happening ‘across the ditch’ makes for very interesting and rather frustrating reading given our relative lack of progress in OZ.
-----

IBM pressed to meet e-health system July 1 deadline

IBM is being pushed to deliver the National Authentication Service for Health in time for the Gillard government's $1 billion personally controlled e-health record system's July 1 launch.
The NASH service should be delivered on June 26, the National E-Health Transition Authority's PCEHR project head, Andrew Howard, has told an industry webinar.
"I'll stress that (IBM has) a contractual obligation to deliver a functional authentication solution at a national level to support the PCEHR and other health sector requirements by June 26," Mr Howard said.
"IBM (has told us) they are continuing to meet that schedule."
The NASH is a key part of the PCEHR system, as it will verify authorised users and support secure communications among medical providers.
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Defiant doctors force e-Health backdown

TWO weeks before the introduction of the Gillard government's $1 billion e-Health scheme not one medical practice has signed up to use it, forcing Canberra to back down on a move to compel doctors to accept full liability for problems with the initiative.
The Department of Health and Ageing this week agreed to remove contentious contract conditions that would have made doctors liable if one of their employees leaked information contained in a patient's electronic health record.
It has also amended a clause that would have allowed government officials to raid surgeries and remove computers and records when a breach of the e-Health system was being investigated.
-----

PCEHR data liability

15 June, 2012 Michael Woodhead
The Federal government has agreed to revise the PCEHR terms and conditions to remove a clause that would have made doctors liable for data breaches.
Following a meeting between medical indeminity providers and the Department of Health and Ageing, it was also agreed to amend a clause that would have allowed practices to be raided by government officials to remove computers and records if a data breach was suspected, according to The Australian.
-----

Tanya Plibersek announces $37m boost for Tasmania e-health record rollout

  • by: Karen Dearne and Sue Dunlevy
  • From: The Australian
  • June 15, 2012 3:59PM
TASMANIA's e-health records rollout has received a $37 million boost as part of a $325m "emergency rescue package" for the state's "ailing health system" announced by federal Health Minister Tanya Plibersek today.
The e-health allocation will fund the state's rollout of the personally controlled e-health record to state hospitals, and "enable allied health, pathology and diagnostic imaging services to connect" to e-health services.
With the $37m investment for the Tasmanian rollout, recent e-health budget commitments worth $224m and a further $50m to help Medicare Locals with system training and connectivity, the amount committed to the PCEHR program is now $1.1 billion - more than double the originally budgeted $467m.
-----

Getting Tasmania's Health System Back on Track

Health Minister Tanya Plibersek has announced a $325 million emergency rescue package for Tasmania’s health system.
15 June 2012
Health Minister Tanya Plibersek today announced a $325 million emergency rescue package for Tasmania’s ailing health system.
Ms Plibersek said the Gillard Government was taking urgent steps to head off a crisis caused by Tasmania’s older population, higher rates of chronic disease and state health system constraints.
“During my recent trips to Tasmania, frontline clinicians have told me the state’s health system was struggling and urgent action was required to get it back on track,” Ms Plibersek said.
-----

E-health system to launch without key user verification system

THE Gillard government's $1.1 billion e-health records program will launch without the key user verification system in place, with the National E-Health Transition Authority (NEHTA) conceding it has failed to deliver the project on time.
NEHTA chief executive Peter Fleming confirmed that the National Authentication Service for Health (NASH), being built by IBM under a $23.6 million contract project-managed by NEHTA, would not be ready for July 1.
The Australian reported last week that IBM was being pressed to complete the build by June 26 - just days before the due launch date.
-----

Breakthrough in GP e-health liability

14 June, 2012 Sarah Colyer
The Department of Health and Ageing has agreed to scrap controversial contract conditions that would have made GPs liable if someone in their practice hacked into a patient’s electronic health record.
Medical indemnity insurers met with government officials on Tuesday to try to resolve a dispute over a draft of the contract that GPs will have to sign to  participate in the personally controlled electronic health record system (PCEHR).
Last week Associate Professor Julian Rait, president of MDA National warned that the contract absolved the government of any legal responsibility for breaches of patient’s records, thereby putting unreasonable liability on GPs.
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Emergency meet on e-health indemnity

12 June, 2012 Sarah Colyer
Medical indemnity insurers are meeting with government officials Tuesday to try to resolve a stand-off that threatens to derail the national e-health system.
 Under draft conditions labelled “absurd” by MDA National, the Federal Government would require GPs participating in the personally controlled electronic health record system to sign a contract agreeing the government is not liable for breaches of patients records.
Associate Professor Julian Rait, president MDA National, told Australian Doctor last week: ”The contract doctors have to sign will put the legal liability on the GP. Unless the government is prepared to accept its reasonable liability ; we will be advising members not to participate.”
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E-health snubbed over liability concerns

12th Jun 2012
MDOs and GP organisations have refused to endorse the national e-health record system less than a month from the launch date, amid concerns it will lead to a spike in complaints and the cost of medical insurance.
MO understands that despite almost three months of negotiation, the health department,  AMA, RACGP and medical insurers have yet to reach agreement on the extent to which practices should be liable for claims arising from use of the system.
Further meetings have been scheduled this week in an effort to break the deadlock in time for practices to sign up before the system goes live on 1 July.
A department spokesperson said the patient consent form is expected to go to print soon but said consultations on a range of issues were “ongoing”.
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(Video) Over Half of Auckland’s General Practices Now Use CareConnect eReferrals to Improve Referral Quality & Integrate Care

by Tom Bowden on June 13, 2012
The CareConnect eReferrals initiative is in the throes of revolutionising the primary-secondary care interface.  As of today it is installed on 185 Auckland general practices (that’s over half of Auckland’s general practices) and we are currently installing at the rate of five practices a day.  Five thousand CareConnect eReferrals have now been sent and that number is climbing sharply.
Using CareConnect eReferrals, referrers can send 24 different customised referral forms to 36 services across three district health boards:  Auckland, Waitemata and Counties Manukau. The CareConnect system automatically detects which DHB the patient should go to, based on the patient’s home address (NHI) and where that particular service is available.  When fully deployed and integrated with the DHBs’ patient management systems, the CareConnect solution will be without doubt the most advanced, standards-based eReferral system in the world.
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Rural towns could be in for cyber doc

5:30 AM Thursday Jun 14, 2012
Healthcare in Taumarunui is on the verge of a radical shape-up where patients could be diagnosed by a doctor two hours away using a video link.
The "telehealth" option is being considered by the Waikato District Health Board as it moves to integrate primary and secondary healthcare in Taumarunui and other rural towns such as Tokoroa.
Taumarunui in particular, where a hospital and three medical centres cater to 13,000 people, is struggling to recruit and retain doctors.
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Health apps pose issues of liability, says lawyer

June 12, 2012
Adrian Lowe.
MEDICAL and fitness experts are worried about increasing reliance on smartphone and tablet apps for health and fitness advice, in the same way many people rely on a ''Google diagnosis'' for health problems.
A senior medical negligence lawyer said app creators and distributors could be sued if something goes wrong - in the same way as manufacturers and distributors of drugs or medical devices.
While many apps in medical, health and fitness categories appear to work well, experts are concerned that some do not take personal circumstances into account and could be misused.
Sports Medicine Australia's Queensland branch executive officer, Mark Brown, said it was worrying to see an increasing reliance on apps and the internet to guide diagnosis of conditions and how to exercise.
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Transforming Pathology PIT reports into NEHTA Discharge Summaries

Posted on June 10, 2012 by Grahame Grieve
This is the second of a series of posts dealing with representing pathology reports in NEHTA Discharge summaries. The first post dealt with the transforming the TX format into CDA. This post deals with the PIT format. Follow up posts will deal with the FT format, and then with the general context of representing pathology reports in clinical documents.
The PIT format is an old format for sending pathology reports to the requesting doctor. It’s throughly outdated, everybody dislikes it, and no one is supposed to send it anymore. So, of course, you run into it all over the place. The documentation can be found here.
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Representing Pathology reports in NEHTA Clinical Documents

Posted on June 12, 2012 by Grahame Grieve
This is the 3rd post in a series focusing on the representation of pathology reports in NEHTA clinical documents. The context of this work is that a clinical system is assembling a clinical document for some kind of summary report – a discharge summary, an event summary, or a referral – and document will include a set of pathology reports.
The context doesn’t include a clinical user quoting from a pathology report by copying and pasting into a clinical document, but where the system is assembling the document (usually following some human guidance). Also, the context of this is not for a lab generating the original reports – this is only about reuse for those systems that wish to do so. Finally, a note for my US readers: here in Australia, “Pathology” includes all clinical lab disciplines, not the narrower usage it has in USA.
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Pathfinder PCEHR project provides key to aged care uptake

The success of the PCEHR in the aged care sector depends heavily on getting service and facility providers aboard, according to the national Aged Care IT Council (ACIITC) chair, Suri Ramanathan. Mr Ramanathan is closely involved in the recently announced NEHTA aged care software vendor panel.

Speaking with eHealthspace.org, Mr Ramanathan explained that NEHTA’s establishment of the vendor panel was a recognition of the importance of their role in a like manner to the panels already in operation for other key groups such as general practice and pharmacy.
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eHealth pioneers to lead the way

Published on Wed, 13/06/2012, 09:56:35
By Stephen Easton
The National E-Health Transition Authority (NEHTA) announced last week it had executed contracts with five aged care software makers to form a vendor panel that will support and encourage the introduction of personally controlled electronic health records (PCEHR) across the sector.
The members of the vendor panel are AutumnCare, iCare, Leecare, EOS Technologies (part of the Silver Chain group) and Database Consultants Australia.
NEHTA CEO, Peter Fleming, said the panel’s primary aim would be driving the uptake of the PCEHR among residential and community aged care providers.
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'Deep uncertainty' on MLs could be solved by funding

15th Jun 2012
A REPORT has called for a 10-year federal funding commitment for Medicare Locals to overcome primary health care’s “deep uncertainty” about the future of the reform.
The report by the Australian Health Care Reform Alliance (AHCRA) – a lobby group representing a number of allied health and consumer groups – also said the federal government must give a “clearer shared vision” about primary health care, backed up by changes to ML funding.
The report, based on interviews with ML staff during the early stages of the new reform, was released yesterday just weeks after Opposition health spokesman Peter Dutton surprised ML leaders by indicating he would discontinue the rollout if the Coalition took office. Polls generally suggest the Coalition would win the next election due by late 2013, more than a year after the last general practice division hands its work to an ML.
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Victorian government tackles IT glitches

12/06/2012
David Ramli
A Victorian government report into its spending of hundreds of millions of dollars for technology services has revealed deep flaws that resulted in shelf companies with self-written evaluations being accepted onto supplier panels.
Victorian Technology Minister Gordon Rich-Phillips will on Tuesday tell the industry that the controversial eServices supplier panel will be scrapped and replaced by an open ­registry of tech companies.
The eServices Government and Industry Working Party report comes after several technology ­mishaps for the Victorian government.
Earlier this year several investigations were launched into its technology agency CenITex amid allegations it awarded a contract to itself and paid some contractors more than $1000 a day.
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Cohen plots Hyro infotech revolution

15-06-2012
Paul Smith
Gary Cohen, the founder and former executive chairman of iSOFT, is plotting a return to Australia’s listed information technology sector by derailing the sale of digital services player Hyro.
Shareholders in the struggling Hyro are due to meet on Friday afternoonto vote on a $17.2 million takeover offer from Nasdaq-listed Kit Digital that values it at nearly twice its market capitalisation. The cash and scrip bid has been marred by a 40 per cent drop in Kit Digital shares since the offer was announced on April 23, but the offer has a $13 million floor.
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“That’s democracy” : Cohen fails in Hyro tilt

Paul Smith
High profile technology entrepreneur Gary Cohen has narrowly failed in his bid to derail the sale of ASX-listed digital services player Hyro, after shareholders voted to accept an offer from Nasdaq-listed Kit Digital on Friday afternoon.
Mr Cohen, the co-founder of recently sold health technology company iSOFT, had tabled an alternative proposal to shareholders, which would have seen him inject cash, take over the running of the company as executive chairman, and acquiring a growing social media business business to roll into Hyro.
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WA physiotherapist seeks .physio domain in ICANN TLD round

Another Australian applicant makes TLD play
Tonight, at 10pm Australian EST, the Internet Corporation for Assigned Names and Numbers (ICANN) will unveil the list of applications for new top-level domains (TLDs), which will allow organisations to register 'dot word' domains along the lines of .bank and .web.
Australian organisations known to have applied for new TLDs include the AFL, internet service provider iiNet, and the NSW and Victorian governments. In Western Australia, physiotherapist Glenn Ruscoe has applied for .physio.
Ruscoe, part of Perth physiotherapist practice Risely Physiotherapy, says that he had the idea for the domain after reading a newspaper article on TLDs in July last year. "I thought, 'I'd like to have one of them for my practice,'" he says.
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A Snapshot of Australia’s Digital Future to 2050

Thank you for your interest in A Snapshot of Australia’s Digital Future to 2050 report.
A world-first, the report reveals information and communications technology (ICT) enhanced with ubiquitous high-speed broadband is becoming Australia’s new utility – as historic and game changing as electricity or telephony.
Written by Phil Ruthven, Founder and Chairman, IBISWorld, and commissioned by IBM, the report looks ahead of existing research to examine how Australia can harness this new utility to transform our lives, our cities and the way we interact.
The report rates all Australia’s industry classes (509) against the impact of the new utility. Ruthven and his extended Industry Impact Panel assessed the prospects of the 509 classes of industry in the Australian economy over the next 40-50 years.
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Enjoy!
David.

AusHealthIT Poll Number 126 – Results – 18th June, 2012.

The question was:
Have The Australian Public Received Value For Money For The $500M Spent So Far On The NEHRS (PCEHR)?
Yes
-  4 (8%)
No
-  36 (72%)
Too Early To Say
-  7 (14%)
I Have No Idea
-  3 (6%)
Votes : 50
Looks to me like most readers feel we have rather been ripped off by all this. So far the value delivered has not matched what has been spent.
Again, many thanks to those that voted!
David.

Senate Debate Alert - June 18, 2012

It looks like the NEHRS / PCEHR Legislation will be debated in the Senate in the next few hours.

You can watch the session live from this page.

http://www.aph.gov.au/News_and_Events/Watch_Parliament

Enjoy.

David.

2.15pm Barnaby Joyce has delayed things - looks to be happening very later afternoon now.

D.

4.00pm Update - Looks to happen between 5:30 and 6:30.

D.

Sunday, June 17, 2012

The Government Terror On The Disaster That Is the NEHRS is Becoming Palpable. This Is Soon Going To Make The ‘Pink Bats’ Look Good.

It really has come time an adult - preferably a serious Federal Auditor - had a really close look at all the Australian National E-Health Program.
What we are now seeing is Government panic precipitated by just how badly the whole NEHRS / PCEHR Program has been run, and the utter lack of delivery and results.
In the big picture take this announcement:

Tanya Plibersek announces $37m boost for Tasmania e-health record rollout

  • by: Karen Dearne and Sue Dunlevy
  • From: The Australian
  • June 15, 2012 3:59PM
TASMANIA's e-health records rollout has received a $37 million boost as part of a $325m "emergency rescue package" for the state's "ailing health system" announced by federal Health Minister Tanya Plibersek today.
The e-health allocation will fund the state's rollout of the personally controlled e-health record to state hospitals, and "enable allied health, pathology and diagnostic imaging services to connect" to e-health services.
With the $37m investment for the Tasmanian rollout, recent e-health budget commitments worth $224m and a further $50m to help Medicare Locals with system training and connectivity, the amount committed to the PCEHR program is now $1.1 billion - more than double the originally budgeted $467m.
While the national system is due to launch on July 1, questions about technical and operational readiness remain.
Just this week, the Gillard government has been forced to back down on medico liability for doctors using the Health department- and National E-Health Transition Authority-designed and built system.
Just a fortnight out from the start, not one medical practice has signed up, citing advice from their indemnity insurers.
Lots more here:
As the article then goes on to sensibly point out this actually means - for the rest of the population on a per person basic  - an expense of an ADDITIONAL $1.6B on what has already been a billion or so.
Then yesterday we had this:

E-health system to launch without key user verification system

THE Gillard government's $1.1 billion e-health records program will launch without the key user verification system in place, with the National E-Health Transition Authority (NEHTA) conceding it has failed to deliver the project on time.
NEHTA chief executive Peter Fleming confirmed that the National Authentication Service for Health (NASH), being built by IBM under a $23.6 million contract project-managed by NEHTA, would not be ready for July 1.
The Australian reported last week that IBM was being pressed to complete the build by June 26 - just days before the due launch date.
But Mr Fleming said the delayed delivery "will have no impact on the launch of the personally controlled e-health system as arrangements have been put in place to provide an interim NASH" available from the Human Services department.
The PCEHR lead sites have been running their pilots using pre-existing authentication solutions, primarily Medicare's public key infrastructure (PKI) digital certificates which were originally implemented to support health sector business transactions such as billing and online claiming.
Mr Fleming said the delay was "disappointing" but that "Australians will be able to register for an eHealth record in July as intended".
"We will work closely with our key vendors involved in the e-health sites program to roll out the interim NASH so the launch can go ahead," he said in a statement released late on Friday.
NEHTA has given no indication when the NASH may be available for use.
Lots more detail is found here:
Here is the official - on Friday as usual - release admitting a total stuff up.

NASH delay will not impact consumer registration for PCEHR

15 June 2012. National E-Health Transition Authority CEO Peter Fleming said today the delayed delivery of the National Authentication Service for Health (NASH) programme from IBM will have no impact on the launch of the personally controlled eHealth records system in July, or the ability for consumers to register for an eHealth record.
Mr Fleming said the eHealth records system does not need to be held up because of the delay in delivering the IBM NASH.
"Australians will be able to register for an eHealth record in July as intended," he said.
Mr Fleming said the delay is disappointing but arrangements had been put in place to provide an interim NASH delivered by the Department of Human Services to enable the eHealth records system to launch and begin operations as planned.
"NEHTA will work closely with our key vendors involved in the eHealth sites programme to roll out the interim NASH to allow the launch to go ahead as planned.
NASH is a COAG funded project, which will provide one of the national foundations for a functioning eHealth system for all healthcare providers in the country.
ENDS
Media enquiries: media@nehta.gov.au
Confirm the nonsense here:
How much does the taxpayer have to pay before there is some serious accountability and head kicking at DoHA and NEHTA?  When are we going to see a review that sorts out what is going on and why and how can it be justified?
Don't you just love the spin - you will still be able to register for PCEHR - but it will do nothing and won't be properly secured.
What is amazing to me is that no-one (external, of course, to those involved in this blog) is pointing out clearly this saga has been going on for years and years and has covered absolutely no-one with glory.
See here:
and here:
and here:
for warnings on all this from almost 3 years ago.
Last here is fun:
Additionally - of course - even if NASH was designed and delivered on time - it still has to be implemented. Issuing certificates and tokens to the 800,000 or so people who are eventually going to need them will take years. We have no idea how long that will take - let alone how it will be funded and so on. This really is a mismanaged debacle all on its own. I am also hearing news on the HI Service and the Secure Messaging are not far away. Of course we also need not to forget the AMT - which is yet to show itself to be fit for purpose.
The people who have mismanaged all this are the new definition of ‘teflon men’ as far as any rational observer can tell.
It just has to stop - and a serious review be called - and very, very soon!
David.