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, September 05, 2012

The Office Of The Australian Information Commissioner Provides Draft Enforcement Guidelines for E-Health Records. Seem Fairly Sensible But Will Need To Work in Practice!

First some background from the Information Memorandum:

Privacy and the eHealth record system

The Personally Controlled Electronic Health Records Act 2012 (PCEHR Act) and the Personally Controlled Electronic Health Records Regulation 2012 create the legislative framework for the eHealth record system.
The legislation limits when and how health information included in an eHealth record can be collected, used and disclosed. Unauthorised collection, use or disclosure of eHealth record information is both a contravention of the PCEHR Act and an interference with privacy for the purposes of the Privacy Act 1988.
The OAIC regulates privacy aspects of the eHealth record system. This includes regulating the handling of eHealth record system information by individuals, Commonwealth government agencies, private sector organisations and some state and territory agencies (in particular circumstances).
The OAIC’s role includes investigating complaints about the mishandling of health information in an individual’s eHealth record. The OAIC can also conduct ‘own motion investigations’.
More information about privacy and the eHealth record system can be found on the OAIC’s website at www.privacy.gov.au/law/other/the-ehealth-record-system.

The Australian Information Commissioner’s powers

The PCEHR Act confers on the Australian Information Commissioner a range of enforcement powers following an investigation, including:
·         the power to seek a civil penalty from the Courts
·         the power to seek an injunction to prohibit or require particular conduct
·         the power to accept enforceable undertakings.
In addition, the OAIC has a role in accepting data breach notifications from certain eHealth records system participants.
In addition to the powers conferred by the PCEHR Act, the Information Commissioner’s existing Privacy Act investigative and enforcement powers will be available. This includes complaint conciliation and the power to make formal determinations, as well as the investigative powers and procedures contained in Part V of the Privacy Act. These Privacy Act mechanisms are triggered by section 73 of the PCEHR Act, which provides that certain contraventions of the PCEHR Act are “taken to be: (a) for the purposes of the Privacy Act 1988, an interference with the privacy of a consumer; and (b) covered by section 13 or 13A of that Act.

Enforcement Guidelines

Section 111 of the PCEHR Act requires the Information Commissioner to issue guidelines outlining how the OAIC will approach enforcement issues under the PCEHR Act and related legislation. The Information Commissioner must have regard to these guidelines when exercising functions and powers under the legislation.
The legislation requires the OAIC¡¦s Enforcement Guidelines to be made by legislative instrument. The Legislative Instruments Act 2003 requires the Information Commissioner to undertake appropriate consultation before making the instrument.

Proposed guidelines

Draft Enforcement Guidelines

In order to fulfil the requirements of section 111 of the PCEHR Act, the OAIC has prepared draft Enforcement Guidelines which outline how the OAIC will approach enforcement issues in connection with the eHealth record system.
The draft Enforcement Guidelines are available on the OAIC’s website at www.oaic.gov.au/news/consultations.html#current_consultations

Overview of approach

The OAIC’s intended approach to PCEHR Act enforcement activities is as follows:
·         Complaints will generally be accepted under the Privacy Act and investigated using the investigative powers and processes contained in Part V of the Privacy Act. The OAIC will attempt to facilitate conciliated outcomes between the parties and, where appropriate, will pursue enforcement mechanisms available under either the PCEHR Act or the Privacy Act.
·         Own motion investigations will generally be conducted under the Privacy Act using the investigative powers and processes contained in Part V.
·         The Commissioner retains a discretion to investigate conduct using the investigative power in s 73(4) of the PCEHR Act where the Commissioner considers it appropriate. In such cases, the Commissioner will adopt an investigative process which, wherever possible, mirrors the investigative process contained in Part V of the Privacy Act.
The draft enforcement guidelines are found here:
What I found useful was the following from Page 5.
----- Begin Extract
Alleged contraventions of the PCEHR Act may be brought to the Information Commissioner's attention by a range of avenues including:
a) a complaint by an individual;
b) as the result of a data breach notification provided in accordance with section 75 of the PCEHR Act;
c) as a result of a voluntary data breach notification made by an entity not covered by section 75 of the PCEHR Act;
d) as a referral from another regulator in certain circumstances;
e) as a result of media communications;
f) as a result of communications by an informant;
g) during the course of an investigation conducted by the Information Commissioner.
---- End Extract.
The key to Section 75 of the PCEHR Act appears to be the following reasons for notification to the Information Commissioner .
----- Begin Extract.
(b)  the entity becomes aware that:
(i)  a person has, or may have, contravened this Act in a manner involving an unauthorised collection, use or disclosure of health information included in a consumer’s PCEHR; or
(ii)  an event has occurred or circumstances have arisen (whether or not involving a contravention of this Act) that compromise, or may compromise, the security or integrity of the PCEHR system; and
(c)  the contravention, event or circumstances directly involved, may have involved or may involve the entity.
----- End Extract.
To me all this makes it pretty clear that anyone who feels there has been information leakage can complain to the OIC and that, within resources, it will be followed up. The various other sources of information to alert the OAIC seems sensible. What is a little more problematic is just how the relationship between the poacher and the gamekeeper (DoHA System Operator and the OAIC) will work in practice and how much transparency there will be in practice.
All in all I think this looks pretty reasonable. The test will be in implementation given the UK experience reported here:

UK data-blurt cockups soared 1,000 PER CENT over last five years

That was supposed to be a secret but it got out
The number of times Brits' sensitive data has been lost or leaked in the UK has risen 1,000 per cent over the past five years. Councils recorded the biggest increase in breaches of data protection law, according to figures obtained by a Freedom of Information Act request.
The stats from the Information Commissioner’s Office (ICO) revealed a huge jump in the number of self-reported bungles each year since 2007. Local government data law breaches increased by 1,609 per cent over that period of time. The average increase across Blighty's private and public sectors is 1,014 per cent.
Incidents of lost or leaked information in the private sector grew 1,159 per cent in that five-year period. NHS record breaches increased 935 per cent over the same period while central government data cock-ups increased 132 per cent.
Only the telecoms sector delivered a decrease in the number of info blunders from year to year, falling from six breaches in 2010/11 to zero in 2011/2012.
The latest full-year figures log 821 data breaches in the UK in 2011/2012. Precisely how many individuals were affected by each breach was not disclosed. The most recent quarterly results show that the NHS was responsible for the most incidents in Q2 2012 with 61 breaches, closely followed by local government (59) and private business (26).
Lots more here:
Reads like a huge mess we need to avoid.
Some press comments have also appeared on the Draft Guidelines. Here is one:

OAIC: Are our eHealth breach requirements enough?

Summary: The Office of the Australian Information Commissioner has drafted its guide on how eHealth service providers must respond to data breaches, and is seeking public comment to ensure nothing is missed.
By Michael Lee |
The Office of the Australian Information Commissioner has released its draft guide (PDF) on how mandatory data breach notifications should be handled under the personally controlled electronic health record (PCEHR) system, and is once again polling the public on whether its approach to the issue is adequate.
The draft guide states that organisations dealing with eHealth records must notify the System Operator (SO) — currently, the Secretary of the Department of Health and Ageing — and the OAIC, as soon as they are aware of a data breach occurring. The SO is the only entity that is permitted to inform customers of the breach.
The SO is able to put in place administrative sanctions and cancel, suspend, or vary the offending service provider's registration in the PCEHR system, but it is unable to put in place civil penalties. Instead, the role of issuing penalties will be given to the OAIC, which will for the first time, under the PCEHR legislation, be able to fine organisations for not reporting data breaches. Penalties will be AU$11,000 for an individual, and up to AU$55,000 for organisations.
Unless the organisation is a state or territory entity (which is only required to report breaches to the SO), failing to report to both the SO and the OAIC constitutes as a failure to notify.
If the SO, itself, is involved in a data breach, it must report it to the OAIC, but there are no penalties if the SO fails to do so. However, the OAIC is free to investigate the SO if it suspects that a breach has occurred and has not been reported.
Lots more here:
The author makes a good point about breach disclosure. If it is not automatic all breaches should certainly be the subject of say a monthly public report or similar. The System Operator keeping breaches secret is not on!
I have provided details on how to comment here:
David.

Tuesday, September 04, 2012

Somehow Things Just Seem To Be Getting Worse And Worse The More We Know. I Wonder Who Is Telling The Truth Here?

The following appeared today in the Australian.

Document proves defects in e-health

THE national e-health system was riddled with critical or high-severity defects just days before its launch, casting doubts on the Gillard government's claims that it was pushed live without faults.
The Australian can reveal that the personally controlled e-health records (PCEHR) system, which was taken offline for more than 24 hours for maintenance at the weekend, was affected by 68 critical and high-severity bugs.
Although the government has stood by its insistence that the system was fault-free when it was launched on July 1, the decision to go live was made despite warnings from its own e-health agency, the National E-Health Transition Authority.
The Australian revealed on July 24 that the government knowingly launched the PCEHR with more than 60 high-severity and critical bugs. As previously reported, two weeks before the launch NEHTA told key government stakeholders that the system had more than 200 high-severity and critical bugs. That was reduced to 68 after a "reprioritisation" of defects, sources close to Health said.
This same approach was applied a week before go-live.
The findings were denied by a spokesman for Health Minister Tanya Plibersek and by her department.
As reported, the spokesman for Ms Plibersek said that, based on advice by the Health Department, the minister rejected claims that the system had problems before launch.
"No critical defects remained at the time of the release," the spokesman said.
A spokeswoman for the department concurred. As recent as last week, she said: "The national infrastructure (for the PCEHR) as implemented is complete and live and has signed off for clinical safety, and was implemented with no critical or high-severity system errors or defects. There are no outstanding critical or high-severity defects from any previous releases."
The Australian can now reveal that internal NEHTA documents refute claims made by the government. The PCEHR test document prepared on June 23 -- days before the system went live on July 1 -- details risk descriptions and mitigation strategies for the system.
The document outlined six items, but the most important entry and marked as "high" under residual risk severity was labelled PCEHR 663. It said: "With a total of 68 open severity 1 & 2 defects that are Category 1 functionality, and with one week remaining till 1 July Go-Live, it is highly likely that the system will go live with high volume of defects that includes Severity 2 defects."
NEHTA's suggestion for a mitigation strategy was to "postpone the 1 July go-live delivery date".
.....
The Health spokeswoman yesterday said: "The risk report and other reports that The Australian continues to refer to are for a period prior to the final go-live decision. As we've said before, the system released was safe and secure, as confirmed by the IT and cyber-security experts at the Defence, Finance and Attorney-General's departments. No critical defects remained at the time of release. Any suggestion otherwise is completely wrong." Asked if the minister was sure the PCEHR system went live with no critical or high-severity errors, she said: "This has been answered before. The minister was advised by the department that there were no critical defects."
.....
Extracts from e-health test results on June 23

First 5 issues omitted - available at link.
Risk description: With a total of 68 open severity 1 & 2 defects that are Category 1 functionality, and with one week remaining till July 1 go-live, it is highly likely that the system will go live with a high volume of defects that includes Severity 2 defects
Likelihood: Highly likely
Impact: Major
Severity: Critical
Mitigation strategy: Postpone the July 1 go-live delivery date
Residual risk severity: High
The full article with all the gruesome details is here:
To me what emerges here are two key themes:
First from the paragraph in italics it is totally clear the DoHA is incapable of ‘lying straight in bed’ and the way they spin and are ‘economical with the truth’ is really astonishing. Saying they told the Minister all was fine when their ‘managing agent’ was saying we need more time is a serious governance breakdown.
Second what it revealed is that not only is DoHA ‘calling the shots’ but that they clearly do not know what they do not know. That NEHTA should be just ignored like this suggests the relationship between NEHTA and DoHA must be rather ‘pistols at 20 paces’ like.
These two themes make it utterly clear the long term success of this Program is simply doomed. The pin needs to be pulled and sooner rather than later!
David.

Monday, September 03, 2012

Weekly Australian Health IT Links – 3rd September, 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

A surprisingly busy week as I come to review it.
The announcement of a national dental scheme was the biggie for me - but I really do wonder what will be cut to pay for it. Any bets on the PCEHR when the scheme starts in 2014.

No axe in hunt for health savings: govt

  • AAP
  • August 30, 2012 8:01AM
HEALTH Minister Tanya Plibersek has promised the federal government won't be taking the axe to the health budget to find cash for a landmark dental scheme.
Children and disadvantaged adults will have better access to government-funded dental care from 2014 under a $4.1 billion package announced by the Gillard government.
The deal has been welcomed by most health experts, who've previously criticised Labor for ignoring teeth while boosting funding for aged care and the mentally ill.
-----
Other than that the item that most caught my eye was the scale of information leak from the UK NHS. One wonders just what we will see when there is any substantial use of the PCEHR.
Does anyone know the present level of information leaks is from the Australian Health System? I have to say I have never seen any information.
Setting up a system where investigators can snoop on GP electronic records does not fill one with a high degree of confidence.
------

UK data-blurt cockups soared 1,000 PER CENT over last five years

That was supposed to be a secret but it got out
The number of times Brits' sensitive data has been lost or leaked in the UK has risen 1,000 per cent over the past five years. Councils recorded the biggest increase in breaches of data protection law, according to figures obtained by a Freedom of Information Act request.
The stats from the Information Commissioner’s Office (ICO) revealed a huge jump in the number of self-reported bungles each year since 2007. Local government data law breaches increased by 1,609 per cent over that period of time. The average increase across Blighty's private and public sectors is 1,014 per cent.
-----

Bionic eye goes live in world first by Australian researchers

Date August 30, 2012 - 9:03AM

Kate Hagan

A blind woman can now see spots of light after being implanted with an early prototype bionic eye, confirming the potential of the world-first technology.
Australian researchers have been working for years to develop the bionic eye, in which electrodes are inserted into the retina of vision-impaired patients.
Dianne Ashworth, 54, was the first patient fitted with the device in surgery at the Royal Victorian Eye and Ear Hospital in May.
-----

PSR software will extract GP patient records

29 August, 2012 Michael Woodhead
The Professional Services Review is to use a clinical data extraction program to pull patient records from the desktop software of GPs whose claiming patterns are being investigated.
In an “invitation to tender” notice sent to software developers, the PSR says it wants “a solution that can extract a requested selection of patient records from general practice clinical software systems and return them to PSR in an agreed PDF format”.
According to the tender requirements, the extraction tool is aimed at simplifying the process of extracting the relevant data from patient records. At present, the PSR relies on the doctor under review submitting hard copy printouts of the patients’ medical records, which then have to be transported, collated and scanned in by the PSR.
-----

Canberra admits PCEHR delays

THE Gillard government has confirmed that key components of the personally controlled e-health records program missed the crucial June 30 deadline, but says the entire system has now been "implemented".
Some items have yet to be properly tested, which means complete rollout will take a few more months.
-----

Threat to privacy in e-Health records

PATIENTS who want to keep private a visit to a psychiatrist, the use of a mental health medicine or an abortion under the new e-Health online system will have to ensure Medicare and pharmaceutical subsidy data is not linked to the new record.
The only other way to keep the information private would be to pay the full cost of the treatment and refuse Medicare and pharmaceutical subsidies - or use a fake name, a privacy expert said yesterday.
-----

Privacy fears raised over PCEHR

28 August, 2012 Nick O'Donoghue
Patients may forgo PBS subsidies for medication in order to keep their use of treatments for mental health issues from appearing on their electronic health record, an expert believes.
Julie Zetler, an ethics and legal expert at Macquarie University told The Daily Telegraph that consumers were concerned over how private health data stored on the Personally Controlled e-Health Record (PCEHR) would be treated.
With the PCEHR set to be accessed by doctors, pharmacists and other health professionals, Ms Zetler said the only way patients, who have opted-in to the scheme, to keep details of mental health consultations and medication for such conditions, would be by not accessing Medicare rebates, or PBS subsidies.
-----

Real time database on doctor shoppers goes live

30 August, 2012 Michael Woodhead
GPs can now check up on suspected "doctor shoppers" by accessing a secure real time database that gives details of all prescriptions a patient has received in the last three months.
Medicare has extended its Prescription Shopping Program to provide up-to-date information on the prescription history of a patient accurate up to the last 24 hours.
The new service, modelled on a system pioneered in Tasmania, is available via a 24-hour phone line and also via a secure internet connection.
-----

Don't forget the people in e-health: NSW Health CIO

Summary: NSW Health's CIO is pushing for a change in how IT is used in healthcare systems, after having personally felt the consequences of a system that forgets clinicians and patients.
By Michael Lee | August 28, 2012 -- 05:44 GMT (15:44 AEST)
Augmenting a state's complex health system with technology requires large projects to allow systems to work with each other — and although these are important, they are not what the state now needs to focus on, according to NSW Health CIO Greg Wells.
Speaking to an audience of IT professionals at the Australian Information Industry Association's (AIIA) NSW healthcare briefing this morning, Wells walked through the story of "Pip", a mother of three boys, one of whom was diagnosed with a brain tumour last June.
-----

Why I am withdrawing from the Australian Delegation to Baltimore

Posted on August 30, 2012 by Grahame Grieve
The Australian government has a program that supports Australian delegate’s travel expenses for the purpose of attending international standards meetings and representing Australia. We contribute our own time, but the government reimburses our direct expenses. In exchange, we must represent Australian interests and agreed positions, and we must contribute to a published report about what happened at the meeting. I’ve discussed the usefulness of this report before.
As part of the funding conditions, we are required to sign a “Moral Rights Deed Poll” that assigns the copyright of the report to Standards Australia so they can distribute it as they need to – that makes perfect sense, and I’d be fine with that. However this year, I can’t sign it. Not because of what the intent is, but because of what it says.
-----

Telehealth: the future for better medical care

28th Aug 2012
THE relentless rise in medical subspecialisation over the past 40 years is colliding with an immutable reality: chronic comorbidity and the affordability of health systems.
Ageing populations, technology and the rise of chronic non-communicable disease are placing strains on health budgets that, quite simply, cannot be met.
In an older era, ‘all-rounder’ GPs, faced with a tough diagnostic or clinical management challenge, sought the counsel of a consultant colleague who possessed specific specialist expertise. These professional relationships were symbiotic, referrals judicious and patients enjoyed the benefit of comprehensive whole-person medicine supplemented by targeted expert advice when required.
-----

OAIC seeks comment on PCEHR privacy, data breach investigations

Australians invited to agree or disagree with Information Commissioner’s proposed enforcement of the Personally Controlled Electronic Health Records System (PCEHR)
The Office of the Australian Information Commissioner (OAIC) is requesting feedback from the Australian public on its draft Enforcement Guidelines for the Personally Controlled Electronic Health Records System (PCEHR) Act.
To help Australians prepare comments, the OAIC has published a consultation paper (PDF) called eHealth record system OAIC Enforcement Guidelines on its website.
-----

Information Commissioner polls on e-health privacy enforcement

Summary: The Information Commissioner has set out guidelines on how it will deal with organisations that breach the Privacy and PCEHR Acts, and is asking the public to see if they are appropriate.
By Michael Lee | August 29, 2012 -- 05:42 GMT (15:42 AEST)
The Office of the Australian Information Commissioner (OAIC) is reaching out to the public for feedback on how it should enforce privacy regulation related to personally controlled electronic heath records (PCEHR).
-----

BREAKING NEWS: Penalties for PCEHR privacy breaches

29 August, 2012 Michael Woodhead 
Draft guidelines on the enforcement of penalties for PCEHR privacy breaches have been released by the Office of the Australian Information Commissioner (OAIC).
The guidelines say fines may be imposed for unauthorised collection, use or disclosure of health information in a consumer's PCEHR and for failing to provide sufficient information to identify an individual who makes a request for access to a consumer's PCEHR.
-----

About Cancer Directory Website

The Cancer Directory Website provides the community and health professionals with a useful, comprehensive online directory of trusted Australian cancer care resources that have been published since 2000 in print, audiovisual (AV) or electronic formats.
This website has been developed to enable you to:
  • search for the printed, audiovisual and electronic resources that best fit your needs
  • submit a resource that your organisation has published
  • suggest a resource another organisation has produced that you have found useful
  • sign up to receive an electronic newsletter that provides updates on new resources and developments
  • give feedback on the listed resources and website.
This site aims to make it easier for you to access credible cancer care resources from around Australia, specifically those published by the Commonwealth, State and Territory Government departments, Cancer Councils, major health services and major not for profit organisations.
-----

Press Release: iCare Solutions Pty Ltd acquires UK Community Care company, h.e.t. software

22 Aug 2012
iCare Solutions is pleased to announce the acquisition of h.e.t. software, a leading provider of community care software in the UK, with a presence in Australia.
The acquisition enables iCare to bring community care software into its portfolio and integrate this functionality with its existing Clinical, Care and Medication Management solution. iCare will now be delivering the most complete electronic healthcare record across the continuum of care for the Australian aged care industry.
The acquisition builds on a long term relationship with h.e.t. software and provides a significant presence for iCare in the UK, where the uptake of software solutions by residential aged care providers is growing exponentially. iCare entered the UK market in 2007 and has experienced strong growth since. The combination of the two organisations will enable the delivery of a comprehensive software solution in the UK to create greater efficiencies in the social and home care markets.
-----

Auditor-General gives regional fibre the thumbs up

Summary: The Auditor-General has found no faults in the regional broadband roll-out, finding only one recommendation to give the government to turn good into great.
By Michael Lee | August 31, 2012 -- 04:56 GMT (14:56 AEST)
The Australian National Audit Office has completed its performance audit of the Regional Backbone Blackspots Program (RBBP), giving it a clean bill of health and offering just one recommendation.
The RBBP is part of the Federal Government's plan to fast-track the expected long task of rolling out fibre to regional Australia, passing through about 100 regional towns and connecting 400,000 people through 6000km of fibre. Although the project has suffered some delays, the Auditor-General's report (PDF) noted that these were due to extreme weather events, including flooding in 2011-12.
-----

IPad management, security crucial in hospital tablet roll out

Tablets, especially iPads, have become a way of life at the University of California, Irvine Medical Center, which now issues the tablets to incoming medical students and just last month, the hospital's Department of Emergency Medicine said it's giving iPads to all 18 of its resident physicians as part of a patient-care initiative.
The incoming class of 100 medical students now routinely receives an iPad, thanks to private funding, says Adam Gold, director of emerging technologies at UC Irvine Medical Center, which has a hospital in Orange County and also functions as a teaching center for UC Irvine School of Medicine. The IT department there has set up document-sharing via SharePoint as part of this effort. "The entire curriculum is on the iPad," Gold says.
-----

eHealth CCA Community

Welcome to the Australian eHealth Compliance, Conformance & Accreditation (CCA) community website.
This site provides a library of news and technical information for anyone interested in the national conformance assessment process for medical and health software. It explains the general framework for assessment and accreditation as well as specific requirements for different types of software products and systems.
Sponsored by the eHealth CCA Governance Group, the site demonstrates a close working partnership between leading government policy and design agencies, standards authorities and the medical and health software industry, who have come together to build an effective national scheme designed to improve the connectedness of our healthcare system, the quality of our industry and, above all, the safety of patients.
-----

Departments splurge $10m on monitoring the media

FEDERAL government departments and agencies are spending more than $10.3 million a year checking what is said about them in the media.
The hefty monitoring bill from external companies would pay for more than 100 full-time staff each earning $100,000 a year.
An analysis by The Australian revealed the Department of Health and Ageing ploughs more than any other department or agency into monitoring -- with a bill of $940,000 for press clippings and transcripts in 2011-12.
-----

Windows 7 overtakes XP; Mac OS X steams ahead of Vista

Summary: At long last, Microsoft Windows 7 has overtaken the 11-year-old Windows XP on Netmarketshare's web-based tracking network, while Mac OS X is now a percentage point ahead of Vista. There are also new numbers for mobile operating systems and browsers.
By Jack Schofield for Jack's Blog | September 1, 2012 -- 17:03 GMT (03:03 AEST)
Microsoft Windows 7 has finally overtaken the 11-year-old Windows XP operating system on web-based market share figures from Netmarketshare. Also, Apple's Mac OS X has overtaken Windows Vista this summer, if all versions of Mac OS X are combined.
-----

Robot ethics: Thou shalt not kill?

Military departments around the world are capitalising on improving robotics technology to help them with war efforts.
Where wars were once fought in hand-to-hand combat or soldiers shooting it out, the reality of wars these days mean operators in the US can decide whether people live or die in Pakistan at the touch of a button.
Robots could also one day replace humans on the battlefield, but how far away are we from this type of robotic warfare and what are the ethical implications?
The move to free-thinking robots
The US is a significant user of military drones, unmanned aerial vehicles. Its arsenal of drones has increased from less than 50 a decade ago to around 7000, according to a report by the New York Times[1], with Congress sinking nearly $5 billion into drones in the 2012 budget.
-----
Enjoy!
David.

AusHealthIT Poll Number 134 – Results – 3rd September, 2012.

The question was:

Do You Think The Government's Plan for Paying GPs To Set Up and Maintain NEHRS Records Is Evidence Based Or A Response To Concerns The System Will Fail.

Results were
It Is An Evidence Based Approach To Maximising Adoption 14% (6)
It Is A Policy Born Of Concern and Worry For NEHRS Failure 64% (27)
There Is Another Reason Altogether (Please Explain in Comment on Last Week's Poll) 10% (4)
I Have No Idea 12% (5)
Total votes: 42
Very interesting response. It seems most think it is a rear-guard action to stave off disaster - for a while.
Again, many thanks to those that voted!
David.

Sunday, September 02, 2012

This Really Is An Amazing Way To Run A Clinical System. Clearly The NEHRS System Is Not Intended To Ever Be Used In For Real.

At least a few readers will recall this blog a few weeks ago.

Wednesday, August 15, 2012

Oh No! Not Again! Here Is What Happened Just Now With The NEHRS. 10:15pm Aug 15, 2012

Just logged in.
Got to the main record screen and guess what? Here is what I got.

Error Details:

An error has occurred processing your request.
Worse the records I had entered have gone:
I had recorded allergies and current medications. 4 serious allergies and six medications I am on. Here is what I got.

Allergies and Adverse Reactions

You can enter substances to which you have known allergies and/or the reactions that occur when you come into contact with the substance.
Click “Edit” to update your Summary. All healthcare professionals who have access to this eHealth Record will be able to see this information. No Restricted Settings can be placed on this Summary.
You are encouraged to keep your Personal Health Summary current to ensure it is valuable to healthcare professionals involved in your care
Note: Your healthcare professionals are not obliged to review your summary. You should visit your healthcare professional to discuss changes in your health or any important concerns you may have.
No Allergies and Adverse Reactions associated with this record.
-----
The full blog is found here:
It later emerged that I had just wandered in when the system was being maintained but that there had been no warning that the system was down.
At least it seems someone is reading the comments on the blog. Today - about 9:30am - I thought I would have a browse to see if there were more recent records available than those from May.
Here is what I found when I asked to enter from www.ehealth.gov.au

Service availability

  • Home
  • Service availability
This page identifies scheduled outages to the eHealth record system.

Notification of planned outage

Personally Controlled Electronic Health Record system downtime scheduled for 11:00am Saturday 1 September 2012.

The system will be unavailable for a period of approximately 24 hours. During this time, maintenance to the Personally Controlled Electronic Health Record System and Australia.gov.au will be performed.
We apologise for any inconvenience. Contact the eHealth helpline on 1800 723 471 for assistance during this period.
---- End extract.
Then I thought I would go direct via www.australia.gov.au and obviously things are much better organised even from here:

This service is temporarily unavailable

Personally Controlled Electronic Health Record system downtime scheduled for 11:00am Saturday 1 September 2012.
The system will be unavailable for a period of approximately 24 hours. During this time, maintenance to the Personally Controlled Electronic Health Record System and Australia.gov.au will be performed. We apologise for any inconvenience. Contact the eHealth helpline on 1800 723 471 for assistance during this period.
----- End extract.
This is of course just after we have been told that it is all hunky dory and implemented.

Wednesday, August 22, 2012

It Seems That The NEHRS System Infrastructure Is Now All Complete And Operational. Wow!

The following appeared today:

PCEHR infrastructure finished

The national infrastructure for the PCEHR has been completed, with the final components allowing doctors to upload and view ehealth records.
Other pieces completed include the healthcare provider portal, and healthcare provider PCEHR registration.
More here:
The full blog is here:
Really what we have here is a fake clinical system that no-one can rely on to be there when you need it and which has so grossly underdone despite the claims of all the DoHA spinners to the contrary.
I have to admit I am amazed just how hopeless this is all is. One really would have thought you could do maintenance when in the wee small hours and not just turn off the system for a day. Talk about a total lack of planning, clinical understanding and technical competence.
David.
Postscript: The system is still not up at 3:45pm on Sunday, Sept 2, 2012.