I Wonder How The NEHRS / PCEHR Would Address This Tricky Little One.

The following appeared a few days ago. Fits into to bigger story of what we will needs in EHRs a decade from now - if not sooner.

http://www.fiercehealthit.com/story/incorporate-dna-sequencing-data-ehrs-ethics-panel-says/2012-10-12

Incorporate DNA sequencing data into EHRs, ethics panel says

October 12, 2012 | By Julie Bird

A presidential commission studying privacy issues related to more readily available DNA sequencing recommends integrating whole genome sequence data into health records for research purposes.

In a report issued Thursday, the Presidential Commission for the Study of Bioethical Issues said that electronically exchanging DNA sequencing data through standardized EHRs and infrastructure would provide more data to researchers for genome-wide analysis that can advance clinical care.

The report, "Privacy and Progress in Whole Genome Sequencing," recommends facilitating the exchange of information between genomic researchers and clinicians "while maintaining robust data protection safeguards,"  so DNA sequencing and health data can be combined in advancing genomic medicine.

"Current sequencing technologies and those in development are diverse and evolving, and standardization is a substantial challenge," the panel said. "Ongoing efforts are critical to achieving standards for ensuring the reliability of whole genome sequencing results, and facilitating the exchange and use of these data."

The panel makes clear that it wants to protect individuals' privacy and the right to informed consent to having their DNA collected "while promoting data access and sharing."

.....

To learn more:
- read the full report
- see a report summary

Full article here:

http://www.fiercehealthit.com/story/incorporate-dna-sequencing-data-ehrs-ethics-panel-says/2012-10-12

I can’t see this sort of material would ever be appropriate for a shared EHR - rather than in the hands of a dedicated practitioner with responsibility for patient care. It also makes it clear the PCEHR is an old style of idea which just won’t support clinical practice into the future in the ways we will need.

David.

I Must Be Doing Someting Right!

From Senate Estimates the night before last....

"Senator FIERRAVANTI-WELLS:  Could I just give you a copy of this article. It is 'Experts brand e-health  audit trail as "gobbledygook"'. Did you see that article?
Mr Fleming:  I am aware of it from a little while ago.
Ms Halton:  This is the infamous David More, the well-known blogger. 'E-health consultant and medico Dr David More', otherwise known as the well-known blogger.
Senator FIERRAVANTI-WELLS:  You have not actually heard what my question was going to be.
Ms Halton:  No. I have not seen before.
Senator FIERRAVANTI-WELLS:  It is about the audit trail. Are you questioning Dr More just because he is a serial blogger?
Ms Halton:  I was just reading the second paragraph, so I know can what this is about.
Senator FIERRAVANTI-WELLS:  Are you saying his comments should be dismissed?
Ms Halton:  I have not even got to the next part of the comment.
Senator FIERRAVANTI-WELLS:  I will let you read it. That would be good.
Ms Halton:  We might let the chief information and knowledge officer start talking while I read."

Seems someone is reading. Further coverage on things that matter in all this next week.

Not sure how you can blog without doing it "serially"?

David.

Now Here Is A Site You Need To Review Closely - The Impact Is Hard To Estimate.

I have spent a little time this week coming up to speed on just what the new Medical Locals Alliance is up to in the e-Health space.

eHealth for Medicare Locals

The Department of Health and Ageing is supporting a program to raise the awareness and readiness of MLs to support the eHealth record system, aiming to:

• Raise Medicare Local awareness and understanding of the eHealth record system
• Clarify what MLs can do to support adoption of the eHealth record system (and to assess their readiness to do so)
• Provide MLs with the information they need to communicate the benefits and implications of the eHealth record system to those in primary healthcare settings
• Guide MLs on how they may support primary care providers ‘get ready’ for the eHealth record system (e.g. NASH, health identifiers, software, workflow implications)

This page will be a central point for all materials developed under this program of work.

This is the key link:

http://amlalliance.com.au/medicare-local-support/ehealth

These links - on the side of the main page - take you to a lot of content:

Related Content

• Tier 1: eHealth Record Awareness
• Tier 2: eHealth Record Readiness
• Tier 3: eHealth Record adoption
• Tier 4: eHealth Record meaningful use

The most useful presentation I have found is the one found here:

http://www.amlalliance.com.au/__data/assets/pdf_file/0016/45610/20120903_ML_eHealth-Change-and-Adoption-Program-and-ITA-Webinar.pdf

I strongly suggest you browse carefully through the content provided here.

The success factors are seen to be:

Success Factors:

• Ongoing direct engagement with MLs as the key stakeholders
• Lifting capability and capacity of all MLs and leveraging experience in the network
• Clear and agreed outcomes and activities that can be measured and reported against
• Mobilise as quick as possible to allow maximum support time within the funding period
• Alignment with other initiatives and streams across national eHealth and ML programs

What is happening in the next few weeks is a road show and selection of recipients of grants (of between $450,000  and $600,000) to get all this happening across the 61 Medicare Locals. (Apparently $50M has been allocated overall according to a Ministerial Release earlier in the year)

I particularly point people to Page 15 which provides a timetable for what is planned.

Having all the needed software for Providers to access the PCEHR is planned for Mid November (yes this year) and it only gets worse from there.

My view is that this page reflects a deep lack of understanding of how long things take in the real world and totally misunderstands the feeling of GPs regarding top down initiatives of this sort which suddenly arrive out of a “clear blue sky” as all this has in the last few weeks.

To me this is all hopelessly rushed, under resourced and misunderstands that GPs are busy people who don’t have the mental bandwidth and time to absorb all sorts of complicated documents and instructions in just a few weeks or even months.

I predict a total fiasco will be seen within months as all the consultant “foilware” is shown up for the impractical nonsense I believe it is. This will all take years not months if ever to happen and the plans as they presently exist are pure fantasy.

David.

How Different Is The Health Sector From Other Parts Of Our Economy? Part Of A Course I Am Developing.

I am working quietly to develop a unit of a Masters Course for Health Managers.

One of the topics I am trying to cover, briefly, is why the Health Sector is a bit different. Would love comments on what I have wrong or have missed.

----- Begin Extract

Health Sector Culture.

While hard to explicitly pin down there is a sense that the nature and responsibilities associated with the delivery of health care drives a workplace culture in the sector (at the coal-face of care delivery) which is different from other workplaces.

Some aspects of this culture are important when considering the operations of the sector, especially as this is related to the use of and interaction with technology.

Aspects of the culture that may be relevant include:

1. Conservatism - because much of what is done in the delivery of care has not changed over a long period sticking with the ‘tried and true’ seems both safe and sensible.

2. An understanding of hierarchy and the associated responsibilities. While there is a culture of ‘team work’ clearly needed and indeed in evidence in most settings there is also a need to decisions to be taken when required.

3. Separate and somewhat distinct cultures for each professional group also exist (nursing, medical and so on) and it is noticeable that the further away an individual’s role is from direct patient care the less traditional caring values are in evidence (e.g. clinical and nursing working hours are often very flexible and have a ‘till the job is done’ attitude which does not exist in say the accounting staff).

4. Clinical workplaces are typically environments where patient privacy is carefully protected and where preservation of patient dignity and autonomy is seems as important.

5. A sense of individual accountability for patient outcomes and especially for errors that may have harmed a patient.

6. A lack of sensitivity to cost. What a patient is seen by the carer to need will be provided if at all possible - even though, on occasion, the evidence backing a choice may be lacking.

7. An appreciation of the tenets of the Hippocratic Oath and observance of the general spirit embodied therein.

See here for a range of texts of said oath:

http://en.wikipedia.org/wiki/Hippocratic_Oath

These attitudes can feed into how change management and technology implementation are approached.

Change Management in the Health Sector.

As outlined in an earlier section the Australian Health Sector faces a number of what may be termed ‘challenges’.

A short list of the key ones include:

1. The Ageing Population.

2. Workforce shortages and ageing.

3. Remorseless rises in Healthcare costs above inflation leading to financial sustainability issues.

4. A continuing inability to allocate clear lines of funding responsibility with inevitable political bickering, blame-shifting and waste.

5. Rising cynicism and alienation within the workforce with a loss of some value-driven behaviours (as cited above)

6.  Work-practices which remain arguably much too provider centric rather than consumer / patient centric.

7. Continuing very slow diffusion of evidence based practice approaches into the clinical community.

8. Continuing inability to measure much in the way of clinical outcome and patient satisfaction information.

9. Many professional staff feeling the effects of what are felt to be excessive work pressures and bureaucracy.

Taking the mixture of the culture described above and the issues identified in this section it is clear that any significant change - technology based or not - is going to face considerable resistance and if change is to be successfully implemented then considerable careful planning is needed.

Specific considerations in health sector change management that also need to be considered are:

1. Often the thought leaders are both highly opinionated, highly competent (at least in a narrow field) and typically influential on those they work with on teams.

2. Impact and quality and safety of patient care is much more highly valued that efficiency and cost saving.

3. Many of the hospital workforce and virtually all the non-hospital workforce are independent practitioners who are not responsive to command and control - need incentives, carrots, explanation and intelligent justification of change.

4. At least some any change will need to convince have highly developed ‘bull**** detectors’ and are pretty smart and cynical to boot - so are often a very, very hard sell.

5. The risk / reward ratio of making any change needs to be apparent and easily understood and possible and or potential issues identified up front rather than hoping no-one will notice.

In summary change management in the sector can be very difficult and needs a high level of cultural awareness as well as a sound considered approach.

The Wikipedia article on Change Management provides some useful general background.

http://en.wikipedia.org/wiki/Change_management

----- End Extract.

Additionally anyone who has any useful references in the areas of Health Culture and Health Sector Change Management I would be very grateful!

David.

Karen Dearne: Once again, NEHTA manages both a deficit and a surplus

THE National E-Health Transition Authority had an operating deficit of $29 million in the past financial year, but reports a $91m surplus on a grand total of $241m in revenue.

Income almost doubled from $123.6m in the 2010-11 financial year, when NEHTA had recorded a $9m deficit in tandem with a $33m surplus attributed to forward funding.

Its annual financial statements reveal NEHTA received further funding prior to the end of the 2011-12 financial year, allowing the auditor to prepare its statements on a "going concern" basis even though previous Council of Australian Government funding arrangements ran out on June 30.

"Funding was provided to continue the NEHTA work program until June 30, 2014," auditor Grant Thornton says. "NEHTA has set aside cash reserves sufficient to extinguish any remaining liabilities that exist (at that date), should further funding not be provided."

NEHTA is holding $33.4m in revenue received but not yet earned, compared to $10m in unearned revenue and $7m in program payments received but not yet paid a year earlier.

This year, it reports allowances for expenditure not yet incurred totalling $86m, against $25m previously.

These include $5.1m for the design and build of the National Authentication Service for Health ($6.5m in 2010-11); $3.9m for Healthcare Identifier (HI) service costs ($4.8m), and HI implementation support costs of $11.6m ($10.7m).

Additionally, there are new HI program support costs of $9m; $51.7m for vendor and wave site costs associated with the Personally Controlled E-Health Record implementation; PCEHR "demobilisation" costs of $3m plus $1.9m in design and build costs.

NEHTA's directors report that on July 1 this year, "the key components of the (federal Health department's) PCEHR program were successfully delivered".

"During the year, NEHTA has provided for a number of future financial and contractual commitments associated with its existing work program," the financial report says.

"In particular, in June 2012 NEHTA received funding in advance to cover the COAG work program in 2012-13, and funding for continued work on the PCEHR program.

"In addition to this, funds have been received to enhance the HI service and deployment of (former pilot) e-health sites to the PCEHR."

Because NEHTA adheres to Australian Accounting Standards requirements that income be stated upon receipt, the report notes that "had these transactions been accounted for in accordance with their nature and purpose, NEHTA would have shown a deficit for the year".

The directors say NEHTA entered into discussions with NASH contract provider IBM on July 4 over termination of IBM's $23.6m Design and Build contract between the two parties, and an Operating contract between IBM and NEHTA's wholly-owned $2 subsidiary, E-Health Authentication Services (EHAS).

"The parties are currently engaged in confidential and without prejudice discussions regarding (those) matters," the report says.

"EHAS acts as the Certification Authority of the NASH in accordance with (the federal government's) Gatekeeper PKI policy.

"Its primary purpose is to provide, manage, maintain and enhance the infrastructure, software and systems required to support connectivity and interoperability of electronic health information systems across Australia."

Taxpayers tipped $237.35m into NEHTA during the period, courtesy of the joint Commonwealth, state and territory agreement through COAG, well up from $122.4m the previous year.

NEHTA earned another $3.4m in other income, mainly interest payments; at balance date, NEHTA held $178m in cash or short-term bank deposits (up from $44m a year earlier).

Staff costs account for most of the expenditure, with employees and contractors earning a total $63m (compared with $40m in 2010-11), consultants pocketing $59m ($33m) , while administration cost $20m ($15m).

Twelve senior executives earned a combined total of $3.5m ($3.1m), although not all of these people were full-time staff.

The two independent board members, chair David Gonski and director Lynda O'Grady, together earned $131,210 ($128,475) in salary and superannuation benefits.

Meanwhile, NEHTA paid most state governments for the provision of services in relation to various work programs, with Victoria earning $3m, Queensland $2.3m, Western Australia $1.4m, South Australia $1.2m and the Northern Territory $196,000.

In last year's financial report, NEHTA's short-term goals for 2011-12 were focused on "key strategic priorities", including the NASH, clinical terminology and information services, secure message delivery, the national product catalogue, HI service and software compliance, conformance and accreditation.

This year, its stated aims are to "drive national adoption of e-health" in collaboration with consumers, healthcare provider organisations, industry and government.

"In particular, building on the progress achieved to date with the 12 e-health sites, NEHTA will continue to focus on driving take-up and transitioning the sites to national adoption," the report says.

"NEHTA will also further enable the improved continuity and coordination of care; medications management; and the use of diagnostic information to enhance specifications and standards development."

Karen Dearne is a freelance journalist with a special interest in e-health matters (kdearne@gmail.com).

Weekly Australian Health IT Links – 16th October, 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

The ‘Heckler’ in the SMH has noticed e-Health with a very funny article of the impact on how care is delivered. Very much worth a read.

Otherwise we have a few bits and pieces and we are amazed to discover that the term ‘meaningful use’ has somehow made its way across the Pacific and into the mind of the DoHA bureaucrats.

What is different is that what is proposed is a pale replica of the US program in scope, design and size.

I suspect there will be more to say on all this as time passes!

Otherwise all I can say is I will miss my mouse - it seems to work for me and the screen does not get finger marks! (See last article)

-----

http://www.smh.com.au/opinion/society-and-culture/welcome-to-the-age-of-you-sick-we-click-20121004-2722p.html

Welcome to the age of 'you sick, we click'

Date October 5, 2012

Heckler

IF YOU were in hospital in the good old days - and by that I mean a time when the world was a simpler place - and you saw a doctor or nurse heading your way, they would be most likely armed with one of three things: a stethoscope, a thermometer or a bedpan.

In this modern age, the accessory of choice is likely to be a computer. And while this clever gadget may streamline hospital administration, a fat lot of good it does if you're waiting for treatment in a hospital emergency ward - which is where I recently found myself after fighting a losing battle with modern packaging.

Late on a Friday night, I had foolishly used a pair of rusting scissors to punch a hole in the cap on a tube of toothpaste, piercing instead the index finger on my left hand.

-----

http://www.abc.net.au/news/2012-10-08/mullum-e-health/4301824

Labor says State Govt committed to Mullumbimby e-health trial

Posted Mon Oct 8, 2012 5:08pm AEDT

The State Opposition says a controversial tele-health trial involving hospitals on the far north coast now looks certain to go ahead.

Under the proposal, emergency patients arriving at Mullumbimby after 11 pm would be assessed using a video link by doctors at Tweed Heads.

The local health network has so far insisted the trial won't go ahead unless staff concerns can be addressed.

-----

http://www.crn.com.au/Feature/318349,crn-verticals-health-check.aspx

CRN Verticals: Health check

By David Binning on Oct 8, 2012 4:35 PM

Digital medicine revolution marches into health.

The failure thus far of the Australian healthcare sector to reap the enormous potential for IT to improve the delivery and quality of medical services in Australia represents a massive opportunity for the Australian channel.

Whether it’s the personally controlled electronic healthcare records (PCEHR) system or the generous federal government subsidies to encourage the uptake of telehealth, it seems no matter how clever or potentially game-changing an initiative is, convincing decision makers within the medical profession has always been a challenge, and is expected to remain so for some time.

Typically in healthcare, disjointed data is collected across highly fragmented systems that are still often predominantly paper-based. For those that have evolved into electronic forms, most have poor interoperability with other electronic systems used by various payers, providers, or government agencies. 

-----

http://www.medicalobserver.com.au/news/164m-virtual-mental-health-clinic-to-be-launched

$16.4m ‘virtual’ mental health clinic to be launched

11th Oct 2012

Andrew Bracey

THE federal government will launch later this year a $16.4 million ‘virtual’ clinic which it hopes will increase patient access to phone and online support services for mental health.

Making the announcement during Mental Health Week, Mental Health Minister Mark Butler said with many Australians seeking advice and information on the internet, the new portal would help assure they received “the right help online”.

“We need to eradicate the stigma mental illness can carry, but we also need to recognise that many people still prefer the convenience and anonymity the web can offer when it comes to seeking help,” Mr Butler said.

-----

http://ehealthspace.org/news/bright-future-e-mental-health-kate-carnell

Bright future for e-mental health: Kate Carnell

Posted Thu, 11/10/2012 - 11:04 by Will Turner

You’d expect Kate Carnell to rank her former role as ACT chief minister as the most significant milestone in her career.

Instead, she points to twenty years of work as an owner-operator at a community pharmacy as the defining period of her life which shaped her attitudes towards healthcare.

“I saw just how prevalent mental health issues were and how difficult they could be to deal with. On a daily basis people would come in troubled about seeking help or knowing how to comply with medications they had been prescribed,” she said.

This grassroots experience led to a series of leadership roles in community service, the Australian Pharmacy Guild and a decade long stint in politics.

-----

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr12-tp-tp084.htm

New Website Boosts Patient Access to Australian Clinical Trials

Joint Release

The Hon Tanya Plibersek MP
Minister for Health

The Hon Greg Combet AM MP
Minister for Innovation and Industry
Minister for Climate Change and Energy Efficiency

11 October 2012

Patients suffering chronic diseases will benefit from the launch of a new website that offers easier access to clinical trials of new drugs, treatments and medical procedures.

The Minister for Health, Tanya Plibersek, today said that the Australian Clinical Trials website was created in response to the needs of consumer groups, the pharmaceutical industry and research institutions.

“Clinical trials give tens of thousands of patients access to new and innovative treatments and play a vital part in the fight against disease,” Ms Plibersek said.

-----

http://www.amlalliance.com.au/__data/assets/pdf_file/0016/45610/20120903_ML_eHealth-Change-and-Adoption-Program-and-ITA-Webinar.pdf

Medicare Locals eHealth Change and Adoption Program

3 October 2012

What needs to be achieved

The Medicare Locals eHealth Change and Adoption program is designed to support primary care providers in achieving four successive levels of eHealth change and adoption. Each tier is a foundation for the next and the achievement of meaningful use of the PCeHR (Tier 4) is necessary for delivering the health and economic benefits of eHealth.

-----

http://ama.com.au/ama-response-consultation-draft-national-primary-health-care-strategic-framework

AMA response to the consultation draft National Primary Health Care Strategic Framework

10 October 2012 - 9:51am

National Primary Health Care Strategic Framework – Consultation Draft

The AMA has made comments on the National Primary Health Care Strategic Framework Consultation Draft released by the Commonwealth Government (and prepared with State and Territory governments under the National Reform Agreement).

The AMA supports measures to improve primary health care in Australia and maintain a GP-led primary health care model. The AMA has expressed concern that the draft Framework makes no new funding available in primary health care while expecting the primary health care system to take further pressure off the public hospital system.

-----

http://www.6minutes.com.au/news/latest-news/gps-need-greater-support-in-national-framework

GPs need greater support in national framework

11 October, 2012 Megan Reynolds  

The AMA is calling for new funding to support GP consultations, e-health initiatives and chronic disease management in a submission on the National Primary Health Care Strategic Framework.

Vice president Professor Geoffery Dobb said the organisation is “astounded” the framework that will shift a greater patient care burden into primary care is “based on there being no new funding to support primary care over the next three years”.

-----

http://www.theaustralian.com.au/national-affairs/health-videolink-slow-to-warm-up/story-fn59niix-1226494744032

Health videolink slow to warm up

• by: Adam Cresswell
• From: The Australian
• October 13, 2012 12:00AM

MEDICARE has paid out just a 10th of the projected rebates for telehealth consultation, thanks to a slow uptake by doctors.

The annual report of the Department of Health and Ageing, published this week, shows just $3.6 million was paid in Medicare rebates for online consultations in 2011-12, far below the $30.5m allocated.

The measure was part of a $352m initiative over four years unveiled in 2010, which then health minister Nicola Roxon said would "cut down the tyranny of distance and bring specialist services to the patient's doorstep through the use of online videolink technology".

-----

www.cfoworld.com.au/mediareleases/15033/online-booking-boosts-health-system-capacity/

Media releases are provided as is and have not been edited or checked for accuracy. Any queries should be directed to the company issuing the release.

• 10 October 2012 11:10
• HealthEngine.com.au

Online booking boosts health system capacity: HealthEngine

New figures showing that close to 40 per cent of Australians attending emergency rooms could have been treated by a GP have spurred calls for governments to back online appointment booking systems.

Figures released by the Australian Institute of Health and Welfare show 38 per cent of people attending emergency departments — about 2.1 million a year — could have been dealt with by a GP.

Search and booking site HealthEngine.com.au says publishing available GP appointments online could reduce demand for emergency rooms even in areas with recognised GP shortages.

-----

http://www.theaustralian.com.au/news/health-science/putting-medical-apps-through-their-paces/story-e6frg8y6-1226490189026

Putting medical apps through their paces

• From: The Australian
• October 08, 2012 12:00AM

THE SunSmart app allows users to monitor their exposure to the sun.

APP NAME: SunSmart
PUBLISHER: Cancer Council Victoria
COST: Free
PLATFORM: iPhone and Android

PURPOSE:

Allows people anywhere in Australia to see during which hours of the day they need sun protection, how long they can safely remain outside without burning, and when it is safe to venture out to ensure they get enough vitamin D.

-----

http://www.smh.com.au/technology/technology-news/web-snooping-plan-suppressed-by-government-20121010-27cs7.html

Web snooping plan suppressed by government

Date October 10, 2012 - 2:55PM

Philip Dorling

Law enforcement wants telcos to store vast amounts of data they currently don't keep on us.

National security bureaucrats are keeping secret the details of a plan to store the internet history of all Australians for at least two years.

The Prime Minister's department has rejected a Freedom of Information application by Fairfax Media for release of its file on the proposed “third tranche” of national security laws on the grounds that declassification would “substantially and unreasonably divert the Department's resources from its other operations”.

-----

http://www.medicalobserver.com.au/news/illegal-online-medicines-crackdown-37000-pills-seized

Illegal online medicines crackdown: 37,000 pills seized

8th Oct 2012

AAP  

More than 37,000 pills, including diet supplements, erectile dysfunction medication and steroids, have been seized in Melbourne and Brisbane in a crackdown on fake and illegal medicines.

The haul, valued at more than $147,000, was intercepted as a result of a week-long international effort across more than 80 countries that included Australia's Customs and Border Protection and the Therapeutic Goods Administration (TGA).

Most of the substances were slimming and diet supplements and erectile dysfunction medication, Customs said in a statement on Friday.

-----

http://www.rustreport.com.au/issues/latestissue/aussie-creatives-shine-at-iab-mixx-awards-in-new-york/

First implant of ‘pre-bionic eye’: NICTA

Progress toward Australia’s first bionic eye is well underway, with news last month that Bionic Vision Australia (BVA) researchers have successfully performed the first implantation of an early prototype bionic eye with 24 electrodes. Ms Dianne Ashworth has profound vision loss due to retinitis pigmentosa, an inherited condition.

-----

http://www.medicalobserver.com.au/news/the-interview--djakics-decree-gps-unite

The Interview – Djakic’s decree: GPs unite

9th Oct 2012

Byron Kaye

WHEN Dr Emil Djakic fronted the AMA’s 2011 annual conference, it was always going to be interesting.

It was May, a month from the day the first 19 general practice divisions were to morph into Medicare Locals, taking nurses, pharmacists and all manner of other allied primary health people into their previously GP-focused structures.

The AMA had recently opposed the government-decreed change, and made no attempt to hide this at the conference. The opposition health spokesman, Peter  Dutton, showed up and showed solidarity.

-----

http://www.smh.com.au/digital-life/digital-life-news/technology-for-the-body-on-the-road-to-cyborgs-20121003-26ytg.html

Technology for the body on the road to cyborgs?

Date October 8, 2012

Sarah Bakewell

Speakers at a symposium on body-enhancement technology raised the idea that we may converge with our technology to the point that a superhuman entity emerges.

On September 2, 2010, Karen Throsby became the 1153rd person to swim the English Channel, taking 16 hours and nine minutes, and keeping herself going on handfuls of jelly babies.

Many Channel swimmers are purists: wetsuits are banned, never mind performance-enhancing drugs. The sport sees itself as an assertion of human ability in natural form. But Throsby, a sociologist researching the effects of extreme sports, takes a different view.

She was a speaker at Human Limits, a Wellcome Collection symposium linked to its Superhuman exhibition in London on physical and mental enhancement. The question it investigated was how much technology can humans use before they become something else — a cyborg, perhaps, or a superhuman, a post-human, or a trans-human. What are our limits?

-----

http://www.smh.com.au/digital-life/digital-life-news/mouse-faces-extinction-as-computer-interaction-evolves-20121008-278h0.html

Mouse faces extinction as computer interaction evolves

Date October 8, 2012 - 12:33PM

Swipe, swipe, pinch-zoom. Fifth-grader Josephine Nguyen is researching the definition of an adverb on her iPad and her fingers are flying across the screen.

For my one-year-old daughter, a magazine is an iPad that does not work. It will remain so for her whole life. 

Her 20 classmates are hunched over their own tablets doing the same. Conspicuously absent from this modern scene of high-tech learning: a mouse.

-----

Enjoy!

David.

AusHealthIT Poll Number 140 – Results – 15th October, 2012.

The question was:

Will NEHTA and The GP Software Providers Be Able To Deliver The Required Working, Conformant and Tested Software for the Practice Incentive Program (PIP) Payments to Be Received By GPs? (Due May 2013).

For Sure 12% (5)

Probably 15% (6)

Possibly 10% (4)

No Way 46% (19)

There Is No Way To Know 17% (7)

Total votes: 41

Very interesting.  Many are a little sceptical and even more are reckoning little chance of timely software delivery.

Again, many thanks to those that voted!

David.

Has The NEHRS / PCEHR Initiative Reached A Tipping Point And Is It Now Heading Towards Oblivion? I Wonder.

I have been wondering just what is happening to the NEHRS / PCEHR Initiative as time from launch reaches well over 4 months and still use and adoption is seemingly rather stuck at very low levels.

A few things that have caught my eye:

1. A Google News Search for PCEHR finds a lot of coverage from Pulse + IT magazine, a few tech magazine mentions, and just one article in the mainstream media in the last month or so.

2. No press releases from DoHA on the e-Health project for a good while (months) other than peripheral initiatives.

3. NEHTA having not really updated their sectoral implementation plans for as long as anyone can remember.

See here:

http://www.nehta.gov.au/ehealth-implementation

The IHI Service plans have not been update in years and the last Vendor Webinar seems to have been at the end of July.

4. As of my check today there is not a single provider that is compliant with all the new ePIP requirements. (MD and ZedMed are going well however). Interestingly there have been no additional registrations in the last week or so after an initial rush.

5. NEHTA having a major reduction in funding,  skills and capability with the loss of many contractors who were working on a range on NEHRS related matters (If Government was serious in pushing ahead this would not have happened).

6. The Health Minister focussing on “training more doctors and dental reform” See:

http://www.afr.com/p/national/plibersek_puts_gender_aside_gets_Egl5l1ksG2v9s2VwUZIT9O

7. Very little material in the medical professional press on e-Health (other than concerns about ePIP) - save a recent video I spotted in Medical Observer:

IN CONVERSATION

With e-health records set to become a significant part of general practice, Byron Kaye speaks with National E-Health Transition Authority clinical lead Dr Mukesh Haikerwal to clarify some GP concerns.

http://www.medicalobserver.com.au/video (if you have access)

Specific link:

http://bcove.me/79ef6gix (seems to be fully accessible)

It is interesting that Dr Haikerwal’s main point was that the PCEHR was another tool for Healthcare Providers rather than for patients and did not replace what was presently happening with records and procedures.

8. The AMA saying (10 October release) on e-health the following.

“E-health

One of the biggest reforms currently in train that has the potential to improve patient health outcomes and experiences is in the area of technology and e-health.  As you would be aware, the AMA has been a vocal critic of many of the components of the Personally Controlled Electronic Health Record (PCEHR) in its current form.  While the AMA considers that the PCEHR has the potential over the long term to assist with pathways and improve coordination of care, the PCEHR itself also has significant limitations built into its design (e.g. opt-in and the patient’s ability to control what information is on the record).  This will limit its effectiveness and the potential benefits to patients and the downstream benefits for the health care system.  When clinicians do not trust the content of the e-health records, they will not use them and all the potential that could have been gained from a well-developed system will be lost.  

E-health is one of the key areas where linkages between the primary and acute care sectors can be made.  The AMA considers that any National Primary Health Care Strategic Framework must address in detail what needs to happen to ensure that the PCEHR and any other e-health initiatives are supported by GPs and general practices and well integrated into primary care.  The simple fact is that if GPs and their practices do not support the government-funded e-health initiatives, they will not work and all of that potential gain of linking primary health care with other parts of the health system will be deficient and a waste of health resources.”

The full release is here:

http://ama.com.au/ama-response-consultation-draft-national-primary-health-care-strategic-framework

They are still by no means happy campers.

9. The quite impractical deadlines and for Vendors and GPs to reach ePIP compliance. (sure to shift I reckon.)

10. The reduction in coverage of the NEHRS / PCEHR from the NEHTA sponsored or paid entities.

11. The complete lack of any apparent public awareness campaigns etc.

Overall it seems to me this has been placed on the distant backburner at the very least and has had the plug pulled in all but name more than likely. (I await the announcement of the new “e-Health Change Management Strategy).

What do insiders really think is presently going on. A pause that refreshes, a major longer pause or a major wind-down?

David.