All,
Have found a new 'gadget'. Seems to work to display recent comments.
Let me know if it is not OK.
David.
Thursday, November 22, 2012
A Personal Rant : I Am Just Sick Of Computer Updates. Why Can’t They Give Us Systems That Just Work?
We have just had another one of those wonderful updates from Windows - this time with about 20 different flaws to be fixed on my Win 7 based (64bit) PC. (I am not going to be blogging from a tablet any time soon so a PC is really the only option (glass keyboards I no like!)
The time taken to download, install and re-boot was a good 10 minutes as Windows, the .net framework and so on got their fix. At the same time my laptop(s) needed their fix - and we had Adobe Flash wanting an update as well as Firefox also feeling the need for a refresh!
This is to say nothing of all the other things that pop up from time to time and demand attention.
If there are 1.25 billion Windows Users (See here: http://winsupersite.com/windows-8/windows-charge-few-numbers ) and each has a monthly 10 minute productivity break we are talking an actual measurable hit to global productivity of say 2.5 billion hours of wasted time!
Surely there can be a better way found to develop and protect software that does not wind up with me, at least, having a monthly yell at MS and their associates.
Parenthetically I hear the just released Windows 8 is already in need of some fixes as well!
I am fed up. Solutions welcome!
Rant off!
David.
The time taken to download, install and re-boot was a good 10 minutes as Windows, the .net framework and so on got their fix. At the same time my laptop(s) needed their fix - and we had Adobe Flash wanting an update as well as Firefox also feeling the need for a refresh!
This is to say nothing of all the other things that pop up from time to time and demand attention.
If there are 1.25 billion Windows Users (See here: http://winsupersite.com/windows-8/windows-charge-few-numbers ) and each has a monthly 10 minute productivity break we are talking an actual measurable hit to global productivity of say 2.5 billion hours of wasted time!
Surely there can be a better way found to develop and protect software that does not wind up with me, at least, having a monthly yell at MS and their associates.
Parenthetically I hear the just released Windows 8 is already in need of some fixes as well!
I am fed up. Solutions welcome!
Rant off!
David.
Wednesday, November 21, 2012
What Is The Story Regarding The Privacy Of Your Information From Government If Held In A NEHRS?
I was alerted to this issue by a report from the US:
Monday, November 12, 2012
Despite ONC's Effort, Comparing PHR Privacy Policies Still Challenging
by Kate Ackerman, iHealthBeat Managing Editor
To date, personal health record adoption has been somewhat limited, but the market is expected to get a big boost from Stage 2 of the meaningful use incentive program.
Deven McGraw -- director of the Health Privacy Project at the Center for Democracy & Technology -- said, "The market for those tools has been a little soft I think because people have really had to hand enter in the data or scan [them] in, as opposed to being able to feed [the information] directly from a provider's electronic health record, unless they happen to be a patient at Kaiser or part of a system that already offers them that tool." However, she said, "That's going to change in 2014 when a lot of the early adopters in the HITECH incentive program begin Stage 2 and start actively encouraging patients to view and potentially download and transmit their data."
But is the industry ready when it comes to privacy and security regulations?
Survey data show that consumers routinely cite privacy and security as top barriers to personal health record adoption. A 2010 survey from the California HealthCare Foundation found that 75% of U.S. adults without a PHR cited concerns about the privacy of their information as the top barrier to using a PHR. CHCF publishes iHealthBeat.
Jeff Donnell, president of PHR provider NoMoreClipboard, noted that consumers have been exposed to privacy and security issues in the financial services industry. He said, "So they take a look at that and recognize, 'Okay, often times information is used for nefarious purposes,' and people want to make absolutely certain that their data [do not] somehow get stolen or wiped and end up being used by identity thieves." He added, "It's not uncommon to hear about ... a major breach where thousands or hundreds of thousands or in some cases even millions of patient records walk out of an office on a laptop or unencrypted disc, and then those things disappear or get stolen. ... And, that gives people cause for concern."
Further, when consumers are considering PHRs sponsored by health plans or employers, they want to "make absolutely certain" that their data is not visible to their boss and that their health plan cannot use their information to deny coverage, according to Donnell.
Despite the survey data, McGraw said that in practice, convenience and usefulness -- not privacy -- are likely top of mind when consumers are deciding which PHR tool to adopt.
Donnell agreed. "Certainly there are going to be some people who rightfully are going to be very concerned about why would someone want my health information. You know, if I'm George Clooney or Brittney Spears, I'd be worried because I know people are going to try to get at that data," he said.
However, he said, "If I'm an individual with diabetes or I'm taking care of an aging parent with congestive heart failure, you know what? I'm not all that worried about privacy and security. I'm worried about making sure that I have ready access to information that I'm able to easily manage it, share it with the people who need the data to properly care for me or my family member. So all of a sudden, those privacy concerns while they don't go away, they become very, very minimal in terms of importance."
Donnell said that the data analytics on NoMoreClipboard's website and application show that fewer than 1% of users actually take the time to click through and read the firm's privacy policy.
.....
MORE ON THE WEB
"Are Personal Health Records Safe? A Review of Free Web-Accessible Personal Health Record Privacy Policies" (Carrión Señor, Journal of Medical Internet Research, August 2012)
"Consumers and Health Information Technology: A National Survey" (CHCF, April 2010)
Lots more here:
A point made here is that information held in your PHR may - or may not - be safe from your employer or insurer.
After something of a hunt I tracked down the NEHRS Privacy Statement.
You can follow these links.
This then points to this:
While I am no lawyer it does not seem there is much in the way of barriers for the use of information in the NEHRS by those in DoHA and the Department of Human Services - who choose to do so - given the things like my evolving name changes and so on - as reported last week on the blog.
See here:
I think the general approach of only providing information you are happy to see on the front page at www.smh.com.au makes a great deal of sense in terms of what you put in you NEHRS. You just never know when some information you provide trustingly can come back to bite you!
Remember once information escapes - no matter how - it is very hard to get back.
David.
Tuesday, November 20, 2012
Another Straw In The Wind Of A Dying Health IT Program We Know As The NEHRS / PCEHR.
The following article appeared last week.
Growing frustration with national e-health program
14th Nov 2012
CLINICIANS advising on the national e-health program say they are dissatisfied with the level of engagement by the National E-health Transition Authority (NEHTA), with MO understanding some are reconsidering their involvement.
A number of the 64 clinical leaders – listed on NEHTA’s website – approached by MO, confirmed there was growing frustration among the group.
One clinical leader, who wished to remain anonymous, said there had been a “communication blackout from NEHTA for quite some time” and that they were aware some other clinical leaders were “dissatisfied with the amount of engagement by NEHTA”.
“I’m not sure how much [the clinical leaders] are going to be engaged in the future. People are worried that they have dropped off the equation altogether… worried if e-health becomes a department of health-driven project without the [clinical input],” they said.
NEHTA’s national clinical lead, Dr Mukesh Haikerwal, would not confirm reports to MO that some clinical leaders were planning to pull out of NEHTA due to frustration at not being listened to, but said retaining clinical advisers was vital to the integrity of the PCEHR.
More here:
This is a very important report in my view. If the hand selected - and pretty well paid incidentally - clinicians are starting to ‘up-stakes’ then one really has to wonder if this project has actually got any legs.
I know there was a trivial sum ($2.55M) made available for e-Health course development and some 30 e-health evangelists a short time ago from DoHA .
See here for a report:
I wonder are those leaving those who missed out on the new program - as it seems probable that with contractors being shed at NEHTA there will be less money available from that source.
As we have all noticed there has been a sudden reduction in discussion of e-Health in the media and the maintenance of the NEHTA web site has become perfunctory at best. Additionally one e-Health blogger has stopped posting much and another site has become a much more general health site.
My guess is that we are seeing the early signs of support being withdrawn for the NEHRS program and NEHTA and that the hope is no one will notice!
I note that as of today we see “No positions advertised” here:
Wind down mode if ever you saw it.
David.
The NEHRS Vendor Test Environment Is Going Up And Down Like A Yo-Yo.
It seems something is seriously broken and to date no explanations offered.
Messages like this daily for the last 2 days:
"Due to issues experienced with DHS-Medicare HI Services, Provider Portal and Consumer Portal channels are unavailable. PCEHR SVT support apologises for any inconvenience this may cause."
Outages are lasting hours.
Really lousy value for money for the public and frustration for the vendors developing software!
Just hopeless.
David.
ps. I am told some of the issues are in part due to some changes being made by way of patches to try and make things better that may be missing the mark due to lack of testing etc.
D.
And the update from 5:45pm. (Outage Started 10:07am)
"DHS Medicare are continuing with the restoration steps for unplanned HI Services outage reported earlier in the Software Vendor Test (SVT) environment.
PCEHR SVT support apologises for any inconvenience this may cause."
What nonsense!
David
And on Nov 21, 2012. 9:00 am.
"Due to issues experienced with DHS-Medicare Test HI Services, Provider Portal and B2B Register PCEHR (Assisted Registration) service are unavailable
DHS Medicare are continuing with the restoration steps for unplanned Test HI Services outage in the Software Vendor Test (SVT) environment.
PCEHR SVT support apologises for any inconvenience this may cause."
Said to be fixed at 10:15am
No comment.
D.
Messages like this daily for the last 2 days:
"Due to issues experienced with DHS-Medicare HI Services, Provider Portal and Consumer Portal channels are unavailable. PCEHR SVT support apologises for any inconvenience this may cause."
Outages are lasting hours.
Really lousy value for money for the public and frustration for the vendors developing software!
Just hopeless.
David.
ps. I am told some of the issues are in part due to some changes being made by way of patches to try and make things better that may be missing the mark due to lack of testing etc.
D.
And the update from 5:45pm. (Outage Started 10:07am)
"DHS Medicare are continuing with the restoration steps for unplanned HI Services outage reported earlier in the Software Vendor Test (SVT) environment.
PCEHR SVT support apologises for any inconvenience this may cause."
What nonsense!
David
And on Nov 21, 2012. 9:00 am.
"Due to issues experienced with DHS-Medicare Test HI Services, Provider Portal and B2B Register PCEHR (Assisted Registration) service are unavailable
DHS Medicare are continuing with the restoration steps for unplanned Test HI Services outage in the Software Vendor Test (SVT) environment.
PCEHR SVT support apologises for any inconvenience this may cause."
Said to be fixed at 10:15am
No comment.
D.
Monday, November 19, 2012
Weekly Australian Health IT Links – 19th November, 2012.
Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
General Comment
Well it has really been a quiet week with virtually nothing in the e-health space being reported.
We are now 4.5 months since launch of the live NEHRS, NEHTA says their job is done but there is still essentially no use of the ‘billion dollar baby’.
I wonder is the quiet due to some tricky technical issues not being quite resolved as I am occasionally hearing or something else....time will tell I guess.
My weekly visit to my NEHRS has shown that the performance again seems to be very slow. I am not sure just why this is, given the trivial number of users at this point. If anyone knows why it is seemingly so slow comments are welcome.
-----
E-health supplier link to data fears
- by: Fran Foo
- From: The Australian
- November 13, 2012
THE Gillard government's national e-health system supplier Accenture may have breached data sovereignty regulations if it used servers located overseas.
It would be a move legal experts say would be "troubling" for such a large organisation.
The government's National E-Health Transition Authority found that "use of offshore Accenture mail servers by the PCEHR (personally controlled electronic health records) system may be in breach of legislative requirements".
NEHTA deemed this as high-risk, with major consequences. It said an individual's privacy could be compromised as a result of the actions.
-----
Lack of national complaints reporting crippling health system progress
12 November, 2012 Kate Aubusson
A national database for healthcare complaints is urgently needed to improve services and minimise harm, according to new research that exposes patchwork reporting, “crippling” any chance of thorough national analysis.
A comparison of complaint statistics for all state and territory health commissions (HCCs) over five years found data was shared for only four out of 18 types of complaints, the University of Sydney researchers reported.
“This means that it is not possible to benchmark complaints, make definitive state-by-state comparisons or establish best practice in relation to time frames for assessment conciliation or investigation,” they wrote in the Australian Review of Public Affairs.
-----
Growing frustration with national e-health program
14th Nov 2012
CLINICIANS advising on the national e-health program say they are dissatisfied with the level of engagement by the National E-health Transition Authority (NEHTA), with MO understanding some are reconsidering their involvement.
A number of the 64 clinical leaders – listed on NEHTA’s website – approached by MO, confirmed there was growing frustration among the group.
One clinical leader, who wished to remain anonymous, said there had been a “communication blackout from NEHTA for quite some time” and that they were aware some other clinical leaders were “dissatisfied with the amount of engagement by NEHTA”.
-----
Lines out: $134m cut kills telehealth plans
13th Nov 2012
A DISTRICT of Workforce Shortage (DWS) with plans for an $800,000 Commonwealth telehealth project has been declared ineligible for telehealth Medicare rebates because of controversial spending cuts in the recent mini-budget.
The federal government has committed to a budget surplus this financial year and in a round of mid-year spending cuts said it would save $134.4 million over four years by scrapping telehealth rebates for people in outer metropolitan areas and major regional cities.
GPs in semi-metro areas far from major hospitals had already started rolling out telehealth facilities for specialist consults after the government announced a rebate 16 months ago, but have begun to rethink those plans following news of the latest cuts.
-----
Plibersek and states exchange fire over health funding
12th Nov 2012
HEALTH ministers from Queensland, Victoria and NSW reacted angrily when their federal counterpart gate crashed their media conference in Perth on Friday, fuelling a heated argument about state health funding.
They have accused federal Health Minister Tanya Plibersek of a "dodgy" interpretation of Australian Bureau of Statistics population data that would cut state health funding, claims that she vehemently rejected.
The stoush comes as Ms Plibersek remains at loggerheads with premiers of key states including NSW and Victoria over the issue of intern places for medical graduates, with WA, Queensland and the ACT so far the only juristictions to agree to a deal from the federal government to have the positions jointly funded in order to prevent a training shortfall.
-----
POSTMAN POT: Drug users turn to world weed web
- By Daniel Piotrowski
- news.com.au
- November 08, 2012
- Why is there a boom in cannabis detections at our borders?
- "Weed parties" blatantly organised in public
- Users getting drugs in discreet packages via encrypted websites
POT smokers usually grow marijuana in their backyards or buy from their dealer mates. But now for many Australians, it's their postie delivering them the stuff from overseas.
The latest Customs figures show a boom in the number of cannabis detections in international mail at the border, with drug experts reporting that Aussies are turning to encrypted online stores to purchase what were once backyard drugs.
Dr Monica Barratt, a research fellow at the National Drug Research Institute, said they’re likely turning to online marketplaces like the so-called “Ebay of drugs”, The Silk Road website.
-----
Doctors prescribe iPad Mini - a perfect lab coat fit
Glad that iPad Mini sticks with same interface as its bigger brother
- Lucas Mearian (Computerworld (US))
- 09 November, 2012 19:53
One in three physicians planned to buy the iPad Mini even when its existence was just a rumor, according to a poll of doctors by medical app developer Epocrates.
According to 90% of respondents to the survey, the smaller size of the iPad Mini is their main motivation. The 50 physicians surveyed indicated the iPad Mini will be easier to tote around between exam rooms and on hospital rounds because it fits nicely into the pockets of their lab coats.
Lab coat pockets are 8.5-in. high and 7.5-in. wide. The iPad Mini is 7.87-in. high and 5.3-in. wide.
The use of tablets by physicians for professional purposes almost doubled since 2011, reaching 62% this year, with the iPad as the dominant device. Half of tablet-owning physicians have used their devices at the point of care, according to a study by market research and advisory firm Manhattan Research.
-----
Pay-for-performance closer
AS Australian authorities consider whether to include quality and safety measures in local hospital funding formulae, a UK analysis shows a pay-for-performance program has delivered a small but clinically significant reduction in mortality.
The study, published in the New England Journal of Medicine, found a 1.3% drop in 30-day, in-hospital, risk-adjusted mortality in 134 435 patients admitted to 24 hospitals for pneumonia, heart failure or acute myocardial infarction. Data were compared with 722 139 patients admitted for the same three conditions to 132 other hospitals in England. (1)
The 24 hospitals, all based in the north-west of England, had implemented a quality improvement program developed in the US — the Medicare Premier Hospital Quality Incentive Demonstration (HQID) program. An earlier assessment of that program found improved process-quality measures initially, but a 6-year follow-up found no effect on 30-day mortality. (2)
-----
GPs back new quality indicators
13 November, 2012 Paul Smith
GPs have backed the RACGP’s list of 22 clinical indicators that measure the performance of practices which were first mooted in March this year.
The indicators — which include reviews of antibiotic prescribing and audits of avoidable delays in diagnosing malignancies — were devised by some of Australia’s leading experts to boost quality and safety across the discipline.
In an RACGP survey completed by 500 GPs, every indicator won majority support, with only a minority of respondents — about 20% — saying they either “disagreed” or “strongly disagreed” with them.
-----
Patients clog emergency wards despite phoneline advice
Posted Wed, 14/11/2012 - 09:28 by Will Turner
A study into national triage and advice line healthdirect has sparked debate over its effectiveness in alleviating demand on hospital emergency departments (ED).
Published in the Medical Journal of Australia (MJA), the report found 52 percent of patients who had been given advice by a healthdirect registered nurse to stay put or seek treatment in a non-emergency setting nevertheless presented to an ED.
The report also found 73 percent of healthdirect referrals to emergency departments to have been appropriate, compared with an almost identical number for people presenting of their own accord.
-----
NBN satellite ground station to be built at Broken Hill
NBN Co has now announced the location for nine satellite ground stations for the NBN.
- Stephanie McDonald (Computerworld)
- 16 November, 2012 08:24
A National Broadband Network (NBN) satellite ground station will be built at Broken Hill in New South Wales.
The facility will comprise two 13.5 metre-wide satellite dishes and will service Menindee, Purnamoota, Yanco Glen and Kanbara.
The satellite ground station is expected to be operational by 2015.
“Broken Hill is ideally situated to play a central role in delivering better broadband to the outback,” Matt Dawson, NBN Co’s program director, satellites, said in a statement.
-----
Web's freedom threatened by 'worrisome' rules
Date November 15, 2012
The US faces a tough debate with emerging nations such as India and Brazil at an upcoming UN conference discussing global rules for the internet, the US delegation chief says.
Terry Kramer, who heads the US delegation for the December gathering of the UN's International Telecommunications Union, said on Wednesday he has seen a number of "surprising" and "worrisome" proposals.
The discussions are being held ahead of the ITU's World Conference on International Communications opening next month in Dubai where global telecom rules are to be updated for the first time since 1988.
US officials and lawmakers, along with a number of internet activists, have expressed concern that proposals from China, Russia and other nations could threaten the open model of the internet by giving the UN agency a greater role.
-----
Enjoy!
David.
AusHealthIT Poll Number 145 – Results – 19th November, 2012.
The question was:
In Its Annual Report NEHTA Claims It Successfully Delivered Its Part Of The NEHRS / PCEHR Program. Do You Agree?
Yes - It Delivered 16%
No - No It Didn't Deliver 80%
I Have No Idea 4%
Total votes: 49
Very interesting. It would seem the vast majority feel NEHTA has failed to deliver.
Again, many thanks to those that voted!
David.
Sunday, November 18, 2012
This NEHRS Will Get Unmanageable Over A Pretty Short Time I Reckon. It Will Also Become Increasingly Hard To Use.
Just how messy and unwieldy the NEHRS is going to become is illustrated by the following.
Here is part of the side-bar to access your record (note links don't work)
If you click on one of these links (and you are actually logged in and have access) you will get the following for each link.
----- Begin Document
DAVID G MORE DoB xx Feb 1949 (63 years) Sex Male IHI xxxxx 6011 8114 24xx
6 May 2012 00:00+1000 Pharmaceutical Benefits Report
START OF DOCUMENT
Pharmaceutical Benefit Items
Generic Name
|
ALLOPURINOL
|
Brand
|
PROGOUT 300
|
Prescribed
|
Sat May 05 00:00:00 EST 2012
|
Supplied
|
Sun May 06 00:00:00 EST 2012
|
Form and Strength
|
TABLET 300MG
|
Quantity
|
60
|
Repeat Number
|
2
|
Administrative Observations
Age when record was created 63
Document details
----- End Document.
This is just a 5-6 month display. In a few years even on just a few medicines one will be able to accumulate a heck of a large number of records. Also it needs to be remembered that each pathology test will have a similar record - assuming they make it to the record which in my case very few did.
Once you add the various shared summary record and the other planned documents (referrals and so on) it becomes clear just how unwieldy this will all become.
This whole document based approach may need a careful re-think. It makes much more sense to re-design the way information is presented - both for clinician and consumer - to make it acceptably useful.
My belief is that the root cause of the looming issue of just too many documents that are not properly organised is due to design overreach. We should have had a minimal shared EHR to start with and then move on incrementally. Sadly this is not what has happened.
The mess we have now reveals that NEHTA’s and DoHA’s job is by no means done despite claims to the contrary.
Additionally on the last two occasions I have logged on the performance of the system has been glacial.
I wonder why that might be?
David.
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