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."

Thursday, May 02, 2013

The Privacy Commissioner Is Providing Some Useful Information For All Businesses Including Health Care Businesses.

This article appeared a couple of days ago.

Privacy Commissioner launches Guide to Information Security

Guide covers governance, ICT security, data breaches, physical security and standards
The Office of the Australian Information Commissioner’s Privacy Week has begun in earnest with the unveiling of a Guide to Information Security in Sydney today.
Privacy Commissioner Timothy Pilgrim told delegates at a breakfast briefing that the Guide includes a list of non-exhaustive steps which would be reasonable for an entity to take before new Australian Privacy Principles (APP) reforms take place in March 2014.
The reforms update the Privacy Act 1988 and include changes to how personal information is handled, such as when it can be used for direct marketing and sent overseas.
Commenting on the Guide, Pilgrim said that if an organisation mishandles the personal information of its customers it risks loss of trust and considerable harm to the company’s reputation.
“This can also lead to loss of customers and an impact on the organisation’s ability to function,” he said.
Lots more here:
The article also provided some useful links to some background from Computerworld.
At the same briefing there was also another clear message. Business is not actually ready yet and time is running out.

A privacy time bomb

Reading through the government’s newly released guide to information security, especially with the changes to the Australian Privacy act looming over the horizon, requires sorting through a mess of peculiar acronyms, extended dot points and open-ended questions.
Needless to say, it’s a complex document and it’s thorough. And perhaps this is just the kind of document needed to ensure that companies can’t wriggle their obligations when they are stung with a data breach. But could the complexity of the document prove to be its downfall? And are Australian businesses are in an urgent need of a wake-up call when it comes to data protection?
Well the changes afoot are daunting so perhaps some simplification is in order. But with less than a year to go before the reforms take effect many organisations are seemingly twiddling their thumbs; a prospect that won't fill Australian consumers with any confidence.  
A survey of Australian business and government agencies commissioned by internet security company McAfee has found that 59 per cent of employees responsible for managing the personal information of customers were unaware or unsure of the changes.
While the Attorney-General Mark Dreyfus and the Privacy Commissioner Timothy Pilgrim spent a lot of time yesterday blowing the bugle of impending change, it looks like many organisations are destined to end up on the wrong side of a data breach.
Lots more here:
There is a clear warning here for Health Information custodians and users. The rules are changing and you need to be across just what is means for you. A browse of the Office of the Information Commissioners web-site (www.oaic.gov.au) is a very good place to start.
David.

Have The Standards For NEHRS / PCEHR Registration Been Suddenly Relaxed To Increase Registrations?

Has anyone else heard the rumour of some major easing in the rules for patient registration in the last few days?

Seems the desperation for registration numbers is rising if what I am hearing is true.

Look forward to any feedback / news.

David.

Wednesday, May 01, 2013

Karen Dearne Does What She Does Best. Chases The Truth On An Important E-Health Document From DoHA.

I was alerted today regarding a letter sent to DoHA today.
From: Karen Dearne
May 01, 2013
Dear Ms Zygadio
Can you please advise why I am yet to receive a decision on my request to waiver charges, which was due by April 17?
In the interim, I have noticed that Senator Sue Boyce has requested the same document through the Senate Estimates process.
See Community Affairs committee questions on notice to the Department of Health and Ageing, index number 165:
"In an answer to a written question on notice from the Estimates of October last year [WQON 361] regarding what will replace the expired National Partnership on E-Health DOHA stated that an ; "eHealth Memorandum of Understanding was agreed by the Standing Council on Health at its meeting on November 9, 2012. However, the communiqué released after that meeting stated that the Ministers had only "noted progress on the eHealth MOU."a) Can you explain this apparent inconsistency between your answer and the stated actions of the Standing Council on eHealth? b) If, as you claim a new 'eHealth MOU' is in existence could you please provide me with a copy of it?"
If the department provides a public copy of the MOU Agreement on eHealth through the Estimates process, then I shall not need to pursue this request.
But I note that responses to the Estimates QoNs were due by April 5, so the department is well overdue in responding to this issue.
I also note that Senator Boyce expresses some doubt as to the existence of the MOU agreement.
I am aware that no such agreement has been published, as required, on the Federal Financial Relations website.
Can you please advise whether the document will be made public via Estimates responses?
If not, I will pursue this request. In that event, could you please advise when I will receive a decision on the fees waiver.
Yours faithfully,
Karen Dearne
----- End Letter
You can review the back story (and the current letter) here:
The importance of this document is that this is the document that explains the overall relationship (including funding etc.) between the Federal and State Governments in the total E-Health Program.
There really is no reason for it to be secret that I can see.
In late breaking news it now seems Karen has flushed out a same-day response from DoHA.  It is found just below the initial letter above.
It says that the FOI request will not cost, but sadly production of the document will be delayed until one day after the Budget - on May 14, 2013. So what is contained in the budget will now be very interesting indeed in the e-health context.
Really you would not read about just how determined these people are to keep things secret.
More updates in due course.
David.

Tuesday, April 30, 2013

Here Is A Wonderful Picture Of How Your Money Is Being Spent Unwisely!

See here:

https://twitter.com/Eleonor_G/status/329159086144905216/photo/1

And Edwin Kruys (@EdwinKruys) sent me this! Even worse and quite naughty I reckon.

https://twitter.com/EdwinKruys/status/329203658656989185/photo/1

Please send more!

Enjoy

David.

Another Report Saying Health IT Is Wonderful - Is It Relevant To What Our Government Is Doing?

The following appeared a few days ago.

EHR use provides Canadian docs billions in benefits

April 24, 2013 | By Marla Durben Hirsch
Electronic health records have proven very useful to Canadian physicians in community-based care, helping them to reap more than $1.3 billion in benefits since 2006, according to a new report by PwC.
The report, commissioned by Canada Health Infoway, involved review of over 250 research articles, surveys and other information. The researchers found a number of advantages to EHR use, including:
  • $800 million in administrative efficiencies in workflow as staff time is redeployed
  • $584 million in health system level benefits, such as the reduced number of duplicative tests
  • Improved outcomes and safety through preventive care and disease management, such as a 49 percent increase in pneumococcal vaccination rates with EHR reminders
  • Increased interactions and communications among providers and between providers and patients
The report's authors also found that most physicians have had a positive return on investment due to overhead cost savings and increased revenue.
Lots more here:
You can find the press release announcing the study here:
You can find the full report to download here:
If ever there was a report that needs to be read carefully to discover just how hard consultants can try to con you this is it!
Carefully reading the report - what it is about is the benefits that can be derived from moving the level of GP EHR usage from 26 to a little over 56% and then taking the benefits estimated to have been acquired over the whole six years. i.e. all the benefits are seen to be cumulative.
If you read closely the vast quantum of benefits - small as they are - flow from clinicians using computers for prescribing, managing results and so on.  Oddly there is no attempt I can see to quantify the benefits of Health Information Exchange which is what the NEHRS is intended to enable.
In Australia, of course, we have already achieved most of these milestones with GP computing a while ago. Rather a pity we did not keep consolidating and incrementally improving before leaping into the PCEHR unknown.
Call me cynical but when one reads this article it is pretty easy to see why this report has appeared just now.

Future of electronic health records agency in question

April 18, 2013 - 1:18pm
Ottawa says Canada Health Infoway not being shut down, despite lack of funding
OTTAWA — Canada’s main electronic health records body received no new funding this year, but the federal government says there are no plans to shut down the agency.
At the same time Ottawa is eliminating the Health Council of Canada, Canada Health Infoway discovered it will unexpectedly receive no new program money in 2013.
Created in 2001, Infoway works with the provinces to create a consistent system of electronic health records across the country.
As is typical for health organizations, Infoway receives block funding every few years instead of annually. It was given $400 million in 2007 and then $500 million in 2010.
That funding is almost entirely spoken for now.
“The vast majority of our funding has been allocated for approved projects,” said Infoway spokesman Dan Strasbourg.
It is not clear how much new money Infoway had asked for in 2013.
A spokesman for Health Minister Leona Aglukkaq said there is no plan to wind down Infoway’s operations. Steve Outhouse said the lack of funding was an austerity budget measure.
“It was a year, obviously, where there was some fiscal restraint that needed to be there,” said Outhouse. “There’s no plan to end Infoway operations at this point in time.
“We’re always looking at how to spend money as best we can, but there’s no immediate decision or anything like that coming up for Infoway.”
Its job for 2013 will be implementing projects already underway, he said. The department can’t guarantee funding Infoway in 2014 because that decision will be made in the lead-up to next year’s budget, Outhouse said.
Since its inception, the agency has received $2.1 billion in capitalization across 370 e-health projects.
Lots more here:
So they have spent $2.1 billion and seem to be suggesting cumulative benefits of a rather rubbery $1.3. I know all the Infoway funds weren’t spent in the area discussed but a good deal was and the return to the public looks rather skinny - to say the least.
I wonder what we will get from the PCEHR program in the years ahead?
David.

AusHealthIT Poll Number 165 – Results – 30th April, 2013.

The question was:

Has The Process Of E-Health Standards Setting In Australia Gone Off The Rails?

For Sure 67% (28)
Probably 14% (6)
Probably Not 2% (1)
No - It Is Fine 12% (5)
I Have No Idea 5% (2)
Total votes: 42
Looks like a very clear majority think we have a train-wreck here.
Again, many thanks to those that voted!
David.

Monday, April 29, 2013

Weekly Australian Health IT Links – 29th April, 2013.

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

In a day or so we reach the final stage of ePIP implementation with all the various government plans now finalised and now transitioning to waiting and seeing if there will be any useful outcomes for the $billion or so that has been spent. I am pretty sure that by the end of the year (2013) we will be able to form some clear judgements.
Other than that we have all sorts of interesting links to review with Qld Health and so on still rumbling on.
Lastly we have the news that despite all efforts to disprove his work it still seems that Einstein got it right.
-----

Feds fall behind on e-health sign-ups

By Charis Palmer on Apr 22, 2013 12:28 PM

Data already delivering insights.

The Government will likely struggle to meet its target of 500,000 registrants for the personally controlled electronic health record (PCEHR) by June, after it was revealed only 109,000 Australians had registered in the last nine months. 
The system, launched last July, has been plagued with issues, including with its online registration system and availability for general practitioners.
Speaking today at a conference on big data in health, Department of Health & Ageing chief information and knowledge officer Paul Madden encouraged attendees to sign up to the program.
-----

Study reveals most digital assets are not fully secure

MOST local organisations are ill-equipped to secure their digital assets against hackers and other malicious acts, a study finds.
It reveals securing web traffic has proved the biggest security headache facing companies, despite advancements in network security technologies.
It also shows IT security vendors face reputational issues, with many not delivering what has been promised to customers.
Ponemon Institute asked 485 respondents to rate their organisation's ability to prevent cyber attacks, with 10 being excellent. They gave it a 4.6 rating.
Their organisation's ability to quickly detect cyber attacks was rated at 4.4, and they gave its security standing a 4.5.
-----

ACMA warns telcos after AAPT data breach

THE media regulator has warned telcos not to become complacent about data security after it let AAPT off with a warning for a major breach last year.
Senior Australian Communications and Media Authority (ACMA) member Chris Cheah put the telco industry on notice that the regulator still took data breaches “very seriously”.
He said that publicly singling out AAPT for investigation and naming sent a strong message to the wider industry that ACMA took a stern approach to consumer data protection issues.
-----

Flow modelling cuts emergency wait times

QUEENSLAND'S Gold Coast Hospital has turned to flow-modelling technology to help reduce waiting times and ensure there is an adequate number of beds available.
The hospital is one of the biggest emergency care providers in the country, seeing about 120,000 emergency cases each year.
It worked with the Australian e-Health Research Centre, a joint venture between CSIRO and the Queensland government, to help develop patient-flow modelling.
The centre found emergency departments generally were overcrowded and struggled to respond to day-to-day arrivals in a timely manner.
-----

Bad decision-making biggest threat to health funds: report

Date April 23, 2013

Amy Corderoy, Dan Harrison

Expensive new technologies and treatments are being adopted by the health system, despite a ''big black hole'' in the knowledge about their long-term cost and efficacy, experts say.
A Grattan Institute report released on Monday found increases in health spending, in particular on hospitals, were set to create a decade of budget deficits.
Paying world prices for generic drugs would free up more than a billion dollars per a year. 
Queensland University of Technology's Nicholas Graves said new technologies and treatments were being adopted all the time that led to cost blow-outs and over-treatment.
-----

Surgery blinded by Google Glass advances

Date April 23, 2013

Ben Dixon

Information overload is a dangerous distraction when it's right before your eyes.
Growing up watching Star Wars, I dreamt that one day I'd fly with a "head-up display" that would help me defeat the Empire.
Now the ability to have information projected in front of our eyes is here with Google Glass, which is an internet-connected device. You may have seen the video showing their potential uses.
A tiny camera, microphone and computer processors answer your spoken questions and project responses on the inside of the lens. You can ask, "How do I get to the post office from here?" or "What gate does my flight leave from?", and directions will appear. If you ask it how to say 'half a kilogram' in Chinese, it will.
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Bligh, other pollies to be cross examined

Date April 22, 2013 - 3:20PM
The inquiry into the health payroll debacle has heard former Queensland premier Anna Bligh and former director of public works Mal Grierson will be cross examined in relation to the vendor contract for the flawed IT system.
Assisting Counsel Jonathan Horton said Mr Grierson had a "number of direct contacts and communications with IBM".
Ms Bligh and Mr Grierson are expected to be called to the inquiry within coming weeks.
Former health minister Paul Lucas and former public works minister Robert Schwarten are also expected to be called, however the inquiry has not yet named them.
-----

Scrum before Qld Health payroll system rolled out

Date April 24, 2013 - 1:35PM
IBM and Queensland Health staff were involved in a "daily scrum" in the lead up to the launch of the failed health payroll system, an inquiry has heard.
Queensland Health's former payroll director Janette Jones on Wednesday told the Queensland Health Payroll Inquiry there were simmering tensions between the IT giant and health staff during the testing phase.
"It was so adversarial," she said.
"There was a view that IBM could not do it, so we shouldn't really be helping them.
-----

Drug rings continue to trawl pharmacies for cold medicine to make amphetamines despite police tracking equipment

  • by: Kate McKenna, Josh Robertson
  • From: The Courier-Mail
  • April 15, 2013 12:00AM
DRUG rings continue to trawl pharmacies for cold medicine to make amphetamines despite knowing police can track their purchases in real time.
Hundreds of packets of pseudoephedrine are bought by particular individuals in Queensland, according to the first analysis of suspicious sales shared with police under Project STOP since 2005.
In one case, a single ID card was used to buy almost 500 packets, as many as 50 in one day, from 165 different Brisbane pharmacies between November 2006 and September 2010.
"Pseudo-runners" in Queensland also hit Victorian pharmacies, where purchases might go unrecorded because participation in Project STOP is voluntary.
-----

Canada Finds $1.3 Billion in Savings Through eHealth

A Canadian study by Price Waterhouse Coopers released this week found that the use of electronic medical records (EMR) in Canadian general practice has saved over $1.3 billion between 2006 and 2012.
Savings included an estimated $800 million through administrative efficiencies and $584 million through such savings as a reduction in adverse drug events and in test duplication.
“We’re all under pressure to show stakeholders that there’s value in the big investments that are made in electronic health systems,” says Richard Alvarez, who is the President and Chief Executive Officer of Canada Health Infoway.
-----

Script data firm backtracks on sale of GPs' names

22 April, 2013 Antonio Bradley
A company that buys doctors’ names, contact details and prescribing histories from pharmacists to sell to pharmaceutical companies has partially backed down after a fierce backlash.
IMS Health, which recently began writing to doctors to inform them of its plan to sell data to clients including pharmaceutical companies, now says it will only sell doctors’ prescribing histories — not their personal information.
These histories will not be able to be attributed to individual doctors, the company said in a statement on Friday.
-----

Data collection company denies identifying GPs or patients

23rd Apr 2013
A DATA collection company accused of trying to pay pharmacists for information about GP prescribing patterns has denied identifying any individual GP – or patient – as AMA president Dr Steve Hambleton lodged a formal complaint with the privacy commissioner.
Dr Hambleton wrote to the commissioner, Timothy Pilgrim, saying IMS Health was writing to pharmacists apparently seeking to form agreements “for the release, apparently for reward, of certain information relating to doctors and prescriptions”. He said the information IMS wanted included doctors’ names, practice locations, phone numbers, specialities, and which medicines they prescribed.
-----

3D mammograms 'find more tumours': study

  • From: AAP
  • April 27, 2013 12:00AM
BREAST screening with 3D mammograms increases the detection rate of tumours by a third, a study led by an Australian researcher has found.
Scientists compared the results of ordinary 2D scans with a combination of 2D and 3D screening.
Two-thirds of the cancers detected, a total of 39, were found by both types of scan. But a third only came to light when 3D screening was added.
3D mammograms work in a similar way to a CT scan, by taking multiple X-rays to build up a three-dimensional picture.
They are said to be more sensitive, but have been criticised for increasing the radiation exposure of patients.
-----

Health care robot brings experts to bedside

The RP-Vita robot allows patients to been seen by experts from afar
A health care robot developed by iRobot and InTouch Health allows doctors who may be thousands of miles away to interact with patients at their bedsides.
Called RP-VITA, the robot stands 1.7 meters high and rolls around hospitals controlled by an iPad. The robot was designed to bring world class doctors and specialists to patients who wouldn't otherwise have access to them.
See RP-VITA in action in a video on YouTube.
"Imagine you had a stroke," said iRobot CEO Colin Angle speaking at the company's headquarters in Massachusetts. "Would you rather be seen by the world expert in strokes...or by the guy down the hall? RP-VITA is about allowing people to see specialists and have access to more sophisticated treatments, which leads to better outcomes."
-----

Clever Avatar to help ageing Australians

Anna is the animated face of a new tablet-based artificial intelligence system designed to help Australians manage their lives as they age.
The technology was developed by scientists at Flinders University in Adelaide and is being commercialised by a spin-off company called Clevertar.
“We’re still in the development phase, and we’re doing some small scale testing with older people in a retirement village in Adelaide,” says Clevertar CEO, Tanya Newhouse.
Newhouse, who has a strong background in the aged care sector, is working with scientists to turn some significant research combining artificial intelligence, voice recognition and responding to cues, into a product with huge potential.
-----

NEHTA proud to be a Privacy Awareness Week (PAW) partner

23 April 2013. Privacy Awareness Week (PAW) is an initiative of the Asia Pacific Privacy Authorities forum (APPA) held every year to promote awareness of privacy issues and the importance of the protection of personal information. Privacy Awareness Week 2013 is from 28 April to 4 May 2013 and the Office of the Australian Information Commissioner (OAIC) will celebrate the week with a series of events and the release of new privacy guidance and products. Their focus for PAW 2013 is privacy law reform.
-----

Cost facts may reduce test ordering

TELLING medical practitioners what medical tests cost would be a “good start” in ensuring only the most appropriate tests are ordered, according to AMA president Dr Steve Hambleton.
“We are not going to be able to afford everything for everyone, so every person in the health care system … needs to take responsibility every time we order a test”, Dr Hambleton told MJA InSight.
Dr Hambleton was commenting on a US trial published in JAMA Internal Medicine which found that providing fee data at the time of test ordering resulted in a “modest” reduction in tests ordered. (1)
-----

Tools to find health and a perfect match

BIG data has become one of the most talked about concepts in IT. But its impact on Australian business depends very much on how you define it in the first place.
While the term was originally used to describe massive and complex data sets, increasingly its techniques have come to be applied to smaller problems.
Hence the term big data is often used to describe data problems that involved the blending of structured corporate data with unstructured data from external sources such as social media, or that are being solved at vastly accelerated speeds through use of distributed processing tools such as Hadoop and MapReduce, or in-memory tools such as SAP's HANA or Oracle's Exalytics.
-----

Theory of Einstein's Proved Right—Again

By GAUTAM NAIK

Scientists have subjected Albert Einstein's famous theory of gravity to its toughest real-world test so far—and it has prevailed.
The theory, which was published nearly a century ago, had already passed every test it was subjected to. But scientists have been trying to pin down precisely at what point Einstein's theory breaks down, and where an alternative explanation would have to be devised.
Einstein's framework for his theory of gravity, for example, is incompatible with quantum theory, which explains how nature works at an atomic and subatomic level.
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Hubble spies a nursery in a nebula

Date April 22, 2013

Ben Cubby

Environment Editor

Astonishing new images from the Hubble Space Telescope have pierced through a nebula of gas and dust 1500 light years from Earth, to reveal a nursery of newborn stars.
The Horsehead Nebula, a vast plume that forms part of the constellation Orion, is a favourite of astronomers because of its distinctive dark shape, which is set against a background of glowing hydrogen gas.
Using infrared cameras, which capture more wavelengths of light than the human eye, the telescope was able to peer within the Horsehead.
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Enjoy!
David.

Sunday, April 28, 2013

This Is A Really Interesting Development In Information Sharing. The UK Adds A Duty To Share Information - With Safeguards.

The following appeared a little while ago.

Caldicott recommends 'duty to share'

11 April 2013   Lis Evenstad
The Caldicott2 review of information governance in the NHS recommends a new duty to share information when it is in the interest of the patient.
'Information: to share or not to share' will be launched on 17 April alongside health secretary Jeremy Hunt’s response to the recommendations.
It details how the NHS should share patient information while also protecting patient confidentiality as it moves towards a paperless future.
Speaking at a Westminster Health Forum this week, Dame Fiona Caldicott – who led the review - said that education and information sharing were key to providing safe care for patients.
“We’ve come as far as to suggest a new Caldicott principle, which is that information should be shared when that is in the patient interest,” she said.
“Some professionals have become over occupied with concerns about the security of information to the point where they are not confident about how to share it.
“They have lost the sense of confidence that they are putting the patient first, and are able to make judgements on information being shared, and with whom, and when it cannot be shared.”
More here:
Here is a link to the study.

Information: To share or not to share?

Information Governance Review

Patients and clients give staff in health and social care personal and confidential information about themselves all the time and they trust that we will protect the information they give.  As we move to a more electronic age, where information can be shared more easily, and across many more types of organisations, the Government accepted the Future Forum’s recommendation for a review of the balance between protecting patient information and its sharing, to improve patient care.  The term used to describe how we manage this is ‘Information Governance’.
Dame Fiona Caldicott has been leading this review with an independent panel of experts, on behalf of the secretary of state.  The panel was asked to make recommendations on the balance between sharing personal information and protecting individuals’ confidentiality taking into account; how to ensure that we improve the sharing of personal information to support the care of individuals; enable the further use of information more widely to improve health and social care services; protect individuals’ confidentiality and respect their wishes in relation to how their information is used.
We would like to thank everyone who has taken the time to contact us.  See the news items below for more information or follow us on twitter @caldicott2
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There is now a final report released a few days ago -having been  delayed because of Margaret Thatcher’s funeral for a week or so.
The full report can be downloaded from here:
The concept that there is a duty to share information that is in the interests of the patient - presumably with other care providers seems to me to have some interesting implications. Just how you determine what is in the interests of the patient will be a very interesting discussion in the final report.
The response of the UK Health Secretary is interesting. It is clear opt-out has been adopted with safeguards

Press release: Health Secretary to strengthen patient privacy on confidential data use


The Health Secretary today responded to the Caldicott Review, outlining how technology can have a transformational effect on healthcare.