Quote Of The Year

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

or

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

Wednesday, May 08, 2013

It Looks Like People Are Starting To Get Realistic With Clinical Decision Support - A Good Thing.

This appeared a little while ago.

Benchmarks: Changes are afoot for clinical and business intelligence

By Mike Miliard, Managing Editor
Created 04/22/2013
A study earlier this year from the University of Missouri showed that most patients took a dim view of doctors who make use of clinical decision support technology.
Researchers found that patients saw physicians who use CDS as somehow less capable than those who don't. They saw the IT tools as impersonal, and thought the systems were a barrier between them and their caregivers.
That's the wrong way to think about it, says John Hoyt, executive vice president, HIMSS Analytics.
"They just need to understand it's not taking the place of their physician," he says. "It's an aid and reminder of the latest peer-reviewed advice and best practice alerts, etc."
It can "touchy," says Hoyt, because it may suggest, "subconsciously, that your physician is flawed, that he has a human brain – that may be a shock to some people."
But far from being a cheat, or a crutch to be leaned upon, decision support is an essential tool in the clinician's arsenal. Especially nowadays.
"Things get complex," he says. "A good physician will go out and search the literature. In days of old, they used to spend time in the medical library. But now we can bring it to their faces, at the moment."
But there's a fine line between that and "in your face," as it were.
Designing CDS to supply relevant information – at the right time and place – without risking physician alert fatigue, "is an art," said Hoyt. "We don't want to remind the physician, 'Hey, we've got a patient with high cholesterol, order a lipid test.' For God's sake, they know that."
It's even worse in the pharmacy: "Every minute, today, in these hospitals, the pharmacists are getting alerts that are far more detailed and hypnotic than the physicians get."
But clinical and business intelligence technology is changing, evolving – and getting smarter.
"Now that we've had electronic medical records for years, we have data," says Hoyt. "And we now can do some real analysis of our practice patterns and our outcomes. This is now mega data analytics. But eventually you can bring it to the bedside as well: 'From our experience, here at Acme Hospital, we have learned that . . . ’ And you can no deliver that content to the physicians at the bedside."
For the most part, most decision support content is still purchased from sources like Zynx Health and Milliman, he says. But lately, bit by bit, "organizations that are doing their data analytics are seeing their practice patterns" – seeing what works and what doesn't – "and they're able to deliver that data to the bedside."
Recently, HIMSS Analytics has been publishing a series of white papers examining how different hospitals and health networks have been designing and deploying their own clinical and business intelligence programs in the pursuit of value-based care.
And this past month it was announced at the 2013 HIMSS Annual Conference & Exhibition that HIMSS Analytics is partnering with The International Institute for Analytics to develop a model that's meant to help more providers do the same.
Billed as the first benchmarking survey designed to measure and score clinical and business intelligence and analytics maturity in healthcare organizations, the project – to be launched in May – will offer health organizations an unbiased assessment of their program’s maturity compared to their peers.
"The model helps organizations transition from the acquisition of clinical and business intelligence tools to the implementation and use of those tools in an effective way," says James Gaston, senior director of clinical & business intelligence at HIMSS Analytics, who's spearheading the project.
Heaps more here:
I have to say I thought the study cited in the first few paragraphs was just rubbish. Any clinician, in these days of extreme information overload, who does not fall on practical help with glad cries is, I would suggest both pretty arrogant and also pretty ignorant!
In my many years of practicing in intensive care medicine I was happy - no keen - to take advantage of any help I could get. The old saying two heads are better than one is true in my view - even if one is a smart computer.
David.

AusHealthIT Poll Number 166 – Results – 8th May, 2013.

The question was:

Do Centralised National E-Health Programs (Like the NEHRS / PCEHR) Make Sense Any More?

They Still Do 30% (16)
Probably 11% (6)
Probably Not 2% (1)
No - Very Flawed Approach 50% (27)
I Have No Idea 7% (4)
Total votes: 54
Looks like a small  majority think they are not a great idea - with the experience of history.
Again, many thanks to those that voted!
David.

Tuesday, May 07, 2013

Slightly Conflicting Reports On Frost & Sullivans Review Of APAC E-Health. Not Sure I See What They Do.

A number of reports on a new Frost and Sullivan report appeared this week.
We have first.

Australia leads Asia-Pacific in eHealth

Australia’s PCEHR scheme has driven growth in our healthcare IT market, and is the fastest-growing in the Asia-Pacific region, according to research released this week by market analysts Frost & Sullivan.
The report found that Australia’s National eHealth Strategy has been a key driver for market growth.
Australia’s health IT market, worth an estimated $783 million in 2012, will continue to grow at 10.3 percent a year over the next five years, and will be worth an estimated $1.4 billion by 2018.
The Australian government’s leadership role in eHealth was a key driver, according to health research analyst Natasha Gulati. 
“Government initiatives to establish standards, regulations and infrastructure further encourage healthcare providers to adopt electronic medical records (EMR) and electronic health records (EHR) technology,” she wrote.
Across the Asia Pacific region, the healthcare IT industry earned revenues of around $1.2 billion in 2012, and Frost & Sullivan estimates this will reach US$2.2 billion by 2018.
Frost & Sullivan cite aggressive investment by governments, NGO’s and private organisations as key reasons for growth in in EMR and EHR projects at both regional and local levels.
Lots more here:
Then we have:

Budget threat to Aussie eHealth revolution

04.30.13
Budget difficulties could see Australia lagging behind a forecast digital revolution in healthcare for the Asia-Pacific region, according to analyst firm Frost & Sullivan.
It notes that the Australian government has been actively promoting electronic exchange of health information as part of the National E-Health Strategy.
However, while the market is fast progressing towards sophisticated electronic medical record (EMR) solutions, healthcare providers find it difficult to obtain budget approvals. 
According to the analyst firm, EMR penetration in 2012 was estimated at 66.1 percent for both hospital and ambulatory systems segments combined. 
Currently Australia's  healthcare expenditure is approaching 10 per cent of GDP but Frost & Sullivan predicts it could hit 15 per cent within the next few years.
 Dougan (Frost & Sullivan) explained,  “This makes efficient, affordable and timely delivery of quality healthcare services a high priority for all governments. IT offers a strategic way of achieving this, particularly with the NBN [National Broadband Network] beginning to provide the necessary high-speed infrastructure.  As the network expands its reach, technologies such as cloud services, Big Data analytics and advanced visualisation tools have the potential to revolutionise the health sector.”
Lots more here:
and we also have:

Australia to lead APAC e-health record uptake: analysts

Liz Tay

But national rollout lags behind government targets.

Australia has been crowned the fastest-growing market for electronic health record systems amid the Federal Government’s $628 million PCEHR scheme.
Analyst firm Frost & Sullivan this week pegged the Australian healthcare IT market at $783 million in 2012, expecting it to grow to $1.4 billion by 2018.
The market was expected to grow 10.3 percent a year in that period, including software and applications as well as professional services for implementation and support.
Australian demand for electronic health record systems was expected to grow 15.1 percent in the six years to 2019, ahead of a 10.6 percent growth rate in the wider Asia Pacific region.
Analysts pinned Australian demand for e-health record systems on the nationwide PCEHR (personally controlled electronic health record) scheme, which launched last July.
More here:
This seems to be the link to the research if you wish to purchase it.
Subscription > P6F9-01

EMR and EHR Market in APAC

Electronic Records will Pave the Way for Healthcare Transformation
The Asia-Pacific (APAC) market for Electronic Medical Records (EMRs) and Electronic Health Records (EHRs) is in the growth phase with healthcare providers rapidly moving towards digitization. Governments across APAC are investing in EMR and EHR pilots and pushing for national level EHRs, and this is acting as the main driver for market growth. This research service from Frost & Sullivan analyzes the key drivers, restraints, technology trends, and buying behaviour characteristic of the EMR and EHR market in APAC and presents insights on revenue, market shares, and emerging opportunities in the industry.
Author: Natasha Gulati | 30 Mar 2013
More here:
There are two relevant press releases:
First here:

Frost & Sullivan: Government Initiatives Drive Use of Electronic Medical and Health Records in Asia-Pacific

Regulations and incentives for healthcare providers to go paper-less fuel adoption.


Kuala Lumpur, Malaysia - April 23, 2013 - Electronic medical record (EMR) and electronic health record (EHR) systems are becoming increasingly popular in Asia-Pacific as the region’s healthcare industry moves towards digitization. Governments, non-profit entities and the private sector are aggressively investing in EMR and EHR projects at both regional and local levels to achieve seamless information exchange that will contribute towards cost savings as well as improvements in clinical outcomes.
Full release here:
But much more interestingly here:

Frost & Sullivan: Digitisation of Australia's healthcare system met with widespread apprehension

Failure of several regional health IT projects hinders trust
Sydney, 12 February 2013 – Australia boasts an advanced healthcare system supported by both the public and private sector involvement. The country spent 9.3% of its GDP on healthcare in 2011 and is currently focusing on providing people with the tools to support independent aging care and improve healthcare services in remote regions. While modernisation of healthcare facilities and investment in IT has been rapid over the past ten years, adoption still lags amongst physicians and consumers due to lack of trust in information systems. This lack of trust stems from the failure of several regional health IT projects in recent years.
The Australian healthcare IT market was estimated at AUD 783 million in 2012, which includes software tools and applications leveraged by healthcare providers as well as the professional services needed for implementation and support. The market is expected to reach AUD 1.4 billion by 2018 with a CAGR of 10.3% from 2013-2018. Government incentives towards adoption of Personally Controlled Electronic Health Record (PCEHR) and other healthcare delivery programs such as the Practice Incentives Program (PIP) will be the key driver for market growth. Private players on the other hand are focusing on enhancing customer awareness and engagement in their products.
According to Rhenu Bhuller, Vice President of Healthcare, Frost & Sullivan Asia Pacific, the healthcare IT market in Australia is driven by the shift in emphasis from acute care to prevention. This is apparent from the numerous incentive schemes listed in the PIP, which focus on long-term care including incentives for diabetes detection, cervical screening and asthma. In addition to these, the PIP also encourages digitisation of healthcare providers by incentivising adoption of healthcare IT at the GP level across healthcare organisations.
Australia's Personal Health Record (PHR) program opens doors for private investment in eHealth across the country. The Australian market for Electronic Medical Records (EMR) and Electronic Health Records (EHR) is expected to grow at a CAGR of 15.1% between 2013 and 2018. On average, healthcare providers spend a little less than 2% of their operating expenditure on IT which is less than the global average spend of 3.6% as quoted by CeBIT, Australia. This is essentially because hospital CIOs find it hard to justify significant budget allocations towards activities not directly impacting healthcare delivery, particularly when returns on investment are below expectations. Hospital spend on IT is expected to rise under the influence of government incentives to drive adoption.
However, the PCEHR has been received with strong apprehension and even criticism on some aspects across the country. Adoption of PCEHR has been dismal essentially due to the complexity of procedures and requirements for both physicians and consumers. So severe is the issue that the Australia Medical Association (AMA) has called for a step-by-step toolkit to help medical practitioners to participate in PCEHR. Even the PIP for eHealth, popularly termed ePIP, has been received with criticism and scanty adoption with only about half of all general practices in Australia applying for or assigned a Healthcare Provider Identifier – Organisation (HPI-O) number, a prerequisite for payment eligibility.
More here:
Reading this last release, and indeed most of the commentary above I am not sure I quite recognise the Australian e-Health scene I know.
I especially found this sentence interesting.
“Australia's Personal Health Record (PHR) program opens doors for private investment in eHealth across the country.” I must have missed that happening.
Somehow it feels to me that the analysts are reporting from a rather 'inside the beltway' perspective where what DoHA and Government are saying is given emphasis that many of the rest of us do not see.
There is a lot more than semantics in the distinction between the PCEHR, PHRs and EMRs. Remember the PCEHR does not deliver the consumer benefits that many PHRs do overseas. 
What do others think about all this?
David.

Monday, May 06, 2013

Weekly Australian Health IT Links – 6th May, 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

It is less than a fortnight now until the budget where we will find out what funding will be provided for e-Health in the years going forward. It will be very interesting indeed as this will give us a clear idea of Government commitment in the area.
Other than that we again see some more efforts and warnings on security and privacy and lots on a Report from Frost and Sullivan on APAC e-Health. Qld Health gets a mention again as well.
As usual we have a few pieces of news on the NBN and a few other technical matters. Back next week.
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PCEHR software deadline inundates provider with inquiries

1st May 2013
PRACTICES anxious to meet today’s personally controlled electronic health record (PCEHR) deadline have inundated their software providers with inquiries as the RACGP holds workshops around the country explaining the new system.
To qualify for e-health incentive payments, practices must have their software upgraded by today to include the PCEHR interface.
Craig Hodges, general manager of the practice software company Best Practice, said his company had made a PCEHR-interface upgrade available since late last week. Since then, about 2000 of Best Practice’s 2500 customer practices had downloaded the upgrade.
-----

Aged care med chart gets mixed response

30th Apr 2013
GPs working in aged care have given a mixed response to a new standardised medication chart rolled out by the Commonwealth Department of Health and Ageing, welcoming a one-size-fits-all document but questioning the fact it is not yet e-health ready.
The department confirmed it was phasing in a National Residential Medication Chart (NRMC) in 20 aged care facilities in NSW before considering a national rollout.
A spokesperson said the new chart, which was not compulsory, would eventually have “both paper and electronic capacity when fully rolled out; however the current trial is paper-based, reflecting on operational use in residential aged care facilities”.
-----

Budget threat to Aussie eHealth revolution

04.30.13
Budget difficulties could see Australia lagging behind a forecast digital revolution in healthcare for the Asia-Pacific region, according to analyst firm Frost & Sullivan.
It notes that the Australian government has been actively promoting electronic exchange of health information as part of the National E-Health Strategy.
However, while the market is fast progressing towards sophisticated electronic medical record (EMR) solutions, healthcare providers find it difficult to obtain budget approvals. 
-----

Australia to lead APAC e-health record uptake: analysts

But national rollout lags behind government targets.

Australia has been crowned the fastest-growing market for electronic health record systems amid the Federal Government’s $628 million PCEHR scheme.
Analyst firm Frost & Sullivan this week pegged the Australian healthcare IT market at $783 million in 2012, expecting it to grow to $1.4 billion by 2018.
The market was expected to grow 10.3 percent a year in that period, including software and applications as well as professional services for implementation and support.
-----

Australia leads Asia-Pacific in eHealth

Australia’s PCEHR scheme has driven growth in our healthcare IT market, and is the fastest-growing in the Asia-Pacific region, according to research released this week by market analysts Frost & Sullivan.
The report found that Australia’s National eHealth Strategy has been a key driver for market growth.
Australia’s health IT market, worth an estimated $783 million in 2012, will continue to grow at 10.3 percent a year over the next five years, and will be worth an estimated $1.4 billion by 2018.
-----

Digital repository allows pathologists to share images

Image diagnosis can be made by researchers across Australia using the Hitachi Content Platform
Pathologists working in different parts of Australia will be able to share gigabyte-sized image files and perform a diagnosis together following the rollout of a networked digital repository.
The Hitachi Content Platform (HCP), bundled with Pixcelldata’s Collibio software, allows pathologists access to review and collaborate using images from proprietary scanner systems.
HCP is an information repository that houses images, referrals, reports and associated metadata.
-----

The doctor is online

29 April, 2013 Amanda Sheppeard
The rise of Dr Google has been well documented internationally and recent statistics suggest Australians are using the internet to self-diagnose and manage medical conditions just as much as the rest of the world.
Figures from the international Bupa Health Pulse Survey 2012 showed that almost half of Australians have used internet information to self-diagnose.1 This reflects a similar trend in other countries such as China (53%), New Zealand (49%) and the US (45%).
The survey examined how people across 13 countries use online health resources to become better informed. Internationally, 87% of people said they had used the internet for health-related activities.
More than half (56%) used it to access information about a medicine, making this the most common usage. Getting advice on a condition was another popular use (35%), along with looking for a hospital or clinic (34%).
-----

GPs concerned about call centre glitches

Posted Tue Apr 30, 2013 8:01am AEST
A number of Hunter GPs are concerned patients are being disadvantaged by technical glitches between a national medical call centre and the local service.
The local call centre has been operating since 2003, mainly to direct patients to the GP after hours service across the Hunter, long before the National network was set up.
-----

Queensland Health payroll hit by mood shift

THE mood among those implementing the Queensland Health payroll system became poisonous as the full extent of problems emerged, an inquiry has been told.
IBM executives who won the lucrative outsourcing contract became defensive and abusive, according to Brett Cowan, who was tasked with testing the system before it went live.
"Personally I have never seen a vendor behave so rudely or aggressively," Mr Cowan told the Queensland Health Payroll Inquiry.
Describing the attitude of one IBM executive who was particularly vocal in meetings with Queensland public servants, Mr Cowan said there was a clear impression IBM was not so much interested in completing the project as having a "win".
-----

Dr phone: using apps to check your health

  • From: AP
  • May 03, 2013 5:05PM
IT'S not a Star Trek tricorder, but by hooking a variety of gadgets onto a smartphone you can almost get a complete physical - without the paper gown or even a visit to the doctor's office.
Blood pressure? Just plug the arm cuff into the phone for a quick reading.
Heart OK? Put your fingers in the right spot, and the squiggly rhythm of an EKG appears on the phone's screen.
Plug in a few more devices and you could have photos of your eardrum (Look, no infection!) and the back of your eye, listen to your heartbeat, chart your lung function, even get a sonogram.
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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.
-----

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?
-----

Exclusive: Data breach notification bill revealed

By Darren Pauli on May 2, 2013 6:25 AM

Privacy Commissioner to compel public breach disclosure under draft.

The Australian Government's plans for a data breach notification scheme have been shared with a small number of key stakeholders as a draft exposure bill, marked as Confidential.
The Exposure Draft Privacy Amendment (Privacy Alerts) Bill 2013, obtained by SC, was the strongest sign to date that current Government plans to bring mandatory data breach into force.
The scheme was recommended by the Australian Law Reform Commission in 2008 and would force organisations to notify the Federal Privacy Commissioner, affected consumers and on occasion the media when data breaches occur.
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Telehealth vendors not fazed by NBN debate

Faster broadband could reduce ballooning health IT costs, says Frost & Sullivan.
The NBN will be a boon to Australian healthcare regardless of which political party has its way on the final technology approach for delivery, officials from health IT vendors said at a lunch in Sydney.
The officials indicated that either the Labor party’s fibre-to-the-premises or the Coalition’s fibre-to-the-node plan could offer the minimum speeds and reliability levels required by telehealth and other bandwidth-intensive health IT activities.
The Coalition has said its FTTN version of the NBN, which would provide slower speeds than the Labour’s FTTP approach, will offer minimum speeds of 25Mbps.
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Data collection poses privacy risk: expert

Consumer information is being amassed in a way that does not comply with the code governing data collection by market and social researchers, says the University of Sydney Business School's Terry Beed
  • AAP (Computerworld)
  • 29 April, 2013 13:12
An explosion in the amount of personal data being collected online poses a growing threat to privacy, a marketing expert says.
Consumer information is being amassed in a way that does not comply with the code governing data collection by market and social researchers, says the University of Sydney Business School's Terry Beed.
He says market research tools such as SurveyMonkey are now readily available to individuals or firms who may not use them correctly or ethically.
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No secret safe in an online world

Date: April 28, 2013

Peter Munro

Privacy is hard to hold on to in the digital age.
Over a large flat white, ''no froth'', in a tall glass, John Raprager empties a black backpack of the tools of his trade. Out comes a wristwatch with a built-in video camera, the minuscule spy hole hidden above the six. ''It was a gift from my dad,'' he says. Laid across the cafe table are other surveillance devices disguised as a mobile phone, a car-key fob and a stick of chewing gum. He reaches for a packet of cigarettes. ''Is that also a camera?'' I ask. ''No, just cigarettes,'' he says.
The genial private investigator, from Lyonswood Investigation Services, has bags under his eyes and a ballpoint pen with a video camera in the pocket of his white shirt. He has been a private investigator for 21 years, spying on cheating spouses and light-fingered employees.
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Information policy agency resource 1 — de-identification of data and information - consultation draft April 2013

22 April, 2013
HTML
An agency’s information is one of its most valuable assets. The Freedom of Information Act 1982 declares that government information is a national resource that should be managed for public purposes.
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Privacy business resource 2 — de-identification of data and information - consultation draft April 2013

22 April, 2013
HTML
Many businesses and researchers collect and retain personal information and data. De-identifying that information in an information asset may enable the business or researcher to share or publish it without compromising individual privacy. This can be important, as organisations face strong pressures in a data driven economy to maximise the utility and value of information assets by sharing and publishing information and data.
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Cyber attack hysterics miss the point

Supratim Adhikari  26 Apr, 12:42 PM3
The cyber security industry may have a penchant for hyperbole but just how big a minefield is the internet for businesses big and small? Whether we like it or not the web is no place for a novice and April has been a busy month in the information security space.
The latest flash point came in the form of a group of hackers who managed to send Wall Street into a tailspin, albeit briefly, last Wednesday. As it happens, this exploit was quickly superseded by news of the Australian Federal Police managing to nab the alleged kingpin of the hacking collective LulzSec.
The two events provide a fitting footnote to a month that has had its fair share of cyberattacks and threat perception reports.  
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Conroy gets watchdog growling with $25m push to spruik NBN

  • by: Tom Dusevic, National chief reporter
  • From: The Australian
  • May 01, 2013 12:00AM
STEPHEN Conroy's department is spending $25 million to spruik the National Broadband Network to suburban voters in a campaign that has so far required a record 21 reviews by the body that vets government advertising.
The NBN metropolitan offensive, now running in major markets and approved by the Minister for Broadband, is the largest non-defence-recruitment ad campaign since Labor came to power in November 2007.
But the sales effort has not been smooth, with the Independent Communications Committee, which reviews taxpayer-funded campaigns to guard against overtly political content, convening on 19 occasions "in session" and twice out of session. A revised media plan was given the seal of approval on April 19.
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In Pictures: 10 key Windows 8 features for healthcare professionals

From improved security and administration to better tablet battery life, there's a lot to like in Windows 8 for healthcare organizations.
Doctors and nurses depend on mobile computing devices every day. Whether they're standing by the patient's bedside or typing away in their office, clinicians need to enter and access patient data to make appropriate treatment decisions. Windows 8 mobile devices make it easier than ever for busy clinicians to stay productive in the healthcare environment. Windows 8 Pro and Windows 8 Enterprise offer 10 features that are especially relevant for clinicians who need to maximize productivity while protecting sensitive patient data.
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Faster than a speeding atom: breakthrough to revolutionise computing

Date May 2, 2013

Nicky Phillips

Science Reporter

Australian scientists have developed a breakthrough technique to read information stored on single atoms that will significantly improve the accuracy of future quantum computers.
The University of NSW-led team is the first in the world to use light combined with electrical signals to detect and read information stored on single atoms - the atomic structures that will form the basic storage and processing units of super-powerful quantum computers.
''This is a revolutionary new technique, and people had doubts it was possible,'' said research leader Sven Rogge.
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Vectoring could boost Coalition's NBN speeds

Date May 3, 2013

Stuart Corner

The new DSL technology of vectoring could significantly boost bandwidths over the last few hundred metres of copper in the Coalition's planned national broadband network (NBN), but the great unknown is the length of the copper over which it would be required to operate.
Vectoring is claimed to deliver bandwidths of up to 200Mbps, but a more realistic expectation is 100Mbps over 500 metres of copper. It is one of the technologies cited by opposition communication spokesman Malcolm Turnbull as capable of "dramatically" increasing broadband speeds on copper.
Vectoring is a variation of VDSL2, currently the most advanced technology for delivering broadband services over the telephone network. One of the main limitations of bandwidth in VDSL2 is the interference between signals on different pairs of wire in the cables that run from the telephone exchange to subscribers and that often comprise several hundred copper wire pairs.
-----

Cyber spectacle right before your eyes

BE warned: another hi-tech revolution is in the air. Google has begun distributing the first of its highly controversial Google Glass specs to hundreds of trial users in the US.
The cyber headgear is not so much a pair of specs as wearable computer-phones, each with a tiny display, camera, bone-conducting speaker and microphone mounted on a spectacle frame and perched just above the wearer's right eye.
Google glasses will go on sale to the public early next year, and some analysts are predicting as many as nine million people will be wearing them by 2016.
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Enjoy!
David.

Sunday, May 05, 2013

The Australian E-Health Standards Process Seems To Be Going Down The Gurgler. This Really Matters.

I ran a poll on the blog last week.
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.
-----
Looks like this was almost a prescient poll.
Over the weekend news has emerged from a range of sources a what is described by insiders as a total corruption of the governance of Standards Australia’s (SA) processes around e-Health Standards and the IT-14 E-Health Standards Committee.
What I am hearing is that SA’s approval of the publication of the Electronic Transmission of Prescription Australian Technical Standard has been ‘rammed through’ despite the objection of some major organisations and jurisdictions who sit on the top level IT-14 Committee. This Committee  is simply not able to approve such publication without a genuine consensus - which apparently presently does not exist.
The home page for Australian E-Health Standards setting is here. You can read all about what IT-14 does here.
The Standards Australia IT - 14 Committee has senior representation from the following:

Stakeholders

The organisations involved in IT-014 constituted committee are listed below:
Aged Care Association Australia
Allied Health Professions Australia
Australasian College of Health Informatics
Australian and New Zealand College of Anaesthetists
Australian Association of Pathology Practices Inc
Australian Commission on Safety and Quality in Healthcare
Australian Healthcare and Hospitals Association
Australian Industry Group
Australian Information Industry Association
Australian Institute of Health & Welfare
Australian Institute of Radiography
Australian Medical Association
Australian Private Hospitals Association
Central Queensland University
Commonwealth Department of Health & Ageing
Consumers Federation of Australia
Consumers Health Forum of Australia
CSIRO e-Health Research Centre
Department of Health (South Australia)
Department of Health (Western Australia)
Department of Health (Victoria)
Department of Human Services
Edith Cowan University
Engineers Australia
GS1 Australia
Health Informatics Society of Australia
Health Information Management Association of Australia
HL7 Australia
Integrating the Healthcare Enterprise Australia
Medical Software Industry Association
National e-Health Transition Authority
National Health Information Management Group
National ICT Australia
NSW Health Department
Pharmaceutical Society of Australia
Queensland Health
Royal Australian College of General Practitioners
Royal Australian College of Medical Administrators
Royal College of Nursing, Australia
Royal College of Pathologists of Australasia
Services for Australian Rural and Remote Allied Health
The Pharmacy Guild of Australia
The Royal Australian and New Zealand College of Radiologists
The Society of Hospital Pharmacists of Australia
The University of Sydney
The University of Western Sydney
-----
The list is found here:
Hardly a collection of ill-informed or ignorant rat-bags here! If there are representatives of organisations like this that are not satisfied with a specification then it simply must not be published as a Standard (AS) or Aust. Tech. Spec. (ATS) - it is really as simple as that.
I am told by experts in the area that such over-riding of expert objections is pretty much unprecedented in the 90 years of operation of SA. It would be a great pity if the pressure from Federal Government and its organs push through the publication of a Standard which acknowledged experts in the area feel is incomplete and potentially unsafe.
Obvious questions all this raises (if what I am told is true) are:
1. What is the legal status of vendors and software developers who find the standards are incomplete, unsafe or unworkable because the process was not properly finished?
2. Why does the organisation that sets the Standards for Australian Food Safety, the Standards that prevent you  being electrocuted think it is OK to take short cuts with the quality and safety of the technology that supports health/pharmacy by not following properly consensual processes?
Somehow all this makes the work of the genuine unpaid volunteers- and there are many who have worked very long hours -not just industry, but practice managers and others - a waste of time if the procedural underpinnings are flawed and possibly unsafe.
The bottom line is that, if what I am hearing is true, we are seeing a very serious corruption of processes the public has come to trust and that this is simply unacceptable.
One can only suggest that SA re-convene the relevant committee(s), obtain genuine and effective consensus - if that is possible - and then move to publication.
Without this being done this is a travesty. As others have said we really need technical standards setting being done by experts in the area - not bureaucrats with potentially conflicted responsibilities.
As a side note I see that NEHTA has now finally given up creating a PCEHR Standards catalogue I mentioned here:
The link is now dead:
Oh dear, oh dear.
David.