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."

Tuesday, May 14, 2013

NEHTA Seems Just To Have Released A New Webiste. Very Pretty.

The site can be found at the old address:

http://www.nehta.gov.au/

And it seems to have gone with a tiled Window 8 appearance for the front page.

As far as information is concerned there are publications up to Oct 2012 but is seems to die after than - a work in progress I guess.

See here:

http://www.nehta.gov.au/media-centre/nehta-publications

It is also a little worrying that the Strategic Plan seems to have expired. Does that mean it has all been done?

Our Strategy

Our strategy for progressing eHealth infrastructure and adoption.
Strategic Plan Structure
  Introduction:
  • Building on the previous strategy
  • Catalyst for refresh
  • Reflect the progression of the organisation
 Guiding Principles:
  • New addition to the strategy document
  • A set of principles called out up front
  • Guiding principles are inherent in all activity
 Vision, Purpose and Mission:
  • Vision the end goal of the organisation
  • Purpose what NEHTA has set out to do
  • Mission how NEHTA will go about it 

NEHTA Strategic Plan
 I wonder when a new a current one will appear.

Lastly there are all sorts of web sites NEHTA runs. Here is the link

http://www.nehta.gov.au/about-us/our-websites


It is also not clear how you find the latest documents - it used to be easy with the old site.

I also note the clean-up has removed all sorts of embarrassing implementation pages which really did not seem to get all that far..

David.

Monday, May 13, 2013

Weekly Australian Health IT Links – 13th 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

By the time you read this we will be very close to the Federal Budget and wondering what will happen to the health budget and especially the e-Health budget. I will let people know in due course.
Otherwise there is a lot of publicity on all sorts topics with Government Grants to Telehealth and so on as well as the announcement on the Advanced Care Directives to be made available on the PCEHR.
This comment on 6minutes.com.au raises some issues with this announcement which at least need to be considered.
Look, great idea - but if I recall correctly there is evidence that people change their mind on advanced directive info about every 8 months or so
With the onus on the curator of the PCEHR to keep things correct (the GP), I would HATE to be responsible for incorrect advice.
Better surely to ASK for this information on every admission - my fear is that having a PCEHR entry will 'lock in' a certain course of action/inaction when the patient's wishes/clinical needs/treatment ceilings may have changed
PCEHR - still not fit for purpose.
I think there is a real issue here that will be pretty tricky to address.
I also provide some links regarding Windows 8 - which seems to be about to be dramatically changed and to maybe going to offer both touch and mouse focused versions - to suit desktops and tablets - phones.
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We will find health savings: Plibersek

  • AAP
  • May 09, 2013 11:00AM
FEDERAL Health Minister Tanya Plibersek says the government will continue to find health savings in next week's budget.
"I don't suggest we won't continue to find savings in the health budget," she told reporters in Melbourne.
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Andrew Georgiou: Can you work with IT?

Andrew Georgiou
Monday, 6 May, 2013
DESPITE the zeal with which electronic systems are being rolled out in health care, there’s still scant evidence of their benefit in the real world of our busy and chaotic wards.
That’s not to say we don’t believe technology has a valuable contribution to make. In fact, I was involved in recent research that showed clinicians using electronic information technology (IT) systems in emergency departments find they enable faster and better-informed decision making, hopefully leading to improved patient outcomes.
But the problem remains that electronic systems are being introduced without a clear picture of how they impact on often entrenched work practices and staff interactions.
-----

End-of-life plans of elderly to go online

·  AAP
·  May 09, 2013 6:26AM
THE federal government will unveil new funding to help people update their electronic health records with details of how they'd like to be cared for in their older years.
Health Minister Tanya Plibersek will on Thursday announce more than $10 million in federal funding to develop new advanced care planning and end-of-life care initiatives.
The changes will also see advance care directives put on the national eHealth record system, so doctors across the states and territories can follow the predetermined wishes of their patients.
At the moment, people can use an advanced care plan to stipulate what types of treatment or interventions they would - or importantly would not - like to undergo if their health deteriorated.
-----

Gov invests $10m in another eHealth initiative

End of life plans will provide doctors and carers with information on how people wish to be cared for at the end of their life
The Federal Government will invest $10 million in an eHealth initiative which will enable people to provide information on the health care they wish to receive at the end of their life.
The Advance Care Directives will be stored on the controversial Personally Controlled Electronic Health Record (PCEHR) system.
The Federal Government will also provide a further $800,000 over two years for the Respecting Patient Choices care planning project.
-----

Advance Care Plans to be Included on E-Health Records

Telling your loved ones how you wish to be cared for as you get close to the end of your life will become easier.
9 May 2013
Telling your loved ones how you wish to be cared for as you get close to the end of your life will become easier, with the Gillard Government to invest $10 million to enable Advance Care Directives to be stored on the Personally Controlled Electronic Health Record.
“Most families want to be true to the wishes of their loved ones as they approach the end of their lives, and Advance Care Directives allow that to happen,” said Ms Plibersek.
“Including Advanced Care Directives on the Personally Controlled Electronic Health Record will mean people will be able to share their end of life plans with any of their chosen doctors, hospitals, family or carers,” said Ms Plibersek.
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Frequently Asked Questions (FAQs)

Following are some frequently asked questions (FAQs) and answers to help consumers and healthcare professionals better understand Australia's new eHealth record system and how having an eHealth record could benefit you over time.
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Signing up for eHealth

May 6, 2013, 2:51 p.m.
Dungog resident Don Cummings is the first patient to sign up for an eHealth record at The Medical Practice.
Residents are urged to register for an eHealth record which will allow them to access a summary of their important health information online and share that information with healthcare professionals.
Until now, health records have usually been stored in different locations with little connection to each other, your general practitioner, specialist or hospitals.
Doctor Brendan Chaston from The Medical Practice said there are many benefits to electronic health records.
“If a patient has to go to another hospital we don’t have to duplicate tests such as CT scans, x-rays or blood tests they may already have had done,” Dr Chaston said.
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A caring touch for healthcare

Date May 9, 2013

Garry Barker

The iPad and its apps open a multitude of doorways to information and entertainment for millions of users. They've also moved into highly specialised areas in business, engineering, education and, perhaps most importantly, healthcare. They are giving voices to people who don't have the power of speech; tangible recognition to the blind; and improving the lives of thousands of disabled people.
They are revolutionising the way doctors and hospitals work, too. The devices are being clad in sterile, waterproof cases and taken into operating theatres to help surgeons in complex operations, and they're improving communication with patients about their ailments and treatments. They're being used between doctors, nurses and hospital medical and administrative systems.
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BT leads big push to roll out national telehealth services

GLOBAL telecommunications services giant BT is spearheading a multi-million-dollar push by more than 20 key private and public sector players in the healthcare industry to roll out telehealth services in Australia, mirroring a British e-health initiative to provide services to three million people within five years.
BT is convening a meeting later this month of key players across the sector, including those in private, community and aged care, to sign off on bankrolling the initiative, expected to run for up to two years, to develop a framework to fast-track the rollout of telehealth services.
The group wants to enable changes in the delivery of healthcare and to foster collaboration across industry to deliver telehealth services at scale.
BT Australasia's director of health Lisa Altman said BT had been talking to the federal and state governments in recent months to get their backing for the plan.
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Telehealth and the NBN myth

Opinion: New funding for old innovation.

Of all of the many promises the NBN is supposed to fulfill, its role in the delivery of electronic health is probably the most contentious.
Society has a very real problem of escalating health costs for services struggling to meet the increasing burden of ageing, chronic disease and obesity. Alongside this is the promise of improved efficiencies brought about by computerisation and faster broadband networks.
This makes it easy, as CSIRO has just done to proclaim that $4 million worth of Federal Government grants is going to go some way to solving the burden of healthcare by funding two trials of telehealth.
Like many health issues however, it is not that simple.
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Telstra, Seven West partner with eHealth group

08/05/2013
By a staff reporter
Telstra Corporation Ltd and Seven West Media Ltd have entered into a $10.4 million partnership with HealthEngine, a leading online consumer health marketplace.
In a statement to the Australian Securities Exchange, Tesltra and Seven West announced they would each invest $5.2 million, through a combination of cash and value-in-kind to secure a stake in the business.
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HealthEngine attracts top investors Telstra and Seven West Media

TELSTRA and Seven West Media have announced a joint $10.4 million investment in online consumer health directory HealthEngine.
Each company will invest $5.2 million through a combination of cash and value-in-kind to secure an undisclosed stake in the online health directory business.
With more than 450,000 unique visitors each month, HealthEngine claims to be Australia’s largest online health directory.
Telstra and Seven West Media said HealthEngine was well-placed to capitalise on the growing demand in Australia’s $100 billion-a-year healthcare sector.
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Medical venture to keep Telstra healthy

TELSTRA has expanded on its move into the $100 billion-a-year health industry after partnering with Seven West Media to make a joint $10.4 million investment in online consumer health directory HealthEngine.
Each company will invest $5.2m through a combination of cash and value-in-kind to secure an undisclosed stake in the online health directory business.
The deal reflects a new focus by Telstra Media boss Rick Ellis on partnerships and investments in emerging online businesses rather than paying large lumps of cash to acquire whole operations.
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Telstra, Seven splurge on HealthEngine startup

news Telecommunications and media giants Telstra and Seven West Media have revealed they will splurge a total of $10.4 million on HealthEngine, in a move which represents the second major investment in the seven-year-old Perth-based health appointment search startup in less than a year.
HealthEngine had its basis back in 2006 as an online directory of medical practitioners, but has pivoted to broker appointments between patients and clinicians. In mid-2012 it announced that it had raised $1 million in Australia locally through angel investment. At the time, the company’s medical director (now chief executive) Marcus Tan said it wanted to sign up 10 percent of Australia’s GP clinics in the next 12 months.
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NBN telehealth projects injected with $20.3m in funding

The projects will demonstrate new healthcare models for the elderly
The Federal Government has allocated $20.3 million to nine telehealth projects that utilise the National Broadband Network (NBN) to trial new healthcare delivery methods.
The telehealth projects include a CSIRO project, which has received $2.748 million in funding, for early intervention services that allows specialists in metro hospitals to identify eye disease via video conferencing in remote Western Australian and the Torres Strait communities.
The Royal District Nursing Service has been provided with $2.993 million in funding to allow nurses to support chronically ill and elderly patients via also use in-home monitoring.
-----
Joint media release
Mark Butler MP
Minister for Mental Health and Ageing
Senator the Hon Stephen Conroy
Minister for Broadband, Communications and the Digital Economy
Leader of the Government in the Senate
Minister Assisting the Prime Minister on Digital Productivity

NBN to pilot new models of health care for 2500 patients

The Gillard Government is providing $20.3 million to nine cutting edge telehealth projects that will use the National Broadband Network to pilot new methods of health care delivery.
“These exciting initiatives will help demonstrate how important high-speed broadband is to the future of healthcare and highlight why it should be rolled out to all Australians,” Senator Conroy said.
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ML and uni join to create GP database

7th May 2013
A MEDICARE Local and a university are partnering to create what will be one of the country’s biggest databases of general practice information.
The Melbourne East MonAsh GeNeral PracticE DaTabase (MAGNET), run by Monash University and the Inner East Melbourne Medicare Local (IEMML), will take on Sydney University’s high profile Bettering the Evaluation and Care of Health (BEACH) and Medicare itself by collecting information on patient and GP demographics, risk factors, diagnoses, medications, pathology results, antenatal care, and practice characteristics.
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Outcomes from Atlanta HL7 Meeting for FHIR

Posted on May 11, 2013 by Grahame Grieve
Well, I’m now nearly home from the long week that is the HL7 Working Group meeting. It now goes for 7 long days from Saturday morning through to Friday afternoon. This meeting was held in Atlanta – I’d like to make some comment about Atlanta but the only time I got out of the hotel was to go to Dave Shaver’s Corepoint Party (thanks Dave).
This post is a summary of the progress that occurred at the meeting for FHIR.
General
Two years ago, I conceived of something that has grown into FHIR. Since then, I’ve watched the ripples of our work expand – from just a narrow community in HL7, to include all of HL7 and the wider standards community, and then out into the middleware vendors. Now, the EMR vendors are starting to pay attention. The process is accelerating too – I never expected the EMR vendors to start paying attention to our work until at least after we had completed the DSTU phase (ballot for a “Draft Standard for Trial Use”). And as the ripples spread, the community of people working on FHIR or excited about it grows, and our growth accelerates. This creates it’s own firestorm.
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Robots and telehealth: the future of aged care highlighted at ITAC conference

Technology holds the key to resolve the workforce challenges facing the aged care sector, Aged Care Industry Information Technology Council (ACIITC) Chair Suri Ramanathan said today.
Ramanathan was reflecting on the Council’s fifth annual Information Technology in Aged Care (ITAC) conference in Melbourne last week, which attracted around 450 people from the aged care sector.
The ACIITC is a joint venture between the aged care industry’s two peak bodies, Aged & Community Services Australia (ACSA) and Leading Age Services Australia (LASA), and was established in 2008 to drive the sector’s use of technology and co-ordinate response to government.
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Queensland health payroll: IBM executive blames government over woes, inquiry hears

A HIGH-RANKING IBM executive has put the blame for the collapse of the Queensland Health Payroll firmly back in the State Government's court, saying crucial data was not loaded in time.
Bill Doak is the IBM executive who managed a team of 200 to 300 IBM employees, IBM contractors and Queensland public servants associated with the out-sourced project.
He has told the Queensland Health Payroll Inquiry the payroll system could have worked if the government didn't keep making extra demands.
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South West Alliance of Rural Health is boosting speed to reach patients far and wide

SOUTH West Alliance of Rural Health wanted to increase its services to smaller and more remote regions but was hampered by a lack of fibre infrastructure.
The alliance of public health agencies in southwest Victoria connects all public acute hospitals and associated health services covering an area of about 60,000sq km, extending from west of Melbourne to the South Australian boarder.
SWARH had a TDM (time-division multiplexing) circuit-based transmission network that supported voice, video and data applications throughout hospital locations. Services were delivered over copper and PDH microwave, limiting speeds to 4Mbps and 8Mbps.
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Rural eHealth would benefit more from fibre NBN than wireless: Allocate

Software vendor expects more data intensive tasks to be held back by wireless version of the NBN
Having wireless for eHealth in rural area is not as preferable as having the fibre NBN, according to Allocate Software A/NZ general manager, Peter Croft.
Croft made the observation during at a recent IT healthcare media forum in Sydney during a discussion about the NBN and whether fixed wireless in rural areas is limited compared to fibre.
As for how wireless will affect the online eHealth experience, Croft said it depends on how heavily accessed a database is.
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Singing robot keeps vax tears at bay

7 May, 2013 Kate Cowling
Forget lollypop bribery and bubble blowing, the true secret to a distress-free vaccination experience for kids could lie with a talking robot.  
When tested on a group of young children in Canada, a humanoid robot significantly reduced pain and distress scores, by diverting their attention with singing, hand gestures and commands, researchers found. 
More than 85% of the 4 to 9 year-olds who experienced the robot’s entertainment said they would “very much” like to meet it again for their next vaccination.  
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Stephen Conroy warns of 'digital divide'

  • by: Mitchell Bingemann and Rick Morton
  • From: The Australian
  • May 06, 2013 12:00AM
THE Gillard government has reignited the political fight over the National Broadband Network, saying that 1.3 million homes scheduled to be connected to the $37.4 billion project in 2016 will miss out on high-speed fibre connections if the Coalition is elected.
Communications Minister Stephen Conroy warned voters they would get connected only if they voted Labor at the next election, citing a new construction timetable that increased the number of homes and businesses to be connected to the NBN in 2016 to 4.8 million.
It adds to the 3.5 million connections NBN Co previously included in the first version of the plan launched by Julia Gillard last year, which forecast construction to June 2015.
"These 1.3 million homes that will be built in 2015 to 2016, this will only happen if a Labor government is re-elected in September," Senator Conroy said at an event in the western Sydney suburb of Blacktown, which yesterday became the first existing "brownfield" suburb in Sydney to get access to Labor's NBN.
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Home button may return in Windows Blue

  • From: AP
  • May 08, 2013 7:25AM
MICROSOFT is retooling the latest version of its Windows operating system to address complaints and confusion that have been blamed for deepening a slump in personal computer sales.
The tune up won't be released to consumers and businesses until later this year. The changes, part of a software package given the codename "Blue," are a tacit acknowledgment of the shortcomings in Windows 8, a radical overhaul of Microsoft Corp.'s ubiquitous operating system.
That acknowledgment includes an acknowledgement by Windows chief Julie Larson-Green that users like the comfort of the "home button" axed in Windows 8 - a hint that the home button may return in "Blue".
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Two Products For People Who Miss the Old Windows

·         By WALTER S. MOSSBERG

The face of Windows 8—the tablet-like, tile-based Start Screen that comes up every time you start a new PC—is nicely designed and works well on touch screens. But a lot of people hate it. They do almost all of their computing in the traditional Windows desktop environment, which has been demoted to secondary status in Windows 8. And they are annoyed that Microsoft has replaced the familiar Windows Start Menu with the Start Screen in Windows 8.
For those who dislike the new Windows 8 Start screen, Walt Mossberg has tested two third party plug-ins that bring the traditional Start menu back to the Windows 8 desktop. (Photo: SweetLabs, Inc.)
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Microsoft prepares U-turn on Windows 8

By Richard Waters in San Francisco
Microsoft is preparing to reverse course over key elements of its Windows 8 operating system, marking one of the most prominent admissions of failure for a new mass-market consumer product since Coca-Cola’s New Coke fiasco nearly 30 years ago.
“Key aspects” of how the software is used will be changed when Microsoft releases an updated version of the operating system this year, Tammy Reller, head of marketing and finance for the Windows business, said in an interview with the Financial Times. Referring to difficulties many users have had with mastering the software, she added: “The learning curve is definitely real.”
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How to fix common Windows 8 problems

Date May 8, 2013 - 9:19AM

Anick Jesdanun

Microsoft is preparing an update to Windows 8 for release later this year. It says the changes are designed to address complaints and confusion with the new operating system.
Using Windows 8 feels like running two different computers on the same machine. 
Part of the problem is that Windows 8 tries to be all things to all people. It's designed to respond to touchscreen controls, but it also works with traditional mouse and keyboard commands. It offers a new layout that resembles tablet computers, but it also has a desktop mode that looks like previous versions of Windows. What results is confusion.
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Enjoy!
David.

Sunday, May 12, 2013

It Seems The NEHRS / PCEHR Has Had a Bit Of A Make Over. Interesting Changes In A Couple Of Areas.

After the outage overnight I wandered along to see what changes had been made to the what the user sees.
Here is what the navigation menu down the side now looks like.

Health Record Overview

Clinical Documents
                Shared Health Summary
Medication Records
                Prescription and Dispense View
Personal
Personal Health Notes
Personal Health Summary
Advance Care Directive Custodian
Your Personal Details
Emergency Contact Details
Child Development
                Achievement Diary
                Personal Observations
                Immunisations
                Child Health Check Schedule
                Child Growth Charts
                Information for Parents
                Medicare Records
Medicare/DVA Benefits Report
                Pharmaceutical Benefits Report
                Medicare Overview
Restricted Settings
                Medicare Information Preferences
                Notification Settings
                Manage Access to this Record
                Manage Document Access
                Restricted Settings
                Audit Log
----- End
The main changes since my last visit are the addition of two sections. First we have the Child Development Section - which is some reference material and some user added records on the nipper’s progress. Seems sensible but the access controls are a little odd with the Achievement Diary not clinically accessible but the Personal Observations - next down - being clinician accessible.
The other big change is the section labelled Medication Records. Despite having lots of records  under the Pharmaceutical Benefits Report none of this seems to have made it to the Medication Records - so it is very unclear what is going on with this. Maybe is it just another work in progress.
Overall the system now has so many tabs and sub-tabs that checking on all of what is there is quite a lengthy process.
What is now clear is that the whole thing was not delivered in July last year and that major additions are still going on. I wonder how much all this is costing? It seems the child Development Section is a late idea from DoHA to try and actually make the record useful. The un-intended consequences of all this might be quite interesting. I wonder is there a plan to have this record sharable like the Shared Health Summary?
All we can do it watch and wait and see what happens next!
David.

An Interesting Email Turned Up From SAI Global (The Standards Australia For Profit Arm) A Few Days Ago.

This popped into my inbox a few days ago.

eHealth Standards: Recommended Practice for The Health Industry.

Hello David,
The Australian government is committed to e-Health and is facilitating the transition of paper-based clinical record keeping to electronic means for better information exchange.
www.health.gov.au/internet/main/publishing.nsf/Content/eHealth
Patient information sharing, that occurs mostly on paper, is moving online to increase efficiency and reduce costs, without compromising on the quality of the services delivered.
To this end, the Australian government announced a $67.4 million budget to be spent on the secure electronic exchange of health information, including healthcare identifiers, authentication services and e-Health Standards.1
New e-Health Standards Set - 50% discount for a limited time only*
To support this goal, the Standards Australia IT-014 Technical Committee has developed a wide range of health informatics Standards.
Critical for the success of efficiently gathering, storing, retrieving and classifying recorded information, these Standards can be applied across the broad range of health and medical fields.
While most of these Standards are available for free download, some are not. It is these essential publications that we have bundled into an e-Health Standards Set with a 50% discount* and for a limited time only.
The IT-014 Standards cover:
    Telehealth
    Messaging
    Requirements for an electronic health record architecture
    Geographic information
    Health indicators conceptual framework
    Pseudonymization
    Information security management in health
    And much more.
*50% discount offer applies to publications in the e-Health Standards Set only. Available in hardcopy or PDF format. Compared to buying each publication separately as at 09.05.13. Offer ends 24.05.2013 at 5.00pm AEST.
It seems a collection of ISO Standards - some pretty old - and the IT-14 work has been bundled and is to be sold for $500+ to those who need them - even in .pdf (read very high profit) form.

IT-014 Set-2013, e-Health Standards

e-Health Standards Set
The IT-014 Set includes a variety of guidelines and requirements for the healthcare sector. Available in Hardcopy and PDF with a massive saving of 50% off*.
Click here for a full listing of e-Health Standards created by the IT-014 Technical Committee. This list also includes a variety of products that are available for free download.
Health informatics - Public key infrastructure - Framework and overview
Health informatics - Public key infrastructure - Certificate profile
Health informatics - Public key infrastructure - Policy management of certification authority
Health Informatics - Requirements for an electronic health record architecture (ISO/TS 18308:2004, MOD)
Geographic information - Portrayal
Health indicators conceptual framework
Pseudonymization
Information security management in health using ISO/IEC 27002
*Compared to buying each publication separately as of 29.04.13.
 It really defies belief that of DoHA has made the majority of Standards to be used in Australia free within Australia others would wind up being charged at such a huge fee for a copy. On the basis of the quote above surely they should all be free?
Given all these are created by volunteers from all around the world it seems odd that they are simply not available - at worst - at the cost of production.
If you really need them then at least for a little while they are 1/2 price!
David.