It Looks Like The UK Is Heading Off In A New E-Health Direction. Building On Some Tough Experiences It Has To Be Said.

This appeared a little while ago.

NHS England introduces IDCR

1 July 2013   Rebecca Todd

NHS England has released guidance for trusts to achieve fully integrated digital care records across all care settings by 2018.

'Safer Hospitals Safer Wards: Achieving an integrated digital care record' “sets out the benefits case for adopting safe digital record keeping as a precursor to achieving integrated digital care records across the health and care system."

It also gives full details on how trusts can get their hands on some of the new, £260m Safer Hospitals, Safer Wards Technology Fund and sets a deadline of 31 July for expressions of interest.

Health secretary Jeremy Hunt said in January this year that he wants to see a paperless NHS by 2018.

NHS England’s guidance goes a step further by saying its vision is for a fully integrated digital care record across all care settings by 2018.

It describes an IDCR as the ability of local health and care services to “use digital technology to ensure that vital patient related information and clinical decision and support tools can be viewed by an authorised user in a joined up manner in any single instance."

“Local NHS providers will be free to make investment decisions about the solutions which work best for their organisations as long as they meet national standards in vital areas such as data security and interoperability with other systems,” it says.

The most important standard is that all providers adopt the NHS Number as primary identifier on all patient data.

As reported by EHI last month, this will become a contractual obligation by April 2014 and a key focus for the Technology Fund will be supporting providers to meet this standard.

“A second priority will be to make the digital transformation of health and care a focus for innovation and enterprise and a driver of economic growth, particularly among smaller businesses and third sector organisations,” the guidance says.

This includes the introduction of a ‘Procurement Toolkit’ to help trusts understand their requirements; determine a procurement strategy; and commercial management.

The guidance introduces the concept of a clinical digital maturity index to help local economies benchmark their capability to deliver ‘meaningful use’ of IDCRs.

It says that while international benchmarking models exist and should continue, NHS England is committed to producing a ‘home grown’ model in collaboration with NHS organisations.

NHS England will publish a baseline document identifying the current stage of digital maturity of each NHS hospital and mental health provider before the end of this year.

This will include; infrastructure; current level of clinical digital capability and usage; current use of key information standards such as the NHS number; and level of interoperability.

“Going forward we expect to measure and monitor organisations and systems to ensure that they can demonstrate a progressively increasing level of ‘meaningful use’ of an IDCR and wider digital technologies in the delivery of care,” it adds.

The document’s other ‘key messages’ include the importance of clinicians being at the heart of the decision-making and implementation of IT. It encourages the appointment of chief clinical information officers to drive this.

 More here:

http://www.ehi.co.uk/news/primary-care/8716/nhs-england-introduces-idcr

This is not all new however as they are clearly building on what is already in place:

SCR to be expanded

1 July 2013   Rebecca Todd

Patients’ end-of-life care information, immunisations, and significant past problems and procedures will be added to the NHS Summary Care Record.

New guidance released today by NHS England says its has commissioned the Health and Social Care Information Centre to add immunisations, significant past problems and procedures, end-of-life care information, and other patient preferences to the SCR.

‘Safer Hospitals, Safer Wards: Achieving an integrated digital care record’ describes the SCR is a “key building block” towards achieving an IDCR.

The SCR was one of the key projects of the old National Programme for IT in the NHS.

It was supposed to create the 'national' element of an integrated care records service that was otherwise supposed to be delivered by the roll-out of local, detailed care record systems at trusts.

Lots more here:

http://www.ehi.co.uk/news/primary-care/8719/scr-to-be-expanded

The two areas that are italicised in the first article I see as critically important and agree totally with the direction being taken here.

It is good to see a preparedness to regroup and give e-Health another go after what, it is now agreed, were some pretty major problems.

David.

A Useful Article And Video On CDA and HL7 V2. A Good Summary Of The Current State Of Play.

This appeared a little while ago.

Will CDA replace HL7 version 2 messaging?

By Herman Oosterwijk, AuntMinnie.com contributing writer

July 18, 2013 -- CDA, or Clinical Document Architecture, is the document standard defined by HL7 as part of its version 3, which is used to exchange information between healthcare providers' electronic health records (EHRs). The new requirements mandate EHR implementation as part of qualifying for federal meaningful use payments.

CDA implementations are still in their infancy, even though at the recent Integrating the Healthcare Enterprise (IHE) Connectathon, there were literally hundreds of those documents exchanged and properly "consumed." Consuming a document means that the information is presented properly and added to the appropriate record in the database. For example, a list of medications in the physician electronic medical record (EMR) is properly updated based on a discharge document from an emergency room visit.

A CDA document exchange is quite different than using an HL7 version 2 message, which, for example, is used for the information exchange between a computerized physician order-entry (CPOE) system and a department scheduler to request an order. Another example would be when a reporting system and an EMR exchange a diagnostic report or exchange a lab result message between an external lab and an EHR. Before going into more details about the differences, let's explain a little bit more about CDA.

There are many CDA "flavors," depending on their use. Each type of CDA is identified by a well-defined and constrained template, which defines what information is required in a particular application. A good example of such a constrained template is the CCD, or continuity of care document, which is required by the U.S. government to exchange information in order to qualify for meaningful use payments. This document contains sections about allergies, medications, problems, and laboratory results, in addition to patient demographic information.

Why do healthcare imaging and information professionals need to know about CDA? Well, CDA is going to be the main "transport" mechanism for clinical information between different systems, especially when these are from different vendors and belong to different healthcare providers or parties. These CDA documents provide a snapshot of a particular event, treatment, or episode of care.

…..

In conclusion, CDA is here to stay; it is quite different from HL7 version 2, with its own field of application; and as healthcare information professionals, it is important to learn about its structure. There is a short video that goes into a little bit more detail about the CDA, its use, and the preferred way to learn about the CDA.

Full article is found here:

http://www.auntminnie.com/index.aspx?sec=sup&sub=ris&pag=dis&ItemID=104003&wf=5536

(Link to video is in last paragraph)

It is really good to see a clear exposition of where each of CDA and HL7V2 fit and why both are going to co-exist for a very long time to come.

Things are evolving quite quickly in the HL7 space and it is worth keeping an eye on Grahame Grieve’s (an Australian HL7 Expert)  blog which explores all sorts of issues in this space.

See here:

http://www.healthintersections.com.au/

David.

A Really Interesting Example Of How Geo-location Services Are Making A Difference in Health.

This appeared a little while ago.

Epworth finds healthcare black spots with geospatial analytics

Summary: When it came time to find the best location for its new Melbourne-area hospital, private healthcare group Epworth Healthcare turned to geospatial analytics to find the most underserviced area and deliver exactly the services its population requires.

By David Braue for Full Duplex | July 16, 2013 -- 13:59 GMT (23:59 AEST)

An investment in geospatial data analysis has provided a significant improvement in decision-making as healthcare group Epworth HealthCare scoured the state of Victoria for the ideal location and services mix for a new private teaching hospital.

The choice of site for the $447m facility – which will be built next to Deakin University in the Melbourne satellite city of Geelong and will rival the group’s major facility in inner-Melbourne Richmond – came after the group’s planning heads teamed up with geospatial group MapData Services to conduct an extensive analysis of demographic and medical services across Victoria.

That analysis involved sourcing a range of data including Australian Bureau of Statistics figures around population growth and demographics, details of currently available health services, and the geographical distribution of particular types of conditions.

The latter data set was pulled from the records of Epworth’s existing facilities in Richmond and suburban Camberwell, with years of patient address data – separated from any identifying information to protect patient privacy – fed into the system to model the geographic spread of Epworth patients over the years.

In the past, “we had always looked at these files in Excel and gone through reams and reams of numbers to make these decisions,” Lisa Smith, group manager for business opportunity and development, told ZDNet Australia. “It’s harder to picture it when it’s in a table, but it’s a lot easier when it’s on a map. You can quickly identify the highest use areas, and those areas where there are large numbers of patients but few hospitals.”

Data was fed into a geographical information system (GIS) and colour-coded to highlight significant trends across the region.

Once the MapData work in combining and mapping the myriad data sources was complete, it quickly became clear that Geelong represented a significant vacuum in terms of healthcare availability.

More here:

http://www.zdnet.com/epworth-finds-healthcare-black-spots-with-geospatial-analytics-7000018127/

Other are noting similar trends but with a different take we have the following.

3 things to know about geomedicine

Posted on Jul 16, 2013

By Jeff Rowe, Contributing Writer

"Location, location, location" is a phrase that's long been associated with real estate, but in recent years it's also played a role in attempts by healthcare professionals to track disease. Now, some are putting health IT to work in adding location information – where patients have lived – into their EHRs.

"There's a huge body of health information that's been generated at high levels, particularly at the state and county levels, but it's had little effect in doctors' offices," said Bill Davenhall, senior health adviser for ESRI, a California-based provider of geographic information systems (GIS) services to a variety of industries.

If Davenhall has anything to say about it, that's going to change soon. In his eyes, the healthcare sector has done a great job of incorporating genetics and lifestyle into the factors considered when patients are treated, but "The third leg of the stool should be locational history."

After all, it's certainly worth knowing if a patient grew up near a metal manufacturing plant, for example, as chromium, which is used in metal manufacturing processes, is known to cause brain tumors.

Moreover, Davenhall added, while eating locally grown foods is a growing theme in health circles, it may not be such a wise idea if, say, the local soil has been contaminated by past industrial use or a specific toxic dumping incident.

While geomedicine, which Davenhall describes as a process of taking generalized environmental information "and pushing it into the interface between doctors and patients," may not be a common practice now, he points to three ways that IT is helping pave the way for the use of geomedicine in the future.

More here:

http://www.healthcareitnews.com/news/3-things-know-about-geomedicine

It is fascinating to see how gradually the power of knowing where you are is being integrated into analysis to help with real health problems.

David.

AusHealthIT Poll Number 176 – Results – 24th July, 2013.

The question was:

Are You Concerned That The Public Are Being Given Unrealistic Expectations As To What Can Be Achieved With E-Health Over The Next Few Years?

No - We Can Deliver It All Quickly 9% (5)

Possibly 5% (3)

Probably 9% (5)

Yes - The Expectations Are Way Too High 76% (42)

I Have No Idea 0% (0)

Total votes: 55

This is a pretty clear outcome. 76% are convinced that the public have not been given realistic expectations.

Again, many thanks to those that voted! 

David.

Another Warning To Take EHealth Security Seriously. The Risks Are Rising With The NEHRS/PCEHR.

This appeared a day or so ago:

Health professionals asked to consider security as priority

Sunday, 21 July 2013 06:00

HEALTH providers need to instil a culture of security when safeguarding their medical data to avoid becoming the weakest link in the national eHealth system, according to Edith Cowan University (ECU) researchers.

Security experts at ECU’s Security Research Institute say security is not well regarded by medical professionals and is usually an afterthought they are reluctant to invest time and money in.

“Security as part of requirements engineering is now seen as an essential part of systems development in several modern methodologies,” senior lecturer Mike Johnstone says.

“However, medical systems are one domain where security is seen as an impediment to patient care and not as an essential part of a system.”

He says this attitude makes developers less likely to include advanced security protocols into their products.

“Unfortunately, most software is insecure. This is due to the tension between functional requirements [as seen by a customer] and security requirements [which often are not],” Dr Johnstone says.

“Security is often relegated when shipping dates approach because developers know clients see functionality and don’t think about security as much.”

ECU senior lecturer Trish Williams says the weakest point of the upcoming national eHealth system is with the end users such as health practices and hospitals.

She says there is no security culture among medical practitioners which keeps it from becoming an integral part of operations.

“Medical systems appear especially problematic as their primary focus is patient care and security is either assumed or ignored,” she says.

More here:

http://www.sciencewa.net.au/topics/social-science/item/2286-health-professionals-asked-to-consider-security-as-priority.html

I have to say all this is totally correct. As far as what to do about the issue this is a very good place to start - and it was only updated a few weeks ago.

Computer and information security standards and templates

The second edition of the RACGP Computer and information security standards (CISS) provides general practices with information and recommendations that will raise awareness of contemporary security issues and help protect against potential exposure to loss of sensitive data.

The CISS provides general practice with a framework for evaluating risks, and guidance and solutions to improve competency and capacity in computer and information security. This edition includes additional information to support GPs and their practice teams develop policies that relate to participation with the Personally Controlled Electronic Health Record (PCEHR).

The Computer and information security templates enable general practices to build a comprehensive suite of computer and information security policies and procedures. This document is designed in an interactive PDF format; for practices to download, fill out and save electronically.

This project has been funded by the Australian Government Department of Health and Ageing.

The page with (free) download links is here:

http://www.racgp.org.au/your-practice/e-health/cis/ciss/

Well worth a look and some consideration.

David.

Weekly Australian Health IT Links – 22nd July, 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

A very interesting week with the Health Minister announcing $8M for path and radiology results in the PCEHR.

The only issue with all this is that it is not clear is just what the money is for and who is going to be involved.

The large pathology and radiology providers have an interest in ensuring their name and report formats are preserved and highly visible to both the doctor and the patient. I am not at all sure how this will work in the PCEHR.

Of course the Qld Payroll System makes another appearance as we have the final review report on what happened and who caused all the problems due at the end of the month. Will make fun reading and remind us all of how things go wrong and why.

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http://www.theaustralian.com.au/australian-it/government/most-doctors-reject-e-health-record-system-as-white-elephant/story-fn4htb9o-1226679780209

Most doctors reject e-health record system as 'white elephant'

• by: Fran Foo
• From: The Australian
• July 16, 2013 12:00AM

A VAST majority of doctors continues to shun the government's $467 million e-health record system, with about 58 per cent saying they would never participate in the scheme.

Some have warned that the opt-in, personally controlled e-health system, designed as an online summary of people's health information, risks becoming a white elephant.

Patients decide who can gain access to their e-health record and it allows them to view and control information added to their record by doctors or other healthcare professionals.

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http://www.theaustralian.com.au/australian-it/government/scrap-it-before-it-bleeds-more-money-edwin-kruys-damns-e-health/story-fn4htb9o-1226679780377

'Scrap it before it bleeds more money' - Edwin Kruys damns e-health

• by: Fran Foo
• From: The Australian
• July 16, 2013 12:00AM

EDWIN Kruys didn't ask to be the poster child for GPs railing against the e-health record system, but he wants equity for his patients.

With $467 million already spent on the personally controlled e-health record system, Dr Kruys says the project should be scrapped before it burns more cash.

"It's a big mistake they've made. They just keep throwing money at these projects and it's so painful to see. Some of my patients can't even afford medication," says Dr Kruys, who has blogged and spoken about the PCEHR's pitfalls.

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http://www.abc.net.au/news/2013-07-16/e-health-flaws-adding-to-gp-stress/4822186

E-health flaws adding to GP stress

16 July, 2013

Doctors in the Hunter region are reporting major flaws in the Federal Government's E-health system that was set up to improve patient treatment.

The Hunter Valley is one of three regions in Australia to pilot the program that links a patient's medical records between doctors, hospitals and other providers.

Trials are also running in Brisbane and Melbourne.

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http://ehealthspace.org/news/new-health-informaticians-certification-program-launched

New health informaticians certification program launched

Posted Tue, 16/07/2013 - 11:57 by Fran Molloy

A new health informatician certification program for Australians was launched in Adelaide today at the annual Health Informatics Conference held by the Health Informatics Society of Australia (HISA) (HIC2013).

The certification was developed by HISA in conjunction with the Australasian College of Health Informatics (ACHI) and the Health Information Management Association of Australia (HIMAA) and will provide formal recognition for health informatics professionals.

Sallyanne Wissmann, who is President of HIMAA, today said that the qualification moves to unify the profession.

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http://www.medicalobserver.com.au/news/lurking-perils-of-copious-information

Lurking perils of copious information

9th Jul 2013

AS WE receive ever more information about our patients, the burden for GPs to decide what to do with it grows.

A well-founded, and occasionally tested, fear is that we miss something that will have negative consequences for our patients. But in these days of ubiquitous information, just how much is there to miss?

Obviously a thorough history is basic and if the patient doesn’t offer some important information, a doctor may still be held responsible for failing to ask a critical question, or review previous notes that might have a bearing on the diagnosis or proper management — the notion of single incident versus continuing care.

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http://www.theaustralian.com.au/australian-it/government/e-health-surpasses-500000-mark/story-fn4htb9o-1226681842078

E-health surpasses 500,000 mark

• by: Fran Foo
• From: Australian IT
• July 19, 2013 10:27AM

THE number of consumer registrations for the personally controlled e-health records has passed the magic 500,000 mark, according to latest figures by the health minister.

In her speech at a health conference this week, Health Minister Tanya Plibersek said there were around 520,000 patients on board.

"The government set a goal to have about half a million patients on the national e-health records system by the middle of this year. Not only did we meet this goal, we’ve exceeded it," Ms Plibersek said.

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http://doctorsbag.wordpress.com/2013/07/15/pcehr-poll-shows-what-we-already-know/

PCEHR poll shows what we already know

By Edwin Kruys on 15/07/2013 

The results of an online poll by Australian Doctor Magazine tell us again what we already know: Doctors are not prepared to engage with the current version of the eHealth-record system (PCEHR). It’s unfortunate that one year after the official launch not much has changed. Clinicians have made many suggestions to the government to improve the system, but it seems the feedback has fallen on deaf ears.

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http://www.smh.com.au/federal-politics/political-news/fresh-injection-of-funds-puts-more-medical-data-online-20130716-2q29r.html

Fresh injection of funds puts more medical data online

Date July 17, 2013

Dan Harrison

Health and Indigenous Affairs Correspondent

People will be able to store the results of blood tests and X-rays on their electronic health record after an $8 million upgrade to the system to be announced by Health Minister Tanya Plibersek on Wednesday.

"We expect both doctors and patients will find the new functionality useful, as it will reduce the need for them to chase down results or duplicate tests,'' Ms Plibersek said. "In an emergency, having this kind of information on a patient's eHealth record could save lives."

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http://www.afr.com/p/australia2-0/more_money_for_ehealth_scheme_51OBlYOalDkyQQhdLaxlFJ

More money for eHealth scheme

July 17, 2013

Joanna Heath

Developing the capability to include pathology and diagnostic imaging results in personal electronic health records will be funded under an $8 million pledge by the Rudd government, but without a guarantee the pathology sector will co-operate.

The development of what are known as eHealth records, which came into being in July 2012, is a key initiative for Health Minister Tanya Plibersek. It has been criticised by the Coalition for low take-up rates in its early stages.

In a speech to be delivered to a conference in Adelaide on Wednesday, Ms Plibersek will staunchly defend the system, which now has 520,000 patients registered.

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http://www.itnews.com.au/News/350348,govt-spends-8m-more-on-ehealth-records.aspx

Govt spends $8m more on eHealth records

By Allie Coyne on Jul 17, 2013 2:03 PM

Claims 120,000 people signed up in past weeks.

The Federal Government will pour a further $8 million into its personally-controlled electronic health records system to allow pathology results to be added to a person’s eHealth record.

In a speech to the Health Informatics conference today, Health Minister Tanya Plibersek revealed the further investment and said the total number of users currently on the system was 520,000.

The figure means around 120,000 people had signed up to the PCEHR in the past few weeks.

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http://ehealthspace.org/news/ehealth-natural-extension-universal-healthcare

eHealth a natural extension of universal healthcare

Posted Thu, 18/07/2013 - 08:54 by Sally Glass

Speaking at HIC2013 this week Australia's Minister for Health and Medical Research, Tanya Plibersek, announced $8 million additional funding to ensure pathology and diagnostic imaging results are able to be uploaded to patient's eHealth records.

"The funding will support planning and design work related to upgrading medical software used by doctors so results can be downloaded or uploaded at the click of a button,” Ms Plibersek said.

The work paves the way for x-ray and MRI images themselves to be stored on a patient’s eHealth record in the future.
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http://www.zdnet.com/epworth-finds-healthcare-black-spots-with-geospatial-analytics-7000018127/

Epworth finds healthcare black spots with geospatial analytics

Summary: When it came time to find the best location for its new Melbourne-area hospital, private healthcare group Epworth Healthcare turned to geospatial analytics to find the most underserviced area and deliver exactly the services its population requires.

By David Braue for Full Duplex | July 16, 2013 -- 13:59 GMT (23:59 AEST)

An investment in geospatial data analysis has provided a significant improvement in decision-making as healthcare group Epworth HealthCare scoured the state of Victoria for the ideal location and services mix for a new private teaching hospital.

The choice of site for the $447m facility – which will be built next to Deakin University in the Melbourne satellite city of Geelong and will rival the group’s major facility in inner-Melbourne Richmond – came after the group’s planning heads teamed up with geospatial group MapData Services to conduct an extensive analysis of demographic and medical services across Victoria.

That analysis involved sourcing a range of data including Australian Bureau of Statistics figures around population growth and demographics, details of currently available health services, and the geographical distribution of particular types of conditions.

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http://www.computerworld.com.au/mediareleases/16851/south-west-alliance-of-rural-health-expands-use/

South West Alliance of Rural Health Expands Use of InterSystems TrakCare Healthcare Information System

 12 Public Hospitals Share Electronic Health Records for 200,000 Patients with Support for Administrative and Clinical Functions; Analytics and Community Health Planned

MELBOURNE, Aust. -- July 15, 2013 -- InterSystems, a global leader in software for connected healthcare, today announced that the South West Alliance of Rural Health (SWARH) in Victoria has reached another milestone towards implementing a regional electronic health record (EHR) system. Based on InterSystems TrakCare®, a unified healthcare information system, a new Patient Administration System will serve 12 public hospitals across the region.

SWARH has been running TrakCare’s Clinical Information System, which serves 200,000 patients, for several years. The new TrakCare Patient Administration System is configured to meet the needs of both large and small hospitals across the region. Providing all administrative and clinical functionality within a unified system eases access to healthcare information, improves care coordination, and reduces SWARH’s technical support overheads.

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http://www.medicalobserver.com.au/news/medicare-locals-still-shrouded-in-mystery

Medicare Locals still shrouded in mystery

17th Jul 2013

Andrew Bracey

ALMOST three-quarters of Australians have no idea what Medicare Locals are or what they do, according to research obtained by Medical Observer.

The survey of 1400 people, commissioned by Eastern Melbourne Medicare Local (EMML) and conducted by market research firm Crosby Textor, found 72% of respondents knew nothing about MLs or their role.

Some 5% thought MLs carried out functions relating to “Medicare/claims” — and that was the most common suggestion offered by respondents.

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http://www.smh.com.au/it-pro/government-it/ibm-accenture-at-war-over-health-payroll-bungle-20130716-hv0wa.html

IBM, Accenture at war over health payroll bungle

Date July 16, 2013

Amy Remeikis

The two IT firms at the centre of the health payroll inquiry have taken to public submissions to continue their battle against each other.

Accenture and IBM have each tendered last ditch submissions to Commissioner Richard Chesterman who is finalising his report into the bungled Queensland Health payroll system, which left thousands of workers overpaid, underpaid or not paid at all when it was rolled out in March 2010.

Accenture had been the preferred provider of the system, but IBM eventually won the contract.

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http://www.theregister.co.uk/2013/07/17/vendors_snap_at_each_other_in_queensland_health_inquiry/

IBM, Accenture play blame game over $1bn project blowout

Sueball guns locked and loaded

By Richard Chirgwin, 17th July 2013

IBM and Accenture are sniping at one another in public over just who should take the blame - and the fall - for the $AUD1bn blowout of a project to provide the Australian State of Queensland's Department of Health with a new payroll system.

The project kicked off in 2007 with a budget of just over $6m. It's now expected to cost up to $1.25bn to complete, a failure that has led the State's government to run a Commission of Inquiry into the affair.

That inquiry is due to report by the end of July, and looks set to spark a rolling lawyer-fest on a scale that Cecil B de Mille might find worthy of attention.

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http://doctorsbag.wordpress.com/2013/07/21/nehta-is-coming-to-town/

NEHTA is coming to town

By Edwin Kruys on 21/07/2013 

 “Be a yardstick of quality” ~ Steve Jobs.

First of all, many thanks to the GPs, registrars, practice managers, journos and eHealth-specialists who made suggestions how to move the eHealth-records system forward.

The original comments can be found here. It’s an excellent read and summarises the sticky PCEHR-issues from a clinician point of view.

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http://www.healthintersections.com.au/?p=1631

Why attend the Australian FHIR Connectathon?

Posted on July 19, 2013 by Grahame Grieve

So this week, while I was at HIC 2013, I spoke to a number of vendors about the FHIR connectathon to be held in Sydney in late October in association with the IHIC 2013 meeting. Most of the vendors have heard of FHIR, and expect that it will have a major impact on them at some stage, but are still unsure about attending the connectathon.

They all asked me pretty much the same set of questions:

• When will FHIR be a reality for me?
• How much will the connectathon cost?
• What makes this worth attending?

Note that the same general logic applies to the question of attending the general FHIR connectathon in Boston on Sept 20-21, though the specific details differ.

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http://www.smh.com.au/it-pro/government-it/crisis-talks-to-determine-tasmanian-nbn-rollout-20130715-hv0x1.html

Crisis talks to determine Tasmanian NBN rollout

Date July 15, 2013 - 1:16PM

Rosemary Bolger of The Examiner

Crisis talks are being held on Monday to determine the future of Tasmania's NBN roll-out.

A crisis meeting between contractors and the company responsible for the NBN rollout in Tasmania will be held on Monday afternoon to determine if work on the multi-million dollar installation continues. 

Visionstream has organised the meeting in Hobart at 2.30pm as it attempts to prevent contractors from walking off the job. 

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http://www.theaustralian.com.au/business/companies/rollout-rollout-come-see-greatest-no-show-on-earth/story-fn91v9q3-1226682234088

Rollout! Rollout! Come see greatest no-show on earth

• by: MITCHELL BINGEMANN
• From: The Australian
• July 20, 2013 12:00AM

IT was supposed to be the 21st century's Snowy Mountains Hydro-Electric Scheme. A mammoth, nationwide infrastructure project that would stimulate jobs, the economy and modernise the delivery of high-speed broadband to Australian homes and businesses.

And with the promise of creating tens of thousands of jobs to dig the trenches needed to lay fibre to 93 per cent of the nation's homes, the construction industry thought it had literally hit pay dirt.

But four years since construction began on Labor $37.4 billion National Broadband Network, dollar signs and question marks cast shadows over the flagship broadband project and some of the firms building it consider pulling out altogether because of increasing cost pressures.

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http://www.smh.com.au/it-pro/business-it/pc-sales-now-in-record-slide-as-tablet-market-bites-20130712-hv0te.html

PC sales now in record slide as tablet market bites

Date July 12, 2013

Global shipments of personal computers slumped 10.9 per cent in the second quarter, the longest decline in the industry's history, as the market continues to be devastated by the popularity of tablets, research firm Gartner said on Wednesday.

In an industry now in its the fifth straight quarterly decline, Hewlett-Packard in the June quarter lost ground to Lenovo, now the world's leading personal computer maker with a market share of 16.7 per cent.

"We are seeing the PC market reduction directly tied to the shrinking installed base of PCs, as inexpensive tablets displace the low-end machines used primarily for consumption in mature and developed markets," Gartner analyst Mikako Kitagawa said in a news release.

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http://www.theaustralian.com.au/news/health-science/when-stars-collided-earth-was-sprinkled-with-gold-space-glow-proves/story-e6frg8y6-1226681233262

When stars collided Earth was sprinkled with gold, Space glow proves

• From: AP
• July 18, 2013 11:12AM

A STRANGE glow in space has provided fresh evidence that all the gold on Earth was forged from ancient collisions of dead stars, researchers report.

Astronomers have long known that fusion reactions in the cores of stars create lighter elements such as carbon and oxygen, but such reactions can't produce heavier elements like gold.

Instead, it was long thought that gold was created in a type of stellar explosion known as a supernova.

-----

Enjoy!

David.

This Maybe The Last Roll Of The Dice To Get Some Value From The NEHRS / PCEHR.

This appeared earlier today.

NEHTA is coming to town

By Edwin Kruys on 21/07/2013 • ( 2 )

“Be a yardstick of quality” ~ Steve Jobs.

First of all, many thanks to the GPs, registrars, practice managers, journos and eHealth-specialists who made suggestions how to move the eHealth-records system forward.

The original comments can be found here. It’s an excellent read and summarises the sticky PCEHR-issues from a clinician point of view.

On Friday afternoon I received a phone call from NEHTA (National E-Health Transition Authority). Their clinical leads are coming to Geraldton to discuss the PCEHR. Our team of doctors and managers is getting ready. We have invited the AMA, and they’re flying in to Geraldton as well.

It will be good to hear first-hand why it is so hard to make the system more acceptable to clinicians – and for our clinical team to give feedback. But the main question is: will NEHTA and the Department of Health go back to the drawing board and change what needs to be changed to get clinicians on board?

It’s late, but hopefully not too late to make the PCEHR work for everybody. If there’s anything you want us to bring up (apart from the wish list mentioned above), feel free to leave a comment below and we’ll pass it on!

Related articles

• Will more money fix the PCEHR? What’s on your wish list? (doctorsbag.wordpress.com)
• PCEHR poll shows what we already know (doctorsbag.wordpress.com)

The blog is here:

http://doctorsbag.wordpress.com/2013/07/21/nehta-is-coming-to-town/

Can I suggest those with something to add help Dr Kruys to put all the issues that need to be addressed in this meeting on the table. I suspect there will be a long list.

I have made a few comments as have a good few others - so there is already a long list!

Go for it.

David.

If You Thought Australian E-Health Governance Was Working You Are Presently Wrong.

Two meetings happened last week which confirm the unresponsive mess we are in.

First we had a meeting involving DoHA, NEHTA, The Pharmacy Guild, the AMA, the TGA the MSIA and others.

They were meeting to try and sort out the now expanding mess that was mentioned in this blog found here:

http://aushealthit.blogspot.com.au/2013/06/the-lack-of-organisation-in-health.html

Well, what essentially happened was that, despite it becoming clear the risks were even larger than initially thought and that more prescribed medicines than initially understood were involved, essentially no agreed plan to change the way monthly updates were provided to software vendors and thus their users were made to make the system consistent and safe. Indeed frustration that the problem had become public was expressed by some bureaucrats.

So we have more and more risks of wrong dispensing resulting from poor updates of the medication information from the PBS as vendors find themselves between their customers and the Government.

DoHA, NEHTA and the TGA should have come to the meeting with a well-considered plan as to how the issue - which everyone agrees exits - is to be fixed and quickly. Nope, no such outcome.

Second we had a wonderful example of nonsense at a recent teleconference where Standards Australia (SA) was discussing with members of the IT-14 (Health Informatics Committee) the support that would be provided for Australian Experts to travel to conferences representing us at the major Standards meetings. What was desired from the members was transparency as to the principles that were applied to the selection of who should attend.

SA proceeded to make it clear that principles existed, that they were secret and would not be changing! Talk about a rock and a hard place.

Catch 22 I reckon.

See here:

http://aushealthit.blogspot.com.au/2013/06/do-you-think-standards-australia-is.html

and here:

http://aushealthit.blogspot.com.au/2013/05/the-australian-e-health-standards.html

for some exciting background.

One can only hope that the Deloitte’s refresh of the 2008 National E-Health Strategy can sort the leadership and governance issues around the present situation asap and that the Government will actually listen and make the needed changes.

David.