Quote Of The Year

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

or

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

Thursday, September 19, 2013

It Is Important To Do The Right Thing With Social Media And Smartphones In The Clinical Environment. Lots of Traps And Risks.

Three items have appeared that I spotted in the last week have been on this topic.
First we have this:

Smartphones raise privacy issue in healthcare

Date September 12, 2013 - 1:00PM

Amy Corderoy

Health Editor, Sydney Morning Herald

We've all heard the urban legend of the patient who turns up in hospital emergency with something inserted where it shouldn't be.
But is the easy availability of camera phones encouraging doctors and nurses to take a souvenir snap of the occasion?
A study of one big Australian hospital has found about half of all doctors and nurses take photos of patients in hospital – and one in five using their personal smartphone.
Study author and researcher at RMIT University in Melbourne Kara Burns said the easy availability of camera phones was improving patient care and medical training, but raised serious privacy issues.
"Everybody that you talk to that works in healthcare will have an experience of seeing a doctor pulling out a phone, or even being the patient who is being photographed," said Ms Burns, a medical photographer. "Doctors definitely feel that it is part of good practice to document a patient's condition."
Yet nearly 40 per cent of doctors and nurses surveyed did not always obtain consent for their photos. And "non-compliance with written consent requirements ... was endemic", she wrote in the journal Australian Health Review.
She said the photos were overwhelmingly taken for inclusion in a patient's file, or for medical education, but it was clear there was also immense public interest in medical photographs.
More here:
We also had this:

Hospital docs taking photos on smartphones face legal ramifications

13th Sep 2013
A FIFTH of Australian hospital doctors take photographs of patients using their smartphones, new data shows, potentially exposing themselves and their hospital to legal ramifications because the images aren’t secure.
The study, performed by the Royal Melbourne Institute of Technology, showed that 48% of 170 clinicians from a tertiary hospital took medical photographs, 20% of them on personal mobile phones.

However, only 62% of clinicians who photographed patients for medical files indicated they always got consent, and written consent occurred in only 36 cases, compared with verbal consent in 78 cases.

The majority of surveyed staff, which included doctors and nurses, printed the images for the patient’s file or stored them on the hospital’s hard drive, but a small number of images were stored on mobile phones, memory sticks and personal computers.

Aust Health Rev 2013; 37: 437-441
More here:
We also had some advice for those using the social media space for clinically relevant purposes:

7 online safety tips for doctors


It is good to see that social media and eHealth are becoming mainstream topics at national health conferences. At the recent GP Education & Training Conference in Perth (GPET13) I attended two workshops about our professional online presence.
The first one was about the benefits of social media and was attended by GP supervisors, registrars and students. The second one, sponsored by a medical defence organisation, warned about the dangers of the online world, and interestingly there were mainly GP supervisors in the room.
Before I continue I must declare that I was one of the presenters at the first workshop. But it was good to be reminded by professor Stephen Trumble about what can go wrong. His excellent presentation created a lively discussion. Here are seven random points I took home from the workshop.

Read the tips here:
There is really some important reading here for those who are in situations where the advice is relevant.
I have to say I certainly learnt a few things!
David.

Wednesday, September 18, 2013

This Is A Really Worrying Article Regarding The Credibility Of Medical Research. Not Good At All.

This appeared during last week.

There's a whiff of realty agent about modern academia

12 September, 2013
There is something about the clinical research industry that — despite it giving the world the evidence on which it can base its medicine — generates a substantial amount of bloated, self-serving, pointless nonsense.
And that something has the whiff of the average real estate agent about it.
Each year it churns out in excess of 500,000 published papers ranging from those rarities that change medical practice for good to the mass of desultory studies that become fillers for the media, or the bin.
One small aspect of this publish-or-die world is the business of citations and authorship — the ways and means employed to tart up the work of some poorly paid, post-doctoral drone sweating over microscope slides and reams of statistical data.
Apparently there are three main forms of "citation and authorship manipulation" used in the industry, which is as status conscious as Paris Fashion Week.
The first is where you add the name of an "honorary author", who did bugger all for the study but it makes it look good.
The second — called "gratuitous citation" — is where you add an irrelevant reference to your study.
The last is "coercive citation" where editors of the journals themselves demand authors add an irrelevant reference. This coercion is done to boost the journal's citation rates and thereby the journal's all-important "impact factor".
More here:
This is the direct link to the Abstract- go to Page 5 of the .pdf file

Honorary Authorship and Coercive Citation in Medical Research

Allen Wilhite, Eric A. Fong
Objective
This project measures the extent of, incentives for, and reactions to citation and authorship manipulation in medical grant proposals and publication. We looked into 3 types of manipulation: honorary authorship (adding authors who do not contribute), gratuitous citation (adding citations that are not pertinent), and coercive citation (editors directing authors to add citations to articles from their journal with no indication the manuscript was lacking in attribution or missing content, and no direction to specific articles).
Design
We studied these issues by e-mailing a survey to 37,500 medical researchers and nursing professors. We received 3,485 responses for a response rate of 9.3%. In addition to their knowledge of and personal experience with citation and authorship manipulation, we asked about their motives and opinions. We also gathered information on their academic rank, sex, publication success, and grant experience.
Results
Of our respondents, 3,054 said they were aware of authorship manipulation. Honorary authorship was common: 1,101 respondents (31%) say they felt “obligated” to add an honorary author, even though 80% view the practice as inappropriate. Physicians reported that they most commonly added the directors of their laboratories, while nurses added authors who were “in a position of authority and could affect their career.” Similarly, 936 respondents said they have added honorary authors to grant proposals, and of those, 681 (72.7%) say they did so to increase their chances of being funded. Finally, 996 respondents said they are aware of coercive citation, and 258 reported that they have personally been directed by an editor to add citations to the editor’s journal even if the citations were not material to the research. Response bias is a serious limitation in these survey data, and one must be careful about generalizing, but the demographics of the respondents and our target population match up well.
Conclusions
Our study adds further evidence on the existence and extent of authorship and citation manipulation in medical research. We continue to suggest that blind review of grant proposals will reduce the incentive to add honorary authors to funding proposals.
College of Business Administration, University of Alabama in Huntsville, Huntsville, AL, USA, wilhitea@uah.edu
Conflict of Interest Disclosures
None reported.
Funding/Support
This project is partially supported by a summer research grant from the College of Business Administration, University of Alabama in Huntsville
----- End Abstract.
To me, knowing the level of pressure academics feel to ‘publish or perish’, this is a really worrying set of findings. How far is it from mucking about with authorship to mucking about with the accuracy of what is published. Not far I suspect.
I fear this article may disappear without trace,  suppressed by all those who do not want it to become clear just how  many bits of rubbish are being published.
David.

Tuesday, September 17, 2013

When You Rush, Using Over Paid Poorly Trained Staff, Here Is What You Get!

This popped up today.

Man sent someone else's eHealth details

17 September, 2013

An Adelaide man who was mistakenly sent another person's confidential eHealth login details says he is concerned about the apparent privacy breach.

The eHealth program is being rolled out across Australia to give health professionals and patients access to medical records online.

The man, who wishes not to be identified publicly, says he got an email from the National eHealth Record System operator about having successfully registered.

But he says he had made no such application, and the email seemed intended for someone else with the same last name.

More here:

http://www.abc.net.au/news/2013-09-17/man-sent-someone-elses-ehealth-details/4963268

Just hopeless.

David.

It Will Be Very Interesting To See The Progress That Is Made In SA Over the Next Few Years. Going Well And So Far So Good!

This interesting and detailed article appeared a little while ago.

Inside South Australia's e-health transformation project

SA Health CIO David Johnston talks about the biggest e-health project the state has ever undertaken
Rolling out a state-wide electronic health record system is no mean feat for the CIO of SA Health, David Johnston. The government organisation last month switched on enterprise patient administration system (EPAS) that is set to transform 12 hospitals across South Australia.
“This would be the largest IT-enabled project that the state has ever undertaken,” Johnston told CIO Australia. “It’s a significant initiative because it means that if it works here then it’s completely applicable to other states or countries, other jurisdictions.
“It’s basically leaping the industry forward by about 40 years; health is where manufacturing used to be back in the 1960s. It’s one of the last industries that has held out in terms of its usage of technology.”
The e-health system launched on August 25 at Noarlunga Health Service, with more than 2000 electronic medical orders placed in the first day. The system has been configured for about 30,000 users, and around 1200 people who have been trained to use the system at the Noarlunga hospital. The complete rollout across all hospitals is to take place over the next two years.
SA Health customised the Allscripts’ Sunrise Clinical Manager system to create the EPAS. It can be used for both clinical and administrative hospital functions, assisting in 80 per cent of healthcare workers’ activities.

A complex, lengthy project

Johnston is seven years into $422 million, 10-year project, having spent five years implementing the underlying infrastructure to support EPAS and two years developing the e-health system.
“It was very clinically-oriented so it wasn’t the IT department going out and choosing a system. Less than 20 per cent of the budget was on technology so it’s a massive business change project; it’s not a technology project.”
More than 50 projects were executed in the lead up to EPAS. These included creating a mirror copy of its Adelaide-based data centre for failover and backup/recovery, having redundant fibre optic cables between all the hospitals and data centres, and standardising the PC fleet by moving to a rental model rather than purchasing disparate PCs.
The system is configured to work with the federal government’s personally controlled electronic health records (PCEHR) scheme, with eight metropolitan hospitals and one regional hospital now sending discharge summaries to the PCEHR.
“The PCHER has gotten a bit of criticism but I think that’s a bit short sighted. If you look longer term it’s going to be extremely useful. We’ve had no issues in terms of connecting to it,” Johnston said.
“There’s a lot of work that goes on behind the scenes because it has to translate patient numbers into individual healthcare identifiers, which are allocated by the federal government. But for us it’s seamless, it’s just simply a checkbox.”
Integration of systems is one of the biggest challenges in getting an e-health project of this size and scale up and running, Johnston said. Using an electronic master patient index, Johnston was able to standardise patient numbering to send information electronically to GPs though a secure messaging system.
 Lots more here:
The details found here are really worth reading and thus far we seem to have a large Australian e-Health project which has been undertaken pretty well. Time has been taken, planning has been careful, consultation seems to have been broad, training has been a focus and the infrastructure has been got into place in a sensible sequence.
Here is the background to the health service that is the first implementation site.
“Noarlunga Health Services (NHS) is a 91 bed regional health service located approximately 45 minutes south of the Adelaide central business district and within five minutes’ drive of picturesque hills, vineyards and a spectacular coastline.”
See here:
For me it is from now on that the rubber will really hit the road. The reason I say that is based on the fact that implementing a small - under a 100 bed hospital with a system like this is a challenge but not an especially big one. Both the Flinders Medical Centre and the Royal Adelaide Hospital are 550+ bed research and teaching hospitals and will be major implementation challenges I suspect. Size and complexity really matter in these situations and the large hospital users are much more demanding and assertive than in smaller facilities.
Some messy major Hospital Projects in NSW and Victoria have shown just how big these challenges can be. As the title says so far so good. It will be fascinating to see what happens next.
David.

Monday, September 16, 2013

Weekly Australian Health IT Links – 16th September, 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 know who is going to be the Coalition team in the health area. One constraint seems to be that the actual ministry has to be a bit smaller by 2 out of 30 than the shadow ministry.
I have also been told that Mr Dutton would not be all that unhappy to be selected elsewhere but is seems he has Sport to keep him busy.
Other than this there is a lot happening with the NBN which will be interesting play out and to see how the roll out is altered by the change in Government.
-----

Christian Rowan: E-health success

Christian Rowan
Monday, 9 September, 2013
AUSTRALIA’S experiment with the personally controlled electronic health record has had a bumpy start — the resignation of key clinical advisers from the National Electronic Health Transition Authority does not augur well for its future.
Hundreds of millions of dollars have already been spent on setting up and promoting the PCEHR. Perhaps it’s time to acknowledge that our precious electronic health dollars could have been better prioritised elsewhere.
There will be many reasons given for the disappointment of the PCEHR, which had failed to reach even its own modest target of 500 000 registrations by July 2013. However, in simple terms, the success of electronic and information technology (IT) projects, large or small, depends on leadership and clinical engagement.
Both have been lacking in the rollout of the PCEHR, as borne out by low participation by GPs and the inability of public hospital systems to integrate their records successfully.
-----

Inside South Australia's e-health transformation project

SA Health CIO David Johnston talks about the biggest e-health project the state has ever undertaken
Rolling out a state-wide electronic health record system is no mean feat for the CIO of SA Health, David Johnston. The government organisation last month switched on enterprise patient administration system (EPAS) that is set to transform 12 hospitals across South Australia.
“This would be the largest IT-enabled project that the state has ever undertaken,” Johnston told CIO Australia. “It’s a significant initiative because it means that if it works here then it’s completely applicable to other states or countries, other jurisdictions.
“It’s basically leaping the industry forward by about 40 years; health is where manufacturing used to be back in the 1960s. It’s one of the last industries that has held out in terms of its usage of technology.”
The e-health system launched on August 25 at Noarlunga Health Service, with more than 2000 electronic medical orders placed in the first day. The system has been configured for about 30,000 users, and around 1200 people who have been trained to use the system at the Noarlunga hospital. The complete rollout across all hospitals is to take place over the next two years.
-----

Telemedicine savings confirmed

Nicole MacKee
Monday, 9 September, 2013
THE significant cost-savings generated by a north Queensland telemedicine initiative for remote oncology patients have been roundly welcomed by telehealth experts across a range of specialties.
Professor John Wilson, leader of the Monash Alliance telemedicine collaborative program, described the results from the initiative as “fabulous” and said advances in technology meant savings delivered by such telemedicine programs would only increase.
The retrospective analysis, published online today by the MJA, evaluated the teleoncology services provided by the Townsville Cancer Centre and its six rural satellite centres, finding net saving of more than $320 000. (1)
-----

Thumbs up for telemedicine

9 September, 2013 David Brill
Telemedicine is finally delivering on one of its greatest promises: huge cost savings for the healthcare system, Australian research shows.
After a big initial outlay, Townsville Cancer Centre has now saved more than $320,000 by extending video consults to some of state's furthest-flung cancer patients, a study has found.
From Mt Isa, for example, patients previously had to travel 900km each way to see a medical oncologist in Townsville.
Now they don't leave their local area — and it took just 105 consults for the scheme to break even.
-----

GS1 Australia and NEHTA launch GS1 Recallnet Healthcare

Created on Monday, 09 September 2013
GS1 Australia with the support of the National E-Health Transition Authority (NEHTA) is pleased to announce the official launch of GS1 Recallnet Healthcare – an electronic product recall notification management system for therapeutic goods.
Officially launching at GS1 Australia’s Supply Chain Week 2013 in Sydney on 10 September by Peter Fleming, CEO, NEHTA, with Maria Palazzolo, GS1 Australia’s CEO, Martin Edwards, Director Information Services, Health Purchasing Victoria and Karen O’Donnell, Quality, Regulatory, Environmental and Health Officer – Australia and New Zealand at ArjoHuntleigh, GS1 Recallnet Healthcare is an online portal designed to improve patient safety by streamlining the management of product recall and non-recall notifications.
-----

GS1 Australia and NEHTA launch Electronic Medical Product Recall

The recall process for therapeutic goods in Australia is set to be streamlined with tonight’s official launch of GS1 Recallnet Healthcare at GS1 Australia Supply Chain Week 2013.
In launching the service Maria Palazzolo, CEO of national supply chain standards administrator GS1 Australia, acknowledged the passion, focus and leadership of the National E-Health Transtition Authority team together with the many organisations involved in developing Recallnet Healthcare for the Australian health industry.  
Speaking on behalf of NEHTA CEO Peter Fleming, the NEHTA project lead Mark Brommeyer noted the system was developed over three years by GS1 Australia in association with NEHTA, the Therapeutic Goods Administration (TGA), state and territory health departments and a number of medical device and pharmaceutical suppliers. 
-----

Video game sharpens elderly brains

9 September, 2013 AAP
A video game can help elderly people fight cognitive decline by revealing that the brain is more versatile than previously thought in healthy ageing people, researchers say.
US investigators recruited volunteers aged 60-85 and trained them over a month to play NeuroRacer, which requires participants to race a car around a winding road and press a button when specified road signs pop up.
-----

Zoom sur le « personally controlled electronic health record », le DMP australien

Le mag numéro 9 | 12 sept. 2013
Au-delà des frontières européennes, des programmes de santé publique visent à mettre en place un dossier de santé électronique pour assurer la coordination et la continuité des soins sur tout le territoire. Le Mag a traversé les océans pour essayer de comprendre pourquoi et comment l’Australie, vaste territoire (près de 7.7 Million de km2) composé de 23 millions d’habitants a souhaité mettre en place le « DMP » australien baptisé le « Personally Controlled Electronic Health Record » ou PCEHR.
-----

Pioneering eHealth doctor Trevor Lord retiring from Kimberley

When Trevor Lord turned up to start work at the Kimberley Aboriginal Medical Services Council three years ago as a very experienced GP with an extensive history in medical technology, he expected the Council to have a basic record system in place.
“When I came up here, I was a NEHTA clinical lead and very involved in eHealth, and I had no idea that they had this unique internet-based clinical record system stretching across the whole region,” he said.
“The shine came off pretty quickly when I realised that they were using an Internet-based system in the Kimberley which has the worst bandwidth stability in Australia.”
-----

Smartphones raise privacy issue in healthcare

Date September 12, 2013 - 1:00PM

Amy Corderoy

Health Editor, Sydney Morning Herald

We've all heard the urban legend of the patient who turns up in hospital emergency with something inserted where it shouldn't be.
But is the easy availability of camera phones encouraging doctors and nurses to take a souvenir snap of the occasion?
A study of one big Australian hospital has found about half of all doctors and nurses take photos of patients in hospital – and one in five using their personal smartphone.
Study author and researcher at RMIT University in Melbourne Kara Burns said the easy availability of camera phones was improving patient care and medical training, but raised serious privacy issues.
-----

Hospital docs taking photos on smartphones face legal ramifications

13th Sep 2013
A FIFTH of Australian hospital doctors take photographs of patients using their smartphones, new data shows, potentially exposing themselves and their hospital to legal ramifications because the images aren’t secure.
The study, performed by the Royal Melbourne Institute of Technology, showed that 48% of 170 clinicians from a tertiary hospital took medical photographs, 20% of them on personal mobile phones.
However, only 62% of clinicians who photographed patients for medical files indicated they always got consent, and written consent occurred in only 36 cases, compared with verbal consent in 78 cases.
-----

7 online safety tips for doctors

It is good to see that social media and eHealth are becoming mainstream topics at national health conferences. At the recent GP Education & Training Conference in Perth (GPET13) I attended two workshops about our professional online presence.
The first one was about the benefits of social media and was attended by GP supervisors, registrars and students. The second one, sponsored by a medical defence organisation, warned about the dangers of the online world, and interestingly there were mainly GP supervisors in the room.
Before I continue I must declare that I was one of the presenters at the first workshop. But it was good to be reminded by professor Stephen Trumble about what can go wrong. His excellent presentation created a lively discussion. Here are seven random points I took home from the workshop.
-----

Long delays before privacy complaints assessed

Date  September 13, 2013 - 5:18AM

Ben Grubb

Australia's federal Privacy Commissioner has blamed the federal government for long delays in assessing breach-of-privacy and freedom-of-information complaints.
Complaints about privacy are not being allocated to case officers until just over five months after submission, taking about 19 weeks longer than the usual four-week period.
Separately, freedom-of-information matters (complaints and requests for reviews) are not being allocated to officers for up to seven months.
-----

Election 2013 results and the future: experts respond

Australia has elected a Coalition government. So what will this mean for key policy areas?
Our experts take a closer look at what’s in store for business, the economy, the environment, the National Broadband Network, health, social policy, immigration, science and education.

Primary care

Stephen Leeder, Director, Menzies Centre for Health Policy at the University of Sydney:
General practice is the field where new initiatives will probably appear first under the new Coalition government. The general practice workforce is not evenly distributed and is in short supply in many rural and regional settings.
In response to a call from the Australian Medical Association in the last week of the campaign, the Coalition promised an additional A$50 million for general practice infrastructure.
…..
What will happen with subsidies for private health insurance, funding for prevention, support of medical and health research, or the biggest infrastructural challenge facing Australian health care, IT and computerisation?
-----

Technology helping those with disabilities

Date September 5, 2013

Katie Cincotta

Mandy Lau was inspired to create a Braille alphabet puzzle after a night of darkness.
Australia's National Disability Insurance Scheme legislation isn't the only progress being made for those living with disabilities. Recently we've looked at three new assistive technologies - two of them home-grown - helping people who have autism or hearing or sight impairments.
-----

Artificial nose sniffs out blood sepsis

  • From: AFP
  • September 09, 2013 9:03AM
AN "artificial nose" capable of detecting the odour from germs that lead to blood poisoning could help save many lives and reduce medical costs, a conference heard on Sunday.
Scientists who developed the "nose" said it can show within 24 hours whether a patient's blood has bacteria that cause sepsis, a gain of up to two days over conventional methods.
"The current technology involves incubating blood samples in containers for 24-48 hours just to see if bacteria are present," said James Carey, a researcher at the National University of Kaohsiung in Taiwan.
-----

Self-quantification: the informatics of personal data management for health and fitness

30 May, 2013
30 May 2013 | This report summarises the present state-of-the-art of Self-Quantification in health and fitness applications.
Executive summary
With advances in Self-Quantification applications and systems, it is now possible to capture and record data about nearly all aspects of human health and fitness, including mental, emotional, physical, social and spiritual dimensions. By analysing these numbers, people have a better understanding of their health status and their relationship to the world around them. Furthermore, huge advances in sensor technology – in conjunction with widespread availability of wireless networks – have helped self-trackers to collect data whenever and wherever they want.
-----

NICTA on its own after funding ceases

THE incoming Abbott-led Coalition government has no plans to merge National ICT Australia with the CSIRO but has confirmed it will have to seek alternative funding mechanisms to survive.
In the lead-up to the election, the Coalition had proposed discontinuing, after June 30, 2015, direct commonwealth funding to NICTA to the tune of $42 million.
"The Coalition is supportive of the work that NICTA is doing and we would expect that they will be able to access additional funding through the Australian Research Council," said a spokesman for Malcolm Turnbull, who is tipped to be communications minister.
-----

After the election: What next for the NBN?

A new FTTN network will have significant implications for Telstra's copper network, requiring new negotiations between the telco and the government over a key $11 billion agreement between the two
The National Broadband Network, Australia's largest infrastructure project, is set for a shake-up as Tony Abbott slots into the top job.
The Coalition’s approach to the NBN, begun under Labor, has gone from promising to dismantle the NBN to saying in August 2010 it would spend up to $6.25 billion of public and private funding on an alternate broadband policy.
In April this year the Coalition finally announced its broadband policy, with 71 per cent of Australia to get fibre-to-the-node (FFTN); 22 per cent to get fibre-to-the-premise (FTTP); 4 per cent to get fixed wireless; and 3 per cent to get satellite.
-----

Telstra wants fast action on new NBN deal

  • by: Annabel Hepworth
  • From: The Australian
  • September 09, 2013 12:00AM
TELSTRA has declared it wants a quick renegotiation with the Coalition over its multi-billion-dollar deal on the National Broadband Network, a move aimed at avoiding the tortuous negotiations it had with Labor over its involvement in the project.
Telstra chief executive David Thodey has ruled out settling for less than the $11 billion bounty -- in June 2010 dollars -- that it would be paid to lease its assets and migrate customers on to the NBN, but he has signalled the No 1 telco was prepared to strike a deal that involved rolling out the broadband in a different manner across the nation.
"The new government has committed that they will seek to renegotiate our NBN agreements and keep Telstra shareholders whole," Mr Thodey said.
-----

NBN review: It's time to be independent

Date September 9, 2013 - 3:49PM

Paul Budde

OPINION
The Coalition has 100 days to maximise the outcome of the NBN, warns Paul Budde.
Congratulations to the Coalition, it was a convincing election win as expected.
I sincerely hope that the new government will put politics aside and do a proper technical review of the national broadband network in order to thoroughly investigate what makes sense and what doesn’t. This should now be taken out of the hands of politicians and handed over to engineers.
During the election campaign the Coalition argued for a fibre-to-the-node solution and used information from other parts of the world to show this was a valid option.
-----

Coalition to take axe to NBN Co

Date September 11, 2013 - 9:48AM

Adele Ferguson

OPINION
The biggest certainty facing the country's national broadband network is that it will undergo a complete metamorphosis in the next 12 months with a new board, a new management team, a new culture and strategy, new cost structures and a new set of relationships in the telecommunications sector.
Three separate reviews and a forensic audit of NBN Co will be undertaken immediately, which will effectively give the incoming Abbott government a get-out-of-jail-free card to oust the existing board and take the national broadband network in any direction it wants - and it will.
Critics have described the NBN in its current form as ''overstaffed'', a ''bottomless pit of taxpayer funding'' and a ''quagmire wrapped in a minefield''.
-----

Voyager 1 exits solar system in breathtaking achievement, 36 years after launch

Date September 13, 2013

Voyager reaches interstellar space

Pasadena, California: The spacecraft's technology was laughable by today's standards: it carried an eight-track tape recorder and computers with 240,000 times less memory than a low-end iPhone. When it left Earth 36 years ago, it was designed as a four-year mission to Saturn, and everything after that was gravy.
But Voyager I has become - unexpectedly - the Little Spacecraft That Could. On Thursday, scientists declared that it had become the first man-made object to exit the solar system, a breathtaking achievement that NASA could only fantasise about back when it was launched in 1977, the same year that Star Wars was released.
Voyager 1 is expected to keep sending back data - with a 23-watt transmitter, about the equivalent of a refrigerator light bulb - until roughly 2025.  
-----
Enjoy!
David.

Abbott Ministerial Announcement - What Have We Got?

Here are the relevant ones.

Health and Sport: Mr Peter Dutton

Assistant Minister for Health: Senator Fiona Nash (Nats)

Minister For Human Services: Senator Marise Payne

Assistant Minister for Social Services: Senator Mitch Fifield (Covers Aged Care)

Dr. Andrew Southcott (Boothby SA) - GP spokesman - has been dropped from the Ministry.

Does not look like there is a great deal of enthusiasm for e-Health there. I did like Kate McDonald's tweet that maybe Senator Nash does e-Health - Nash for NASH!

Enjoy!

David.

Sunday, September 15, 2013

Another View On What Is Needed With The PCEHR. With The Planned Review We Need All Input Possible.

This appeared a few days ago.

Christian Rowan: E-health success

Monday, 9 September, 2013
AUSTRALIA’S experiment with the personally controlled electronic health record has had a bumpy start — the resignation of key clinical advisers from the National Electronic Health Transition Authority does not augur well for its future.
Hundreds of millions of dollars have already been spent on setting up and promoting the PCEHR. Perhaps it’s time to acknowledge that our precious electronic health dollars could have been better prioritised elsewhere.
There will be many reasons given for the disappointment of the PCEHR, which had failed to reach even its own modest target of 500 000 registrations by July 2013. However, in simple terms, the success of electronic and information technology (IT) projects, large or small, depends on leadership and clinical engagement.
Both have been lacking in the rollout of the PCEHR, as borne out by low participation by GPs and the inability of public hospital systems to integrate their records successfully.
IT in health care is an enabler which augments good clinical care — projects are likely to succeed when project teams follow the basic principles of good planning, effective clinical leadership and a commitment to stakeholder engagement.
There are several successful examples in the Australian health sector where these principles have been taken seriously, including two in Queensland — the new UnitingCare Health St Stephen’s Hospital at Hervey Bay and the new purpose-designed Health City precinct at Greater Springfield, south-west of Brisbane.
At the heart of both these initiatives are clinical leaders, health planners and administrators whose aim is to share information using digital technology and create synergies between primary, secondary and tertiary care.
…...
For the PCEHR to succeed we need to return to basics — get the planning right, ensure the project is led by clinicians, and don’t forget to engage the very people who will use the system: the doctors and their patients.
Dr Christian Rowan is the President of the AMA Queensland, an Associate Professor of Addiction Medicine and Public Health at the Centre for Medicine and Oral Health, Griffith University, Queensland, and Director of Medical Services at St Andrew’s War Memorial Hospital, Brisbane.
The full article is here:
As I read this article I wondered what success was being discussed - having read the initial few paragraphs suggesting the PCEHR as not going well - but then realised as I read on that what the success was that was being discussed was not the PCEHR but a smaller and obviously much better run project. This paragraph lays it out pretty clearly:
“IT in health care is an enabler which augments good clinical care — projects are likely to succeed when project teams follow the basic principles of good planning, effective clinical leadership and a commitment to stakeholder engagement.
For mine this is absolutely spot on and unless these basics can be worked into the PCEHR program - and soon - my feeling is that success is very unlikely indeed and that we should not be throwing any ‘good money’ after bad.
I look forward to the commencement of the Government review. I hope submissions will be accepted.
David.

AusHealthIT Poll Number 183 – Results – 15th September, 2013.

The question was:

Should The Coalition Government Undertake A Detailed Review Of The PCEHR To Ensure Its Objectives And Purpose Are Clear And Likely To Be Met?

For Sure 88% (52)

Probably 3% (2)

Maybe 2% (1)

No Way 7% (4)

I Have No Idea 0% (0)

Total votes: 59

This is a pretty clear outcome. Seems a large majority say a detailed review is vital.

Again, many thanks to those that voted!


David.