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, October 03, 2013

This Is Actually A Very Serious And Worrying Trend. We Are Being Treated Like Mushrooms.

This appeared a little while ago.

Health reporting at risk

Nicole MacKee
Monday, 23 September, 2013
THE loss of experienced journalists from some mainstream media outlets could lead to the “dumbing down” of health reporting, says a long-term observer of health in the media.
Professor David Henry, co-founder of the online health reporting watchdog Media Doctor, said the sudden exodus of experienced journalists from major media outlets last year due to the restructuring in two of Australia’s most influential media companies would have consequences for health literacy in the community.
“The existence of an independent media and in particular one that includes journalists that have the skills and the knowledge to report accurately on health care interventions, is really quite critical”, said Professor Henry, who is now a professor of clinical pharmacology at the University of Toronto, Canada.
He was commenting on an MJA article in which the authors, including Dr Christopher Jordens of the University of Sydney’s Centre for Values, Ethics and the Law in Medicine, raised concerns about the public health impact of the extensive loss of experienced journalists from major newspapers. (1)
The authors cited a Media Entertainment and Arts Alliance estimate that one in seven journalism jobs in major Australian newspapers were made redundant in 2012.
“Given that the loss of journalism jobs affected some of the highest quality newspapers, there is clearly cause for concern about their effect on the future quality of health reporting in this country”, they wrote.
Carol Bennett, CEO of Consumers Health Forum, said the departure from newspapers of journalists with years of experience in reporting health issues had weakened the coverage of often complex issues.
Lots more here:
Can I say this is a really serious trend that I am sure we have all noticed. The loss of people like Karen Dearne (News) and Mark Metherall (Fairfax) has really meant the level of coverage in e-Health has fallen away as well as the general level of Health coverage overall.
As reported in the article there really has been a night of the long knives in print journalism in the last year or two and some good people have surely been lost. It is also obvious from the coverage we now see that those who survived have been more thinly spread than is reasonable - especially as we are now asked to pay more for access to what is a clearly inferior overall product. Note this is no criticism of those remaining - there are simply not enough of them!
At least the Guardian in Australia (http://www.theguardian.com/au) and The Conversation (https://theconversation.com/au/health) are helping to fill the gap.
Sadly with the loss of general coverage we also seem to be getting less e-Health coverage from the technical press.
What is now your best source of e-Health information? Pulse + IT must be up there http://www.pulseitmagazine.com.au/) . How unbiased are you finding coverage and do you see some coverage as being distorted by sponsorship and the like?

Are there any blogs you like that are not listed here as being worth a read?
Comments welcome.
David.

Wednesday, October 02, 2013

Two Good And One Not So Good Individual Suggestions On How To Fix The PCEHR.

First the two I liked.
First we have this.

The PCEHR: Moving forward

I can confirm that the Government is not going to build a massive data repository. We don’t believe it would deliver any additional benefits to clinicians or patients – and it creates unnecessary risks (~Nicola Roxon)
I’ve studied the PCEHR but I’m still not sure what the government has built and for what purposes. I was always under the impression that the PCEHR was designed to assist clinicians to improve patient care through better data flow. But this may not be the case.
The recent resignation of NEHTA’s top National Clinical Leads is an ominous sign. If the Department of Health does not start sharing ownership of the PCEHR soon and improve governance of the system, the PCEHR will fail. Here’s a quick rundown of the issues and how to move forward.
Legal issues
A first glance at the PCEHR Act 2012 seems to confirm that the PCEHR is built for clinicians, as its four purposes are clinical in nature:
  • To help overcome fragmentation of health information
  • To improve the availability and quality of health information
  • To reduce the occurrence of adverse medical events and the duplication of treatment
  • To improve the coordination and quality of healthcare provided to consumers by different healthcare providers
So far so good. But the Act is 93 pages long and I could find at least five other ‘non-official’ purposes of the PCEHR spread out throughout the Act:
  • Law enforcement purposes
  • Health provider indemnity insurance cover purposes
  • Research
  • Public health purposes
  • Other purposes authorised by law
And this is where the concerns begin. These ‘non-official’ purposes are not directly related to the care doctors provide to their patients. In general, one would say that patients and clinicians have to give informed consent before their health information can be used for research or other purposes. It seems like informed consent is missing here.
Read the rest of the concerns and the author’s preferred  fix here:
Second we have this:

Aniello Iannuzzi: Time for change

Aniello Iannuzzi
Monday, 23 September, 2013
EVEN though voters consistently place health high on their list of important issues, both sides of the political divide somehow managed to dodge the issue in the recent election campaign.
“Voting for change” and “6-point plans” seemed to grab the media’s attention rather than health.
In the hope that new Prime Minister Tony Abbott and new Health Minister Peter Dutton read MJA InSight, here is my 6-point plan for health change:
1. Change our approach to Indigenous health
Whatever we’re doing now is plainly not good enough. Programs are disjointed, lack penetration and are often bogged down for several reasons, including lack of funds, geography, politics and red tape. Many health professionals lack cultural awareness and experience in Indigenous health and therefore miss opportunities to intervene.
Given Tony Abbott’s zeal to address Indigenous disadvantage, I want to again suggest a free and open model of Medicare for Indigenous people based on the Department of Veterans’ Affairs system. No matter what it costs, the results will be worthwhile.
…..
6. Change e-health
The profession has not embraced the National E-Health Transition Authority or the personally controlled e-health record. Part of this failure is poor communication from the government and ongoing suspicion about privacy and intellectual property issues.
Another big reason for the lack of engagement is that practices are already overwhelmed with the administrative burden of running a viable e-health-based practice. We need to step back. Many doctors still have not come to terms with electronic prescribing and medical record keeping.
The change of government brings with it an opportunity to listen to health experts — practising doctors — about how to improve medicine for patients and the profession, and to begin a program of positive change.
Dr Aniello Iannuzzi is a GP practising in Coonabarabran, NSW.
Interestingly what both are recognising are the clear need to clinician input in the design and deployment of any proposed national record so there is usability, usefulness and evidence that the system will actually make a difference as well a real bi-directional communication to ensure the program stays on track. 
Sadly here is a view that I think is vastly over-simplistic. See the bold paragraphs.

Why clinicians don’t like national e-health

And what needs to be done to change their minds
If a recent survey by Australian Doctor is anything to go by, many general practitioners (GPs) across the country don’t want to participate in the challenged national e-health program.
There are two key reasons for this: time and money. In recent months, several prominent healthcare professionals have criticised the time it takes to prepare information that can be submitted to a patient's personally controlled electronic health record (PCEHR), particularly to ensure the accuracy of data recorded about a patient’s health.
They’re also concerned about information contributed to a PCEHR system being viewed by the wider health community and the time it takes to ensure the data is concise.
As expected, the majority of Australians will nominate their GP as their primary healthcare provider. Consequently, some GPs claim they will spend even more time managing their patient’s shared health summaries.
Although GPs are compensated by Medicare – through several MBS codes – for contributing information to the PCEHR, they believe that having to complete these administrative tasks will mean there’s less time available to care for patients.
But over time, the national e-health program will actually enable GPs to focus more on treating their patients.
As a patient’s primary healthcare provider, the national PCEHR system will help GPs co-ordinate care and cut the amount of time spent chasing information from other healthcare providers, such as hospitals, pharmacies, and specialists.
This will particularly benefit older Australians, and people living with chronic disease or ongoing health conditions.
So given the potential, how can GPs be encouraged to contribute the necessary clinical information so the benefits of the PCEHR will be realised?
Perhaps most importantly, software vendors need to demonstrate maturity in their implementations to support the PCEHR to make access easy and ensure little impact to current work practices. This will go a long towards encouraging GP adoption.
Creating a consumer’s shared health summary could be (and should be) as simple as pressing a button.
The information required in the standardised electronic summary can be updated from the GPs clinical software that stores local consumer e-health records and should require little or no human involvement.
In addition, the GP’s clinical software should provide seamless access to a consumer’s PCEHR and make available information that they would not currently have access to. It should present a consolidated summary of a consumer’s important health information through the series of views already provided by the PCEHR.
This will ensure that the right information is available to GPs in the right format to help them make the right decisions at the time of care.
Lots more here:
My view is that there is much more than time and money involved in clinician rejection. It is about recognising the system was not architected as a system to help clinicians, that the Government is excessively unresponsive and over legalistic and that usage is presently excessively complex and risky.
In essence the clinicians recognise this is a system that is not addressing any of their needs in their efforts to best treat and communicate with their patients. It really is as simple as that.
David.

Tuesday, October 01, 2013

E-Health Professionals And Consumer Groups Express Concern Regarding Outcomes Of The Planned PCEHR Review.

The following appeared last week.

Peter Dutton shifts into high gear for e-health overhaul

HEALTH Minister Peter Dutton has moved swiftly to initiate a review of the troubled $1 billion personally controlled e-health record system at the behest of Tony Abbott.
Mr Dutton has received initial briefings on the PCEHR from key stakeholders such as the Department of Health.
The Coalition will undertake a comprehensive assessment of the true status of the PCEHR implementation as outlined in its health policy released in the lead up to the election.
"In government, the Coalition implemented successful incentives to computerise general practice and will continue to provide strong in-principle support for a shared electronic health record for patients," the policy says.
"The Coalition will again work with health professions and industry to prioritise implementation following a full assessment of the current situation."
A spokeswoman for Mr Dutton declined to say who was expected to lead the review or how long it would take.
"We all support an electronic health record," she said.
"However, we have grave concerns about the amount of money the previous government spent on e-health for very little outcome to date.
"At a cost of around $1bn, we should have a lot more to show for it."
In opposition, Mr Dutton and others criticised the PCEHR's performance, saying that while more than 650,000 people had registered for an e-health record, only 4000-plus shared health summaries were created.
The summaries are generated by a patient's GP and contain diagnoses, allergies and medications.
The spokeswoman declined to say if Deloitte's refresh of the 2008 national e-health strategy had begun.
Medical Software Industry Association president Jenny O'Neill said her organisation was "very willing to assist the new Health Minister in a review and planning for a sustainable (e-health) future".
"In a recent Q&A program on the ABC, former health minister Tanya Plibersek equated a $1.5bn investment by government as a 'rounding error'," Ms O'Neill said.
"Had her department invested this 'rounding error' in the e-health sector by strengthening the electronic bridges between all the parties, Australia would have achieved major and sustainable transformational change in this timeframe. If all the important infrastructure supporting current data transfer had been strengthened and upgraded with the latest technologies, national security and safety standards would now exist."
She said the PCEHR was "a much advertised national system which is next to empty".
"Each transaction in this national system has to be routed through a national repository," Ms O'Neill said.
"It is like building a fast train system between the cities and towns of Australia and requiring every trip to go via Canberra."
She said taxpayers could not afford rounding errors in e-health.
Lots more here covering the consumers, pharmacy guild and a rather confused CIO of the now DoH.:
It strikes me the comments of the former health minister explain why Labor lost Government - seeing $1B + on the PCEHR as a ‘rounding error’ betokens an attitude to the spending of tax money of extreme profligacy.
Ms O’Neill also catches the point many others miss - the fundamental architectural design error that at, at least in my view, dooms the entire program.
The full article is well worth a careful read as those outside DoH clearly know more about what is needed with the PCEHR than those who designed and are ‘managing’ it.
David.

Monday, September 30, 2013

Weekly Australian Health IT Links – 30th 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

A really, really quiet week.
What is interesting to note is just how quiet the new government is being so far.
A new website has appeared at www.health.gov.au. Was pleasing to see it seems to be reasonably organised - but it is not clear just where the archives are.
As of 29 September, 2013 there is not a single news related media release.
As far as what the health Department looks after you can find that on Page 23 of 45 of this document.
The Personally Controlled EHR Act (2012) is administered from here. Just which minister is responsible is not clear.
-----

The PCEHR: Moving forward

I can confirm that the Government is not going to build a massive data repository. We don’t believe it would deliver any additional benefits to clinicians or patients – and it creates unnecessary risks (~Nicola Roxon)
I’ve studied the PCEHR but I’m still not sure what the government has built and for what purposes. I was always under the impression that the PCEHR was designed to assist clinicians to improve patient care through better data flow. But this may not be the case.
The recent resignation of NEHTA’s top National Clinical Leads is an ominous sign. If the Department of Health does not start sharing ownership of the PCEHR soon and improve governance of the system, the PCEHR will fail. Here’s a quick rundown of the issues and how to move forward.
-----

Peter Dutton shifts into high gear for e-health overhaul

HEALTH Minister Peter Dutton has moved swiftly to initiate a review of the troubled $1 billion personally controlled e-health record system at the behest of Tony Abbott.
Mr Dutton has received initial briefings on the PCEHR from key stakeholders such as the Department of Health.
The Coalition will undertake a comprehensive assessment of the true status of the PCEHR implementation as outlined in its health policy released in the lead up to the election.
-----

Guild supports PCEHR audit

24 September, 2013 Kirrilly Burton
The Pharmacy Guild of Australia has backed a review of the $1 billion Personally Controlled Electronic Health Record (PCEHR) system by Peter Dutton, the Minister for Health. 
In the Coalition’s health policy released in the lead up to the election, it said it will undertake a “comprehensive assessment of the true status of the PCEHR implementation.”  
“Unfortunately, the Labor Government has failed to deliver on its PCEHR. Despite the $1 billion price tag, only 4000 records are reported to be in existence,” the Coalition said.   
“In Government the Coalition implemented successful incentives to computerise general practice and will continue to provide strong in-principle support for a shared electronic health record for patients.”
-----

Guild keen to discuss PCEHR with Coalition

The Pharmacy Guild of Australia supports the concept of an electronic health record and has invested significant time and financial resources to see such a system become a reality. 
The Federal Election has just concluded and one significant area of policy difference between the major parties is in the area of eHealth. We welcome and support the direction of the incoming Coalition Government where a focus will be on electronic prescriptions and medication management. However the Coalition has announced they will undertake an audit of the current Personally Controlled Electronic Health Record (PCEHR) System and we wait to see the outcomes of the new Government’s audit and the subsequent policy changes before we review our position. 
-----

Aniello Iannuzzi: Time for change

Aniello Iannuzzi
Monday, 23 September, 2013
EVEN though voters consistently place health high on their list of important issues, both sides of the political divide somehow managed to dodge the issue in the recent election campaign.
“Voting for change” and “6-point plans” seemed to grab the media’s attention rather than health.
In the hope that new Prime Minister Tony Abbott and new Health Minister Peter Dutton read MJA InSight, here is my 6-point plan for health change:
-----

Commonwealth agencies to be cut by Abbott Government

  • Steve Lewis
  • News Limited Network
  • September 22, 2013 10:00PM
AGENCIES responsible for tackling obesity, capital city planning and security advice on asylum seekers are to be slashed as Tony Abbott takes the axe to Labor's reform agenda.
Less than a week after taking office, the Coalition Government has scrapped plans to build a multimillion-dollar embassy in Africa, and will also wipe $100 million off research funding.
The Prime Minister has also pulled the pin on a key Kevin Rudd initiative - Community Cabinet - as he instructs his new ministry team to put the broom through the bureaucracy.
-----

Call to introduce real-time prescription monitoring

25th Sep 2013
BLEAK figures on the increase in deaths due to acute prescription drug toxicity in Victoria in the first half of the year provide new impetus for introducing real-time prescription monitoring, an expert believes.
Figures released by the Coroners Court of Victoria show prescription pharmaceuticals contributed to 82.3% of the 176 deaths due to drug overdose from January to June.
Benzodiazepines overtook opioids as the most prevalent contributor (58%) to death, with diazepam contributing to more deaths (84) than heroin (67) for the second year.
Alcohol was contributor to 30% of the deaths compared to 21% for 2102, while codeine contributed to one in four deaths.
-----

Ephedrine bust shows benefits of Project STOP

26 September, 2013 Nick O'Donoghue
A 274kg haul of illegally imported ephedrine seized by a Department of Agriculture and Food officer in Port Melbourne this week is leading to calls for Government to fund Project STOP.
The find was made when the officer was testing several thousand bags of basmati rice imported from India, and was the third biggest in Australian history.
Speaking on ABC Radio National’s The World Today, Kos Sclavos, Pharmacy Guild of Australia national president, said the bust indicated that Project STOP has been effective preventing illicit drug manufacturers from sourcing materials through pharmacy.
“Unfortunately, historically, as we know this product was being misused and diverted to make speed, and so we’ve put in a system in place,” he said.
-----

Mind of amputee controls new leg

  • RON WINSLOW
  • The Wall Street Journal
  • September 27, 2013 12:00AM
IN an advance that could eventually improve the mobility of thousands of people living with amputations, researchers say a 32-year-old man has successfully controlled movements of a motorised artificial leg using only his thoughts.
Aided by sensors receiving impulses from nerves and muscles that once carried signals to his missing knee and ankle, the patient was able to climb and descend stairs. Importantly, he was able to flex the device's ankle, enabling a near-normal gait, something not possible with prosthetics.
It was "night and day" between the experimental bionic leg and the mechanical prosthetic limb he used every day, said Zac Vawter, a software engineer from Washington State who lost his right leg in a motorcycle accident four years ago.
-----

On the future of CDA

Posted on September 28, 2013 by Grahame Grieve
I’ve had several questions about my comments on the future of CDA in the Structured Documents working group (SDWG) this week, so I thought I’d clarify here.
The context of this work was a question from the CDA R3 team whether they should close down the existing CDA R3 work, and instead focus on FHIR as a vehicle for CDA R3.
I think there was some confusion about this – in no way should this idea be understood as “abandon CDA” or even “stop working on CDA R3″, which I heard it characterized as. It’s simply proposing that the underlying format for the next release of CDA will be based on the technical vehicle of FHIR rather than the technical vehicle of the RIM Based ITS(s). The same functional use cases get carried forward to the next version of CDA, and the same basic requirement applies: that there be a conversion process to go forward from CDA R2 to CDA R3, just as there was for CDA R1 to R2.
-----

Medical apps face tougher scrutiny

24 September, 2013 David Brill
Diagnostic smartphone apps are set to face tougher regulatory scrutiny under long-awaited new guidance from the US Food and Drug Administration.
In a document released Monday, the FDA said most medical-related apps posed minimal risk to the public and should not be regulated as medical devices.
However, the FDA said it intended to focus on those apps that posed a possible safety risk if they malfunctioned, such as apps that transform a phone or tablet into an ECG, ultrasound or glucose meter.
Apps that display patient-specific information, such as for viewing X-rays or analysing and interpreting test results, will now also be subject to FDA oversight.
The guidelines, first released two years ago in draft form, represent a trade-off between protecting patient safety and encouraging innovation, Jeffrey Shuren, director of the FDA's Center for Devices and Radiological Health, said.
-----

Formulary for success

Tasmania’s new Electronic Medicines Formulary, launched in June, is a web-based database for use by clinical staff across Tasmania’s four main hospitals and 17 rural and regional hospitals, and the most comprehensive formulary in Australia.
“Previously doctors wanting to access information about what they could prescribe, had to access a variety of sources – and in fact, a lot of the information wasn't available at all,” says Tom Simpson who is the Executive Director, Statewide Hospital Pharmacy at Royal Hobart Hospital.
“We didn't publish within our hospitals what drugs we stocked in the pharmacy, what drugs were allowed to be used for what indications, all those sorts of things.”
-----

Why clinicians don’t like national e-health

And what needs to be done to change their minds
If a recent survey by Australian Doctor is anything to go by, many general practitioners (GPs) across the country don’t want to participate in the challenged national e-health program.
There are two key reasons for this: time and money. In recent months, several prominent healthcare professionals have criticised the time it takes to prepare information that can be submitted to a patient's personally controlled electronic health record (PCEHR), particularly to ensure the accuracy of data recorded about a patient’s health.
They’re also concerned about information contributed to a PCEHR system being viewed by the wider health community and the time it takes to ensure the data is concise.
-----

Sinapse Delivers Rapid Implementation of Athena Software's Case Management Software Solution to Large Australian Government Department

Waterloo, Ont. company Athena Software and Australia-based firm Sinapse successfully implemented Athena's Penelope case management software solution to the Australian Government's Department of Veterans' Affairs, Veterans and Veterans Families Counselling Service (VVCS)

Waterloo, ON (PRWEB) September 25, 2013
Earlier this year, Sinapse was contracted to implement and support the deployment of Athena Software's Penelope case management application with the Australian government's Department of Veterans' Affairs (DVA).
The project saw the web-based Penelope application replace the Veterans and Veterans Families Counselling Service Management Information System previously used by the DVA.
-----

NSW Health Pathology seeks CIO to improve networks

IT boss will oversee five networks at the new state-wide clincial service
NSW Health Pathology is looking for a CIO to create and deliver a five-year strategic plan to improve the organisation’s networks.
This is a new role at NSW Health Pathology, which has only been established for about 10 months. The state-wide clincial organisation is part of the NSW public health system and provides public pathology, forensic and analytical science services across NSW.
The CIO will overlook five specialised networks, which include: Pathology North, Pathology West, South Eastern Area Laboratory Service, Sydney South West Pathology Service, and the Forensic and Analytical Science Service.
-----

Health reporting at risk

Nicole MacKee
Monday, 23 September, 2013
THE loss of experienced journalists from some mainstream media outlets could lead to the “dumbing down” of health reporting, says a long-term observer of health in the media.
Professor David Henry, co-founder of the online health reporting watchdog Media Doctor, said the sudden exodus of experienced journalists from major media outlets last year due to the restructuring in two of Australia’s most influential media companies would have consequences for health literacy in the community.
“The existence of an independent media and in particular one that includes journalists that have the skills and the knowledge to report accurately on health care interventions, is really quite critical”, said Professor Henry, who is now a professor of clinical pharmacology at the University of Toronto, Canada.
-----

AMLA CEO resigns after just six months

23rd Sep 2013
AUSTRALIAN Medicare Local Alliance CEO Claire Austin has left the organisation just six months into the job as the 61 MLs brace for a sweeping review under the newly elected Abbott government.
The alliance confirmed Ms Austin’s departure late on Friday but declined to give details, including whether it was Ms Austin’s choice to leave. 
In a statement, the alliance said its board appointed its general manager for national programs and member services, Sean Rooney, as acting CEO.
-----

The NBN board has run away. Why?

23 September, 2013
The resignation of the entire board of NBN Co has brought into sharp focus my membership of the NBN Peanut Gallery. Perhaps it is time to move on, to acknowledge the Coalition’s mandate and Get A Life.
But, no – I have decided to stay on; my country needs me. Ziggy Switkowski, on the other hand, needs to think twice.
The current chair, Siobhan McKenna and her five colleagues, will no doubt be unable to get out of the place quick enough. Each will be hoping not to be the one whom the new minister and shareholder, Malcolm Turnbull, asks to stay on to assist with the transition.
Meanwhile it is persuasively suggested that the minister has prevailed upon the former chief executive of Telstra, chair of Opera Australia and examiner of the Essendon Football Club to be executive chairman of NBN Co, which is another term for CEO.
-----

Control-alt-delete was a mistake, says Bill Gates

Date September 27, 2013 - 9:29AM

Will Oremus

Bill Gates has admitted the control-alt-delete command used to log on to PCs was a mistake.
Hundreds of millions of people around the world, including virtually everyone who has ever used a Windows device, have had to memorise the key command "control-alt-delete". In retrospect, that was probably unnecessary, Microsoft co-founded Bill Gates revealed in a talk at Harvard last week.
As Geekwire points out, the surprising – and, let's face it, seriously belated – admission came in response to a wonderfully blunt question from David Rubenstein, co-chair of a Harvard fundraising campaign. "Why, when I want to turn on my software and computer, do I need to have three fingers: control, alt, delete?" Rubenstein asked the living tech legend. "Whose idea was that?"
-----

In pictures: The desktop lover's guide to supercharging Windows 8.1

Don't like the Metro interface? Here's the best way to banish it and boost your productivity.
-----
Enjoy!
David.

Sunday, September 29, 2013

Senator Boyce Gets The Most Recent Collection Of Non-Answers From NEHTA at Senate Estimates From June This Year.

There were five interesting responses among about 30 provided.

Subject Outcome: E-Health 10.2

Agency: NEHTA
Issue: NEHTA – Standards/Functionality of the PCEHR
Name of Senator: Sue Boyce
QUESTION: 21
Senator Boyce asked:
Given the safety implications did NEHTA issue any form of warning alert? If not why not?
Answer:
The information provided within the AMT fully describes and accurately identifies medicines. The descriptions listed in the AMT are correct. These are based on current Editorial Rules and accurately describe the products. The major issue relates to the different representation of the order of ingredients within the AMT Medicinal Product and Medicinal Product Pack descriptions which do not match the order on the product packaging. These are generic concepts and are not intended to reflect actual product labeling. Examples exist where different brands of the same set of ingredients have product labels with ingredients in different orders.
The issue or ingredient order for all medicines has been considered on a number of occasions by the AMT Support Group and late in 2012 an alphabetical approach to ingredient order was proposed and agreed. This would then result in descriptions that were clear and consistent. The Support Group is made up of representatives from Pharmaceutical Benefits Division, the Therapeutic Goods Administration, various state health jurisdictions, clinicians, medical software vendors and relevant professional organisations.
QUESTION: 24
Senator Boyce asked:
Is it true that all the stakeholders in Standards Australia - 44 of them - with the exception of DOHA and NEHTA have lost confidence in, or are concerned about, the standards now being applied to electronic prescriptions?
Answer:
This matter should be referred to Standards Australia. NEHTA cannot comment on the Standards Australia’s stakeholder’s confidence levels.
QUESTION: 27
Senator Boyce asked:
Given the importance of transparency in encouraging co-operation, clarity and trust why hasn’t NEHTA/DOHA released PCEHR safety Report Part B and the HI Service pre-commissioning safety report?
Answer:
NEHTA’s Clinical Safety Unit (CSU) works very closely with the Department of Health and Ageing in its role as System Operator of the PCEHR. This includes participation by NEHTA CSU in key committee processes including review by the Clinical Safety Working Group and Clinical Governance Committees. These Committees provide a forum for the safety assessments presented in the PCEHR Clinical Safety Case Report so they can be thoroughly considered in the development, testing and operations of the PCEHR. The reports are released and shared between forum participants. The Australian Commission on Safety & Quality in Healthcare have undertaken two of four audits of the safety of the PCEHR and the methods and processes that determine its creation. The clinical safety case reports are a key input to these audits and include findings noting that partner organisations continue to ensure that clinical safety case reports are shared appropriately between agencies and form a basis for ongoing risk management of the PCEHR. This work will ensure that recommended mitigating controls are being acted against and that existing mitigating controls can be evaluated for ongoing effectiveness.
QUESTION: 28
Senator Boyce asked:
Given the widespread concern expressed by stakeholders in regard to issues of safety and privacy surrounding the concept and construction of the PCEHR why has NEHTA shown continuing reluctance to release PCEHR safety and compliance reports?
Answer:
The PCEHR Clinical Safety Case Report assessments and recommendations are a key input to processes underpinning the continuing development, testing and operations. The report is released in the context of key governance processes important to clinical safety including review by the Clinical Safety Working Group and Clinical Governance Committees. The Australian Commission for Safety & Quality in Healthcare are leading through the audit activities the evaluation of arrangements for sharing the outputs of the NEHTA CSU.
QUESTION: 31
Senator Boyce asked:
It’s also alleged by certain vendors that AMT codes in the PBS distribution appear to be different from AMT codes for the same concept in the AMT distribution. Is this correct and if so what are the consequences if that is not rectified?
Answer:
If the question being addressed is “Do all AMT codes contained in the PBS exactly match codes contained in the NCTIS AMT releases” the answer is no. PBS have on occasion the need to allocate their own ‘AMT-like code’ due to differences in how a product may need to be described for legislation/ reimbursement purposes and the corresponding AMT description contains either too much/too little detail (e.g. inclusion/exclusion of a container type or salt of a substance). In these cases, PBS create their own description and use their own namespace identifier (a 7 digit ID which appears within the full identifier string) to differentiate it from a true AMT code.
NEHTA and PBS will continue to work together to ensure quality mapping processes and alignment between the releases. NEHTA anticipated that there would be a number of questions from vendors around inclusion of AMT codes and descriptions in PBS files and has drafted an FAQ document outlining some of the most likely questions to assist and guide vendors.
You can download and read all the answers from this link:
What we have here, to me, is foot dragging, denial and refusal to be open to potential problems and to have a reasonable sense of urgency in fixing potential issues.
I wonder will the change in Government lead to an improvement in openness and transparency or will Mr Dutton simply get rid of NEHTA.
Place your bets in the comments section.
David.

AusHealthIT Poll Number 185 – Results – 29th September, 2013.

The question was:

How Would You Rate The Overall Performance Of The Labor Government In The E-Health Space Over The Last Six Years?

Excellent 5% (3)

Not Too Bad 6% (4)

Neutral 5% (3)

Not At All Good 11% (7)

Just Awful 74% (48)

I Have No Idea 0% (0)

Total votes: 65

This is a pretty clear outcome. Put simply Labor is seen as having failed by those who read here.

Again, many thanks to those that voted! 

David.