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."

Sunday, December 29, 2013

It Will Be Interesting To See Where This Is Heading. Looks Important And Not Good!

Sorry to interrupt the Summer of cricket but this might be pretty important.
This popped up on the weekend.

Government puts key talks on health reform on hold for six months

FEDERAL, state and territory health ministers earlier this year resolved to have a high-level advisory committee explore "possible future directions for future reform of Australia's health system".
The committee was to look at how this could be done through a closer working relationship between GPs and hospitals, better e-health solutions and improved co-ordination of care for people with chronic and complex conditions, including cancer.
The NSW government was then tasked with reporting on the progress of the existing National Health Reform Agreement, including the performance of various bodies established by the Rudd and Gillard governments, and with developing a framework and timeline for further reform work.
The much-anticipated blueprint was not delivered at last month's meeting of the Standing Council on Health as expected, and documents obtained by The Weekend Australian under Freedom of Information laws show it was deliberately deferred.
A briefing paper for federal Health Minister Peter Dutton shows the federal government wanted to delay the blueprint presentation until the council meets next May, to allow further budget cuts and governance changes to be detailed.
"We do not currently have a clear indication of the government's inclination to support further health reform," the paper said.
There was also some concern that preparation of a blueprint "may initiate reform proposals from the states and territories that the commonwealth does not support" whereas "deferral will allow more time to ensure the proposed work aligns with the commonwealth government health priorities".
More here:
The delay is clearly to allow the present Government to absorb and develop responses to the Medicare Locals Review, the PCEHR Review and the Commission of Audit - all of which seem likely to be responded to in the May Budget.
One has to imagine that the deferral means there is going to be budget action one way or another in these areas. I would lay ‘London to a brick’ that funding increases are not actually being seriously considered. I think you can also be sure the Health Sector overall is going to take some sort of hit in May!
Back to the restful quiet summer now!
David.

AusHealthIT Poll Number 198 – Results – 29th December, 2013.

Do You Believe The PCEHR SHOULD Be Closed Down?

Yes 69% (36)

No 23% (12)

I Am Undecided 8% (4)

Total votes: 52

Again, it seems that the review should recommend ending the suffering and stop wasting everyone’s time and money.

Again, many, many thanks to those that voted!

David.

Wednesday, December 25, 2013

For The Record - Australasian College Of Health Informatics Responds To Medicare Locals Review

You can download a copy - only a few short pages with 15 recommendations - from this link:

http://www.achi.org.au/docs/ACHI_Response-Medicare_Locals_Review_V1.0.pdf

In summary I think it is fair to say that ACHI sees Medicare Locals (ML) as very much a work in progress that really need a great more clarity on what they should do and what is the evidence supporting the various current and proposed ML activities and associated spending.

Have a quick read to find out more.

I would be interested in links to other submissions people know about - other than the AMA submission which was covered earlier on the blog.

See here:

https://ama.com.au/submission-australian-government-review-medicare-locals

David.


Tuesday, December 24, 2013

Happy Christmas And A Great 2014 To All!

Thanks for reading during the year.

All the best to you and yours!

Will be back, fate and God willing,  January 6, 2014 to do it all again!

I wonder what the Minister for Health has been told about PCEHR? Inside information in the comments welcome!

Now we know what has been said, it is really astonishing that the Minister can think a worthwhile review could be done in the six to seven weeks.

Certainly all the commenters picked up on this:

1 – 3 of 3
Anonymous Anonymous said...
 
"Their report provides a comprehensive plan for the future of electronic health records in Australia." Wow! Now we have the record system, let's develop the plan. Does the plan include a Tardis? I do hope they publish this report and let us all in on the plan.
12/23/2013 10:01:00 PM
Delete
Anonymous Anonymous said...
 
Maybe the plan is to have another review and then develop a plan to replace the plan they never had in the first place.....
12/24/2013 06:32:00 AM
Delete
Anonymous Anonymous said...
 
If its true that they produced a "comprehensive plan" then their lack of insight into their limited knowledge is worse than I thought. Perhaps those with deep knowledge of eHealth could be employed producing comprehensive plans for education or defense spending as it seems in this new order having experience in anything just clouds your judgement. My confidence in western civilization is waning... Perhaps we should begin stockpiling guns, ammo and canned food?
12/24/2013 12:33:00 PMDelete
 ----- End Comments.

I have to say I really do enjoy all the comments. It is great to have so many different slants on things!

Do have a good one!

David.

Monday, December 23, 2013

As We Always Suspected The E-Health Review Will Be Secret For A While! And It Won’t Help Either!

This has just appeared.
THE HON PETER DUTTON MP , MINISTER FOR HEALTH,  MINISTER FOR SPORT

MEDIA RELEASE

20 December 2013

E - Health Record Review

The review of the Personally Controlled Electronic Health Records (PCEHR) system has been completed.
Health Minister Peter Dutton today received the report from the review team headed by the Executive
Director of the UnitingCare Health Group, Mr Richard Royle.
The review looked into significant concerns about the progress and implementation of the PCEHR.
Mr Royle was assisted by AMA President Dr Steve Hambleton and Australia Post CIO Andrew Walduck.
Their report provides a comprehensive plan for the future of electronic health records in Australia.
Mr Dutton said the Government would now take time to c onsider the review recommendations and would respond in due course.
“I sincerely thank the members of the review panel for their work on this matter.”
Media Contact: John Wiseman
0401 776 108
Clearly Mr Dutton has no idea what a real plan would actually look like as it is impossible to develop anything remotely that in a few weeks.
Sorry to provide such nonsense just before Christmas.
David.

Weekly Australian Health IT Links – 23rd December, 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

There seemed to be enough news to make a summary worthwhile.
So have a good one in a day or two.
-----

NSW launches eHealth Blueprint

Health Minister Jillian Skinner spoke to ehealthspace.org today following the launch of A Blueprint for eHealth in NSW at Parliament House this morning.  The Blueprint formalises the establishment of eHealth NSW as a separate entity.
The Minister said that part of the rationale behind introducing this structural change now was the departure of former HealthShare NSW head Mike Rillstone and CIO Greg Wells who both joined FACS in October.
“We are using this as an opportunity to split the two areas, to give greater focus to both, although they will still be working very closely together,” she said.
-----

Super-CIO, new tech body to lead NSW e-health drive

Minister brings health IT higher up the food chain.

An IT leader with freshly expanded authority, a clinical technology champion and a brand new strategic health organisation will form the foundation of the NSW government’s new blueprint for e-health.
The five year roadmap, formally launched today by health minister Jillian Skinner, makes good on a 2011 commitment to establish a standalone IT body that will oversee the strategic direction of e-health across hospitals and health districts.
Speaking to iTnews, NSW Health director-general Dr Mary Foley said the new eHealth NSW body would be formed from a lift and shift of IT staff out of the department’s current corporate support agency Healthshare NSW. 
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NSW govt touts e-health future

Government introduces new blueprint for services delivery across the state and will soon appoint chief executive of eHealth NSW, and chief CIO
The NSW government has unveiled its Blueprint for eHealth in NSW, aimed at improving collaboration between agencies and the development of a strategy to provide services to rural and remote areas.
The blueprint – announced today by health minister Jillian Skinner – outlines a framework for enhanced collaboration between eHealth NSW, the NSW Ministry of Health and the Local Health Districts.
The blueprint formalised the establishment of eHealth NSW, the minister said. The government will appoint an inaugural chief executive of eHealth NSW by April, as well as a chief CIO to engage clinicians on eHealth.
-----

E-health software risk flagged

6 December, 2013 Paul Smith
The software GPs use when accessing the PCEHR is not clinically safe, the RACGP warns.
In a highly critical submission to the Federal Government's review of the billion-dollar system, the college said there were serious failures in the project's rollout, fuelled by a failure to consult with doctors.
Vendors upgraded their GP software systems earlier this year, allowing doctors to access patient information held on the PCEHR.
But the college said: "The views provided through the various vendor desktop systems are not standardised, safe or intuitive.
"The individual desktop systems each display different documents and are not searchable.
-----

QLD's ban on IBM stays put as state government sues for damages

Published on Mon, 09/12/2013, 04:56:23
By Julian Bajkowski
Queensland premier Campbell Newman has confirmed that a ban on IBM securing new public sector business in the state is still standing after the government commenced legal action for damages late last week in the Supreme Court of Queensland.
A spokesman for the Premier told Government News that there has been “no change in position” in relation to the ban that was put in place in August this year following the release of findings from a special Commission of Inquiry into the $1.2 billion Queensland Health Payroll software disaster that labelled the incident as possibly the worst IT project failure Australia has ever seen.
Technology industry sources outside IBM have told Government News they believe that the ban appears aimed at giving the Newman government better leverage in terms of attempting to force IBM to the table to come to a financial settlement.
-----

Fujitsu Enables a Winning Solution for Healthshare NSW

Enterprise Imaging Repository scoops Premier’s Award for developing the first state-wide medical imaging repository in Australia

Sydney, 13 December, 2013
Fujitsu announces that HealthShare NSW1 has won a prestigious NSW Premier's Award for the pioneering Enterprise Imaging Repository (EIR). Presented at a gala ceremony in Sydney on November 13, the award honours the significant achievements and collaborative efforts of the HealthShare NSW and Fujitsu Australia teams, which are implementing the EIR at more than 220 public hospitals across the state’s 15 Local Health Districts.
A NSW Health2 initiative, the EIR is based on a leading patient-centric management and distribution solution. In an Australian first, the new scalable medical imaging exchange will make a significant difference to patient care, especially for people who need treatment in multiple hospitals and also for those who live in rural and regional areas.
-----

Who will be iTnews' Healthcare CIO of the year?

Benchmark finalists revealed.

Three CIOs incredibly passionate about their jobs -  down to the impact that they have at the patient bedside - have been shortlisted as finalists for Healthcare CIO of the Year at this year's iTnews Benchmark Awards.
David Johnston, who during 2013 was CIO of the South Australian Department of Health, Greg Wells, who served as CIO of NSW Health, and Glenn Payne, CIO at aged care provider Feroscare, make up the select group.
In terms of the total submissions, we can say with confidence that 2013 was the year of the electronic health record. Two of our finalists - and several other high scoring entries - have created platforms that allow their state-based medical record systems to interface with the national Personally Controlled Electronic Health Record (PCEHR), a project which aims to usher in a new era of clinical collaboration.
-----

World Congress Tackles Diabetes Management with Technology

Posted: Tuesday, December 17, 2013 - 09:43
Young global diabetes advocates joined forces to help design a sophisticated eHealth app for diabetes prevention and management, expected to assist more than a million Australians living with diabetes.
As part of the recent World Diabetes Congress program in Melbourne, Nigerian Prince and International Diabetes Federation Young Leader, Prince Ikenna Nwaturuocha, joined 170 Young Leaders representing 69 countries to solidify the group’s vision for a world-leading digital platform.
The output will directly feed the development of Diabetes Australia’s eHealth app, supported by a donation of up to $1 million through the 2013 eftpos Giveback campaign.
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MLs review timetable and terms of reference announced

16th Dec 2013
THE future of Medicare Locals may be decided early next year following a review being led by former Commonwealth Chief Medical Officer Professor John Horvarth.
The review, a promise made by Health Minister Peter Dutton prior to the Coalition’s election victory in September, is to report by March next year and will examine whether MLs are enhancing clinical services, and what bureaucratic impact they have had.
Stakeholders have been invited to make submissions to the review discussing issues such as the extent to which general practice has been maintained “as the cornerstone of primary care in ML functions and governance structures”, as well as MLs' management of after-hours services.
-----

Medicare Locals review

Australia’s former Chief Medical Officer Prof John Horvath AO will oversee the Australian Government’s review of Medicare Locals.

Page last updated: 16 December 2013
16 December 2013
Australia’s former Chief Medical Officer Prof John Horvath AO will oversee the Australian Government’s review of Medicare Locals.
Prof Horvath is a distinguished doctor, researcher and health adviser and served as the nation’s CMO from 2003 to 2009.
Health Minister Peter Dutton has announced details of the review which was a Coalition election commitment.
------

MLs not delivering: AMA review submission

19th Dec 2013
MEDICARE Locals do not communicate effectively with GPs, do not understand their own roles and have disenfranchised those previously involved in after-hours care according to the AMA.
The association’s latest critique of the organisations, which also included a renewed call for the ‘Medicare Local’ moniker to be replaced with a less misleading name, came in its submission to an ongoing review of the MLs program being headed up by Professor John Horvarth.
Along with its submission the AMA also released the results of a recent survey it had conducted of 1212 GPs which found that almost half (48.9%) of respondents believed they had not been kept informed of the work being done by their ML.
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Submission: AMA submission to the Australian Government Review of Medicare Locals

19/12/2013
The AMA has made a submission to the Australian Government Review of Medicare Locals.  Former Chief Medical Officer, Professor John Horvath will oversee the Review.
 The AMA submission is supportive of a network of Primary Health Care Organisations (PHCO), but highlights significant problems in the design and implementation of Medicare Locals.  The AMA submissions calls for fundamental changes to the model implemented by the former Government so that a future PHCO structure is
  • GP-led and locally responsive;
  • focused on supporting GPs in caring for patients, working collaboratively with other health care professionals;
  • not overburdened by excessive paperwork and policy prescription
  • focused on addressing service gaps, not replicating existing services; and
  • better aligned with Local Hospital Networks, with a strong emphasis on improving the primary care/hospital interface.
-----

Medicare Locals slammed by AMA

19 December, 2013 Jo Hartley
A radical overhaul of Medicare Locals - including ditching the meaningless name - should be a key priority for the Abbott government, according to the AMA.
In its submission to the Federal Government’s review of the program, the AMA says the Medicare Locals model is a failure and no better than its predecessors, the GP divisions.
Medicare Locals had systematically failed to engage GPs in their work, with notifications of meetings often given at short notice and arranged during working hours.
Instead many had used  “high-cost consultancy” firms with no understating of local health needs to determine service provision – often resulting in duplication, the submission reveals.
AMA president, Dr Steve Hambleton, said: "The performance of Medicare Locals against their objectives has been patchy, and there is little evidence of improvement over the divisions of general practice structure they replaced – despite additional funding."
-----

Public hospital boards struggle with patient care and safety, study finds

Date December 20, 2013

Julia Medew

Health Editor

Some Victorian public hospital boards and executives are struggling to deal with quality of care and patient-safety issues despite the buck stopping with them if things go wrong, according to a study published in an international journal.
A survey of 233 board members from 82 Victorian public hospitals has revealed wide variation in engagement with quality-of-care matters such as monitoring death and injury rates that might be caused by errors or systemic negligence.
------

Companies not ready for privacy laws

AT least half of corporate Australia will not be compliant with new privacy laws when they come into effect in March next year, according to a legal expert.
DLA Piper intellectual property and technology partner Alec Christie said there was little understanding of what businesses had to change in order to be compliant.
"My feel is 50 to 60 per cent of corporate Australia will not be compliant by March 12 and either it is a hangover from not taking the previous law that seriously, because there weren't penalties and fines, or it is just not on their to-do list," he said.
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Wearables tipped to power next wave of gadgets

Date December 17, 2013 - 12:15AM

Stuart Corner

The pundits are in agreement: 2014 will be the year that the market for wearable devices takes off.
But if you think wearable devices are limited to things like the popular Nike FuelBand and the much publicised Google Glass, think again. Californian software developer EyeMynd claims to have developed a "Brain Operating System" that, it says, "allows anyone to interact with their electronic device just by thinking what they want to occur".
According to founder and chief executive, Dan Cook, it will soon be possible to use EyeMynd's technology to control your computer by thought alone.
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No way to future proof NBN: Switkowski

James Hutchinson
Ziggy Switkowski concedes Australia’s biggest infrastructure project, the national broadband network, could become obsolete in decades, overtaken like the once-promising networks built by Telstra and Optus he is negotiating to take over.
In an interview with The Australian Financial Review, the new executive chairman of NBN Co says the danger of obsolescence is a key factor behind the radical redesign of the network that will combine cutting-edge fibre optics with century-old copper wiring.
Central to the new strategy are ­Telstra and Optus’s existing copper and cable networks. Once at the forefront of communications and now-fading assets, Dr Switkowski predicts he will get both at no extra cost to NBN Co, a coup for him and his boss, Communications Minister Malcolm Turnbull.
-----

NBN alternatives: fibre to the node or HFC cable?

Date December 21, 2013 - 10:17AM

Adam Turner

A third of Australian homes will connect to the internet via pay TV cables under the latest national broadband network proposal.
After scrapping the plan to run fibre to 93 per cent of premises, the government initially proposed switching many homes to fibre to the node – using the copper phone lines to cover the last few hundred metres. Now it supports a multi-technology mix with roughly an even split between fibre to the premises, fibre to the node and the existing hybrid fibre-coaxial (HFC) pay TV cable.
Fibre to the node will struggle to offer more than 50 megabits-per-second (Mbps) in the near future but could eventually reach 100 Mbps, depending on the condition of your copper line. Cable already offers the 100 Mbps speeds promised by fibre to the premises. Unfortunately cable is highly susceptible to congestion and regularly grinds to a halt for some users.
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CryptoLocker still a danger

·  Chris Griffith
·  December 16, 2013 12:00AM
NETWORK security engineers have had limited success disabling devastating malicious software that encrypts all files on a user's computer.
The malware, CryptoLocker, uses sophisticated 256-bit encryption which makes it virtually impossible for the encryption code to be cracked by accident. Affected users are forced to pay hundreds, sometimes more than $1000 to obtain a "private key" -- a special string of digits and letters needed to decrypt their files.
The only hope for defeating CryptoLocker is when users have offline backups of their data before their computer is infected. The Trojan horse malware will also try to encrypt files on USB external hard drives and even network attached storage -- so as to make it hard for users to recover data without paying up.
-----

Microsoft likely to bring back Start menu in future Windows update

If rumors are right, Redmond will mimic Stardock's tools that already offer Start menu and 'Metro' apps on the desktop
Microsoft will bring back the Start menu to Windows 8 and let users run "Metro" apps inside windows on the desktop, restoring traditional elements to its newest operating system, according to a report by a long-time Microsoft watcher.
Paul Thurrott, citing anonymous sources, claimed Monday that the next update for Windows, which other pundits have pegged for the spring of 2015, will offer options for both a Start menu and on-desktop execution of the touch-centric "Modern," nee "Metro," apps.
In October, Microsoft restored a pseudo-Start button in Windows 8.1, and gave users the option of circumventing the tile-style Start screen by booting directly to the conventional desktop. However, it declined to reinstate a Start menu.
-----
Enjoy!
David.

Sunday, December 22, 2013

I Suspect None Of Us Are Taking This Seriously Enough. Get Caught And It Could Be Very Bad.

About a year ago we had this appear.

Practice won’t pay for ransomed records

9 January, 2013 Kate Newton
A Gold Coast medical practice whose patient records were hacked and encrypted by foreign cyber criminals will not pay a $4000 ransom, instead choosing to recreate the records bit by bit.
GPS at Miami Family Medical Centre discovered last December that their server had been hacked and all 15,000 patient files encrypted, making them unusable.
The hackers, believed by Queensland police to be operating from eastern Europe, did not steal any patient details but demanded a ransom of $4000 to decrypt the files.
The practice was able to recover some patient details through referrals, pathology reports and other outside health services, but had to rely on handwritten notes and appointment books for several days to ensure patient care was not disrupted.
Before Christmas, the practice was seriously considering paying the ransom. However, practice co-owner David Wood, whose wife is a GP at the clinic, said they had now decided against it.
"It's not that simple to pay anyway. You have to give photo ID and all sorts of things to a faceless website, so you just add another problem to the mix of potentially having your identity stolen," he said.
Instead, the practice was piecing together a new set of patient records.
More here:
This then appeared last week:

CryptoLocker still a danger

·         Chris Griffith
·         The Australian
·         December 16, 2013 12:00AM
NETWORK security engineers have had limited success disabling devastating malicious software that encrypts all files on a user's computer.
The malware, CryptoLocker, uses sophisticated 256-bit encryption which makes it virtually impossible for the encryption code to be cracked by accident. Affected users are forced to pay hundreds, sometimes more than $1000 to obtain a "private key" -- a special string of digits and letters needed to decrypt their files.
The only hope for defeating CryptoLocker is when users have offline backups of their data before their computer is infected. The Trojan horse malware will also try to encrypt files on USB external hard drives and even network attached storage -- so as to make it hard for users to recover data without paying up.
Once the encryption process finishes, it tells users to pay a ransom, which so far has been $100, $300 or two bitcoins, currently worth about $1950.
CryptoLocker was first detected in September. Since then, it has infected mainly Windows-based computers in Britain and USA with devastating results. As The Australian recently revealed, there are now confirmed cases of CryptoLocker infecting computers locally.
A number of antivirus suites will detect and disable CryptoLocker malware, which enters computers disguised as attachments on fake emails purportedly from companies such as courier companies FedEx and UPS, and antivirus firm Symantec.
However antivirus suites that disable and remove CryptoLocker can render it impossible for users to get their files back. Victims wanting to decrypt their files have been forced to reinstall the malware and apply the criminal-supplied private key.
Network security firms however have been investigating ways to render CryptoLocker harmless on networks before the malware gets the chance to encrypt any files on a user's computer.
Lots more here:
Given none of the security firms (Symantec etc.) seem to have the problem beaten it is clear that prevention is way better than cure.
See here for very recent Symantec article:
Short summary - once encrypted - files that are not backup up safely are gone for all practical purposes.
There is a useful Computerworld article here:
So what to do:
1. Take the threat seriously - pretty obvious.
2. Make sure your anti-virus and anti-malware scanners are current and active.
3. Make sure you and all who access your network are aware of the risks associated with opening attachments that are not from trusted sources and expected. If at all unsure just delete!
4. Make sure you have current data backups that are not network accessible (switched off drives, detachable drives that are detached, non-mapped drives to your NAS, backups that are encrypted etc.)
5. You may want to check out CryptoPrevent.
Seems like a useful way of adding some protection. Near 100,000 downloads seems to mean others think so. This is the only blocker I have found so far.
Hope this helps…If just one person is saved it will be a very good thing!
David.

AusHealthIT Poll Number 197 – Results – 22nd December, 2013.

A special week with 2 polls!

Do You Think The Consent Model For The PCEHR Should Be Changed From Opt-In To Opt-Out. i.e. The Population Should All Be Enrolled In The PCEHR Unless They Actively Decline To Be Enrolled?

I Strongly Favour Opt-Out 14% (11)

I Favour Opt-Out 8% (6)

I Favour Opt-In 4% (3)

I Strongly Favour Opt-In 71% (56)

I Have No Idea 4% (3)

Total votes: 79

Opt-In is certainly the favoured approach on this blog.

Should The PCEHR Review Recommend That The PCEHR Program Be Cancelled?

Definitely 70% (55)

Probably 11% (9)

Possibly 3% (2)

Definitely Not 16% (13)

I Have No Idea 0% (0)

Total votes: 79

It seems that the review should recommend ending the suffering.

Again, many, many thanks to those that voted!

David.