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."

Saturday, June 27, 2015

Weekly Overseas Health IT Links - 28th June, 2015.

Note: Each link is followed by a title and 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.
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Report: 72.1 million wearable devices to ship this year

June 19, 2015 | By Katie Dvorak
About 72.1 million wearable devices will be shipped this year, a new report estimates, a clear sign that the market will not be slowing down anytime soon.
An uptick in popularity for the tools likely is being spurred, in part, by Fitbit's decision to go public. The wearable company exceeded expectations on its opening day Thursday with a starting trade value of $20 a share--$1 more than the expected high pricing of $19. The share price will result in a $732 million IPO and values the company at $4.1 billion.
The new report, from the International Data Corporation, says there were 26.4 million wearables shipped last year; if its estimate holds true for 2015, that will be a growth of 173.3 percent, according to an announcement.
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29% of U.S. Broadband Households Have Connected Health Device

JUN 19, 2015 7:04am ET
New research reveals that 29 percent of U.S. broadband households own a connected health device—up from 27 percent a year ago—while 12 percent of broadband households own multiple connected health devices.
Those are among the findings of Dallas-based research and consulting firm Parks Associates. The firm also reports that more 50 percent of broadband households use an online health tool to communicate with their doctor, access personal health data, or fill prescriptions.
“The adoption rate for fitness trackers and GPS watches has increased, while the adoption rate for other connected health devices has been more stable,” said Harry Wang, director of health and mobile product research at Parks Associates. “Fitness trackers stand out as one of the more successful product categories thanks to the release of better products and major marketing campaigns.”
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IT Company awarded millions for cancelled eHealth contract

The 6-year deal was scratched back in 2012...
Posted on 6/19/2015 by Canadian Press
An arbitrator has awarded IT company CGI $26.9 million in a dispute against eHealth Ontario over a cancelled contract for a diabetes registry.
Details of the arbitration by former Ontario judge Warren Winkler were sparse,  eHealth refused to provide a copy of the decision, citing privacy concerns.
In 2012, eHealth had cancelled a $46.2 million, six-year deal that was signed in 2010 to design, build and maintain the registry to better monitor diabetes patients.
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In search of a better discharge summary

Posted on Jun 18, 2015
By Bernie Monegain, Editor-at-Large
New research under way at University at Buffalo School of Nursing, could lead to automating hospital discharge communication and reducing readmissions. Automating, the discharge process, UB officials say, could add critical data and reduce the time it takes the information to reach community health care providers from weeks to hours.
The preliminary study, led by Sharon Hewner, assistant professor in the School of Nursing, could speed delivery of the hospital discharge summary to less than 24 hours and potentially reduce the number of patients readmitted to hospitals.
The research, "Exploring Barriers to Care Continuity during Transitions: A Mixed-methods Study to Identify Health Information Exchange Opportunities," is funded by a $35,000 UB Innovative Micro-Programs Accelerating Collaboration in Themes, or IMPACT, grant.
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Canada also faces EHR interoperability woes

June 16, 2015 | By Marla Durben Hirsch
Canada is suffering some of the same interoperability problems with its electronic health records as the United States, albeit for somewhat different reasons, according to a recent article in the Journal of the Canadian Medical Association (CMAJ). The country lacks uniform national specification standards; moreover, each province has established its own health information software requirements, creating 11 different e-health jurisdictions and the adoption of EHRs that are incompatible with those used in other provinces.
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ICD-10: We don't know what we don't know

Posted on Jun 18, 2015
By Jon Elion, MD, ChartWise
After decades of experience with ICD-9, we have learned and come to grips with its quirks. We do not yet have that comfort level with ICD-10 -- after all, it’s still pretty new to most of us in the U.S. I’m not really concerned about the diagnosis side of ICD-10 and its Clinical Modification, ICD-10-CM.
But what does concern me is ICD-10 PCS. So far, we don’t have a good idea of how this is going to impact reimbursement, and what documentation requirements are really going to be needed. We really don’t know what we don’t know.
ICD-10-PCS coding demands a new level of documentation and coding specificity. There are few procedure codes in ICD-10 that will allow nonspecific or “not otherwise specified” codes, as are allowed in ICD-9. In the ICD-9 coding environment, it is still possible to generate a code and get reimbursed even with minimal specificity. But under ICD-10, if specificity is lacking, there may not be a procedure code that can be used, and the reimbursement will therefore suffer.
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E-prescribing takes off like a rocket

Posted on Jun 18, 2015
By Bernie Monegain, Editor-at-Large
The global market for e-prescribing will reach $887.8 million in 2019, according to a recent report published by Persistence Market Research
The market, valued at $250.2 million in 2013, is expected to grow at a 23.5 percent annual compound rate from 2013 to 2019, reaching an estimated value of 887.8 million, according to “Global Market Study on E-Prescribing: North America to Witness Highest Growth by 2019."
The report reflects similar findings on the increasing uptake of e-prescribing recently indicated by Suresripts, which noted in its most recent progress report last month tthat its network handled more transactions in 2014 than American Express (6 billion) and PayPal (4.2 billion).
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Full records access promised for 2018

17 June 2015   Rebecca McBeth
Patients will have real-time access to their full digital health record by 2018, under new plans unveiled by NHS England.
The National Information Board is today discussing a series of road maps designed to “make technology work harder and faster for patients and increase transparency across more services”.
Plans include the expansion of the Patient Online programme to give people electronic access to all data held on them by the NHS, by 2018. 
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Ireland plans five year e-health journey

18 June 2015   Lyn Whitfield
Ireland’s new chief information officer for health, Richard Corbridge, has issued a ‘Knowledge and Information Strategy’ that sets out the building blocks for a transformation of the country’s health services using e-health.
Corbridge took up his post as CIO of Ireland’s Health Service Executive in December, and told Digital Health News at the time that he was “getting in at the ground floor” with the opportunity to “start from the beginning, add to a strategy, and pull a team together.”
The Knowledge and Information Strategy launched yesterday follows up on this by focusing on the basics of getting a new IT infrastructure, interoperable systems, data use and patient services in place; and on creating the leadership to do it.
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IT could save NHS £13.7bn a year: Kelsey

17 June 2015   Thomas Meek
The use of digital technology can create savings in the NHS in England of up to £13.7 billion a year by 2020, according to Tim Kelsey, national director for patents and information at NHS England.
Kelsey presented the plans in a board meeting for the National Information Board, which was set up to deliver the goals in the ‘Personalised Health and Care Framework 2020’ to encourage the NHS to embrace modern technology.
The plans suggest that the work of the NIB could drive savings of £8.3 billion to £13.7 billion across six key areas identified by the board.
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CHIME letter: Telehealth is key to managing chronic conditions

Written by Akanksha Jayanthi (Twitter | Google+)  | June 17, 2015
In comments sent to the Senate Committee on Finance, CHIME outlined the key role IT, telehealth specifically, plays in managing chronic conditions.
CHIME sent the letter to the committee in response to the committee's stakeholder letter asking for input on crafting legislation to improve care for patients with chronic conditions.
Telehealth and "robust care coordination" are key to improving outcomes for patients with chronic conditions, according to the letter. To achieve these initiatives, CHIME outlined the following three recommendations.
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MIT researchers develop the world’s first USB-powered mobile stethoscope

Daniel Chamberlain
A prototype design of the world’s first USB-powered mobile stethoscope.
17 June, 2015
Take a deep breath before you read this: A team from MIT has built the world’s first USB-powered mobile stethoscope. Plugged into a smartphone, its companion app transforms the device into a low-cost diagnostic tool, which health workers and nonspecialist physicians can use to diagnose lung disease.
Diseases of the lungs — such as pneumonia, chronic obstructive pulmonary disease, or COPD, and lung cancer — cause more than 14 percent of deaths worldwide. Others like asthma reduce the quality of a person’s life. These diseases hit the developing world the hardest, because the major risk factors — air pollution, indoor cooking on coal fires, and smoking — are more prevalent there.
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Advocates Urge CMS To Reverse its Plan To Lower Patient Engagement Bar

by Lisa Zamosky, iHealthBeat Contributing Reporter Thursday, June 18, 2015
In April, CMS proposed reducing Stage 2 meaningful use provider requirements from having to get 5% of patients to view, download or transmit (VDT) their online health information to just one patient. Patient advocates were stunned.
"This particular retreat is dismaying," said Mark Savage, director of health IT policy and programs with the National Partnership for Women & Families. "Of the various tools you have to help put the patient at the center of care and understanding, access is fundamental," he said.
The move came in response to concerns expressed by the provider community.
"The complaint from providers' perspective is that they're being held responsible for something they don't control," said David Harlow, a health care attorney and author of the HealthBlawg. "Organized medicine lobbied Congress, which put pressure on the agency."
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ED Discharge App Wins Contest, Goes Live

JUN 17, 2015 7:56am ET
There is no shortage of healthcare app hackathons and contests these days, but the William Osler Health System in Brampton, Ontario, wastes no time in getting its contest's winning apps into the hands of patients and caregivers right away.
Susan deRyk, vice president of patient experience, communications, and strategy at Osler, said the system's approach to involving technology students in diving right into solving contemporary problems has gained attention from other industries.
"Since we launched the contest last year, we have received a number of questions and have been asked for advice – not within the healthcare space, but from other businesses, as to how we've done it," deRyk said. "It is seen as innovative. It is different in that the winner was announced and the app went live immediately. It's been patient tested and staff tested and it is actually in use currently."
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Senators Look to Improve EHRs from Physician Perspective

JUN 17, 2015 7:39am ET
A Senate committee on Tuesday examined how to improve electronic health record systems, focusing on the physician experience with EHRs which continue to be a source of widespread dissatisfaction.
Sen. Bill Cassidy (R-La.), himself a doctor, told the Senate Health, Education, Labor, and Pensions Committee that unfortunately physicians are spending more time entering data into EHRs and less time speaking to and examining patients. “As a physician, time is better spent looking into a patient’s eyes as opposed to clicking on a computer screen to document something unimportant to the patient but required by someone far removed from the exam room,” said Cassidy.
Tuesday’s hearing was the second in a series of hearings on developing possible solutions—either through administrative or legislative action—to address the failed promise of EHRs, which have the potential to make healthcare more efficient while also reducing costs and medical errors.
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Digital Health - FT Supplement

Digital health looks like an idea whose time has come. The rise of digital technology has coincided with growing cost pressures on health systems from an ageing global population
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'Dissatisfaction' leading to EHR replacement trend

Posted on Jun 17, 2015
By Mike Miliard, Editor
More and more buyers of electronic health records are finding themselves having second thoughts and opting to replace their existing systems, according to a new report.
"When buyers contact us, we determine whether they are purchasing an EHR for the first time or replacing an existing system," writes Gaby Loria, market research associate at Software Advice, in its 2015 EHR Software BuyerView report.
"In the six years we've been studying EHR buyers, 2015 marks the first time that the amount of clinicians looking to replace an existing EHR outnumbers the amount of clinicians looking to purchase an EHR for the first time," she writes.
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Medical identity theft hits all-time high

Posted on Jun 17, 2015
By Erin McCann, Managing Editor
The lion's share of medical identity theft victims can expect to pay upwards of $13,500 to resolve the crime. What's more, about 50 percent of consumers say they would find another healthcare provider if they were concerned about the security of their medical records. How's that for a business case to take security a little more seriously?
As Ann Patterson, senior vice president and program director for the Medical Identity Fraud Alliance, emphasized, the reputational impacts of medical identity theft for both consumer and provider organizations are huge. Patterson, who will be speaking at the HIMSS Media and Healthcare IT News Privacy and Security Forum in Chicago July 1, pointed to some concerning numbers found in the MIFA-sponsored annual medical identity theft study. Conducted by researchers at the Ponemon Institute, the study underscored a staggering 22 percent increase in medical identity thefts from just last year.
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EHR Data, Model Better Predict Patient Suicide Risk

JUN 16, 2015 7:39am ET
Using data from electronic health records, Department of Veterans Affairs and National Institute of Mental Health researchers were able to identify VA patients with very high, predicted suicide risk that were not previously flagged by clinicians.
According to researchers who developed a suicide-risk algorithm by studying the VA patient population from fiscal years 2009-2011, these methods could help prevent civilian as well as veteran suicides. The study, published in the online issue of American Journal of Public Health, randomly divided the patient population in half — using data from one half to develop the predictive model and then testing the model using data from the other half. Both study samples included 3,180 suicide cases and 1,056,004 control patients.
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Care.data re-launched this month

11 June 2015   Rebecca McBeth
One of the four care.data pathfinders will start contacting patients about the re-launch of the controversial scheme later this month.
The Blackburn with Darwen clinical commissioning group is ready to start communicating with patients about the government’s data-sharing programme at the end of June.
Other pathfinder CCGs, Somerset and West Hampshire, will start testing their public communications at the beginning of September and Leeds have not confirmed when it will begin the process, but is working towards the end of September.
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Joe’s view: interoperability is the new black

Joe McDonald has seen some impressive record sharing efforts recently, and thinks the big remaining question is how to fund similar across the country.
15 June 2015
Can you tell when they switched on single sign-on for the Hampshire Health Record? Can you see when everything got a bit safer for the patient? Can you see the revolution?
Southampton signs on  
In an exciting couple of months I have had three very interesting days in the interoperability area.
Firstly, Amir Mehrkar, the chief clinical information officer of the Hampshire Health Record, showed this slide during a recent CCIO Network site visit to Southampton. I think it is the most important slide I have seen in the eight years I have spent in the health IT arena.
Amir’s presentation showed how the Hampshire Health Record contains a rich portfolio of information about the patient, brought together from a variety of acute and primary care sources, using technology from Graphnet.
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4 ways to optimize health IT

June 16, 2015 | By Susan D. Hall
To truly optimize systems, healthcare organizations will need to move out of traditional silos and work in multidisciplinary teams to achieve workflows and processes that are streamlined and supported by IT, according to a report from the Scottsdale Institute.
At its Spring Conference CIO Breakout session in April, chief information officers from 13 leading healthcare organizations discussed healthcare IT optimization.
For the most part, they agreed that too many organizations are looking for IT to drive optimization, while it actually has more to do with people and processes.
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EHRs need five 'use cases' to be interoperable

June 15, 2015 | By Marla Durben Hirsch
Electronic health records should have five "use cases" in order to be considered "open" or interoperable, according to a new article in the Journal of the American Medical Informatics Association (JAMIA).
Authors Dean Sittig, from the University Texas Memorial Hermann Center for Health Care Quality and Safety, and Adam Wright, from Boston's Brigham and Women's Hospital, state that five functionalities--to EXtract, TRansmit, Exchange, Move and Embed data (or "EXTREME" uses)--are important to move to EHRs more globally. The authors identify requirements for each use, such as infrastructure that can respond to queries 24-hours-a-day, seven days a week, the ability to preserve metadata when moving data and secure log in and role based access controls.
"Widespread access to 'open EHRs' that conform to at least the five EXTREME use cases we propose is necessary if we are to realize the enormous potential of an EHR-enabled healthcare system," Sittig and Wright say. "Healthcare delivery organizations should require these capabilities in their EHRs. EHR developers should commit to providing them. Healthcare organizations should commit to implementing and using them.
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Fire CEOs who don't see cyberattacks as a business risk

June 16, 2015 | By Katie Dvorak
Many chief executive officers don't embrace the threat of a cyberattack as a business risk, and healthcare organizations should fire those high-level executives immediately, Mansur Hasib, M.D., writes in an opinion piece for Enterprise Tech.
Many CEOs seem far more focused on ensuring they have cybersecurity insurance instead of turning their attention to the protection of patient information, the former chief information officer says. Mansur points to leadership and governance breakdowns, poor organization and lack of due diligence as problems plaguing companies hit by security breaches.
One example is Anthem, Mansur says. The cyberattack compromised the data of 80 million Americans, but CEO Joseph Swedish, the company's executive vice president and the chief administrative officer, all have kept their jobs. This shows a lack of accountability, he says, though removing them is not the only fix to the problem--organizations must repair the leadership chart as well.
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3 Reasons the Use of mHealth Is Limited

by Tim Cannon Tuesday, June 16, 2015
We are always connected. From multiple devices, networks and applications, we're constantly accessing and sharing information on the go. As hospitals and health systems look for new ways to engage patients to improve care, mobile health tools have huge potential.
Primary care providers will soon be in short supply, and more telemedicine and mobile solutions will be needed to manage a growing number of patients. Several studies have shown the benefits of mobile health apps, and a recent survey conducted by Salesforce found that 60% of respondents support the use of telehealth.
Yet, in 2014, only 24% of U.S. physicians surveyed by Deloitte used mhealth technologies. As with most technology innovations, hospitals, health systems and health care organizations have been slow to create their own and integrate mhealth technologies into their practices.
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Population Health Priorities from ONC's Own Dr. McCoy

Scott Mace, for HealthLeaders Media , June 16, 2015

The federal government's chief health information officer is shaping ONC's interoperability roadmap. It's a foundational step to achieving goals such as precision medicine. But ONC's priorities don't always align with those of healthcare providers.

This week, to understand the future of population health, I turned to Dr. McCoy. Not the guy on the Starship Enterprise. This is the real-life Michael McCoy, MD, chief health information officer for the federal Office of the National Coordinator for Health Information Technology.
When I first asked McCoy for his thoughts on population health, he brought up a couple of HHS's big-think current initiatives: precision medicine and semantic interoperability. Here's a quick primer gleaned from our conversation.
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EHR/PHR Vendor MIE Gets Hacked

JUN 14, 2015 3:19pm ET
Electronic health records vendor Medical Informatics Engineering and its personal health records vendor subsidiary NoMoreClipboard have been hit by a sophisticated cyber attack. The companies, based in northern Indiana, are working with the FBI and law enforcement agencies.
Suspicious activity on a server was noted on May 26 and a forensics investigation determined that unauthorized access started on May 7, according to public notices posted on both company websites. Access to the EHR affected only certain MIE clients, including Concentra, Fort Wayne Neurological Center, Franciscan St. Francis Health in Indianapolis, Gynecology Center Inc. in Fort Wayne, and Rochester Medical Group. These clients have been notified and MIE continues work to identify affected individuals and hopes to soon start mailing notices, says Eric Jones, COO.
Protected health information compromised in the EHR for patients of the affected organizations includes patient name, address, email address, date birth, and for some patients Social Security number, lab results, dictated reports and medical conditions.
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Is your EHR hurting your nurses?

Posted on Jun 15, 2015
By Steve Reinecke, Ergotron Healthcare
Healthcare organizations continue to face unprecedented change. Electronic health records are altering nearly every aspect of the caregiver-patient relationship – not to mention changing caregivers’ workflows with omnipresent tablets, handhelds, wall mounts and mobile carts. Today, nurses are on the front lines of this transformation. During a typical shift, they spend 35 percent of their time on documentation, or 3.5 hours of their workday entering information at a computer. Despite this, a recent survey from HIMSS Analytics found that 71 percent of nurses would not consider going back to paper-based medical records. What’s more, nurse respondents agree that EHR benefits are good for patient safety: 72 percent believe they improve patient safety and avoid medication errors and 73 percent admit they enable collaboration with other clinicians inside their organizations.
Underscoring every EHR implementation is the goal of doing business more efficiently, and the HIMSS Analytics findings demonstrate nurses’ integral role in helping hospitals achieve this. It is of equal importance that administrators understand the complete picture surrounding the complex systems nurses have to master. If the necessary equipment doesn’t fit within their workflow or is uncomfortable to work on, not only will EHR systems never reach their full potential, but they stand to cause physical strain to caregivers. This limits their ability to execute their jobs and can ultimately impact the quality of care patients receive. In order for organizations to maximize their system implementations and investments, they must evaluate their caregivers’ new workflows and embrace supportive design and devices that improves comfort while also allowing them to deliver a similar or improved level of patient care.
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Survey: Buyers Increasingly Looking to Replace EHR Software

June 12, 2015
The number of electronic health record (EHR) buyers who are looking to replace their systems has increased by 59 percent since 2014, according to new research from the Austin, Tx.-based EHR comparison site Software Advice. 
The researchers say that this implies that many EHR products are failing to meet physicians' needs. Currently, the research found, clinicians looking to replace an existing EHR outnumbers the amount of clinicians looking to purchase an EHR for the first time. Back in 2010, a full 63 percent of buyers were looking to replace paper methods—but in 2015, that number has dropped to 37 percent. 
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Traversing the Meaningful Use Minefield

Scott Mace, for HealthLeaders Media , June 15, 2015

Dealing with the complexity and, ironically, the flexibility of the regulations is leading providers, large and small, to seek external resources.

This article appears in the May 2015 issue of HealthLeaders magazine.

The federal meaningful use program remains a minefield that providers are carefully stepping through to avoid losing out on incentives or being hit with the ever-increasing Centers for Medicare & Medicaid Services penalties for failing to file timely attestations of use.
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Telemedicine is Unstoppable

Tinker Ready, for HealthLeaders Media , June 15, 2015

Resistance from regulators, restrictive licensing rules that make it difficult for doctors to practice in multiple states, and even push-back from physicians themselves stand in the way of telemedicine. But nothing seems to be able to stop it.

Spawned by the Internet and fueled by consumer interest in self-monitoring and videocasting, telemedicine—a broad term that covers a range of services including virtual visits and remote monitoring—is growing, despite some stubborn obstacles.
In Austin, MN, employees of the local school system can step into a booth at work, shut the door, and consult a doctor via video. Inside, the booth, they can put on blood pressure cuffs and instantaneously send the results to the Mayo Clinic, 40 miles away.
In Ohio, Cleveland Clinic is offering $49 virtual visits to patients who have an Internet connection and a video-enabled device. And University of Iowa Health Care just launched a telemedicine program last month.
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Enjoy!
David.

Friday, June 26, 2015

Do You Think NEHTA is Planning To Close Down At The End Of The Year, Or What Is Going On?

I noticed two NEHTA advertisements in the last week for reasonably senior positions.
First here:

Applications Support Manager

  • Fixed term contract
The National E-Health Transition Authority (NEHTA) was established by the Council of Australian Governments (COAG) to develop better ways of electronically collecting and securely exchanging health information. NEHTA is the lead organisation supporting the national vision for eHealth in Australia.
NEHTA is currently seeking people with a desire to make a difference to health outcomes, who are passionate about the use of eHealth to meet these goals and have the relevant experience to deliver solutions in a highly complex stakeholder and technical environment.
The purpose of this position is to provide robust management and operation of NEHTA’s internal and externally facing terminology systems. In this professional systems operation role you will be the primary liaison between the system implementers and IT Infrastructure team regarding production system deployment/modification and operational procedures and will manage and perform all operational and first/second tier support functions for production terminology systems.  You will be required to lead the activity around system changes and upgrades to ensure ongoing system integrity, identify opportunities for continual improvements and make recommendations for future enhancements along with providing stakeholders with clear reporting of system delivery attainment levels and health.
More here:
and here:

Product Manager

  • Fixed-term contract position to 31 December 2015
  • Support and drive outcomes for eHealth
The National E-Health Transition Authority (NEHTA) was established by the Council of Australian Governments (COAG) to develop better ways of electronically collecting and securely exchanging health information. NEHTA is the lead organisation supporting the national vision for eHealth in Australia.
NEHTA is currently seeking people with a desire to make a difference to health outcomes, who are passionate about the use of eHealth to meet these goals and have the relevant experience to deliver solutions in a highly complex stakeholder and technical environment.
In this role, the Product Manager facilitates, coordinates and prioritises requirements and specifications for the Healthcare Identifiers (HI) Service and National Authentication Service for Health (NASH) arising from market needs, in consultation with product stakeholders.  These needs must fit within and be consistent with the NEHTA Strategic Plan, other national eHealth services, and master program plans and have acceptance and commitment to adoption by the Australian Health Sector.
More here:
What I found interesting was that both positions end at end December 2015.
Are those hired going to get a new job then with the new AeHC or are they intended to be out the door as NEHTA closes down? Why would you take a job like that?
I wonder what is actually being communicated here?
David.