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, November 07, 2015

Weekly Overseas Health IT Links -7th November, 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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Why Patient Portals Need to Serve All Populations

OCT 30, 2015 7:12am ET
While patient portal adoption appears to be increasing, greater attention is needed to understand why underserved populations—in particular—do not access portals at the same levels as the rest of socio-demographic groups.
That's the finding of a new Vanderbilt University study of more than 2,800 patients with chronic kidney disease treated at nephrology clinics that examined patient portal use.
The study, published in the Clinical Journal of the American Society of Nephrology, reported that 39 percent of patients accessed the patient portal.
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A New Role for HIEs: Exchanging Specimens

OCT 29, 2015 2:51pm ET
The Delaware Health Information Network, a statewide health information exchange that also serves parts of Maryland, is offering a novel new program—the exchange of medical specimens among hospitals and researchers.
The idea is to repurpose liquid and solid clinical laboratory specimens, such as tissues, plasma, serum, blood and urine, so that hospitals no longer destroy leftover specimens but make them available—with patient consent—to medical research programs.
Union Hospital in Elkton, Md., is the first hospital to commit to the program, and will start with liquid specimens. Delaware Health Information Network serves eight other hospitals and will approach them and local laboratories about joining the program, says Randy Farmer, COO of DHIN.
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CMS Issues ICD-10 Progress Report

OCT 30, 2015 7:25am ET
For the first time since the ICD-10 compliance deadline went into effect Oct. 1, the Centers for Medicare and Medicaid Services on Thursday released data indicating that the code transition is going smoothly for those providers that have submitted claims to CMS.
The agency made public metrics detailing Medicare fee-for-service claims from Oct. 1-27. Over the nearly four-week period, CMS reported that 2 percent of total claims submitted were rejected due to incomplete or invalid information—the same rejection rate according to the historical baseline.
In addition, CMS revealed that 0.09 percent of total claims submitted during that timeframe were rejected due to invalid ICD-10 codes, compared to 0.17 percent of total claims rejected based on CMS end-to-end ICD-10 testing conducted last year. The agency also disclosed that 0.11 percent of total claims submitted were rejected due to invalid ICD-9 codes versus0.17 percent of total claims rejected based on end-to-end testing.
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Cleveland Clinic picks top 10 innovations for 2016

Posted on Oct 30, 2015
By Bernie Monegain, Editor-at-Large
Topping the list of the Top 10 Medical Innovations for 2016 are new, faster methods of creating vaccines, a process for rewriting genetic code, and a water purification system for the developing world.
A panel of 75 Cleveland Clinic physicians and scientists selected the medical innovations expected to take hold in 2016 and make the most difference in medicine.
Cleveland Clinic released the list October 28 at the end of the 2015 Medical Innovation Summit, which drew 1,600 participants and marks the 13th year of the event. The physician panel presented the 10 in order of importance to medicine and with comments.
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Telemedicine market to hit $2.8 billion by 2022

October 30, 2015 | By Katie Dvorak
There are no signs the telemedicine market will be slowing down anytime soon, especially in light of a report from Grand View Research Inc. forecasting that the market will reach $2.8 billion by 2022.
Rising consumer demand for the tools will play large part in that growth, according to the report's authors. They cite an example from Community Care Plan of Eastern Carolina, where the facility was able to double the number of patients it could see a week thanks to telemedicine.
In fact, one new healthcare facility is entirely built on telemedicine. Mercy Hospital's virtual facility is being called the hospital's "telemedicine mother ship." The Chesterfield, Missouri-based system will house all of Mercy's telehealth programs, which total close to 80.
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EHRs improve ICU care for certain quality measures

October 27, 2015 | By Marla Durben Hirsch
Electronic health records can help improve patient treatment in intensive care units (ICUs), but only to some extent, according to a new study in CHEST, the journal of the American College of Chest Physicians.
The researchers, from Mount Sinai School of Medicine, conducted a retrospective chart review to record quality indicators for all patients admitted to a surgical ICU in a tertiary facility from Jan. 1, 2009, through Dec. 31, 2013. They excluded the data from the year that the ICU transitioned to an EHR (2011). Quality indicators reviewed were length of stay, mortality, central line associated blood stream infection (CLABSI) rates, Clostridium difficile (C. diff.) colitis rates and readmission rates. They also reviewed the number of coded diagnoses.
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How healthcare organizations can avoid repeating 2015's IT security failures

Posted on Oct 29, 2015
By Nathan Wenzler, Thycotic
In 2015, it seems like barely a month goes by without another report of a data breach suffered by a health care organization exposing personal information about patients, employees and related health services providers. HIPAA was intended to provide a framework for health care organizations to improve their overall security posture from both a technical and procedural standpoint, with the ultimate goal of preventing these kinds of breaches from happening. Unfortunately, what we've seen this year is quite the opposite.
As IT security professionals, we have been doing it wrong for years. We are taught about castles and moats and building strong perimeters to keep the outside at bay, but that just doesn't work anymore. Instead, we have to start from the inside and work backwards from the core of our environment in order to achieve better security. A few months ago, I wrote about lessons healthcare organizations can learn from Ponemon's 2015 study on Privacy & Data Security of Health Care Data report. Since then, I've often been asked to further explain why healthcare organizations must focus more on securing data closest to its source, in addition to traditional cyber defenses such as external firewalls.
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On trying (still) to access one's health data electronically

Posted on Oct 28, 2015
By Michelle Ronan Noteboom, Contributing writer
A few months back, I shared my struggle to obtain copies of my daughter's and my medical records. Initially I had made my requests through the doctors' portals and/or websites. Overall the results were disappointing, primarily because a couple of the providers never responded to the requests.
Since then I have sought assistance from a couple of "professionals," namely apps listed on the GetMyHealthData site. I intentionally only selected apps that were free and that would request copies of my records on my behalf.
In mid-August, I tested one of the apps to request records from my primary care physician and gastroenterologist. Initially I entered my date of birth incorrectly so the requests were rejected. After fixing the date, the requests were resubmitted at least two more times. To date, nothing is showing up online in the app, so either the providers never sent the records, or, the records were never uploaded into the app.
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Perspective: One patient's satisfied experience with hospital IT

Posted on Oct 29, 2015
By Skip Snow, Contributing writer
On Sept. 27, a piece of wood flew up from a power saw, crashing into my thumb. The nail was bleeding and my hand radiated a dull but intense throbbing. I knew that the emergency department made more sense than an urgent care facility, which would not offer orthopedic services.
I live within six miles of 10 emergency departments, but I chose Huntington Memorial Hospital because I knew that this relatively posh suburban hospital might have a better shot at giving me efficient care than other more urban emergency rooms near me. Its good reputation made me choose it over other emergency departments even nearer to my home and equally suburban.
What I did not know is that Huntington had just completed an $80 million donor-sponsored, state-of-the-art emergency department upgrade in 2014.
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Many EDs dissatisfied with enterprise EHR emergency modules

October 29, 2015 | By Katie Dvorak
Visits to the emergency department are on the rise in the U.S., and a lack of usability and interoperability of ED Information Systems (EDIS) are only adding more complications, according to a new survey from Black Book.
Of hospitals with enterprise electronic health record emergency modules, 39 percent are moderately or highly dissatisfied with their current EDIS, with many are looking to replace them, according to an announcement. About 730 emergency department administrative and nursing managers and 1,104 ED physicians were surveyed for the report.
In fact, 35 percent of hospitals that have more than 150 beds want to replace their EDIS next year. Sixty-nine percent of those replacements will be from an enterprise EHR emergency model to a system that can integrate with the hospital's EHR.
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Open source e-prescribing in pipeline

Rebecca McBeth
26 October 2015
An electronic prescribing system open sourced for the NHS may be introduced at Taunton and Somerset NHS Foundation Trust.
Taunton, which became the first acute trust to go-live with an open source electronic patient record last month, is now planning on introducing Marand’s medication management system.
Slovenian company Marand announced it was releasing its system as open source to the NHS late last year.
Taunton’s director of informatics Malcolm Senior told Digital Health News the trust is committed to building a, “real open source EPR”.
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Kelsey: November start on DMI data

Rebecca McBeth
29 October 2015
NHS England’s director of patients and information Tim Kelsey has told Digital Health News the commissioning board will write to trusts in November to kick off the first baseline self-assessment for a new ‘digital maturity index’.
NHS England announced plans in September to put clinical commissioning groups in charge of defining how their local economies will achieve the ambition of being paper-free at the point of care by 2020.
Guidance released to help the groups create their roadmaps said CCGs and providers would be expected to complete a digital maturity self-assessment between November 2015 and January 2016.
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Telemonitoring reduces diabetes patients’ blood sugar levels

October 28, 2015
A pharmacist-led telemonitoring program reduced blood sugar levels in diabetics, according to a new study.
Published in the September/ October issue of the Journal of the American Pharmacists Association, the study was led by Laura Shane-McWhorter, PharmD, certified diabetes educator and professor of clinical pharmacotherapy at the University of Utah in Salt Lake City.
The Utah Community Health Centers, the Utah Telehealth Network and Shane-McWhorter set out to determine whether telemonitoring could improve diabetes disease measurements at clinics that provide care to underserved patients in Utah. The participating patients’ daily blood glucose (BG) and blood pressure (BP) values were reviewed, and Shane-McWhorter conducted follow-up phone calls with patients to assess and manage out-of-range BG and BP levels.
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Asthma App Improves Patient Health, Eases Doc Jobs

OCT 28, 2015 7:51am ET
A mobile phone app for asthma patients appears to help them improve their health, according to preliminary results of a study evaluating use of the app.
Other dividends of the app include making it easier for clinicians glean useful data, and the study also yielded clues about ways to improve the design of such platforms, said the CEO of the company that developed the app.
"Participants using the app on a regular basis reported improved exercise capabilities, and also from objective data, significantly increased step count," said Corey Bridges, CEO of San Jose, Calif., and New York-based LifeMap Solutions.
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Safety still shaky at most hospitals, says Leapfrog

Posted on Oct 28, 2015
By Bernie Monegain, Editor-at-Large
The number is startling for how large it is. It pops off the page: 440,000 people die each year from preventable errors in hospitals.
As it does twice a year, hospital safety watchdog The Leapfrog Group shines its light on the good, the bad and the ugly with a letter grade – A through F.
What it shows with this fall ranking is sluggish improvement on the safety front, even as some hospitals continue to sustain A ratings year after year, others can't seem to make the grade.
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The rise of ransomware, crafty hackers and health data destruction

Posted on Oct 28, 2015
By Tom Sullivan, Editor-in-Chief, Healthcare IT News
It's no secret that many professionals tend to focus on what's right in front of them and healthcare as an industry is no exception. For hospital CIOs and CISOs that often means compliance, HIPAA regulations, security governance, safeguarding against accidental breaches and imminent threats – as opposed to the cybercriminals lurking in a shadowy and lucrative underworld.
But they're out there. And they're creeping into healthcare in sophisticated ways.
Take ransomware, for instance. "We're starting to see on a regular basis the use of ransomware where someone will get in and encrypt everything on the network then tell the owner of that network 'I will give you the keys for $100,000 sent to an offshore bank account,'" said Richard Clarke, the cybersecurity czar to three U.S. Presidents who is now a security consultant and author.
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Medicine through the looking glass

Posted on Oct 27, 2015
By Teresa Knight, MD, Women's Health Specialists
I still remember my first encounter with an EHR. I was visiting my primary care doctor, and the green glow from her computer screen reflected off her glasses like an extraterrestrial aura. Where there should have been eyes, I saw boxes and pop-ups, scroll-downs and charts.
My doctor wasn't alone in this scenario. Eight out of 10 office-based physicians use an EHR, but few of us are fans. Yes, EHRs reduce errors, guard safety, remind us about the arcane rules of medical billing and provide a clean chart with legible handwriting. Yet the EHR has largely transformed into a compliance tool, focused on accountability, regulation, and meeting industry mandates. It distracts doctors and alienates patients who receive less and less attention during the encounter.
One need only observe a physician for a short time to witness the daily tragedy of health IT. We spend hours reconciling charts, searching for patient information, filling prescriptions, minimizing pop-ups, checking boxes. The result is less time with patients and, at times, what feels like an entirely inhumane encounter. As an OB/GYN, women strip down naked in front of me and share their most intimate details. Yet a computer demanding data entry leaves very little room for intimacy in the exam room.
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Clinical workflows improve when pharmacists can access provider EHRs

Jeff Rowe
Oct 28, 2015
If there is a clear success story in the transition to health IT, it’s CPOE, or Computerized Physician Order Entry. 
A new study from AHIMA (American Health Information Management Association)  describes an experiment in which a physician’s office and a community pharmacy shared access to an EHR in order to promote practice efficiency while also providing enhanced access to clinical information on both ends of the care continuum.
The writers found the roles of pharmacists in community settings “continue to expand beyond dispensing medications and into areas of extended-duration medication counseling, such as medication therapy management (MTM) and disease state management. The pharmacist may need additional information in order to advise patients about their medication use and to evaluate medication regimens to ensure that they are appropriately indicated, efficacious, and safe, and that the patient is adherent.
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Study examines how patients are using portals

Jeff Rowe
Oct 28, 2015
A new study in the Clinical Journal of the American Society of Nephrology  suggests providers need to take comprehensive steps to ensure that all of their patients are taking full advantage of portal offerings.
Patient portals are widely considered a key tool in getting patients more engaged across the care continuum, but, to date, little research has been done to determine how that assumption holds up when it comes to patients of medical specialists.
Researchers looked at the online behavior of nearly 3,000 patients who were seen between January 1, 2010, and December 31, 2012, at any of four university-affiliated nephrology offices and who had at least one additional nephrology follow-up visit before June 30, 2013.  Of those, 39% accessed the portal.  Of that population, “over 87% of users reviewed laboratory results, 85% reviewed their medical information (e.g., medical history), 85% reviewed or altered appointments, 77% reviewed medications, 65% requested medication refills and 31% requested medical advice from their renal provider.”
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WEDI-Con: Kathleen Sebelius on how health IT is driving big changes in healthcare delivery

October 28, 2015 | By Katie Dvorak
There is a technology revolution going on among healthcare providers, former Health and Human Services Secretary Kathleen Sebelius said Tuesday at WEDI-Con, the Workgroup for Electronic Data Interchange's annual fall conference.
Currently, health IT may sometimes seem "slow and cumbersome," she said to the crowd gathered at Reston, Virginia's Hyatt Regency. But she added that moving data into actionable health information at the point of care is beginning to make a big difference, helping providers understand the impact of their clinical decisions.
The U.S. is trying to take an entire health system into the electronic age in a short time, she said. "It's pretty daunting, but it is happening," she added.
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Why Your Family Medical History Matters

Knowing more about the illnesses that relatives have faced can tell you a lot about your own health risks

By Orly Avitzur, M.D.
Last updated: October 26, 2015
A few years ago, a 21-year-old college student came to my office because of intermittent pain in his right ankle. He'd had a ski accident 10 months earlier, but had also been experiencing increasingly frequent pain and numbness in his hands for several years—for which the cause was not clear. After a Lyme disease test came back negative, his primary care doctor referred him to me to investigate the possibility of nerve damage.
I found no nerve damage. It was not until I asked about his family medical history that I determined the possible cause of his concerns. My patient’s mother and maternal grandmother had rheumatoid arthritis, an autoimmune disorder that tends to attack the joints. Having a parent, sibling, or child with rheumatoid arthritis is one of the strongest risk factors for the disorder.
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For CIOs and large hospitals, information security is a top priority

October 27, 2015 | By Susan D. Hall
Hospital execs have a lot on their minds amid government mandates, shifting population demographics and industry consolidation, according to a new survey from peer60.
The report "Into the Minds of the C-Suite 2015" includes feedback from 336 C-level healthcare executives from 320 hospitals.
When asked their biggest challenges, the group overall cited managing the switch to value-based reimbursement (64 percent). On the IT front, managing data (36 percent), meaningful ROI on technology purchases (31 percent) and improving information security (30 percent) were among the top issues.
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AMA, MedStar framework aims to improve EHR usability

October 27, 2015 | By Dan Bowman
Optimal usability of electronic health records is the goal of a newly developed framework rolled out this week by the American Medical Association and MedStar Health's National Center for Human Factors.
The framework, according to principle developer Raj Ratwani (pictured), the center's scientific director, is based on research he and his team published last month in the Journal of the American Medical Association. The study, which examined available reports from 50 EHR vendors, determined that the Office of the National Coordinator for Health IT for the Meaningful Use program certified many vendors' products even if the vendors didn't follow "basic federal" certification requirements around usability.
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HIMSS, AHIMA, IHE map data governance strategies

Posted on Oct 26, 2015
By Mike Miliard, Editor
Seeking to better align health IT standards with health information management practices, three industry groups joined forces for a new report aimed at speeding standards-based interoperability.
HIMSS, AHIMA and IHE call Health IT Standards for Health Information Management Practices, a "first-of-its-kind" report that's meant to be a guide for those HIM and health IT professionals working to develop interoperability standards.
It aims to enlighten standards developers about information management practices and show how to better align them with health information technology. It will also serve as a roadmap of sorts for the development of standards to support information governance, including efforts in the U.S. and abroad to ensure semantic, technical and functional interoperability among information systems.
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The Growing Connected Health and Smart Home Industries

by Harry Wang Tuesday, October 27, 2015
The smart home is an emerging, high-growth market attracting many players, both old and new. With aggressive marketing and word-of-mouth campaigns, smart home products and services are gaining awareness and adoption among consumers. Many purchase one smart device at a time to solve an individual problem, while others purchase through a service provider that offers a bundle of products and services. Currently, about 10% of U.S. broadband households now have some smart home product, service or both.
The leading value propositions for smart home systems today relate to personal and family security, followed by home control and energy management. But many offerings are adding or will add home health, wellness and aging-in-place tools.
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How Precision Medicine is Unlocking EHRs' Potential

Scott Mace, for HealthLeaders Media , October 27, 2015

The prospect of incorporating human genomic data into electronic health records is closer than you think. Extensions to one system promise to improve patient safety, research, and clinical outcomes for 10 neurological disorders, research shows.

The healthcare IT industry has been vigorously touting President Obama's precision medicine initiative all year, ever since he announced it in the State of the Union address.
No doubt, IT's enthusiasm for precision medicine is fueled by visions of extracting even more IT-oriented revenue from payers and providers. The assumption is that great medical breakthroughs are just around the corner.
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The Future for Terminology Standardization

OCT 23, 2015 2:44pm ET
Agreeing on terminology will grow in importance as different entities in healthcare see the need to share information frequently and seamlessly.
Information transfer has been limited in past years, either between healthcare organizations or between providers and payers. Now, providers are working together to better coordinate care and share risks in population health initiatives. Payers are working more closely with providers and want a better understanding of the care that their covered lives are receiving.
As a result, the need to improve communication, via standardized terminologies, is expected to grow rapidly.
A recent roundtable discussion hosted by Health Data Management and sponsored by Health Language discussed terminology and standards challenges that now face all segments of the industry.
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3 upgrades EHRs need to integrate CDS, streamline workflow

October 26, 2015 | By Katie Dvorak
Electronic health record systems currently can leave much to be desired when it comes to integrating clinical decision support and streamlining workflows, and there are many enhancements needed for the next generation of EHRs, according to a recent research paper.
"The vast amount of information and clinical choices demands that we provide better supports for making decisions and effectively documenting them," according to the authors of the paper, published in the Journal of Medical Internet Research (JMIR).
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Global IT enabled Healthcare Market 2015 is poised to reach $262.46 billion by 2022

Global IT enabled Healthcare Market Outlook – Trends, Forecast, and Opportunity Assessment (2014-2022)
The Global IT enabled Healthcare Market is accounted for $108.21 billion in 2014 and is poised to reach $262.46 billion by 2022 growing at a Compound annual growth rate of 11.71% during the forecast period 2014 to 2022. The factors that are favoring the market growth include expanding e-Health programs, rising government support, and high-minded incidence of chronic conditions. However, security problems associated with the data in IT enabled Healthcare technology is hindering the market growth.
Asia Pacific region is anticipated to show speedy development in the global IT-enabled healthcare market during the forecast period led by the growing number of government initiatives. Countries such as India, China, Japan and Singapore are amongst the most productive markets pertaining to healthcare reforms and legislations, for instance e-Japan policy is likely to increase the demand for service providers and vendors in Japan. On other hand, Rest of the World market is still at a budding stage providing future investment opportunities.
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Enjoy!
David.

Friday, November 06, 2015

Clarity Comes On The Claims On ZDNet That The PCEHR is Saving Lives In Queensland.

I have to say I was quite surprised when this appeared last week:

E-health saving lives in Queensland: CSIRO

Australia's e-health record system has brought down the rate of mortality in Queensland, according to the CEO of CSIRO.
By Corinne Reichert | October 27, 2015 -- 02:58 GMT (13:58 AEDT) | Topic: Innovation
The Australian government's e-health record system is a lifesaving initiative, according to the chief executive of the Commonwealth Scientific and Industrial Research Organisation (CSIRO), who said the scheme has been so successful in Queensland that the mortality rate has decreased.
"We've already shown very conclusive evidence of improved mortality through Queensland hospitals as a result of that data mining and feedback to them that enabled them to improve their processes," said Larry Marshall, CEO of CSIRO, at Telstra's 2015 Australian Digital Summit in Sydney on Monday.
"Many, many people are alive today as a result of those improvements."
Marshall also pointed towards aged care as a potential usage for e-health, with Australia's ageing population needing modernised care facilities that take advantage of technology and data mining.
"Aged care, which is going to be a big issue in Asia as it is in this country -- e-medicine enables new types of censors to be placed around aged-care facilities that enable monitoring of the people in that facility without interfering in any way, shape, or form with what they do every day," he said.
Marshall admitted, however, that e-health hasn't been a successful initiative in any of Australia's other states or territories thus far thanks to a lack of cooperation.
"We haven't had that much success in e-health outside of Queensland -- Queensland's been a remarkable state for us, they're the first place in the country to give us access to their state health database," he said.
The government's e-health record system was given further funding of AU$485 million in the 2015-16 Budget in May, and rebranded from the personally controlled e-health record system (PCEHR) to My Health Record.
The most recent funding injection will improve the billion-dollar system by updating it with various recommendations from GPs who have used the system in its current state.
Here is the link:
As noted in blogs last week I was a little sceptical of this claim. After some e-mails etc. the article was updated.

E-health saving lives in Queensland: CSIRO

The use of e-health data mining projects by CSIRO has brought down the rate of mortality in Queensland, according to the organisation's CEO.
By Corinne Reichert | October 27, 2015 -- 02:58 GMT (13:58 AEDT) | Topic: Innovation
The e-health initiative being undertaken by the Commonwealth Scientific and Industrial Research Organisation (CSIRO) is already saving lives, according to the chief executive, who said a joint scheme with Queensland Health to create the Australian e-Health Research Centre has been so successful that the mortality rate has decreased.
"We've already shown very conclusive evidence of improved mortality through Queensland hospitals as a result of that data mining and feedback to them that enabled them to improve their processes," said Larry Marshall, CEO of CSIRO, at Telstra's 2015 Australian Digital Summit in Sydney on Monday.
"Many, many people are alive today as a result of those improvements."
The joint project uses a Patient Admission Prediction Tool (PAPT) to collect and analyse hospital data to forecast numbers of patients in emergency, and therefore predict how many staff members and resources will be required for the future.
Marshall also pointed towards aged care as a potential usage for e-health, with Australia's ageing population needing modernised care facilities that take advantage of technology and data mining.
…..
Updated on October 28, 10.35am AEST: This article originally stated that CSIRO had made use of the government's My Health Record data, but this is not the case.
This is the same link:
So first it is good to see the CSIRO is doing good work to make a difference in Qld and second it is good that the journalist swiftly corrected the record when the error was noticed.
What is not as good is that the journalist was somehow led to initially believe the PCEHR was involved.
Much, much worse is that for reasons unknown there are no studies on the PCEHR that show whether it is actually making a difference or not.
After three years of operation this really is not acceptable - given the cost incurred creating and operating the System.
David.