This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
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."
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 seems to be
a bit happening but nothing I would really describe as obvious progress, more
sadly, tiny stuttering steps.
Anyone who has
really good news please share via comment or e-mail!
Some
patients are facing delays receiving medicines because the move to active
ingredient prescribing has led to an increase in invalid scripts, pharmacists
say.
Under
the rules that came into effect on 1 February, the active ingredients of a
prescribed PBS drug must be printed first on the script.
Doctors
can still specify brands, but the changes are designed to increase uptake
of generic drugs and reduce medication errors.
The
Federal Government has said all major medical software providers
have updated their programs to comply.
But
the Pharmaceutical Society of Australia says its members are
reporting that hundreds of invalid scripts are being generated by doctors
using older versions of the prescribing software.
Pregnant
women have embraced telehealth during the COVID-19 pandemic, with almost one in
10 antenatal appointments in Australia via telehealth in the pandemic's first
six months.
Though
the pandemic caused a slight dip in the number of antenatal health services
reported in 2020, the use of telehealth nearly made up the difference.
There
were around 120,000 fewer face-to-face antenatal consults nationwide between
January and September 2020, compared to the same period in 2019.
But
there were around 91,000 telehealth appointments between March and September —
one in 10 of total appointments.
The
number of face-to-face services was around 10% lower than the same period the
year before. All up, the pandemic caused a reduction of only about 2% of
antenatal appointments.
Electronic Medical Records will be linked to My Health Record in South
Australia
Roy Chiang | 24 Feb 2021
The
Australian Digital Health Agency (ADHA) has publicly stated on 17 February that
it has completed its final stages of integration between South Australia
Health’s Sunrise Electrical Medical Records (EMR) and patient administration
system (PAS) to the country’s My Health Record (MHR). This will grant
healthcare providers the access and ability to upload information directly onto
the MHR platform.
An
embedded tab within the Sunrise EMR provides clinicians with access to MHR
which creates a unified view of a patient’s interactions across the health care
system. This contains shared health summaries from general practitioners,
pathology and imaging reports as well as prescription information from a
patient’s visit both within South Australia and interstate.
Why
it matters
By providing a more holistic view of the patient’s past medical records as well
as information on any medical care that was previously administered, clinicians
will be able to provide more personalised medical care which would potentially
translate into better patient outcomes. As a result of this integration,
hospital staffs are also more willing to use MHR due to the easy availability
of information.
A
new data privacy tool, designed to ensure publicly released anonymised datasets
remain secure and private, has cybersecurity experts asking questions about its
veiled design.
An
early version of the Personal Information Factor (PIF) tool, developed by the
NSW government and the Cyber Security Cooperative Research Centre in
collaboration with CSIRO’s Data61, has already been put to use in the pandemic,
analysing privacy risks of sharing deidentified datasets tracking COVID-19
cases across the state.
With
the pandemic still in full swing, more personal data is flying around than ever
before. Deidentifying data involves removing any personal
identifiers and using other software safeguards to prevent reidentification.
In
the context of the pandemic, making such information available to policy
makers, health experts and researchers has been critical to informing COVID-19
outbreak response.
The
Royal Commission into Aged Care Quality and Safety will complete its report
today. It is crucial this report includes technological advancements, especially
around caregiving, says Epicor Regional Vice President ANZ, Greg O’Loan.
The
Royal Commission into Aged Care Quality and Safety was established to report on
the quality of aged care services and whether those services are meeting the
needs of the older Australian community. This includes care for older people
living at home, people living with dementia, and people living in residential
aged care including younger people with disabilities.
Epicor
has significant experience with the concerns and needs of Aged Care, especially
in Australia where Epicor SLS - Senior Living Solutions - forms one of the core
pillars of the product, along with the traditional modules of general ledger,
accounts receivable, accounts payable, and so on.
With
all eyes on the government’s rollout of the first COVID-19 vaccines this week,
it was timely for the Institute to advocate for movement on the international
digital vaccine passport.
We
have published a position statement and issued a media release on the need for
Australia to be on the front foot in managing returning travellers’ records.
The Institute has many Fellows and members who are expert in health data and
who are currently making a huge contribution to national and international
efforts during the pandemic.
Once
international borders re-open, there will be a need to digitally manage records
of those vaccinated either in Australia or overseas. For this, the Institute
supports work on the international Yellow Card, the medical passport issued by
the World Health Organization.
AIDH
Fellow and global health informatics leader Grahame Grieve has been assisting
WHO by providing advice on the proposed data model. He says many countries have
a great need for a valid, secure digital record of vaccination which is recognised
by other countries, given the travel patterns of people around the world and
the challenges they’re facing in managing outbreaks.
Medical
deliveries by drone are ready for take-off in Australia, with startup Swoop
Aero expecting to start bringing medicines to regional patients in May.
Swoop
Aero has signed a deal with chemist chain TerryWhite Chemmart, and the
first deliveries will be out of a pharmacy in Goondiwindi in the south of
Queensland. Drones will be used to deliver medicines to customers within a 130
kilometres range of the town, sparing them trips of up to three hours to visit
the pharmacy.
The
drones contain a secure chilled container, where pharmacists put in the
medicines. They will be flown by a pilot based in Melbourne to deliver the
medicines to customers who use a QR code to open the drone on arrival.
The
pilot can fly up to five drones at a time. Swoop Aero has been working with the
Civil Aviation Safety Authority for over a year to finalise approvals for the
flights.
Lucy
Walker, pharmacist and owner of the TerryWhite Chemmart pharmacy in
Goondiwindi, said there was definitely a need for the service in the region.
More
than two million Australians have created digital identities through the
government my.Gov portal in order to access digital services, a statement from
two ministers says.
Government
Services Minister Stuart Robert and Superannuation, Financial Services and
Digital Economy Minister Jane Hume said the myGovID facility was managed by the
Australian Taxation Office.
They
said to protect a user's identity and stop fraud, the app used encryption and
proven cryptographic technologies. myGovID also uses security features on a
smartphone — like a fingerprint, password or facial verification — to provide
secure access.
Researchers
have, however, criticised the program and said it needs to
be redone from scratch. Dr Vanessa Teague of Thinking Cybersecurity and
independent researcher Ben Frengley said in a submission to the DTA that
neither the trusted digital identity framework's high-level design, nor its implementation
by the ATO (myGovID) met their intended security goals.
With
the claim of "cutting edge biometric and document verification", the
Australian founded identify verification solution, greenID, has been seriously
upgraded.
GBG. The
company says it is a "global technology specialist in fraud and compliance
management, identity verification and location data intelligence", and it
has "announced the expansion of greenID, the Australian founded solution and industry leader in
identity verification, to an end to end digital identity verification
platform."
We're
told the new greenID Digital Identity Verification Platform is "complete
with biometric and document verification, data matching, and data intelligence
to improve and accelerate the eKYC process."
Acquired
by GBG in 2018, the company explains "greenID has been helping
organisations in Australia and New Zealand address regulatory and compliance
requirements, anti-money laundering (AML) / Counter-Financing of Terrorism
(CTF), PEPs and sanction since 2005."
Researchers
at New York University
have come up with a novel way to help foretell COVID-19 surges before they
materialise — an approach that could cost-effectively restrain viral spread
until vaccination programs are complete.
Analysing
online searches of mobile and isolated activities, their preliminary AI tool
can predict where and when an outbreak might take place. Equipped with this
information, authorities could stage urgent responses — like that recently seen
in Victoria — nipping the virus in the bud before it replicates to uncontainable
levels, and reducing the impact on local businesses.
Professor
Megan Coffee and Professor Anasse Bari from New York University say the
technology is based on “alternative data” — a concept previously used in
finance to generate data-driven investments, such as predicting business
earnings from satellite images of parked cars.
Some
of the local industries Australia relied on during the coronavirus pandemic,
such as healthcare and manufacturing, are under threat from overseas digital
competition, analysts warn.
A
report commissioned by search giant Google found Australia ranked second-last
out of 37 countries in the Organisation for Economic Co-operation and
Development when it came to investment, uptake and output in digital
technologies.
The
digital performance index compiled by AlphaBeta, part of Accenture, ranks
countries and industries based on the use of technologies such as cloud
computing, automation, robotics and internet of things technology.
AlphaBeta
director Andrew Charlton said local industries risked a digital
disruption, similar to Uber for taxis or the internet for the media
industry.
$100 million for major advances in medical research technology
The Australian Government is investing $100 million into the
development of new technologies to improve diagnosis and treatment of stroke,
epilepsy and lung disease, including COVID-19.
Date published: 26 February
2021
Media type: Media release
Audience: General public
The
Morrison Government is investing $100 million into the development of new
technologies to improve diagnosis and treatment of stroke, epilepsy and lung
disease, including COVID-19.
The
funding will be split across three research projects led by senior researchers
at the University of Melbourne, the Australian Lung Health Initiative, and
Florey Institute of Neuroscience and Mental Health.
The
five year funding is being provided under Stage Two of the Frontier Health and
Medical Research Initiative, an unprecedented program which allows researcher
collaborations to explore the most bold and exciting ideas that could have a
dramatic, global impact on health care.
Hospitals using ICNET for Covid infection surveillance
Tuesday, 23 February 2021
NEWS - eHealthNews.nz editor Rebecca McBeth
Ten hospitals across the country are using the ICNET
clinical surveillance platform, including new functionality for Covid-19.
Canterbury District Health Board deployed ICNET, developed by Baxter
Healthcare, in 2012. Over the past two years it has worked with ACC and Baxter
to roll it out to another nine DHB Infection Prevention Teams.
The software provides real time surveillance designed to prevent, detect and
advise on infections such as Covid-19.
Susan Wood, director quality and patient safety for Canterbury and West Coast
DHBs, says the initial requirement was for software that would track and
prevent ‘everyday’ hospital-acquired infections such as Norovirus.
“We have always been mindful since H1N1 flu hit in 2009, that we would need to
be able to capture real-time information in another pandemic,” Wood says. -----
Bettina McMahon joins Healthdirect Australia as Chief Executive Officer
Published: 26 February 2021
Healthdirect Australia is pleased to announce the appointment of
Bettina McMahon to the role of Chief Executive Officer.
Ms McMahon brings to the role significant experience in digital
transformation in the health sector and an extensive track record in delivering
major reforms in complex regulatory and stakeholder environments.
Prior to joining Healthdirect Australia, Ms McMahon was the
Interim Chief Executive Officer at the Australian Digital Health Agency (ADHA),
where she had also held roles as the Chief Operating Officer and Executive
General Manager for Industry and Government.
Before that, Ms McMahon played a key role in the successful
transition of the National e-Health Transition Authority (NEHTA) into ADHA,
with a tenure across the two organisations spanning 11 years.
New resource:
Safety and Quality Benefits of Secure Messaging
The need for
healthcare providers to connect safely and securely is greater than ever.
Secure messaging
is an efficient and timely method for sending and receiving clinical information,
minimising the burden of paper and manual processes. Increased uptake improves continuity
of care for patients, saves time and can help protect vital health information.
Following a
review conducted by the Australian Commission on Safety and Quality in Health Care,
the Australian Digital Health Agency (ADHA) has released Safety and Quality
Benefits of Secure Messaging. This new resource delves into findings from the
review and subsequent recommendations for healthcare organisations.
It is
important to note that the recommendations of this review support the national
scaling initiatives outlined in the ‘Communique – National Scaling of Secure
Clinical Messaging’. The eight recommendations aim to enhance the safety and
quality aspects of secure messaging and enable enhanced models of care. These
recommendations support the Agency’s national scaling initiatives, which
require industry partnerships to ensure their successful implementation.
There are eight points:
A. Enable the secure messaging ecosystem
1. Identify
or leverage existing digital health test beds for evaluating secure messaging
for selected use cases and assess user experience
Expanding
secure messaging system functionality to support additional use cases is
essential to supporting its uptake and increasing adoption across the
healthcare sector. Continued evaluation and early adopter testing through the
appropriate analysis of healthcare provider networks and potential test beds
will enable secure messaging systems and standards. These can be used to
enhance clinical workflows within controlled ecosystems, support healthcare
provider information exchange and facilitate a patient’s choice in provider.
2. Promote
the increased use of structured data elements and understand impacts on
clinical information capture and exchange
The use of
structured data is seen to be one of the key drivers that will uplift secure
messaging solution capability and enhance healthcare system interoperability.
Secure messaging interoperability requirements need to align with structured
data element capabilities which can enhance the benefit focus areas of safety,
quality, efficiency and access.
3. Consider
the development of technical incident monitoring framework to assess adherence
to standards
A technical
incident monitoring framework should be developed in order to monitor the
successful exchanges of secure messages and address transmission errors.
Currently, standards for secure messaging have been implemented differently by
vendors across the secure messaging ecosystem. Implementation of a framework
that supports adherence to clinical documentation standards and secure
messaging delivery standards will help to address transmission errors. This
monitoring framework will be supported by the governance framework initiative
and likely to compel all secure messaging vendors to comply. Note that the
current secure messaging industry offer provides a conformance profile that will
need to be incorporated into this framework.
Furthermore,
the use of application level acknowledgement capability will need to be
implemented by CIS vendors in order to enable read-receipt functionality. This
feature can be used to inform of any incidents that may occur and to enhance
clinical workflows by notification of message delivery to the intended end
point.
B. Enhance the
secure messaging capability
4. Assess
the impacts of FHIR implementation on the secure messaging ecosystem and
understand opportunities to address key barriers
The use of
Fast Healthcare Interoperability Resources (FHIR) standards offers a model for
clear conformance and test frameworks with secure messaging vendors looking to
provide additional support for the FHIR paradigm. It is necessary to understand
the impacts of implementing FHIR and the opportunities provided for the
Australian secure messaging ecosystem.
5. Assess
the feasibility of incorporating patient–provider communications into the wider
secure messaging ecosystem and aim to preserve a patient’s choice
Secure
messaging and CIS vendors have started to expand the use of secure messaging to
facilitate patient–provider communications and healthcare providers have
increased the use of telehealth and remote consultations. The patient–provider
communication model can be investigated in order to understand how patient
choice in determining their provider can be preserved, and how it can be
integrated into secure messaging scope.
C. Optimise the
current state of secure messaging
6. Use the
secure messaging benefits framework to accelerate national scaling initiatives
and the risk profile to address key barriers
The benefit
focus areas of safety, quality, efficiency and access outlined in the section
Benefits of secure messaging can be used to accelerate the seven national
scaling initiatives detailed in the Communique – National Scaling of Secure
Clinical Messaging. These barriers can be addressed by using the risk profile
for secure messaging to communicate the implications on safety and quality of
care.
7. Promote
the standardisation of payload specifications relating to clinical
documentation templates and clinical terminology for secure messaging
Promoting the
standardisation of payload specifications relating to clinical documentation
templates for relevant use cases and assessing the use of clinical terminology
is necessary to expanding secure messaging adoption and promoting
interoperability between secure message information exchange.
8. Use
lesson learned from COVID-19 as a lever to further exemplify the need for
secure provider-to-provider and provider-to-consumer digital communication
Changes
driven by social distancing have accelerated the need to roll out and adopt
digital healthcare models and tools. Out of necessity, there has been a shift
in provider and consumer attitudes with regard to engaging in and receiving
forms of healthcare virtually. This can be used as a lever to demonstrate the
benefits of secure messaging. Peak bodies and primary health networks can play
an important role in building awareness, promoting advocacy and upskilling the
workforce around the need for secure forms of digital communication.
----- End
Recommendations
The Conclusion
is telling.
Conclusion
This
review has found widespread recognition of the potential benefits of secure
messaging across the stakeholders interviewed; however, low uptake as a result
of barriers and perceived risks to patient safety and quality will continue to
challenge uptake and broader adoption.
The barriers
and risks raised throughout the stakeholder interviews led to the
identification of opportunities to address gaps in the current secure messaging
ecosystem. The increased rate of digital adoption through the COVID-19 pandemic
provides one of the major opportunities for acceleration in digital health
transformation initiatives worldwide. These opportunities enable the
realisation of secure messaging benefits across safety, quality, efficiency and
access and incorporate specific use cases where secure messaging or other
digital solutions have demonstrated reasonable success. These opportunities
also reflect the diverse views of stakeholders interviewed, providing insight
into stakeholder priorities and the attitudes prevalent across the sector. To
enable the fulfilment of these opportunities and the mitigation of the risks
identified with the use of secure messaging, several recommendations were
outlined in the review that align to the Communique – National Scaling of
Secure Clinical Messaging as well as the National Digital Health Strategy
2018-22 and the associated Framework for Action. This was supplemented by
several success criteria that can enable the future state of secure messaging.
----- End Conclusion.
Despite the
hope for really concrete plans and proposals and some real quantified benefits
and impacts the reader is left with what amounts to a ‘mush sandwich’. It’s
just motherhood and apple-pie!
In the real
world we have a range of private players (HealthLink, Medical Objects, Telstra
Health and others) just getting on with he job and providing pretty useful
services to 1000’s of clinicians all over the country.
To me this
glossy report gets us no further ahead and offers no agreed path forward
towards a universally standardised secure clinical messaging environment with a
nationally supported end point addressing facility to offer full easy national addressing
and rich – rather than the least useful – message content and interoperability. NEHTA / ADHA have been at this for what seems decades but somehow the progress is glacial!
On current
evidence the ADHA does not appear to be the entity to get the job some and the Australian
Commission on Safety and Quality in Health Care has re-confirmed it capacity to
produce useless but graphically pretty reports. Does anyone know of any valuable
and impactful reports the Australian Commission on Safety and Quality in Health
Care has produced in the last few years. I don’t.
The reports on the safety of the #myHealthRecord
set a benchmark for not answering the questions posed!
Do You Believe Making The
#myHealthRecord Accessible Via The SA Health Hospital EHRs Will Make Any Real
Difference To The Quality And Safety Of The Patient Care Delivered?
Yes 5% (4)
No 93% (80)
I Have No Idea 2% (2)
Total votes: 86
It seems most are pretty unimpressed with the addition of the
myHR to the hospital EHRs in South Australia, and are not convinced it will
make much difference.
Any insights on the poll welcome as a comment, as usual.
A good number of votes.
It must also have been an easy question as only 2/86 readers
were not sure how to respond.
