This Is Really Important Stuff. I Wonder Will The NEHRS / PCEHR Support This Activity Effectively.

First - Happy Australia Day - we all have a lot to be grateful for I believe despite all the irritants we all observe. We have a wonderful country taken all in all!

This appeared a little while ago

January 14, 2013

Mining Electronic Records for Revealing Health Data

By PETER JARET

Over the past decade, nudged by new federal regulations, hospitals and medical offices around the country have been converting scribbled doctors’ notes to electronic records. Although the chief goal has been to improve efficiency and cut costs, a disappointing report published last week by the RAND Corp. found that electronic health records actually may be raising the nation’s medical bills.

But the report neglected one powerful incentive for the switch to electronic records: the resulting databases of clinical information are gold mines for medical research. The monitoring and analysis of electronic medical records, some scientists say, have the potential to make every patient a participant in a vast, ongoing clinical trial, pinpointing treatments and side effects that would be hard to discern from anecdotal case reports or expensive clinical trials.

“Medical discoveries have always been based on hunches,” said Dr. Russ B. Altman, a physician and professor of bioengineering and genetics at Stanford. “Unfortunately, we have been missing discoveries all along because we didn’t have the ability to see if a hunch has statistical merit. This infrastructure makes it possible to follow up those hunches.”

The use of electronic records also may help scientists avoid sidestep the rising costs of medical research. “In the past, you had to set up incredibly expensive and time-consuming clinical trials to test a hypothesis,” said Nicholas Tatonetti, assistant professor of biomedical informatics at Columbia. “Now we can look at data already collected in electronic medical records and begin to tease out information.”

Recent work by Dr. Altman and Dr. Tatonetti, published in 2011, offers a compelling case study. As a graduate student at Stanford, Dr. Tatonetti devised an algorithm to look for pairs of drugs that, taken together, cause a side effect not associated with either drug alone. One pairing popped up when he used his new software to search the Food and Drug Administration’s database of adverse drug reports: Paxil, a widely used antidepressant, and Pravastatin, a cholesterol-lowering drug.

Neither was known to raise blood sugar, but Dr. Tatonetti’s results suggested they might when taken together.

For confirmation, he and Dr. Altman turned to Stanford University Medical Center’s electronic medical records. The scientists needed to find patients who were prescribed either Paxil or Pravastatin, had a blood sugar test, were then prescribed the second medication, and had another blood sugar test — all within a period of a few months.

Finding such patients was a tall order, but the medical center’s database was large enough that eight cases surfaced. In most, patients had experienced a significant increase in blood sugar. The researchers expanded their search to databases at Harvard and Vanderbilt. They found about 130 cases that fit the improbable criteria — and more evidence that patients given both drugs showed a rise in blood sugar.

The F.D.A. is currently evaluating the data to see if they warrant new information on the drugs’ labels. “I underestimated the abilities of a clever informatician to figure out algorithms for data mining,” said Dr. Altman, once a critic of this sort of “data mining.”

“We didn’t need to set up a clinical trial,” he said. “We didn’t need to enroll a single research subject.”

Kaiser Permanente, which documented the connection between Vioxx and heart trouble nearly a decade ago by reviewing internal medical records, is now testing preliminary evidence that men taking statin drugs for cholesterol have a lower risk of a recurrence of prostate cancer. The organization is also evaluating diabetes protocols, using a database of more than 25,000 people over age 80 with diabetes — a difficult population to study in clinical trials.

Lots more here:

http://www.nytimes.com/2013/01/15/health/mining-electronic-records-for-revealing-health-data.html?ref=health&_r=1&

For this to be replicated in Australia using the NEHRS a few things will need to happen.

First we will need to ensure the Governance processes around this sort of use will need to be effective, robust, transparent and streamlined - i.e. minimum bureaucracy and maximum transparency and effective privacy controls.

Second there will need to be ongoing clinical and research involvement.

Third we may need to obtain mechanisms to effectively link the NEHRS with live GP Systems and be able to obtain more detail than the NEHRS holds.

Fourth there will need to be a full array of interoperability Standards in place.

I fear it will be a big ask - but not impossible I hope!

David.

They Consultants Sometimes Really Can’t Help Themselves. I Wonder What The Assumptions Were?

This appeared a little while ago.

Hunt wants paperless NHS in five years

16 January 2013   Lyn Whitfield

Health secretary Jeremy Hunt has set out a tight timetable for making all records and communications in the NHS paperless.

In a speech to the right-wing think-tank Policy Exchange on Wednesday, he said that all records and communications in health and social care would be electronic by 2018.

There is no central funding for the plans, but a report commissioned from consultants PriceWaterHouseCoopers has estimated that more ambitious use of IT would save the NHS £4 billion.

Hunt took over from health secretary Andrew Lansley in the last government’s reshuffle. The new team at Richmond House has continued Lansley’s interest in IT.

Junior minister Dr Dan Poulter told EHI Live 2012 in Birmingham that IT was essential, not just to make savings but to pursue the government's choice and transparency agendas.

To date, however, the coalition’s firmest promise had been to give patients online access to their GP records by 2015, although the NHS Commissioning Board has been given some important IT imperatives in its 'mandate' from the government.

The mandate indicates that the NHS CB should develop electronic health records that work across the health and care system by 2015.

The 'planning guidance' issued by the organisation in December also indicated that it will run a consultation on patient access to these records later this summer.

In Wednesday's speech, Hunt reiterated the GP pledge and a commitment made by NHS CB national director of patients and information Tim Kelsey to make referrals paperless by 2015.

He also added to the IT sections of the mandate, by setting a 12 month deadline for hospitals to computerise their records “in such a way that they can be shared."

Lots more here:

http://www.ehi.co.uk/news/EHI/8315/hunt-wants-paperless-nhs-in-five-years

All one can say to this enthusiastic Minister is ‘Good luck with that’!

No funding and a PWC report saying there is 4 Billion pounds to be saved just fills one with that sense of ‘I have seen this before somewhere and it did not quite turn out like that’. An ambitious time table and an optimistic consultant report are not a good mix!

There is also coverage of the report from PwC here:

http://www.ehi.co.uk/news/industry/8316/pwc-finds-%27even-more%27-it-savings

PwC finds 'even more' IT savings

16 January 2013   Lyn Whitfield

A report from consultants PriceWaterhouseCoopers has concluded that the NHS could save billions of pounds a year if “ambitious, proactive NHS organisations” improved their use of information technology.

In a report published ahead of a speech by health secretary Jeremy Hunt this evening, which will call for a paperless NHS by 2018, PwC says the NHS could save £4 billion more than the government’s estimate in its NHS information strategy.

It argues that around half of this - £1.7 billion - could be generated from four actions, including the roll-out of e-prescribing in hospitals and the Electronic Prescription Service in primary care.

This paper might inject a touch of sanity.

The Real World of Cost-Benefit Analysis: Thirty-Six Questions (and Almost as Many Answers)

Cass R. Sunstein

Harvard Law School

January 10, 2013

Harvard Public Law Working Paper

Abstract:

Some of the most interesting discussions of cost-benefit analysis focus on difficult problems, including catastrophic scenarios, “fat tails,” extreme uncertainty, intergenerational equity, and discounting over long time horizons. As it operates in the actual world of government practice, however, cost-benefit analysis usually does not need to explore the hardest questions, and when it does so, it tends to enlist standardized methods and tools. It is useful to approach cost-benefit analysis from the bottom up, that is, by anchoring the discussion in specific scenarios involving trade-offs and valuations. Thirty-six stylized scenarios are presented here, alongside an exploration of how they might be handled in practice. Open issues are also discussed.

Full paper here

http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2199112

This really shows how hard it is to get a real and accurate handle on costs and benefits. Must read material!

David.

NEHTA Achieves A Really New High In Irony. An Example Of Those Who Can Do And Those Who Can’t Teach.

This links appeared a few days ago.

Making Sense of eHealth Collaboration: A guide to getting started     Date:-21/01/2013

The direct link is here:

http://nehta.gov.au/component/docman/doc_download/1596-making-sense-of-ehealth-collaboration-a-guide-to-getting-started

The title of the document is ‘Making Sense of eHealth Collaboration’ A guide to getting started.

The date of the document is October 2013 - .pdf dated 8 Jan. 2013.

The document runs to an amazing 107 pages.

Those who provided wisdom were listed as follows:

‘Acknowledgement NEHTA would like to thank the following groups and organisations who contributed to the development of this Guide:

•          Accoras
•          ACT Health
•          Australian Commission on Safety and Quality in Health
•          Australian Medicare Local Alliance
•          Calvary Healthcare
•          Continuity of Care Reference Group
•          Department of Health and Ageing
•          Department of Human Services
•          Hunter Medicare Local
•          Identification, Authentication, and Access Reference Group
•          Inner East Melbourne Medicare Local
•          Mater Health Services Brisbane
•          Metro North Brisbane Medicare Local
•          NSW Health
•          Northern Territory Consortium/NT Health
•          Queensland Health
•          Royal Australian College of General Practitioners
•          St. Vincent’s and Mater Health Sydney

The Disclaimer and Security On The Document Are A Fun Read.

‘Disclaimer NEHTA makes the information and other material (“Information”) in this document available in good faith but without any representation or warranty as to its accuracy or completeness. NEHTA cannot accept any responsibility for the consequences of any use of the Information. As the Information is of a general nature only, it is up to any person using or relying on the Information to ensure that it is accurate, complete and suitable for the circumstances of its use.

This publication may contain links to websites that are run by third parties. Such links are provided for the user’s  convenience and do not constitute an endorsement or a recommendation by NEHTA for itself or on behalf of DOHA, of any third party products or services. These links are provided for convenience and in good faith but may not be or remain current. NEHTA for itself and on behalf of DOHA takes reasonable care in selecting linking websites but accepts no responsibility for the accuracy, currency, reliability and correctness of information contained in linked external websites. Access and use of any linked website is at your own risk.

Security The content of this document is confidential. The information contained herein must only be used for the purpose for which it is supplied and must not be disclosed other than explicitly agreed in writing with NEHTA.’

So it seems how to collaborate in e-Health is a secret!

Moving on.....

The requirement for the document is as follows:

“The requirement for this guide emerged from recognition that there was a need to:

• Bring together the vast array of guides and materials available

• Provide a common starting point for collaborative eHealth implementation projects

• Provide insights and lessons learned specific to collaborative eHealth implementations

As part of the development of this document, a number of representatives from eHealth project teams were consulted including teams from a range of Australian jurisdictions, acute and primary care settings, public and private institutions as well as both metropolitan and remote locations. The learnings and insights they shared were invaluable in developing this document. The authors note their contribution with thanks.” (Page 6.)

Note no sign of the vendor community or the MSIA or the AMA or the RACGP. Just who is intended to collaborate with whom in all this?

The rest of the document is a summary of the basics of well-planned e-Health implementation - none of which seems to have really been followed by DoHA and NEHTA (e.g. actually have proper governance and have a decent well considered business case as well as real stakeholder engagement)

For the last 20-30 pages there is a link of what look like some quite useful resources that are said to be available at the NEHTA web site. Sadly I could not find them which was a pity. A portal with all this material would be a good idea. I wonder is it I just could not find it?

All in all this is a document that might actually have helped DoHA and NEHTA about 3 years ago - especially if they have taken notice of it. Just goes to show how useless developing “shelfware” actually is! That said it seems that some of those mentioned above as contributors do have some real clues on how things should be done!

The irony that this document turns up so late in the day is hard to bear!

David.

Is This An Accident Of Timing Or Something More Sinister? Reporting Of The NEHRS / PCEHR Seems To Have Vanished.

Since coming back from the break I have noticed public interest in pretty much all matters e-Health seems to have evaporated. At the time of writing (22/01/2012)

www.Ehealthcentral.com.au has not been updated in almost 6 months - so clearly the blogger had no actual interest in e-Health other than attacking me (and a few others especially from the Australian) and getting paid. When the money ran out apparently so did his interest.

www.ehealthspace.org has not apparently been updated since before Christmas and the only contact has been a summary email on last year’s efforts

Pulse+IT (www.pulseitmagazine.com.au) continues to be busy watching the ePIP site and letting us know when some vendor or others claims compliance as well as other matters ePIP. Not much other than that recently.

Other than this there seems to be a dearth of information and very little strategic commentary indeed.

It seems to me the lack of information - and even the one or two articles in Australian Doctor and Medical Observer are not really enough given the amount spent and the ongoing amount that may be spent. At least ZDNet had a couple or reports last week and used fillers from the US to keep us alert!

I would have expected a flurry of reporting alerting all those involved to the looming ePIP deadlines etc. but it is just not happening as yet.

Theories and comments welcome. Maybe it is just a typical January but it does seem much quieter than the last few years.

Interestingly, today I got my new Medicare card and there was a small flyer on e-Health included suggesting just how good it might be to register. It will take a long time for the news to get out at the rate of turnover of these cards (about 4-5 years).


I really hope we start to see more serious reporting from the media majors and the specialist medical press going forward.

David.

AusHealthIT Poll Number 151 – Results – 22nd January, 2013.

The question was:

Will The e-PIP Incentive Program Result In A Really Worthwhile Level Of Adoption And Use Of The NEHRS / PCEHR?

Definitely 10% (4)

Probably 15% (6)

Probably Not 54% (21)

No Way 21% (8)

I Have No Idea 0% (0)

Total votes: 39

Very interesting. A clear majority are by no means convinced the ePIP program will actually make a major difference.

Again, many thanks to those that voted!

David.

Weekly Australian Health IT Links – 21st January, 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

This has to have been one of the quietest weeks ever - but lots going on I am sure with work being done for e-PIP.

Seems the DHS has got the message that their downtime has got past a joke!

However more work seem to be needed!

My NEHRS check here on Sunday 20/01/2013 was interesting:

http://australia.gov.au/faqs/service-availability-and-scheduled-outages

In part it said:

“The Personally Controlled Electronic Health Record System is currently unavailable for new registrations. Please keep referring to this page for any updated messages on availability. We apologise for any inconvenience.

For eHealth related issues contact the helpline on 1800 723 471 for assistance during these periods.

For more information see the links below:

• Department of Human Services
• Department of Veterans' Affairs
• Personally Controlled Electronic Health Record system”

Seems like it has been down for new registrations for a week! WTF!

Interestingly the response time of the NEHRS / PCEHR on my weekly visit,from entry to first screen fully painted, was 17 seconds. Just useless I reckon!

Makes the first article below important.

-----

http://www.computerworld.com.au/article/446767/department_human_services_vows_reduce_system_outages_2013/

Department of Human Services vows to reduce system outages in 2013

The department experienced 137 system reliability outages between October 1, 2011 and September 30, 2012

• Byron Connolly (CIO)
• 17 January, 2013 16:26

The Department of Human Services (DHS) is hoping to cut the number of system outages across its complex IT environment by 5 per cent per quarter over the next 12 months.

The large government agency experienced 137 system reliability outages in the 12 months between October 1, 2011 and September 30, 2012. Twenty-eight of these outages were experienced in environments that were operated by the department’s outsourced providers.

Responding to a written question to the Senate Community Affairs Legislative Committee from Queensland Senator Sue Boyce in late October, the DHS said systems stability was a key priority for the organisation.

-----

http://www.smh.com.au/digital-life/digital-life-news/digital-health-movement-in-focus-at-ces-20130111-2cjwp.html

'Digital health' movement in focus at CES

Date January 11, 2013

Rob Lever

With an app, a game or a gadget, technology start-ups and major companies across all sectors are trying to tackle some of the thorniest problems in health and medicine.

The Consumer Electronics Show is filled with new gadgets to monitor fitness, detect problems and find solutions to health issues ranging from obesity to diabetes to rare medical conditions.

One trend is "gamification," which uses a model from the game industry to offer points and rewards to boost health and reduce costs.

-----

http://www.smh.com.au/digital-life/smartphone-apps/skin-cancer-apps-dangerous-20130117-2cva6.html

Skin cancer apps 'dangerous'

Date January 18, 2013 - 7:53AM

Robyn Preston

People are being warned to avoid using smartphone apps to detect skin cancer.

Experts are warning people not to replace visits to the doctor with smartphone apps that claim to detect skin cancer after a study found the technology gets it wrong almost a third of the time.

A number of phone applications, widely available to the public, market the ability to evaluate skin legions and provide advice to the user about whether it is cancerous.

The apps give a recommendation after comparing photos taken of the suspicious legion over a period of time to gauge unusual changes, or by judging a photo against a library of skin cancer images.

-----

http://www.medicalobserver.com.au/news/smartphone-skinlesion-apps-not-so-clever

Smartphone skin-lesion apps not so clever

17th Jan 2013

CONSUMER-targeted smartphone apps which assess skin lesions are poor at detecting melanomas, a study has found.

Patients who rely on the technology may not seek medical advice and delay the diagnosis of melanoma, the authors warn.

US researchers submitted 188 digital images of pigmented cutaneous lesions to four consumer smartphone apps designed to provide users with feedback about the likelihood of malignancy. Of the images, 60 were melanomas and 128 were benign.

-----

http://www.zdnet.com/au/tas-govt-connects-healthcare-and-education-with-new-it-system-7000009753/

Tas govt connects healthcare and education with new IT system

Summary: The Tasmanian government has gone to market to find a contractor that can build an information system to link student clinicians with placements in the heath-care industry.

By Michael Lee | January 14, 2013 -- 05:51 GMT (16:51 AEST)

The Tasmanian government Department of Health and Human Services (DHHS) has jumped in to tackle the issue of ensuring that health-care students get proper practical experience placements by asking the IT industry to develop an information system to match students and health providers together.

DHHS previously created a Clinical Education and Training Framework through which to guide all clinical education placements. Due to the demand for placements and the need for health providers to also coordinate with educational institutions, the Tasmanian government has gone to tender for a "Clinical Education and Training Information System," which will be used throughout the state. This will build further on the framework already established by DHHS.

-----

http://www.pharmacynews.com.au/news/latest-news/non-guild-members-to-pay-for-project-stop

Non-Guild members to pay for Project STOP

18 January, 2013 Nick O'Donoghue

Community pharmacies that are not members of the Pharmacy Guild of Australia are set to pay $300 a year if they want to continue using Project STOP to monitor sales of pseudoephedrine-based products.

The decision was made by GuildLink, the Guild’s subsidiary company, which operates Project STOP, could have an impact on more than 700 pharmacies across the country, due to “the significant ongoing cost of maintaining and operating the system”, which are estimated to be $650,000.

The program has been mandated by a number of state and territories – currently NSW, Victoria and Tasmania are the only states that have not mandated the system – as a real-time monitoring system to prevent pseudoephedrine-based from being stockpiled to illicit drug manufacturers.

-----

http://www.australiandoctor.com.au/clinical/therapy-update/useful-websites-on-indigenous-healthdr-bryan-palme

Websites on Indigenous health

17 January, 2013 Dr Bryan Palmer

Dr Bryan Palmer gives a round-up of helpful websites on Indigenous health issues, in a bid to help GPs close the gap on health for Indigenous Australians.

www.aida.org.au

The Australian Indigenous Doctors' Association has multiple roles in promoting Indigenous health, as well as providing collegiate support for Indigenous doctors and medical students.

I love their website, which has a modern homepage with a clear layout and links to other areas of the site. The links uncover a wealth of comprehensive information.

There are also non-intrusive links to social media and no adverts. I would be surprised if this site fails to encourage an uptake in membership.

-----

http://www.zdnet.com/au/hcf-fleshes-out-data-analytics-with-electronic-patient-records-system-7000009924/

HCF fleshes out data analytics with electronic patient records system

Summary: The new dental patient records system will give the healthcare insurance provider more granular data on its members for analytics purposes.

By Spandas Lui | January 18, 2013 -- 01:18 GMT (12:18 AEST)

Healthcare insurer HCF has integrated its dental electronic patient records (EPR) system with its data analytics initiative in order to gain more insight into its customers' oral health.

HCF started exploring a new EPR system for its network of dental care centres five years ago, around the time that it kicked off a core IT systems upgrade. But after two false starts, the company called in Sydney-based software provider Centaur to roll out a Dental4Windows SQL system, hosted out of HCF's own datacentre.

The EPR system operates on the latest Citrix XenApp virtual environment, and the project was officially completed in mid-2012. HCF currently has around 94 dentists and 250 clinical staff across seven dental care centres, all of which have access to the system.

-----

http://www.australiandoctor.com.au/news/latest-news/medical-director-complies-with-pcehr

Medical Director complies with PCEHR

16 January, 2013 Kate Newton

A major GP software program has finally become e-health compatible just weeks before the first deadline for practices to have eHealth Practice Incentive Payment requirements in place.

Software vendor HCN's product, Medical Director, was listed on the National E-Health Transition Authority's website on 10 January as being compliant with the $1 billion personally controlled electronic health record system (PCEHR).

The firm behind MedTech had its software listed a day later.

Practices can also use an add-on program, made by PEN, to make their existing software compatible.

-----

http://www.nehta.gov.au/registration-support

ePIP Support

From 1 February 2013, the PIP eHealth Incentive eligibility requirements change.

To help practices meet these new eligibility requirements, guidance is available for both organisations providing support to General Practice as well as for General Practices registering independently for the ePIP and meeting each of the five requirements.

Practices are strongly encouraged to read the PIP eHealth Incentive Guidelines and use the ePIP Compliance Checklist contained in the General Practice Registration Workbook to help establish eligibility for the ePIP.

• Visit Department of Human Services

-----

http://www.healthintersections.com.au/?p=1336

Standards have no sense of humor

Posted on January 17, 2013 by Grahame Grieve

FHIR is a draft standard that is early in it’s ballot cycle. It’s a reasonable anticipation that it will end up as a ISO standard in the fullness of time. But for now, it’s just a draft standard. Writing a standard is a huge piece of work, and you have find entertainment where you can…. with that in mind, I added a couple of jokes to the specification.

In the roadmap, after describing the general nature of FHIR, I add this line:

Compared to the all the other approaches, FHIR… [-- Obligatory: insert your FHIR FIRE related joke here --].

-----

http://www.linkedin.com/jobs?viewJob=&jobId=4640407&srchIndex=0

Benefits and Evaluation Analyst

NEHTA - Sydney (Sydney Area, Australia)

Job Description

Benefits and Evaluation Analyst – Sydney –

The National E-Health Transition Authority Limited (NEHTA) was established by the Australian, State and Territory governments to develop better ways of electronically collecting and securely exchanging health information.  NEHTA is the lead organisation supporting the national vision for e-health in Australia. 

NEHTA has a goal to attract high performing, experienced individuals looking to be involved in a unique and exciting venture. We are committed to providing a work environment where people enjoy what they do and are motivated to achieve.

• Measure & monitor processes to assist with implementing e-health in Australia
• Data analysis to support change management e-health strategies

-----

http://www.global-health.com/News/2013/PULSE-IT-Global-Health-listed-for-ePIP,-launches-c.aspx

PULSE IT-Global Health listed for ePIP, launches cloud-based SMD service

18 Jan 2013

Global Health the Melbourne-based vendor of the ReferralNet secure messaging service, has been listed on NEHTA's ePIP product register as being SMD-compliant, and has also launched a cloud-based secure messaging solution for specialists and allied health practitioners.

-----

http://www.medpagetoday.com/Genetics/GeneticTesting/36893

No Privacy Guarantee for Genomic Data

By John Gever, Senior Editor, MedPage Today

Published: January 17, 2013

Supposedly anonymous individuals who have contributed their genomic information for research can sometimes be identified through free, publicly available Internet tools, researchers found.

An effort to find the full names of 10 participants in a Utah-based genomic research project was successful for five of them, reported Yaniv Erlich, of the Whitehead Institute for Biomedical Research in Cambridge, Mass., and colleagues.

In fact, the researchers said in a report in the Jan. 18 issue of Science, they were able to identify not only the participants but their entire families, a total of nearly 50 people -- relying entirely "on free, publicly available resources," they wrote.

-----

http://www.smh.com.au/technology/sci-tech/new-dna-test-puts-a-face-to-the-longdead-20130114-2cptl.html

New DNA test puts a face to the long-dead

Date January 15, 2013

A NEW DNA test can supply at least some features of long-dead people for whom there is no image, scientists reported on Monday.

The technique has revealed possible hair and eye colours of anonymous people slaughtered by the Nazis, and of a woman buried alongside monks in a mediaeval crypt, they said.

''This system can be used to solve historical controversies where colour photographs or other records are missing,'' said Wojciech Branicki, of Poland's Institute of Forensic Research in Krakow.

-----

http://www.smh.com.au/technology/technology-news/avatars-of-patients-used-during-surgery-20130111-2cky5.html

Avatars of patients used during surgery

Date January 11, 2013

Julia Medew

Health Editor

Melbourne surgeons are using technology that turns patients into avatars on computers so they can navigate their bodies with unprecedented precision.

The life-saving technology is being used for brain and spine surgery which has been impossible in the past due to navigational issues.

Professor Peter Choong, director of orthopaedic surgery at St Vincent's Hospital, said he had been using a "stealth guidance machine" to recreate patients on a computer so he could monitor movements in their body during surgery.

-----

http://www.zdnet.com/microsofts-windows-8-upgrade-promotion-really-is-ending-on-january-31-7000010025/

Microsoft's Windows 8 upgrade promotion really is ending on January 31

Summary: Existing Windows licensees have until January 31 to get Windows 8 Pro for $39.99. After that, upgrade prices are on the rise.

By Mary Jo Foley for All About Microsoft

When Microsoft announced last year a "limited time offer" for Windows 8 upgrade pricing, some thought -- or at least hoped -- that the discounted price might be indefinite.

Microsoft officials announced on January 18 that this will not be the case.

After January 31, the $39.99 upgrade price will end. Starting February 1, the Windows 8 upgrade (from previous Windows home/consumer SKUs) will cost $119.99. The Windows 8 Pro upgrade will cost $199.99.

Currently, Microsoft is charging $39.99 for an upgrade license to Windows 8 Pro from Windows XP, Windows Vista or Windows 7.

-----

Enjoy!

David.

Just How Pathetic Is This In Terms Of Planning and Implementation? An Utter Joke Reflecting Spectacularly Bad Performance.

This collection of files appeared the day before yesterday on the NEHTA web site.

Go here to see for yourself.

http://nehta.gov.au/publications/whats-new

What is even more typical is - guess what? - it turns up on a Friday!

Documents	Details	Published Date	Hits
GP Practice Registration Overview_v1.00_18012013		18/01/2013	11
Seed Organisation Registration Confirmation and Next Steps for ePIP Checklist_v1.0_18012013		18/01/2013	6
Seed Organisation Application Checklist_v1.00_18012013		18/01/2013	9
Useful eHealth Links_v1.0_17012013		18/01/2013	7
Secure Messaging Delivery Policy Template_v1.0_17012013		18/01/2013	10
Sample RO Authority Document for Seed HPI-O Application_v1.0_17012013		18/01/2013	7
Registration Workshop Checklist_v1.0_17012013		18/01/2013	8
Pre-Registration Workshop Checklist_v1.0_17012013		18/01/2013	6
Post-Registration Workshop Checklist_v1.0_17012013		18/01/2013	5
PCEHR Security and Access Policy_v1.0_17012013		18/01/2013	6
PCEHR Consumer Registration Helpful Hints_v1.0_17012013		18/01/2013	4
NASH Organisation PKI Application_AH2542.1212_17012013		18/01/2013	5
Healthcare Provider FAQs_v1.0_17012013		18/01/2013	3
Guide - Seed Organisation Application Form_v1.01_17012013		18/01/2013	5
Guide - PCEHR Participation Agreement_v1.01_17012013		18/01/2013	2
Guide - NASH Organisation PKI Form_v1.0_17012013		18/01/2013	3
GP Practice Registration Workbook Approach_v1.0_17012013		18/01/2013	2
GP Practice PKI Summary_v1.0_17012013		18/01/2013	3
Healthcare Provider FAQs_v1.0_17012013		18/01/2013	8
Guide - PCEHR Participation Agreement_v1.01_17012013		18/01/2013	6
Guide - NASH Organisation PKI Form_v1.0_17012013		18/01/2013	1
GP Practice Registration Workbook Approach_v1.0_17012013		18/01/2013	9
GP Practice PKI Summary_v1.0_17012013		18/01/2013	4
GP Practice Helpdesks by ePIP Stage_v1.0_17012013		18/01/2013	18
Glossary - eHealth record system_v1.0_17012013		18/01/2013	5
Getting your HPI-Is_v1.0_17012013		18/01/2013	4
ePIP Overview_v1.0_17012013		18/01/2013	15
ePIP Implementation Guide - Req 5 - PCEHR_v1.0_17012013		18/01/2013	8
ePIP Implementation Guide - Req 4 - ETP_v1.0_17012013		18/01/2013	5
ePIP Implementation Guide - Req 3 - Data Coding_v1.0_17012013		18/01/2013	5
ePIP Implementation Guide - Req 2 - SMD_v1.0_17012013		18/01/2013	11
ePIP Implementation Guide - Req 1- HI Service_v1.0_17012013		18/01/2013	12
ePIP Compliance Checklist_v1.0_17012013		18/01/2013	16
Clinical Terminology Policy Template_v1.0_17012013		18/01/2013	6
Application to Register a Seed Organisation_2978_1301_p_17012013		18/01/2013	5
Accessing the HPD via HPOS_v1.0_17012013		18/01/2013	6
ePiP Implementation Guide - Req 1- HI Service_v1.0_17012012		17/01/2013	8
ePiP Compliance Checklist_v1.0_17012012		17/01/2013	8

This is simply amazing! All of 12 days before all this is meant to be in use we have a mega data dump.

This material should all have been finalised and distributed to everyone involved at least six months ago.

This is not the way to run a ‘chook raffle’ - let alone a billion dollar e-Health program that has to have many thousands of busy professionals get involved and be supportive.

The old saying ‘I am from the Government and I am here to help’ has now become ‘I am from the Government and I am going to do my best to screw you over’!


I think we will look back at the execution of this program in this messy way and realise that this sort of failure is a major contributor to what I believe will turn out to be a pretty bad waste of public funds and clinical time.

Astonishing.

David.