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."

Friday, October 30, 2015

A Couple Of Perspectives On Electronic Health Records That Face Reality For A Change.

This appeared in the New England Journal of Medicine last week:

Transitional Chaos or Enduring Harm? The EHR and the Disruption of Medicine

Lisa Rosenbaum, M.D.
N Engl J Med 2015; 373:1585-1588
October 22, 2015 DOI: 10.1056/NEJMp1509961
A decade ago, a primary care physician I admired seemed to come undone. His efficiency had derived not from rushing between patients but from knowing them so well that his charting was effortless and fast. But suddenly he became distracted, losing his grip on the details of his patients' lives. He slumped around, shirt half-untucked, perpetually pulling a yellowed handkerchief from his pocket to wipe his perspiring forehead. Everyone worried he was sick. His problem, however, turned out to be the electronic health record (EHR).
Ten years and nearly $30 billion of government stimulus later, the mandate to implement EHRs has spawned many similar stories, some of which Robert Wachter catalogues in The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age, which explores the tension between the push to digitize medicine and the sanctity of the doctor–patient relationship.1 Wachter centers his EHR analysis around the story of an 18-year-old given a 39-fold overdose of Bactrim (sulfamethoxazole–trimethoprim) — a near-fatal error partially caused by an EHR. Investigating the root causes, Wachter discovers design flaws, such as defaulting to certain units for medication dosing and alerts rendered meaningless by their sheer number. But he concludes that the mistake stemmed less from the EHR itself than from its effects on our collective psychology. “I realized,” he writes, “that my beloved profession was being turned upside down by technology.”
For inhabitants of this upside-down world, Wachter's “House of Horrors” tour is vindicating. There's the critical care doctor who, unable to identify new information in daily notes, has begun printing them out and holding two superimposed pages up to the light to see what's changed. There's the cardiologist who says, “It could be worse . . . I could be younger.” To these tales of EHR fallout, most of us could add our own. Physicians retiring early. Small practices bankrupted by up-front expenses or locked into ineffective systems by the prohibitive cost of switching. Hours consumed by onerous data entry unrelated to patient care. Workflow disruptions. And above all, massive intrusions on our patient relationships.
These complaints might be dismissed as growing pains, born of resistance to change. But transitional chaos must be distinguished from enduring harm. According to sociologist Ross Koppel, who has studied the EHR's limitations and why they've been largely ignored, one key barrier is that physicians who voice reservations are labeled “technophobic, resistant, and uncooperative.”2 But in fact a recent RAND study showed that most physicians recognize the potential of EHRs and appreciate such features as the ability to view data remotely. Nevertheless, the researchers found remarkable EHR-induced distress. They conclude, “No other industry, to our knowledge, has been under a universal mandate to adopt a new technology before its effects are fully understood, and before the technology has reached a level of usability that is acceptable to its core users.”3
Lots more here:
Then we has a discussion of Health IT risk.

Your safety can't be guaranteed in the use of IT for healthcare

Monday 19 October 2015 5:30PM (view full episode)
When you think of medical risk you might assume that the most harm would arise from surgery or multiple x-rays.
But what if the use of IT systems was causing you more harm than any visit to the GP?
Farah Magrabi says that this area of healthcare needs to be more thoroughly researched.
She has advised governments on IT-related patient harm in the US, UK and Australia.
Web site is found here:
So many clinicians are unhappy and others have good reason to be concerned about the safety of the tools.
Hardly the nonsense ‘all e-health is good’ that some like DoH, NEHTA and the CHF push.
I think we need much more nuanced discussions.
David.

Thursday, October 29, 2015

The Macro View - General And Health News Relevant To E-Health And Health In General.

October 29 Edition
Well this is the week calm returns with the pollies away for another week and a half.
As always politics and policy inevitably get mixed up in all this so a wide range of views get canvassed.
It is interesting just how quickly the new government is working to get rid of all the ‘stinkers’ (Phil Coorey) in the 2014 and 2015 Budgets.
Interestingly the exclusions of diseases from health insurance is becoming a hot issue, as people discover 'cheap' health insurance may be a big let down.
-----
Here is some other of the recent other news and analysis.

The Political Scene.

Turnbull stands by policies as Labor lags

Prime Minister Malcolm Turnbull is standing by Abbott government policies on health, education and other budget savings, as Labor seeks to link him to his dumped predecessor.
The opposition used parliament on Monday to quiz Mr Turnbull on whether he still backed a raft of unpopular policies including university deregulation, the Medicare co-payment and $80 billion in slowed-down spending on schools and hospitals.
"All of our existing policies and proposals, whether they are before this house or in the policy statements by ministers, remain on foot," Mr Turnbull said.
-----

General Budget Issues.

Warning about further cuts to the public service in ACT due to budget 'red ink': report

Date October 18, 2015 - 11:45PM

Ross Peake

Senior reporter for The Canberra Times

The federal public service could be hit with another round of swingeing cuts to rescue the Budget from a "sea of red ink", according to an economic forecast to be released on Monday.
It warns that new Treasurer Scott Morrison is already increasing the rhetoric about spending being the problem, not revenue.
However, the Deloitte Access Economics Business Outlook says job growth in the ACT has continued to pick up, growth in retail sales is slightly ahead of the national average and small business confidence is also slightly ahead of the national average.
-----
  • Updated Oct 20 2015 at 9:00 AM

Budget repair a difficult and long-term challenge, says Turnbull

Prime Minister Malcolm Turnbull left open the door to further delays returning the budget to surplus – one of the biggest challenges facing his government – after the independent Budget Office warned slow economic growth would mean less money for government services.
With the Coalition swinging its focus towards preparations for the mid-year budget update, which is due within eight weeks, Mr Turnbull cautioned that delivering a budget surplus would be a "very difficult … and long-term challenge".
The remarks are a sign the government is eager to manage expectations about how quickly it can repair the budget, which is under pressure from falling commodity prices, lower sharemarket dividends and faltering wages growth.
By promising to pursue policies that boost economic growth, spur innovation and encourage infrastructure investment, Mr Turnbull has probably made it harder to balance the budget. The full-year 2015-16 budget deficit is forecast to be $35.1 billion. Gross government debt hit a record $402 billion on Friday.
-----

Budget projections to be revised: Morrison

  • AAP
  • 20 Oct, 5:14 PM
Treasurer Scott Morrison says the projection of a return to budget balance within four years will be revised by the end of the year.
The current budget papers project a balanced budget in 2019/20 after a series of deficits.
Asked whether he stood by the projection, Mr Morrison told Sky News on Tuesday the latest figures would not be known until the mid-year economic and fiscal outlook due in December.
"Those projections and those forecasts will be revised in MYEFO and refreshed," Mr Morrison said.
-----
  • Oct 20 2015 at 5:09 PM
  • Updated Oct 20 2015 at 8:33 PM

Scott Morrison waters down cuts to family payments

The government has watered down some of the harshest cuts proposed in its notorious 2014 budget a bid to secure a passage through the Senate.
Just after announcing the government's response to the financial system inquiry, Treasurer Scott Morrison and Social Services Minister Chris Porter secured the support of the Coalition party room to offer the compromises.
These include lifting from six years to 13 years the age of a family's youngest child at which the government would cut off family tax benefit part B payments.
Family tax benefit part B is paid to single-income families and is means tested at $100,000 a year. In the 2014 budget the government sought to lower the cut-off age from 16 to six but has been unable to get it through the Senate. The measure was budgeted to save $5.1 billion over the next four years.
-----

Families win as Coalition eases cuts to benefits

  • The Australian
  • October 21, 2015 12:11PM

David Crowe

Rosie Lewis

Treasurer Scott Morrison has labelled the government’s compromise package on cuts to family tax benefits a “better offer”, as the Turnbull government retreats on the controversial policy from last year’s unpopular budget.
Mr Morrison said today’s package was the product of months of negotiations with Labor and the crossbench, but the opposition and some independent senators have already expressed some concerns about the new proposal.
“It’s a better package, it’s a better offer and it also achieves the government’s savings objectives so we haven’t had to walk away from that and nor would we because as a government we know you’ve got to pay for what you spend,” Mr Morrison said.
-----
  • Oct 22 2015 at 4:17 PM
  • Updated Oct 22 2015 at 5:49 PM

RBA makes $6.1b from falling $A

Treasurer Scott Morrison will be the main beneficiary of a $1.6 billion windfall from the Reserve Bank of Australia after it generated more than $6 billion in profit from the falling Australian dollar.
The payment from the central bank to Treasury's coffers - which was made on September 3, a day after the Reserve Bank's accounts were finalised - is the biggest to government in 13 years, except for Wayne Swan's 2009 draw-down of $5.2 billion.
Determined by both Reserve Bank governor Glenn Stevens and former Treasurer Joe Hockey, the payment is almost equivalent to what the bank delivered Canberra over the previous five years.
-----

Family tax benefit cuts: more than 130,000 single parents would lose out

Date October 22, 2015 - 6:01PM

Judith Ireland

National political reporter

Family tax benefits revamped

The government remodels its family welfare changes to pass the senate while still delivering savings.
More than 130,000 single parents stand to lose family benefits under the Turnbull government's family payments plan. 
Department of Social Services officials have told a Senate committee in Canberra that 136,000 single parents will see a reduction in family tax benefit part B once their youngest child turns 13, if the government gets the green light from the Senate for its new package
-----

Grandparents and single parents to be spared in welfare cuts — others to lose up to $5700-a-year

October 25, 2015 12:00am
Samantha Maiden National political editor The Sunday Telegraph
TREASURER Scott Morrison has offered to exempt grandparent carers and some single parents from tough family ­payment cuts that will slash up to $5700-a-year from families with teenagers.
In an exclusive interview, the Treasurer said it was vital to secure Labor’s support for the budget savings in the ­welfare portfolio to pay for childcare reform.
Parents face a double hit under Malcolm Turnbull’s “fairer’’ family payments plan because of the combined impact of the family tax benefit changes and the looming abolition of the Schoolkids Bonus.
The hit to family budgets is designed to encourage parents to get back into the workforce but will strip payments from around 1.7 million low and middle income families.
-----

Health Budget Issues.

9:58am October 21, 2015

Medicare safety nets being merged

AAP
The government is tidying up the Medicare safety net.
Health Minister Sussan Ley on Wednesday introduced a bill to parliament to remove the two existing safety nets and the Greatest Permissible Gap and replace them with a single safety net.
Ms Ley said the change would ensure a strong safety net continues to protect all Australians from high costs for medical services provided out of hospital.
The current safety nets were complicated and confusing, had different thresholds and were inconsistent.
-----

Digging deeper hole on hospital

October 21, 20159:48pm
CHRISTOPHER WALSHThe Australian
FEDERAL Health Minister Sussan Ley has warned the CLP Government that any delays at the Palmerston Hospital will be at the Territory’s expense and that the situation will be monitored.
The warning comes after revelations that the so-called first pour of concrete for a central stairwell at the hospital site has been buried in dirt and abandoned.
And yesterday NT Health Minister John Elferink continued to dig his own hole, blowing up in a press conference twice while trying to explain why last Friday’s concrete pour was not a $20,000 taxpayer-funded publicity stunt.
-----

Labor asks for audit of funds for hospital where hole was dug and filled in

Northern Territory government denies media event to mark the first concrete pour was staged but Labor senator and MPs ask auditor general to investigate
Helen Davidson in Darwin
The federal Labor party has written to the auditor general requesting the funding of a Northern Territory hospital at the centre of an alleged government media stunt be examined.
The Palmerston hospital project, which has $110m in federal funding, came under scrutiny this week when the NT government was accused of staging a media stunt at the construction site. The health minister, John Elferink, invited media to attend the first concrete pour last Friday, only for the hole to be filled in and covered up in the days following.
The NT government denied the event was staged and said construction site managers Lend Lease filled it in for “public safety” but did not answer questions on why it was dug in the first place or who made the decision.
-----

Business plots Medicare takeover

Date October 21, 2015 - 11:30PM

Noel Towell

Reporter for The Canberra Times

Big companies want to take over the processing of Medicare claims and assess eligibility for benefits as well as run the agency's call centres and other functions, internal Health Department documents reveal.
The federal government is considering bringing in a private player to take over Medicare's payment system but documents released under FOI laws show that big business is hungry for a much bigger chunk of the Medicare pie.
The department has been approached by private-sector players who want to take over claims processing, benefit assessment, call centres and registrations.
The documents were release after an FOI request by the Community and Public Sector Union, which is bitterly opposed to any outsourcing, fearing its members at Medicare's parent department Human Services might lose their jobs.
-----

Medicare: 'Thousands more' to receive benefits under merged scheme

Date October 21, 2015 - 7:35PM

Jane Lee

The Turnbull government will pay thousands more Medicare benefits to help patients with out-of-hospital costs under a plan expected to save it millions of dollars, a Senate estimates hearing has been told.
Health Minister Sussan Ley introduced the plan to merge two Medicare Safety Nets into Parliament on Tuesday. The changes will lower the spending thresholds required for patients to access benefits, but cap the benefits payable for individual medical services once this has been reached.
Ms Ley said the plan offered patients up to one-and-a-half times the fee for a medical procedure once they reached their safety net. It was expected to save $266.7 million over five years, which would go into the Medical Research Future Fund.
-----

Medical Future Fund.

Scientists in sales pitch for Medical Research Future Fund

  • The Australian
  • October 19, 2015 12:00AM

Rosie Lewis

Australians will be asked to embrace the $20 billion Medical Research Future Fund as leading scientists launch a national campaign to expose the “critical role” it will play in the future health of the country.
With notable names such as Gustav Nossal, Ita Buttrose, Natasha Stott Despoja, Patrick McGorry and Carrie Bickmore volunteering to front the campaign, it will run on TV and online and highlight the need to invest in treatments and cures for conditions such as dementia, brain cancer, mental illness and heart disease.
The fund was one of the Abbott government’s signature budget measures last year and passed the Senate in August despite the dumping of the controversial GP co-payment that had been designed to bankroll it.
Ms Buttrose, Alzheimer’s Australia national ambassador, said it was “imperative” the nation invested in medical research to find treatments and a way to slow down the progression of dementia.
-----

Health Insurance Issues.

Health funds demand action on overservicing

  • The Australian
  • October 20, 2015 12:00AM

Sean Parnell

The government must target overservicing by doctors in both the public and private sectors to bring spiralling costs under control, leading health funds say.
With cost pressures prompting insurers to consider premium ­increases again, Health Minister Sussan Ley has agreed to address affordability issues in the sector.
A separate Medicare review will have flow-on effects, potentially reducing government ­rebates and benefit outlays, but funds Bupa and HCF want more action on overservicing.
The managing director of Bupa’s health insurance business in Australia, Dwayne Crombie, said there were “perverse incentives” that led doctors to see, test, scan and treat more patients and conditions than necessary. “There is quite a bit of inappropriate care and overservicing going on and it’s pretty hard to question doctors on whether it is needed,” he said.
-----

Watchdog blasts health insurers

Andrew Tillett Canberra
October 21, 2015, 12:30 am
Health fund members are confused and potentially misled by insurers about their cover and slugged with shock out-of-pocket costs, the competition watchdogs warns.
In a scathing report on the industry, the Australian Competition and Consumer Commission says a “number of market failures” left customers struggling to compare policies because they were so complex.
The Turnbull Government seized on the report to promise a fix for the health insurance industry’s ailments.
The insurer’s peak lobby group laid the blame for complexity on government regulation of the sector and argued that the raft of policies on offer was good for consumer choice.
-----

Health fund covers 88-year-old man for baby but not hip replacement

October 24, 20154:55pm
Stuck ... Health fund exclusions leave patients without cover.
Sue Dunlevy News Corp Australia Network
ELDERLY men are being sold health insurance that covers them for having a baby but not a hip replacement as private hospitals warn health fund exclusions have reached crisis point.
Taxpayers spend $6 billion a year subsidising private health insurance but the number of people who find their fund doesn’t cover their surgery has tripled in the last few years.
Just days after the consumer watchdog, the ACCC, set up an inquiry to put health funds through the wringer, a News Corp investigation has found many people are finding their health funds desert them when they need help.

ACCC report on private health insurance – an analysis

Editor: Jennifer Doggett Author: Ian McAuley. John Menadue and Jennifer Doggett on: October 24, 2015
Last Tuesday the Australian Competition and Consumer Commission (ACCC) released its  report on private health insurance.  Private health insurance (PHI) was also in the news a day later with the standing down of the CEO of Medibank Private, the largest PHI company.
In the following piece, Ian McAuley, John Menadue and Jennifer Doggett analyse the report and discuss its implications for the future of private health insurance policy. In particular they challenge the Report’s underlying assumption that competition is desirable (or even possible) in many areas of health care. They write:
The ACCC report has been a regular report since 1999, when the Howard Government introduced a swag of subsidies for private health insurance. It covers specific “consumer” issues, such as possible false or misleading representation of products, anti-competitive behaviour, and the incidence of unexpected out-of-pocket expenses.
-----
It has been an interesting time with the new Government settling in and all sorts of options now back on the table, including the Harper Competition Review - pharmacy might be worried. Health is also clearly under review as far as its budget is concerned. Lots to keep up with here! Enjoy.
David.

Wednesday, October 28, 2015

Just What Are The Implications For The Health Identifier Service Of This Announcement? I Wonder How The Public Will React?

This appeared last week:

Turnbull promises national digital identity, fintech committee

Government tables long-awaited response to FSI report.

The federal government has adopted the majority of recommendations made in last year's financial systems inquiry report, promising to deliver a national federated digital identity framework and a public-private sector innovation committee for the financial sector.
In its long-awaited response to the December 2014 report, tabled today [pdf], the federal government also said it would ask the Productivity Commission to review options to improve data-sharing within the sector, and remove regulatory impediments to modern product information disclosure.
By the end of next year, the government also intends to consider how to amend priority areas of regulation to make it technology neutral.
Digital identity
The FSI report, led by David Murray, highlighted a national federated digital identity as key to improving the efficiency of digital identity processes as well as to minimise the costs and regulatory burden of customer authentication for financial services firms.
Its recommendation - accepted by the government - called for the establishment of a framework under which private and public sector bodies could compete to supply digital identities.
A single minister should be given responsibility for the framework, the report suggested, and a private-public sector taskforce should develop the detail of the framework and standards.
Banks and other financial services firms are currently required to verify an individual using government-issued, paper-based credentials such as a passport or drivers license.
By introducing a national digital identity framework, reliance on paper-based mechanisms could be reduced, making the process more secure and convenient for customers and more efficient for governments and banks, the FSI report said.
It recommended the government utilise the national document verification service, the myGov service portal, the national e-authentication framework, the Finance department’s third-party identity services assurance framework, and the government’s Vanguard electronic authentication service, among others, to create the framework.
The government today said it would task its Digital Transformation Office with developing the trusted digital identity framework.
There is also some coverage here:

Orwell returns: Government promises to implement digital ID for all

COMMENT: After being returned to office in 1987, Prime Minister Bob Hawke triumphantly announced that he now had a mandate to introduce an ID card for all Australian residents. Such was the outcry, that Hawke backed down and talk of the card disappeared into the ether. In 2015, the Orwellian Australia Card has returned in the form of a digital ID.
Buried deep in the bowels of the 32 page Government Response to Financial System Inquiry report by former Commonwealth Bank CEO David Murray, were some chilling sentences that confirmed the Government’s intentions to figuratively stamp the biblical mark of the beast’ on every Australian residents’ foreheads.
In actual fact, the ‘mark of the beast’ happens to be a national system to implement a digital identity for all individuals, which was recommended by Murray in his report.
Here are the actual words on page 20 of the document:
Digital identity.
Develop a national strategy for a federated-style model of trusted digital identities.
The Government agrees that a national digital identity strategy will help to  streamline individuals' engagement with government and provide efficiency improvements.
The Digital Transformation Office will work across government and with the private sector to develop a Trusted Digital Identity Framework to support the Government's Digital Transformation Agenda.
As is always the case with government propaganda, the words are couched in benevolent terms - ‘streamline individuals’ engagement with government’.
In actual fact, what this really means is a more convenient way for government to track and keep tabs on every single living soul residing in this country - from birth until death.
As they have in the past, proponents of the scheme may argue that if you have nothing to hide then why should you be concerned. After all, you don’t mind using your Medicare Card or Driver’s License to identify yourself.
The answer is of course that Australians are not by law required to carry either card as proof of identity or to perform transactions. In fact, we are a freedom loving people who love the freedoms that Australia has always provided and who don’t like to be presided over by authoritarian governments - especially centralised federal governments.
More here:
What is going to be very interesting is to see what the reaction to this is. Will people be thrilled or see the plan as the Australia card Mark III.
Also, if we have a digital id that we can use to move money etc. will the same id be used for health care identification for the individual?
Will be interesting to watch over the next year or so.
David.

ZDNet Article Has Now Been Retracted - With A Correction.

Here is the link:

http://www.zdnet.com/article/e-health-saving-lives-in-queensland-csiro/

Bottom paragraph now reads:

"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."

David.

ZDNet Article Seemingly Incorrect Regarding The PCEHR Health Impacts. Opt-Out Trials To Be Announced!

This appeared as a comment from Bernard Robertson-Dunn.

It is worth turning into a post.

"If anyone has seen this article:

E-health saving lives in Queensland: CSIRO

http://www.zdnet.com/article/e-health-saving-lives-in-queensland-csiro/

You would have read this claim:

"Australia's e-health record system has brought down the rate of mortality in Queensland, according to the CEO of CSIRO."

The only problem is it's a total fabrication.

I checked with the CSIRO and they said:

"we haven’t used any information from the PCEHR to date nor looked at the impact of the PCEHR on mortality in Queensland."

and

"While we have had some projects where we have used MBS and PBS data to look at the outcomes of an intervention, we haven’t used any information from the PCEHR."

It will be interesting to see if the government tries to make use of this rather misleading report and if the CSIRO issues a correction.

----- End Extract

Thanks Bernard - it really did look a bit suss. Who can imagine the Feds would be giving Qld specific data to the CSIRO in Qld., and no where else.

I wonder does this have anything to do with the Press Club speech Ms Ley is giving at 12:30pm. On Sky News if you want to watch. The ABC is reporting the PCEHR Opt-out trials will be announced for Nth Qld and the Blue Mountains!

David.

Tuesday, October 27, 2015

What Is Happening In New Zealand Looks Very Interesting. I Hope They Are Careful As It Looks Complicated.

These two articles appeared last week.

E-health records in Government's sights again after 2014 target missed

TOM PULLAR-STRECKER
Health Minister Jonathan Coleman says information technology has a 'crucial role' in making the health system more 'sustainable'.
Electronic health records are back on the Government's agenda after it missed a target of introducing them by 2014.
A government source said without electronic health records, patients could not assume healthcare providers would always have access to key clinical information about them, such as whether they were allergic to a common drug such as penicillin.
Health Minister Jonathan Coleman told a conference in Christchurch that the Government had commissioned consultants Deloitte to undertake a study into the benefits of electronic health records.
He said they would create efficiencies by "joining" up patient information held by hospitals and other healthcare providers.
Electronic health records had been the cornerstone of a National Health IT Plan agreed by the Government in 2010.
The goal then was that all Kiwis would be able to access an online record by 2014 that would contain a summary of their GP visits, specialist and hospital treatment, test results and prescriptions.
However, National Health IT Board chairman Murray Milner admitted in December 2013 that the health sector would struggle to achieve the deadline.  
Coleman did not set out a new timetable for electronic health records in his speech to the Health Informatics conference in Christchurch.
However, he said the Government wanted to establish a "blueprint for a digital hospital" by November 2016, "where all patient information is linked up into a standard electronic medical record" and can be accessed from anywhere in the hospital.
Iain McCrae, chief executive of Orion Health, New Zealand's largest health software firm, was not able to speculate on why the 2014 target had been missed, but said electronic health records were key to the future delivery of healthcare.
More here:
There is also coverage here:

NZ announces plan for single national e-health record

Thursday, October 22, 2015 - 14:21
The New Zealand government has announced plans to build a single, national electronic health record (EHR) able to be accessed via portals and apps running on a variety of devices.
Minister of Health Dr Jonathan Coleman said a report on the benefits of an electronic health records had been commissioned from consulting firm Deloitte which found that there is growing international support for adopting a “Hybrid/Best of Suite strategy for Electronic Health Records, where a ‘single’ EHR is introduced to join up information held in a smaller number of Electronic Medical Record systems.”
The Deloitte report will be published shortly on the Ministry of Health website
In a speech to the Health Informatics New Zealand Conference held in Christchurch this week, Coleman said “As I travelled around meeting clinical leaders, patients and IT providers it became clear that our eHealth system was complicated, fragmented and not as user friendly as it could be.
More here:
Here is a link to the full speech.

Health Informatics New Zealand Conference, Christchurch



Hon Dr Jonathan Coleman
Minister of Health
20 October 2015
Speech
Health Informatics New Zealand Conference, Christchurch
Opening
Thank you for inviting me here today to open the 2015 Health Informatics New Zealand conference – the most important fixture on the health IT calendar.
It’s great to be in the South Island – the first time in 14 years the conference has been held here.
I’d like to acknowledge Liz Schoff, HiNZ chair, and David Meates, chief executive of Canterbury DHB.
Attending the HINZ conference in Auckland last year was one of my first speeches as a Minister of Health. I am pleased to be part of your conference again this year. You have chosen a highly relevant and important theme - Collaborate: Share. Solve. Achieve. Measure.
The full speech is here:
Here is the report:

Independent Review of New Zealand's Electronic Health Record Strategy


Published online: 
21 October 2015

Summary

The Minister of Health has requested an independent report on the benefits of a single electronic health record in New Zealand.
There are five key findings in the report.
  • Quality and productivity benefits are available by rationalising the systems used by secondary care facilities (eg, hospitals).
  • Creating a ‘single’ electronic health record that physically consolidates health information in one place will improve decision support and care coordination especially for complex patients with multiple long-term conditions.
  • Primary care needs to be connected real-time with the ‘single’ electronic health record.
  • Implement closed loop medicine management, as this is the area that offers the highest benefits in terms of patient safety and quality.
  • Develop consumer portal access to improve the ability to serve up information from a physical repository in real-time, through digital channels to consumers. Consumer engagement around their health and wellness is key to implementing a preventive or primary care-led strategy.
The Minister referred to this report during the Health Informatics New Zealand conference in Christchurch on 20 October 2015, where he announced a new health IT programme for 2015-2020.
Here is the link:
This report needs close reading and I look forward to comments:
I note the examples of success used are Kaiser Permanente, Denmark, Singapore and British Columbia. Australia is not even mentioned in passing - and neither is the PCEHR which clearly is not anywhere close to what is being discussed in the Deloitte Report. The five bullets above make that clear - and also note just where the consumer fits. This is a system for carers not for consumers as far as I can tell.
Must read stuff and I look forward to comments.
David.