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, September 10, 2010

Good Heavens - They are Popping Up Everywhere!

It seems the e-Health Web Site population in OZ is definitely on the rise!

We have now had launched this new site.

http://ehealthspace.org/

The site is significantly sponsored by the likes of:

  • NEHTA
  • iSoft
  • CHIK Services
  • Telstra.

It seems sponsoring www.ehealthcentral.com.au was just not getting enough cut through and now we have a much richer site which is just brimming with e-Health enthusiasm.

I do wonder how a sponsored, obviously professionally run site can have a .org domain registration however. This is clearly, at the very least, a venture designed to break even – or the subscription manager and journalists would be out of a job! Their ‘about us’ section makes as much clear.

See:

http://ehealthspace.org/about/our-story

All one can do is with them luck with this and the Community they are fostering

Don’t forget, for balance, to keep reading here:

http://blog.healthbase.info/

and also here of course!

Exciting times indeed!

David.

Thursday, September 09, 2010

Where to For E-Health in Australia Now We Have a New Government?

Now the election has been decided (for now at least) it is probably time to try and assess where we might go over the next few years with e-Health.

One good thing that seems to have emerged is that there does seem to be a considerable political consensus (from each of Labor, the Coalition and the Greens) that introduction of reasonable levels of computerisation and electronic messaging within the health sector can have a significant positive impact on the quality, safety and efficiency within the health sector while recognising there are issues of information security and privacy that do need to be addressed. This is a least a basic starting point for ‘moving forward’!

A reasonable point to start this brief review is from the most recent budget in May, 2010 as this was the first occasion we had a budgetary commitment from the previous Rudd Government outside support for the half funding of the National E-Health Transition Authority (NEHTA) in a Council of Australian Governments (COAG) meeting in November 2008. The shared funds ($218million) were to run NEHTA from July 2009 to June 2012.

There have been four significant announcements including the Budget announcement.

First, in the 2010 Federal Budget the Government announced an investment of $466.7 million that was claimed would revolutionise the delivery of healthcare in Australia. It was said that for those Australians who choose to opt in, they would be able to register online to establish a personally controlled e-Health record (PCEHR) from 2012-13. It was later made clear that the service would be provided by a centralised portal and that the patient would control who would be able to access the information held within the portal. The source of the information to populate the portal has never been clarified to my knowledge.

What details that are available from the source are found here:

http://aushealthit.blogspot.com/2010/05/few-details-from-minister-roxon-on-e.html

and here:

http://aushealthit.blogspot.com/2010/06/spend-five-minutes-with-nicola-roxon-to.html

The second e-Health related announcement was that of a package of measures that were announced at the Labor Party policy launch on August 16, 2010.

The announcement was costed at $392 million and was intended to modernise the health system, including allowing patients to access Medicare rebates for online consultations. At the launch Ms Gillard also said a re-elected Labor Government would use the internet to modernise the health system by funding online consultations and videoconferencing.

The package was made up as follows:

1. $250 million for online consultations, providing about 495,000 services over four years for rural, remote and outer metropolitan areas.

2. Financial incentives for GPs and specialists to deliver the online services at a cost of $56.8 million and an expansion of the GP after-hours helpline at a cost of $50 million.

3. $35 million to support training for health professionals using online technologies.

Read about this here:

http://www.governmentnews.com.au/2010/08/16/article/ELECTION-2010-Labor-commits-to-rural-e-health-measures/GIWFZJQWAG

Third we had an announcement from the Health Minister (Nicola Roxon) that some of the budget money ($12.5 million) would be spent on three e-health pilots. She noted that “each of the e-health sites announced today – GPpartners (QLD), GP Access (NSW) and Melbourne East GP Network (Victoria) – was chosen because they already have strong e-health capability and support within their communities.” Each site was to receive $100,000 to be involved and NEHTA was to receive $300,000 to co-ordinate and manage what are technically very different pilots in terms of architectures and applications.

You can read all about this here:

http://alp.org.au/federal-government/news/first-places-in-australia-to-get-e-health/

Fourth we had a very late joint announcement with the Australian Institute of Health and Welfare (AIHW) of a MyHospitals web site where people could locate comparative information on the performance of the nation’s public hospitals. (As of today this is still not operational – despite having been due last month – ‘coming soon’ as they say)

Check here:

http://myhospitals.gov.au/

Note it is odd going here gives you a different page:

http://www.myhospitals.gov.au/

What is that about I wonder?

What was missing from all these announcements was, among other things:

First any revamp of the national leadership and governance of e-Health in Australia or reform of the way NEHTA supports the whole health sector and not just jurisdictional interests. It has been an ongoing problem that NEHTA has failed to really address the needs of the whole health sector rather than the focus of its directors.

Second any clarity about just what the PCEHRs would deliver, what the business case for their implementation was and what information would be used to populate the patient’s record. With the new apparent ‘rainbow coalition’ this really needs to change and fast

Third it was hard to see how these announcements fitted into the priorities which were established in the National E-Health Strategy that had been endorsed and supported by the Department of Health and Health Ministers as recently as December, 2008. Neither was there any commitment to actually proceed with the implementation and funding of this Strategy. This is a really serious problem I believe. If we are not implementing that strategy just what are we doing?

Fourth any coherent explanation of how all these initiatives were developed and what the organising concept behind these apparently random announcements was. It all seems pretty ad-hoc and non-strategic to me but I could have missed something.

Fifth there was really no explanation of how this was to be implemented and what impact these proposals might have on clinical workflows, liability insurance and so on.

On the basis of the last four months and this set of election campaign announcements I fear we are in for more of the glacial, non-strategic, money wasting progress we have seen over the last decade. Time will tell I guess.

David.

Wednesday, September 08, 2010

It Looks To Me NEHTA is Being Excluded from the Personally Controlled EHR Project.

I thought I would wander along to the NEHTA web site to see just what was available on the PCEHR given the dearth of information available from DoHA.

I have discussed what we had a few weeks ago, during the election campaign, here:

http://aushealthit.blogspot.com/2010/07/we-have-utter-madness-afoot-at-doha.html

Here is what I found from NEHTA:

http://www.nehta.gov.au/coordinated-care/whats-in-pcehr

What is a PCEHR?

A Personally Controlled Electronic Health Record (PCEHR) is a secure, electronic record of your medical history, stored and shared in a network of connected systems. The PCEHR will bring key health information from a number of different systems together and present it in a single view.

Information in a PCEHR will be able to be accessed by you and your authorised healthcare providers. With this information available to them, healthcare providers will be able to make better decisions about your health and treatment advice. Over time you will be able to contribute to your own information and add to the recorded information stored in your PCEHR.

The PCEHR will not hold all the information held in your doctor's records but will complement it by highlighting key information. In the future, as the PCEHR becomes more widely available, you will be able to access your own health information anytime you need it and from anywhere in Australia.

IEHR General

Documents

Public Opinion Poll - IEHR (07/11/2008)

NEHTA Consultation Report (14/10/2008)

IEHR Fact Sheet

Documents

Individual Electronic Health Record Fact Sheet (04/07/2008)

IEHR Context and Strategic Direction

Documents

Standards for E-Health Interoperability v1.0 (08/05/2007)

Review of Shared Electronic Health Records Standards v1.0 (21/02/2006)

IEHR Archived

http://www.nehta.gov.au/coordinated-care/benefits-of-an-pcehr

Benefits of a PCEHR

The Personally Controlled Electronic Health Record (PCEHR) will greatly enhance both the quality and the timeliness of available healthcare information, delivering substantial benefits to you, your healthcare provider and the healthcare system as a whole.

More specific benefits of PCEHRs include:

  • assisting the self-management of stable chronic diseases (for example, high blood pressure, diabetes and asthma)
  • increasing communication between clinicians and individuals by using e-consultations and online services to support self-care management using broadband services and online records to share relevant health information
  • reducing hospital re-admissions by making accessible timely and accurate health information essential to the better coordination of post-hospital care
  • improving use of scarce resources through better quality health information, faster clinical assessments, more accurate diagnoses and referrals, and more effective treatment and prescribing of medication
  • better decision making by healthcare providers and individuals through the availability of more complete, more accurate and more up-to-date health information
  • better policy development as a result of the high quality data potentially available for use in research and planning.

----- End Extract.

It is really hard to know why it would be that a (even the) major e-health initiative would be announced, NEHTA would update the headings on its web site and have no new information since November, 2008 on their web-site.

As for that benefits list, will patient controlled information actually be useful, trustworthy and complete enough to be useful? I somehow doubt it.

The NEHTA Blueprint was also essentially silent on the PCEHR– saying essentially ‘watch this space’!

I wonder what will flow from our new Government! We really are entitled to know what is going on with all this!

David.

Tuesday, September 07, 2010

So We Have A New Labor Government! It Will be Fascinating I Suspect!

Well it seems we have a Government formed by 76 to 74 votes.

It is also seems the National Broadband Network was a key decider, although I heard no specific mention on e-Health in the "Decision Press Conference".

It will be fascinating to see what this new paradigm actually results in. I certainly hope we get much increased transparency and especially in regard to e-Health.

It is interesting to note the the Independents are only offering quite limited guarantees and that every Bill will be fully debated and discussed! I imagine any legislation to implement the Personally Controlled EHR will certainly now get very careful scrutiny.

We are in for a very interesting period I suspect.

David.

Monday, September 06, 2010

This is Really A Sad State of Affairs. We Need to Look Closely At What is Going On!

The following appeared last week.

Australia behind on e-health: HealthLink

  • Karen Dearne
  • From: Australian IT
  • September 01, 2010 10:05AM

NEW Zealand continues to outpace on e-health Australia still grapples with key design, funding and planning issues.

Tom Bowden, chief executive of Auckland-based secure messaging and integration specialist HealthLink, said Australia had failed to do the hard work on building basic capacity, setting standards and improving data quality.

"All the really flash stuff has been worked on and there's been lots of bright ideas, but the real effort is still to be done and we won't see solid progress until that occurs," he said.

"Nowhere near enough effort has gone into getting the quality of GPs' electronic patient records up to scratch, and organising standardisation of the information that's to be exchanged."

In contrast, 100 per cent of GPs were using fully functional e-medical records by 2000; 100 per cent have been doing clinical messaging and 95 per cent of hospitals have provided e-discharge summaries over the same period. Because of this infrastructure, New Zealand has been able to build and release a raft of more sophisticated applications.

The latest is electronic referrals from a GP's office to hospital specialists. HealthLink has completed the rollout of a web services e-referral platform across half the country. New Zealand celebrates the 10th anniversary of its universal patient record system this year.

"A hospital offers a menu of referral types depending on specialty, the GP picks one and the GP's system automatically picks up all the required information with one click," Mr Bowden said.

"The referral is then submitted electronically to the hospital, where it becomes part of the patient's incoming record.

"Where the system is in use, some 80 per cent of referrals are being done while the patient is in the GP's room, during a 10-minute consultation.

"The specialists like it because they get all the information they need, and the inclusion of test results or digital photos cuts waiting time because they have a much clearer understanding of what's wrong."

Mr Bowden said New Zealand achieved its connectivity using the messaging standard HL7 version 2, while most labs in Australia still used the outdated pathology reporting format PIT.

"I'm sad to say PIT should have been replaced long ago by HL7v2, but its use for pathology messaging is still rising," he said. "This gets back to basic messaging not being properly run here.

"Every lab is supposed to go through testing with the Australian Health Messaging Laboratory to ensure their conformance with HL7v2.

More here:

http://www.theaustralian.com.au/australian-it/government/australia-behind-on-e-health-healthlink/story-fn4htb9o-1225912683944

If ever there was an example of ‘perfection being the enemy of the good’ in e-Health it is the comparison that can be made in progress in the basics between NZ and OZ. Even with a financially more constrained nation it has been possible, with some decent strategic leadership to more steadily, if not rapidly forward. Pity we have not been able to replicate the same here!

I leave it as an exercise for the reader to suggest how we might change things to improve our chances in the future.

This blog offers some of my thoughts.

http://aushealthit.blogspot.com/2010/08/there-is-small-window-for-sanity-in-e.html

David.

Sunday, September 05, 2010

Weekly Australian Health IT Links – 05 September, 2010.

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. 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:

We are assured that this week we will know who is going to govern for the next little while. That will be a good thing as I suspect most people are a little sick of waiting for things to clarify.

On the e-Health front there has been continuing coverage of iSoft’s woes and the Health Informatics Conference from last week.

The first article cited below – and Prof Greenhalgh’s views – need to be taken pretty seriously. I believe and before we leap into implementing the still pretty obscure NEHTA / DoHA plans for their various forms of shared electronic records I think we need to carefully review all that has gone one in the rest of the world and try and work out an optimal way forward. To just steam ahead, without pausing for careful review, would be just silly in my humble opinion.

-----

http://www.theaustralian.com.au/australian-it/doubts-over-value-of-records-in-emergency/story-e6frgakx-1225912046193

Doubts over value of records in emergency

THE oft-touted summary care record that would save the lives of unconscious patients in emergency situations was a myth.

It distracted from broader e-health gains, said a British researcher in the field.

Trish Greenhalgh, professor of primary healthcare at the London School of Medicine, says her detailed review of the National Health Service's Summary Care Record program found scant evidence that SCRs would have made any difference to patient outcomes.

"I'm quite irritated by politicians like Tony Blair who in 1998 said his vision was 'if I live in Bradford and I get sick in Birmingham, I want doctors to have my records on hand there'," she told the Health Informatics Conference in Melbourne.

-----

http://www.theaustralian.com.au/australian-it/government/australia-behind-on-e-health-healthlink/story-fn4htb9o-1225912683944

Australia behind on e-health: HealthLink

  • Karen Dearne
  • From: Australian IT
  • September 01, 2010 10:05AM

NEW Zealand continues to outpace on e-health Australia still grapples with key design, funding and planning issues.

Tom Bowden, chief executive of Auckland-based secure messaging and integration specialist HealthLink, said Australia had failed to do the hard work on building basic capacity, setting standards and improving data quality.

"All the really flash stuff has been worked on and there's been lots of bright ideas, but the real effort is still to be done and we won't see solid progress until that occurs," he said.

"Nowhere near enough effort has gone into getting the quality of GPs' electronic patient records up to scratch, and organising standardisation of the information that's to be exchanged."

In contrast, 100 per cent of GPs were using fully functional e-medical records by 2000; 100 per cent have been doing clinical messaging and 95 per cent of hospitals have provided e-discharge summaries over the same period. Because of this infrastructure, New Zealand has been able to build and release a raft of more sophisticated applications.

-----

http://www.itnews.com.au/Tools/Print.aspx?CIID=230622

E-health groups seek systems for 'data harvest'

Liz Tay|Sep 1, 2010 12:39 PM

US experts flag opportunity for software vendors.

E-health experts have called for information management systems to "harvest" data from electronic health records for medical research.

According to Donald Mon of the American Health Information Management Association (AHIMA), "secondary use" of data by researchers could improve medicine, patient safety and public health.

While current e-health software was "rich in functionality", Mon said products tended to store information as "free-text" data that could be read by a human but not easily analysed by a machine.

He explained that researchers needed quality e-health data that could be analysed based on clinical results, quality indicators and any public or population health trends.

Data had to be in a "computable form" so that relevant information could be "harvested" from e-health records for researchers to test hypotheses or conduct ad hoc investigations.

"Some systems are capturing a text stream when they could easily have captured [that information] as a numeric value," said Mon, AHIMA's vice president of practice leadership.

"There is huge opportunity for software providers ... We hope to take these already rich products and make them better."

-----

http://www.australiandoctor.com.au/articles/14/0c06c314.asp

Online CBT cuts anxiety and depression

3-Sep-2010

By Louise Wallace

RESEARCH confirming the success of internet-based therapies for patients with depression and anxiety shows doctors can be confident in recommending them to patients, an expert says.

A systematic review of more than 20 randomised studies found for every two people who used a web-based intervention, one would be cured, said study co-author Professor Gavin Andrews. Most patients who completed internet-based CBT for depression, panic disorder, social phobia or anxiety for up to 13 weeks had reduced symptoms and better outcomes after treatment, the review found.

The benefits persisted after course completion, and most patients were satisfied with online therapy despite having less clinical contact, the review noted.

-----

http://www.smh.com.au/nsw/tebbutt-accused-of-hiding-health-data-20100903-14ufk.html

Tebbutt accused of hiding health data

Louise Hall

September 4, 2010

A DAY after the state government pledged to be open and transparent about the performance of the health system, leaked documents show hospitals in Sydney's west have fallen far short of recommended treatment times during winter.

The Minister for Health, Carmel Tebbutt, launched a new website, Your Health Service, on Thursday, saying it would give people ''the most current information, hospital by hospital'', to help them find the healthcare they needed.

However, the website is already six months out of date. Information about waiting times in emergency departments, for elective surgery and to be admitted to a ward based on the January to March period.

-----

http://www.australiandoctor.com.au/articles/4f/0c06bc4f.asp

How hard is it to set up a national e-health record?

24-Aug-2010

By Dr Linda Calabresi, Australian Doctor Medical Editor

IT was just your average Saturday morning surgery. The old regulars, the coughing executives who’d been too busy to get to the doctor during the week, the young mothers who finally had someone to mind the baby — you know the drill.

Among the morning’s list was an older Eastern European lady who I occasionally see when she’s in town visiting her daughter. A really delightful lady. But a really woeful historian.

Since I’d last seen her she’d been in St Elsewhere’s, apparently following an episode of chest pain.

“Did you have a heart attack?” I asked. Well — not quite sure about that one.

She had come in because she’d left her medications at home and she knew it was important she take them.

You can imagine how we spent the next 10 minutes. It was something of a cross between a game of charades and Russian roulette.

Unfortunately, her local doctor wasn’t available and in the end I ‘googled’ then called her local chemist, who kindly confirmed her suspected medication cocktail and was able to shed light on the identity of that “extra little white one”.

-----

http://www.medicalobserver.com.au/news/ehealth-rollout-blueprint-too-little-too-late

E-health rollout blueprint ‘too little too late’

30th Aug 2010

Caroline Brettingham-Moore

A NATIONAL E-Health Transition Authority (NEHTA) blueprint outlining the rollout of e-health in Australia has been labelled “too little too late” by health IT experts.

The 200-page document released late last month canvassed the current state of the health sector, targets being promoted by NEHTA and current strategies to deliver a national e-health system.

Dr Andrew McIntyre, director of software firm Medical-Objects, said the blueprint added to the “inertia” the industry had suffered over the past five years.

“They have been at this for so long and yet seemingly everything is still in the process of being sorted out,” he said.

-----

http://www.theaustralian.com.au/business/isofts-ceo-quits-after-383m-plunge-into-the-red/story-e6frg8zx-1225912536337

iSoft's CEO quits after $383m plunge into the red

ISOFT chief executive Gary Cohen has quit less than three months after relinquishing the chairman role after a horror full-year result.

The Sydney health information technology company yesterday reported a $382.9 million loss, following a $34.7m profit last year, that included a hefty $341m one-off impairment charge, primarily related to goodwill.

The result increased the prospect that suitors, including private equity, could be set to launch a takeover bid for the company after months of speculation.

Industry insiders said the terrible earnings numbers, coupled with the loss of a chief executive who is also a large shareholder, makes the group vulnerable to a takeover. Private equity firms and major global software players such as Microsoft are tipped as possible candidates.

-----

http://www.computerworld.com.au/article/358951/isoft_records_383_million_statutory_loss/?eid=-255

iSOFT records $383 million statutory loss

Boots CEO in wake of ailing operations

The long-time chief executive of troubled e-health giant iSOFT (ASX:ISF), Gary Cohen, has resigned without a statement in the face of disastrous annual results over the past year that have seen revenues shrink.

Cohen’s resignation was revealed today as part of the company’s annual financial results for the year to 30 June, in which it revealed revenues were down 20 per cent to $431 million over the previous year, and earnings before interest, tax, depreciation and amortisation (EBITDA) down 78 per cent on constant currency terms to $30 million.

It also reported a statutory loss over the financial period of $383 million.

-----

http://www.ehealtheurope.net/news/6200/isoft%E2%80%99s_cohen_stands_down_after_losses

iSoft’s Cohen stands down after losses

31 Aug 2010

Gary Cohen has resigned as the chief executive of iSoft as the company has announced major losses in its full-year results.

This morning, iSoft posted a statutory loss of £221m (AUS $383m) for the financial year 2010, with total revenue down 20% to £249m (AUS $431m).

In its announcement to the Australian Stock Exchange, the company also said that earnings before interest, tax, depreciation and amortisation (EBITA) had plummeted 77% to £17m (AUS $30m).

Last year, the company reported a profit of £20m (AUS $35m) for the year to 30 June 2009.

-----

http://www.tradingmarkets.com/news/stock-alert/occaf_april-deadline-for-isoft-1146096.html

April deadline for iSOFT

Posted on: Wed, 01 Sep 2010 20:50:30 EDT

Symbols: OCCAF

Sep 01, 2010 (The Australian Financial Review - ABIX via COMTEX) --

Australian health software group iSOFT is under increasing pressure to improve its performance. Major stakeholder Oceania Capital Partners (OCP) has announced that it will decide whether or not to retain ownership of the group in April 2011.

-----

http://www.e-health-insider.com/news/6203/next_lorenzo_go-lives_put_back

Next Lorenzo go-lives put back

02 Sep 2010

Birmingham Women’s NHS Foundation Trust will not be going live with Lorenzo Care Management on Monday 6 September as planned.

The trust has confirmed that it has pushed back its go-live date, which was originally 10 May 2010, until it is sure that the system is “safe to be deployed.”

In a statement to E-Health Insider, the trust said: "Birmingham Women’s NHS Foundation Trust is now working towards a go-live date in early October to implement Lorenzo Care Management across the trust.

“Deployment plans are progressing at a safe and steady pace, and a series of checkpoints and a final assurance process are currently being worked through to ensure the system is ready to be deployed."

-----

http://www.techworld.com.au/article/359422/isoft_lay_off_800_staff

iSOFT to lay off 800 staff

Follows resignation of CEO, Gary Cohen

Renai LeMay 03/09/2010 10:59:00

Australian e-health giant iSOFT (ASX:ISF) will lay off 800 staff, constituting 17 percent of its total workforce, over the next financial year in a bid to halt its sliding financial fortunes.

On Wednesday the company’s chief executive Gary Cohen stepped down in the face of disastrous annual results over the past year that have seen revenues shrink. At the time iSOFT said it was planning to reduce staff numbers this year.

But sources said the company had already gone through two rounds of layoffs over the past year — one in November last year, and one in July.

A company spokesperson confirmed those rounds had already seen 290 iSOFT staff lose their jobs, and a further 800 more would go over the next year — more than 17 percent of the company’s total global workforce of around 4,500.

-----

http://www.theaustralian.com.au/australian-it/web-medicine-an-investment-for-the-bush-broadband-access/story-e6frgakx-1225912077383

Web medicine an investment for the bush: broadband access

RESIDENTS in rural and regional Australia can expect improvements in essential healthcare services as a result of the hung parliament.

The three independents who represent country regions of NSW and Queensland have made it clear they will go in to bat for rural Australia in negotiating their terms.

With broadband high on the agenda, the provision of e-health services to the bush is also of major concern for regions that have been plagued by unreliable communications and disparate systems.

Speakers at the recent National Health Conference in Sydney said existing rural services were frustrated by inefficiencies which led to poor quality patient care.

Chief executive of the e-Health Transition Authority Paul Fleming said reliability was the big issue for any electronic health system and more bandwidth would be needed in the future for e-health to realise its potential.

AMA president Andrew Pesce also criticised the regular waste that occurs because doctors can't access patients' medical records.

-----

http://www.medicalobserver.com.au/news/realtime-prescription-monitoring-will-combat-abuse

Real-time prescription monitoring will combat abuse

28th Aug 2010

David Brill

TASMANIAN GPs will be the first in Australia to have real-time, 24-hour access to prescribing information – long touted as a major step in combating the problem of prescription shoppers.

From December, GPs state-wide will simply go online to find out which Schedule 8 drugs a patient has already received that day.

Currently, they would have to call the State Health Department during business hours for information, which could be up to six weeks out of date.

Dr David Knowles, chair of the RACGP’s Tasmania faculty, said the new system would be “a significant help” to GPs – not only in informing prescribing decisions but also facilitating conversations with patients to help them address their problems.

-----

http://www.theaustralian.com.au/australian-it/e-health-funding-enough-for-a-prototype-national-e-health-record/story-e6frgakx-1225912067599

E-health funding enough for a prototype: national e-health record

THE $500 million committed by Labor for e-health records is not enough for a full national rollout.

It should deliver a prototype "that's impossible to ignore", Victoria's top health bureaucrat Fran Thorn says.

"I can't say there's a lot of money for e-health at this stage and that's a disappointment to me," she told the Health Informatics Conference in Melbourne last week. "But being an optimist, if we can use that $500m in a very targeted approach of building the prototype case for this, then I think it would be impossible for anyone to continue to ignore what in the end is a very small investment, in the order of a couple of per cent (of the total health budget)."

Signalling a tightening of control over the work program, Ms Thorn, who is secretary of the Victorian Department of Health, said the nation was in the second year of a 10-year strategy commissioned by the advisory body she chairs, the National E-Health Information Principal Committee, and adopted by health ministers through the Council of Australian Governments. "We do not have the money that we all believe should be invested in e-health yet, but the allocation will further a significant e-health trial that over time will include other things," she said.

-----

http://www.computerworld.com.au/article/358763/e-health_funding_enough_victorian_department_health/?eid=-6787

e-Health funding not enough: Victorian Department of Health

$446 million in funding not enough for e-health record trial

The Federal Government's $446 million commitment to e-health is “not enough” and could deliver a "prototype" to sell the benefits of technology and healthcare, according to the Victorian Department of Health.

In the recently released budget papers, the documents for the health portfolio stated the sum would be spent over the next two years to “establish key components of the personally controlled electronic health record system”.

“This secure online system will enable improved access to healthcare information, commencing in 2012/13.” the documents said.

However, the allocated funding is not enough for a national rollout, Department of Health secretary, Fran Thorn, said last week at the health informatics conference in Melbourne.

-----

http://www.computerworld.com.au/article/358746/e-health_diverts_funding_away_from_other_healthcare_services/?eid=-255

E-health diverts funding away from other healthcare services

E-health has been used as a political football, which takes funding away from other health services, according to the medical practitioner who reviewed the UK government's e-health record implementation.

E-health has been used as a political football, which takes funding away from other health services, according to the medical practitioner who reviewed the UK government's e-health record implementation.

The comments were made last Tuesday at the health informatics conference in Melbourne, where ABC's Tony Jones moderated an e-health discussion with five industry representatives.

Panellists discussed a number of issues, including the merits of e-health, which was debated by UK professor Trisha Greenhalgh, (who conducted the independent review of Britain's national health service summary care record project) and technology vendor Intersystems's CEO Professor Stan Capp.

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http://www.smh.com.au/business/waiting-on-a-missed-connection-20100829-13xm9.html

Waiting on a missed connection

August 30, 2010

Government intervention will be required to give Australian households super-fast fibre, writes Lucy Battersby.

As summer spreads across Scandinavia, thousands of Norwegians will take to the garden with a shovel, digging a trench between their house and a metal box at the end of their street.

Altibox, owned by the electricity provider Lyse, has found an ingenious solution to the prohibitive costs of installing fibre broadband to suburban and regional areas. It offers customers a $450 discount on installation costs if they dig a trench between their premises and the fibre node at the end of the street. So far about 136,000 households, or about 80 per cent of their customer base, have got their hands dirty.

Altibox will not connect a town to the backhaul unless 60 per cent of households sign up to its internet service, ensuring every fibre rollout is profitable. This is one of many different ways governments and businesses are encouraging the spread of fast, affordable broadband.

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http://www.businessspectator.com.au/bs.nsf/Article/The-true-price-of-the-NBNThe-cost-of-the-NBNWhatS--pd20100827-8Q3QF?OpenDocument&src=sph

What's the NBN really worth?

Paul Budde, Election 2010

Published 6:44 AM, 30 Aug 2010 Last update 10:01 AM, 30 Aug 2010

When the NBN announcement was first made and the issue of the cost-benefit analysis came up, BuddeComm’s comment was that it would be necessary to be aware of all the ingredients of such a plan before one could carry out such an analysis.

This is not just an issue for Australia. Other governments are also grappling with it. If the analysis were to be based simply on the use of traditional telecommunications services, it wouldn’t even be worthwhile starting on it, as it would not hold together.

One could argue that this is national infrastructure – as distinct from simply telecommunications infrastructure – and that no national cost-benefit analyses were provided for previous large-scale infrastructure projects.

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Enjoy!

David.

AusHealthIT Poll Number 34 – Results – 05 September, 2010.

The question was:

Will The Election Outcome Lead to Major Changes in E-Health Plans?

Definitely

- 1 (3%)

Probably

- 5 (19%)

Not Sure

- 1 (3%)

Probably Not

- 18 (69%)

No Way

- 1 (3%)

Votes: 26

Looks like most readers think the election outcome will not be a game-changer for e-Health. It looks to me, at 11am on Sunday, that Labor seems to likely to be given a first go at establishing a Government and so that view may very well turn out to be correct.

We shall all see this week I believe.

Again, many thanks to all those who voted!

David.

Saturday, September 04, 2010

Now This Sounds Like an Interesting Idea! Might Even Be Able To be Implemented Here.

The following appeared a few days ago.

Markle Foundation's recommendations for 'blue button' backed by 46 organizations

August 31, 2010 | Molly Merrill, Associate Editor

NEW YORK – Forty-six organizations have showed their support for the Markle Foundation’s recommendations for privacy and security practices for the “blue button,” which would allow patients to have instant access to their healthcare records.

“By clicking the blue button, you could get your own health information electronically – things like summaries of doctor visits, medications you are currently taking, or test results. Being able to have your own electronic copies and share them as you need to with your doctors is a first step in truly enabling people to engage in their healthcare,” said Carol Diamond, MD, MPH, managing director at Markle.

The private not-for-profit organization based in New York, released a policy paper on Tuesday that called on the U.S. Department of Health and Human Services to make patients' access to their records a priority in all health IT efforts, including:

  • Specifying the download capability as an allowable means for providers to deliver electronic copies of health information to individual patients consistent with the policy and technology recommendations of the Markle Connecting for Health Common Framework.
  • Making the download capability and our policy recommendations a requirement of qualified health IT so that providers using qualified systems will have this capability.
  • Making the download capability a core requirement for federal- and state-sponsored health IT grants and projects.

Markle Connecting for Health has developed a set of privacy and security practices to guide implementers. This new policy guidance builds on the Markle Connecting for Health Common Framework for Networked Personal Health Information – a set of policies and practices that provide a foundation for all health IT tools directed at consumers.

Lots more here:

http://healthcareitnews.com/news/markle-foundations-recommendations-blue-button-backed-46-organizations

You can download the press release from the Markle Foundation here:

http://www.markle.org/downloadable_assets/20100831_bluebutton_pr.pdf

This has been stimulated by the US Government developing a standard exportable format for US Veteran’s Affairs and Department of Defence patients to share and download there information.

Sound like such a format might be developed between the GP Computer System Vendors and that it could be much simpler and easier than waiting for the IEHR/PCEHR or whatever.

Hopefully the detailed policy document will soon be released. It does not seem to be up just yet.

Very interesting idea indeed.

David.