NEHTA’s Clinical Leads Recognise NEHTA is Not Enough! It is Time To Fix This!

The following editorial appeared in the Medical Journal of Australia yesterday.

E-health in Australia: time to plunge into the 21st century

Christopher Pearce and Mukesh C Haikerwal

MJA 2010; 193 (7): 397-398

Abstract

• E-health is the health care buzzword of the moment, with a person-controlled electronic health record funded in the 2010 federal Budget and legislation to introduce health identifiers recently passed by Parliament. E-health can ease the patient journey, improve quality of care and reduce costs.
• Australia’s health care system lags behind all other sectors of our economy in the use of computerised systems. While general practice and community pharmacy are highly computerised, the hospital sector is not.
• Adopting e-health is likely to result in higher quality practice, but general practice and hospitals need a mechanism for securely sharing patient data. Uncoordinated implementation of differing, incompatible systems within and between hospitals compounds a dire lack of national coordination of effort.
• Multiple funding streams and jurisdictions and the lack of an implementation strategy have slowed e-health development. Government programs underestimate the costs of change management and the need for training and technology. Confusion reigns about responsibilities, but governments must ensure connectivity between health care providers and recognise that the benefits will accrue into the future.
• The National E-Health Transition Authority has developed national open-access standards, and its foundation projects and the National Broadband Network are now coming into place.
• To ensure the clinical relevance, utility, safety and acceptability of e-health systems, health professionals urgently need technical capacity and expert guidance.

The full article for those that can access it is here:

http://www.mja.com.au/public/issues/193_07_041010/pea10510_fm.html

Now both the authors are Clinical Leads and important spokesmen for NEHTA.

This is acknowledged here:

Competing interests

“Christopher Pearce is Clinical Lead at NEHTA. Mukesh Haikerwal is Head of Clinical Unit and National Clinical Lead at NEHTA.”

Also in the article we find the following:

“To reap the benefits of e-health, the national role of NEHTA must be matched with a national implementation arm, with the ability to coordinate across the states and territories, and across the myriad private providers that administer the bulk of health care to Australians.”

If readers refer to my Australian Article from last week we see that I identified leadership and governance as key issues as well as pointing out that both the BCG and Deloittes had said NEHTA was not enough. The use of phrases like ‘confusion reigns’ says it all!

See here:

http://www.theaustralian.com.au/news/health-science/we-cannot-afford-an-e-health-failure-national-electronic-health-system/story-e6frg8y6-1225928601190

Here we have NEHTA’s own telling them essentially the same thing!

I wonder will they listen?

You can read coverage from the Australian here:

E-health needs implementation body: Haikerwal

• UPDATED: Karen Dearne
• From: The Australian
• October 05, 2010 12:41PM

NEHTA'S Mukesh Haikerwal has called for a new entity to co-ordinate activities across the states and with the private sector.

Dr Haikerwal, head of the National E-Health Transition Authority's clinical leads program, says a more integrated approach is needed if the community is to gain improved patient care and cost savings from e-health programs.

"To reap the benefits, the role of NEHTA must be matched with a national implementation arm with the ability to co-ordinate across the states, and across the myriad private providers that administer the bulk of healthcare to Australians," Dr Haikerwal said. "With the rubber now set to hit the health superhighway, health professionals urgently need technical capacity and expert guidance to ensure clinical relevance, utility, safety and acceptability of e-health systems."

NEHTA was established in January 2004 as a joint federal-state not-for-profit entity intended to deliver a nationwide health IT infrastructure.

Since it began operating in July 2005, NEHTA has made limited progress in achieving its goals, despite spending around $164,000 a day on its activities.

In the latest Medical Journal of Australia, Dr Haikerwal and Christopher Pearce, a GP and NEHTA clinical lead, say implementation of differing, incompatible systems within and between hospitals “compounds a dire lack of national co-ordination of effort”.

Lots more here:

http://www.theaustralian.com.au/australian-it/government/more-integration-needed-to-reap-benefits-of-nehta/story-fn4htb9o-1225934046664

David.

Here We Have Some Pretty Sad Stuff.

This appeared tonight.

http://www.ehealthcentral.com.au/2010/10/the-oz-vs-blogs-part-ii/

I will leave readers to be the judge.

This is the last time I will even comment on this blog and its author.

David

I Wonder Can We Take Advantage of This Work In Some Way?

The following press release appeared a few days ago.

http://www.reuters.com/article/idUS157752+29-Sep-2010+PRN20100929

Wed Sep 29, 2010 11:00am EDT

Kaiser Permanente Opens Access to Internal Medical Terminology to Help Others Meet U.S. Department of Health and Human Services Goals for Better Use of Health Information Technology

Convergent Medical Terminology Tools Allow Clinicians to Use Familiar Language to Achieve Standard Electronic Health Information Exchange

PR Newswire

OAKLAND, Calif., Sept. 29

OAKLAND, Calif., Sept. 29 /PRNewswire/ -- Kaiser Permanente today announced it is donating its Convergent Medical Terminology (CMT) to the International Healthcare Terminology Standards Development Organisation (IHTSDO©) for U.S. distribution through the U.S. Department of Health and Human Services (HHS) so that all health care providers—large and small—can benefit from the translation-enabling technology.

This donation makes the results of years of work at Kaiser Permanente available to help U.S. health professionals and hospitals achieve key meaningful use standards set forth by the Office of the National Coordinator of Health IT and the Center for Medicare and Medicaid Services.

Kaiser Permanente is a pioneer in supporting the production of structured health data by creating and linking clinician- and patient-friendly terminology to the health data standards now required for U.S.-wide use. The Convergent Medical Terminology has been developed by clinicians and technologists over many years. It is in active use to document thousands of patient encounters every day. Kaiser Permanente's Convergent Medical Terminology will now be available for use by a wide range of health IT developers and users to speed implementation of electronic health record systems. This will support efficient patient care, as well as the production and export of standardized data needed to support quality assessment, decision support, exchange of data for patients with multiple health care providers, and public health surveillance.

"One of the key challenges to achieving a coherent health record for every U.S. consumer is the need for consistent data across all systems and institutions," said HHS Secretary Kathleen Sebelius. "This donation of the Convergent Medical Terminology from Kaiser Permanente addresses that critical need by making it easier for health professionals and patients to create standardized data in electronic health records. It can help physicians provide better evidence-based care, while directly supporting the administration's investment in bringing information technology to health care."

Kaiser Permanente's donation, which is being provided at no charge, consists of terminology content they have already developed, a set of tools to help create and manage terminology, and processes to control the quality of terminology that is developed. CMT also includes mappings to classifications and standard vocabularies, such as the Systematized Nomenclature of Medicine – Clinical Terms (SNOMED CT©) already accepted by U.S. and international health policy makers. In addition to being of immediate value to EHR developers and users, these resources will assist the distributed enhancement of standard vocabularies, such as SNOMED CT, to better meet U.S. and international needs. Kaiser Permanente has agreed to work with the IHTSDO, the owner of SNOMED CT, and its U.S. Member, the National Library of Medicine, to help make an internationally distributed network of terminology development a reality.

"Better data is critical for better health. That is why physicians, nurses, and pharmacists worked together with technology specialists to develop CMT," said Jack Cochran, MD, Executive Director of The Permanente Federation. "Modern medicine is very complex and information about a single patient can be reported in different ways by different doctors who are treating different conditions for the same patient. Utilizing a common terminology that translates complex medical concepts into language that is both clinician- and patient-friendly has helped us coordinate teams, improve the quality of care for our patients and enhance efficiency in our organization. We would like to share the tool we developed with the country."

"CMT is designed to be seamless so clinicians see the familiar clinical language on their monitors while other users can see a simpler, translated version," said Phil Fasano, Chief Information Officer, Kaiser Permanente. "The development and implementation of this terminology system was a strategic investment as part of our commitment to improve health care, and we are pleased to share it with providers across the country so that they and their patients can benefit from it as well."

CMT is used in the underlying architecture of Kaiser Permanente's HIT systems to support data flow between health care providers. It provides mapping to standardize the use of terminology and ensure systems, some already in use in most U.S. medical offices, can talk to each other effectively. The utilization of CMT will support a common set of medical concept descriptions so that one doctor's diagnosis can be reconciled with another's. CMT includes the key taxonomies required for stage one of the Meaningful Use program such as problem list sets in SNOMED CT. Thus, it can help clinicians map to the standards set forth by the Office of the National Coordinator of Health IT and the Center for Medicare and Medicaid Services

"A primary focus of this administration is the transformation of the quality of health care while reducing costs," said U.S. Chief Technology Officer Aneesh Chopra. "A core enabler for that transformation is the ability to study health outcomes across many institutions on a large scale with electronic health records and the best technology available. This contribution from Kaiser Permanente takes us several steps closer to realizing that goal and improving the quality of care for all our citizens."

CMT is a core component of Kaiser Permanente's comprehensive electronic health record, KP HealthConnect®, helping physicians communicate with their patients more clearly. KP HealthConnect is the world's largest private electronic health record, connecting more than 8.6 million people to their physicians, nurses, and pharmacists, personal information, and the latest medical knowledge.

CMT is also utilized by Kaiser Permanente's personal health record, My Health Manager, on kp.org so that patients can get a better understanding of their medical care. My Health Manager provides patients with secure, timely access to their lab test results, medication information and refill capabilities, summaries of their health conditions, and other important health information at just the click of a mouse. The technology empowers patients to manage their health by allowing them to access health information and tools and securely e-mail their doctor.

To watch a video of Stephen Ondra, MD, senior policy adviser on health affairs for the VA, and John Mattison, MD, chief medical information officer, Kaiser Permanente Southern California, talk about this announcement, visit http://www.youtube.com/watch?v=JIgKCcBhXjQ

About Kaiser Permanente

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America's leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services to improve the health of our members and the communities we serve. We currently serve 8.6 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: www.kp.org/newscenter.

This seems to be pretty big news with coverage here:

Kaiser will donate terminology system

By Maureen McKinney / HITS staff writer

Posted: September 28, 2010 - 11:15 am ET

Kaiser Permanente announced plans to donate its systemwide terminology system, known as Convergent Medical Terminology, for open access in an effort to ease providers' transition to electronic health records, according to joint news release from HHS and the Oakland, Calif.-based integrated health plan.

Kaiser operates the largest private-sector EHR in the world and uses CMT as an interoperable source for clinical definitions, billing codes and language.

CMT uses several components, including the Systemized Nomenclature of Medicine-Clinical Terms, or SNOMED-CT, and the Logical Observation Identifiers Names and Codes, or LOINC, a database created to facilitate the movement of clinical laboratory information.

More here:

http://www.modernhealthcare.com/article/20100928/NEWS/309289996/

and here:

Kaiser Permanente Donates Terminology Technology

Integrating the Convergent Medical Terminology into clinical information systems could help make the meaningful use of e-health records easier and faster for U.S. healthcare providers.

By Marianne Kolbasuk McGee, InformationWeek
Sept. 30, 2010
URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=227500992

Kaiser Permanente spent about 16 years and millions of dollars developing its Convergent Medical Terminology for its own use. But now the healthcare provider is donating the CMT to the global health community -- a dictionary of 75,000 medical terms and concepts for interoperable use among electronic health records.

The open availability of vendors, healthcare providers and others to integrate KP’s CMT in its clinical information systems, including e-health records, can make it easier for clinicians to communicate with each other, as well as with patients.

KP decided to donate its CMT to the International Healthcare Terminology Standards Development Organization (IHTSDO) for distribution in the U.S. by IHTSDO members and the National Library of Medicine, to help other U.S. healthcare providers meaningfully use health IT, KP officials said.

“Every vendor needs to find a way to take standards medical terminology and translate it” so that terms and concepts used in the electronic medical records of patients are understood by clinicians and patients, said Dr. David Blumenthal, national coordinator of health IT during a U.S. Health and Human Services Dept. press conference in Washington D.C. where KP announced the CMT donation.

The donation of CMT by KP for use by others will allow vendors and providers to implement common medical terminology content into new and existing e-health records faster and more easily than developing their own translation solutions, Blumenthal said.

KP’s CMT donation also includes a set of tools to help create and manage terminology, and processes to control the quality of terminology that is developed or added in the future. CMT also includes mappings to other classifications and standard vocabularies, such as the Systematized Nomenclature of Medicine Clinical Terms, or SNOMED CT. Also, CMT can link to standard codes, such as ICD-9 and ICD-10, used in medical claims documents.

CMT is used by about 15,000 clinicians at KP hospitals and other care facilities in the U.S. as it “sits inside” KP HealthConnect, which is KP’s EHR system, said KP senior VP and CIO Phil Fasano in an interview with InformationWeek.

KP HealthConnect, based on software from Epic, is the nation’s largest private deployment of an EHR system in the U.S. Only the VA has a larger EHR system in use in the U.S.

CMT was created with collaboration among more than 1,000 KP clinicians -- including doctors, nurses and pharmacists -- as well as technologists over the last 16 years, said Fasano, who estimated that KP spent “many millions of dollars” to develop the technology.

More at site

As well as here:

Kaiser offers translator tech to health community

By Mary Mosquera
Wednesday, September 29, 2010

The Health & Human Services Department will make available to vendors and providers starting in early November software developed by Kaiser Permanente that translates physicians’ use of diagnostic and other medical terms into standard data formats that can be shared via electronic health record systems.

Kaiser Permanente has made the technology, called Convergent Medical Terminology (CMT) available at no cost. CMT automatically translates “clinician and patient friendly” terms into standard data, making it easier for providers to move from paper to electronic health records (EHRs) systems.

Dr. David Blumenthal, the national coordinator for health IT, said at a briefing Sept. 29 that the move would foster the use of consistent data formats across systems and institutions.

Blumenthal said that Kaiser’s donation addresses, “not only a technical issue but a human issue, which is the difficulty in understanding all this complicated terminology that we use in medicine so that people in their daily work can use it.”

The CMT software solves a problem that every doctor faces every day, he added. “We want our patients to have information about what we’re doing, but we don’t want the medical terminology to be misunderstood, not understood at all, or alarming if unnecessary,” Blumenthal said, adding, “It’s like a continuous translation between different languages.”

More here:

http://govhealthit.com/newsitem.aspx?nid=74750

In am sure all sorts of parts of this work are very America centric but it seems to me there may be a range of ideas that KP have developed to integrate both terminology and coding into an advanced HER system.

It sure would not hurt to ask KP if there were ways Australia could possibly learn and profit from their work. It seems clear the US Government is pretty chuffed by this gift! There are also tools etc. that might even also help here.

David.

Some Serious Experts Wonder Just What the Government is Up To With the PC-EHR. So Do I!

The following editorial appeared in the Medical Journal of Australia today.

Will information and communication technology disrupt the health system and deliver on its promise?

Johanna I Westbrook and Jeffrey Braithwaite

MJA 2010; 193 (7): 399-400

Abstract

• Investment in information and communication technology (ICT) in the health sector can bring important benefits. To date, the focus has been on automating clinical work practices such as ordering tests and prescriptions, which significantly improves efficiency and safety.
• Uptake of ICT has been slow and the results less favourable than anticipated for various reasons, including poor integration of systems into complex clinical work processes, limited training, and the intermittent nature of ICT funding. As a result, many health care organisations have been operating hybrid paper and computer systems that introduce new patient risks, staff frustration, and outcomes below expectation.
• The focus must shift from automation of clinical work to innovation; from evolutionary application of ICT to revolutionary uses. Health professionals must embrace ICT as a “disruptive technology” that will produce significant changes in their roles and responsibilities and lead to real health reform with new, innovative models of health care delivery. As other industries have shown, substitution and role changes are areas in which ICT can lead to the greatest gains.

Author details: Johanna I Westbrook, PhD, FACMI, FACHI, Director, Centre for Health Systems and Safety Research Jeffrey Braithwaite, MBA, PhD, FCHSM, Director, Centre for Clinical Governance Research.

Australian Institute of Health Innovation, Faculty of Medicine, University of New South Wales, Sydney, NSW.

The full paper is here with those who have access.

http://www.mja.com.au/public/issues/193_07_041010/wes10686_fm.html

This I found to be the most interesting paragraph.

“Given that $462 million was allocated to individual e-health records alone in the 2010–11 federal Budget, clarity about what is desired and expected from e-health is becoming an urgent problem. The key lies in how ICT in health care is viewed and what people want it to do. At present, the focus is on creating efficiency and safety gains by using computers to automate existing manual processes. For example, computerised ordering systems largely substitute paper orders with electronic orders. This has produced demonstrable and sustained improvements in the speed with which test results are available to clinicians. Substantially reduced rates of medication errors following automation of the prescribing process are further promising evidence of the benefits of ICT.”

What is being said here, with me paraphrasing is that these experts are really not sure just what the Federal Government is proposing with the Personally Controlled Electronic Health Record (PCEHR).

To put it colloquially, if these smart people are wondering just where does that leave the rest of us?

The other key theme of suggesting we need to move from automating ‘what is’ to working out what is possible with better technology will also get no fight at all from me!

We really deserve better from government than the present ‘mushroom treatment’.

David.

It Looks Like The Empire Is Planning to Strike Back. This Will Be Fun To Watch!

I have just had the following pointed out to me.

Two needed to fill Devine shoes

• THE DIARY: Caroline Overington
• From: The Australian
• October 04, 2010 12:00AM

ONE of the most wonderful things about the internet is surely the opportunity it presents for all people -- smart or stupid -- to have their say.

Quite a few are having a red-hot go at it, screeching loudly into the abyss that is the world wide web, and good for them.

To be a columnist on a real newspaper, though -- that takes skill.

----- Huge amount of non e-health commentary left out. Then we come to this!

Flush the blog

IS the federal government now paying people to bag The Oz? It seems so.

Charles Wright is an ex-Age computer writer who runs one of a tiny handful of blogs actually funded by the federal government. Earlier last week, he got stuck into News Limited, saying: "If you're bewildered by the persistent undermining of Australia's e-health program by The Australian, you might gain some enlightenment from John Menadue's comments in an interview on the ABC with Deborah Cameron. As a former general manager of News Ltd, the highly experienced public service chief and businessman knows exactly how Murdoch works. I found his remarks about The Australian's campaign against the NBN and Labor's school building program illuminating." There's more, but it's jibberish, and defamatory, so we won't republish it here.

Full article is here:

http://www.theaustralian.com.au/business/media/two-needed-to-fill-devine-shoes/story-e6frg996-1225933569008

This seems to have been triggered by the blogger, and his cheer squad, at E-Health Central having a go, for the umpteenth time at Karen Dearn and incidentally yours truly.

Here is the link to the blog.

http://www.ehealthcentral.com.au/2010/09/explaining-the-madness/

The best I can say on all this is to point readers to a comment posted on the E-Health Central blog pointing out that much of the commentary found there is just plain wrong from a long time NEHTA insider Dr Eric Browne:

He blogs here:

http://blog.healthbase.info/

and the comment can be found here:

http://www.ehealthcentral.com.au/2010/09/the-non-story-story/comment-page-1/#comment-623

The best bit is this:

“You claim that NASH is “the one specification” that NEHTA has struggled with. Not true! NEHTA has struggled with pathology terminology for almost 6 years. NEHTA has struggled with HL7 CDA for discharge summaries for some 4 years. They have struggled with other specifications.

Now there might be legitimate reasons for them to have struggled, but it is completely wrong of you to claim that is has been confined to NASH!”

For an organisation that has essentially sucked out from Australian e-Health pretty much all its resources to have delivered so slowly and so poorly is both a tragedy and a disaster.

Really sad.

I really think it is time all this paid blogging stopped -but that’s just a personal view. It seems to me anything that descends to the personal should just be ignored and I hope I have avoided that.

My views on NEHTA’s unaccountability are made pretty clear and every day it seems the evidence I am pretty close to the mark seems to build.

You can review the ‘spin plans’ for the HI Service etc. (which led to the creation of sponsored blogs as best I can tell) here with some background also included:

http://aushealthit.blogspot.com/2010/02/another-chance-to-read-nehta-health.html

David.

AusHealthIT Poll Number 38 – Results – 03 October, 2010.

The question was:

Do You Believe DoHA and NEHTA are Providing the Quality of Leadership and Governance Australian E-Health Needs?

Absolutely

- 1 (2%)

Possibly

- 3 (7%)

Neutral

- 1 (2%)

Just Maybe

- 3 (7%)

Sadly Not At All

- 30 (78%)

Votes :38

Very clear cut view here 78% saying it is a mess. Ms Roxon, Mr Gonski and Mr Fleming should pay close attention. Those who know the most about the area (readers here) reckon they are pretty hopeless by a very large majority

Again, many thanks to those that voted!

David.

Weekly Australian Health IT Links – 03 October, 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:

It seems to have been mostly a quiet week, except for those at iSoft who seem to be suffering death by a thousand cuts with repeated downgrades coming every few weeks.

I am always a little nervous when things go quiet. One suspects those bureaucrats may be planning to unleash yet another ill-considered and under consulted plan upon us all. I don’t know about you but I find the lack of public information on what is going on and what is planned pretty worrying.

I think it is time for a well-timed leak or two to let us all know what is going on.

By far the best comment this week has been a clearly well informed anonymous informant reminding us all know just how often major IT tenders cost the providers squillions and then go nowhere - with the Government happily stealing off with the intellectual property contained in the bids.

The track record of major projects of the scale of what seems to be being planned with the PCEHR should make for careful consideration of all the risks before leaping ahead!

-----

http://www.computerworld.com.au/article/361916/wcc2010_e-health_held_back_by_doctors_/?eid=-255

WCC2010: E-health to be held back by doctors?

Tech-wary doctors, under investment in technology, could be responsible for slow e-health takeup

• Lisa Banks (Computerworld)
• 23 September, 2010 14:34

Technophobic healthcare practitioners along with immature technology could be preventing the accelerated rollout of e-health in Australia, according to one e-health industry expert.

Speaking at the World Computer Congress 2010 in Brisbane, John Neville from Data Agility, a provider of e-health technology, said while e-health records will be a natural progression, the challenges on the road ahead will be intense.

“The science of IT is nowhere near as mature as the science of medicine, and doctors don’t trust IT systems,” he said.

"If you want to implement a medication management system into a hospital that in any way, shape or form gives guidance, provides decision support or tells a doctor what to prescribe, you better be very, very sure that the science behind that system is more robust than the science behind the doctor's brain."

-----

http://www.computerworld.com.au/article/362347/e-health_urgency_required_overhaul_industry/?eid=-6787

E-health urgency required to overhaul industry

Former Queensland Health CIO, Peter Grant, picks apart the problems in health informatics

• James Hutchinson (CIO)
• 28 September, 2010 11:33

A former CIO of Queensland Health has called upon the health informatics industry to rethink the way the way health IT and e-health projects are implemented.

Speaking at the World Computer Congress 2010 in Brisbane, Peter Grant, who spent eight months in the role during 2007, warned the focus was in the wrong place for his successors and equivalents in the industry.

“When you’re the CIO of health your job isn’t to make the hospital work properly, it isn’t even to make a network of hospitals to work properly,” he said. “It’s to make the whole ecosystem work properly, so you’re dealing with all of these other professionals and all of these other organisations outside of your organisation, and we just haven’t been thinking that way. Each hospital thought of themselves as the only centre of the universe.”

-----

http://www.australiandoctor.com.au/articles/b7/0c06c6b7.asp

GPs must drive e-health records process

21-Sep-2010

By Dr Sam Heard

AS a senior GP, a director of the openEHR Foundation* and CEO of a software company working to enable shared electronic health records, I want to share my thoughts on the role of clinicians in the rapidly developing e-health environment. I want GPs, as well as practising generalist physicians, to take a key role in the design of their future health records.

The Federal Government’s agenda for the introduction of electronic health records (EHRs) is broadly aligned with international efforts to harness technology to improve healthcare. Suddenly the information we record during consultations is being seen as the key asset for improving healthcare.

The sharing of summary and consultation data, medication lists and laboratory and radiology results may well change the face of healthcare. However, clinicians around the world are largely excluded from these advances, due to the technical nature of the solutions offered. But this is largely our record of care.

-----

http://www.theaustralian.com.au/australian-it/britains-fivium-wins-45m-deal-to-upgrade-pbs-processes/story-e6frgakx-1225930184811

Britain's Fivium wins $4.5m deal to upgrade PBS processes

• Karen Dearne
• From: The Australian
• September 28, 2010 12:00AM

BRITISH workflow specialist Fivium will replace the Pharmaceutical Benefits Scheme's paper-based processes with a computerised system.

Under a $4.5 million contract , Fivium will transform the PBS's paper-based back-office processes with a computerised drug-tracking and listing system.

The PharmCIS project also involves new IT tools to support more efficient pricing of new medicines, and streamlining the work of the PBS Advisory Committee.

-----

http://www.smh.com.au/nsw/move-to-stop-speed-pushers-slows-up-20101002-161w4.html

Move to stop speed pushers slows up

Michael Duffy

October 3, 2010

WHAT has happened to Project STOP? The Pharmacy Guild introduced this computerised system to stop criminals buying large quantities of cold tablets and products that contain pseudoephedrine. These are used to manufacture amphetamines.

The idea is that online, real-time reporting of the driver's licence numbers of purchasers, or attempted purchasers, will allow pharmacists to identify “pseudo runners” and refuse to sell to them. Detective Superintendent Nick Bingham, commander of the Drug Squad, thinks it is a great idea. But only 60 per cent of pharmacists have taken it up so far, and half are not using it effectively.

Back in August 2009, police approached NSW Health and asked for the use of STOP to be made compulsory in all the state's 1500 pharmacies. Superintendent Bingham says extending the system would not require legislation but, after a year, police have heard nothing. Last week Health Minister Carmel Tebbutt told us she had asked her department to look into the matter. The Sun-Herald will follow up this important initiative in a few months.

-----

http://www.zdnet.com.au/qld-health-rolls-out-personalised-payroll-339306365.htm

Qld Health rolls out personalised payroll

By Josh Taylor and Luke Hopewell, ZDNet.com.au on October 1st, 2010

After receiving a scathing report from the Queensland Auditor-General into the Queensland Health payroll disaster, Queensland Health Minister Paul Lucas has today announced that a personalised payroll system has now been rolled out across the state's facilities.

The original SAP-based payroll system, implemented in March, was found to have missed critical testing phases and lacked correct governance across the project.

An auditor-general's report into the payroll bungle found that a lack of appropriate testing and oversight led to some staff being underpaid, others not at all, and even a case where deceased employees were paid and put on active work rosters.

-----

http://www.zdnet.com.au/govt-consolidates-public-service-id-system-339306366.htm

Govt consolidates public service ID system

By Darren Pauli, ZDNet.com.au on October 1st, 2010

The Federal Government has today launched a single agency to issue commonwealth security clearances for public servants and contractors.

The Australian Government Security Vetting Agency will replace the need for some 100 agencies to issue individual clearances, and save some $5.3 million a year, according to the government.

It is expected to process some 48,000 clearances a year from 300 government agencies.

Federal Attorney-General Robert McClelland said the agency will cull inconsistencies and duplication under the existing system.

-----

http://www.theaustralian.com.au/business/city-beat/troubled-isoft-ripe-for-takeover/story-fn4xq4cj-1225932809111

Troubled iSoft ripe for takeover

• Michael Bennet
• From: The Australian
• October 01, 2010 1:00PM

PREDATORS could be sizing up struggling iSoft Group following the 84 per cent slump in its share price this year, analysts say.

Following major shareholder Oceania Capital Partners, formerly known as Allco Equity Partners, yesterday lashing the company's performance under former boss Gary Cohen, Deutsche today downgraded its recommendation to “sell” from “hold”.

By early afternoon its shares were trading at 12 cents, giving iSoft a market value of about $128m, compared with a peak market value of about $1.7 billion in February 2007. In this year alone, almost $700 million has been wiped off its value.

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http://www.zdnet.com.au/new-deal-sees-isoft-down-not-out-339306317.htm

New deal sees iSoft down, not out

By Luke Hopewell, ZDNet.com.au on September 30th, 2010

Ailing healthcare IT provider, iSoft, has today announced a deal to restructure its debt facilities, as part of a plan aimed at clawing the company's bottom line back into the black.

In a market update issued to shareholders today, iSoft chairman Robert Moran said that "the reorganisation and extension of our debt facilities removes the short-term financial uncertainty that we have faced over the last few months and provides a stable platform for us to execute upon the next stages of our plan."

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http://www.theaustralian.com.au/business/major-shareholder-lashes-isoft-for-poor-performers/story-e6frg8zx-1225932549570

Major shareholder lashes iSoft for poor performers

• Damon Kitney, Michael Bennet
• From: The Australian
• October 01, 2010 12:00AM

HEALTH IT company iSoft Group has been lashed for poor performance under former chief executive Gary Cohen, who has resigned as a director.

Major shareholder Oceania Capital Partners, formerly known as Allco Equity Partners, said yesterday it fully supported board renewal and improved corporate governance at iSoft.

"However, OCP remains extremely disappointed that iSoft's potential and our expectations to date remain unmet," OCP chairman Ian Tsicalas said.

OCP is a 24 per cent shareholder in iSoft and in June OCP managing director Robert Moran became non-executive chairman of the health IT group following the resignation of Mr Cohen.

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http://www.computerworld.com.au/article/362940/isoft_cohen_leaves_building/?eid=-6787

iSOFT’s Cohen leaves the building

Follows news that iSOFT’s revenues were down 20 per cent to $43 million

• Jenna Pitcher (Computerworld)
• 01 October, 2010 10:58

Besieged e-health company iSOFT has confirmed the departure of former chief executive Gary Cohen, just weeks after he quietly resigned from the CEO role in late August.

“iSOFT announces that Gary Cohen has resigned from the board and has completed all executive responsibilities with the company. Gary has assisted professionally and properly in the transition period,” a statement by the company this afternoon said.

“The board thanks Gary for his professionalism and assistance during the transition period,” iSOFT chairman, Robert Moran said.

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http://www.theaustralian.com.au/business/city-beat/weakened-isoft-reaches-deal-with-banks/story-fn4xq4v1-1225932255469

Weakened iSoft reaches deal with banks

• Michael Bennet
• From: The Australian
• September 30, 2010 12:03PM

STRUGGLING health IT company iSoft Group has struck a deal with its banking syndicate to re-organise its senior debt facilities.

ISoft, which commenced a review of its business in August after a $382.9 million full-year loss, said today its senior lenders have agreed to extend the group's existing senior debt facilities and remodel its financial covenants.

The banks have also agreed to provide a new senior revolving debt facility of up to ₤40m ($65m).

The restructure of the company’s debt structure is the first of several steps being undertaken by the board to establish a “more appropriate capital structure for the company”.

But the company is yet to find a permanent replacement for long-standing chief executive Gary Cohen who stepped down following its horrific result in August. Mr Cohen, who earned a total package of $1.1m last year, formally resigned today.

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http://www.e-health-insider.com/news/6271/isoft_new_director_to_lead_restructuring

ISoft new director to lead restructuring

28 Sep 2010

ISoft has appointed an executive director to lead on the restructuring of the company, which will include further significant redundancies over the coming year.

The company, which last month posted a statutory loss of £221m for the financial year 2010, said Ron Series will be based in the United Kingdom and will work closely with the executive management team to ensure an “efficiently executed restructure plan.”

Until now, Series has been heavily involved with the restructuring of Nakheel PJSC, the real estate arm of Dubai World. It had debts of almost £40 billion and made 10,500 staff redundant following problems caused by the financial crisis.

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http://www.abnnewswire.net/press/en/63858/iSOFT_Group_Limited_%28ASX:ISF%29_Company_Updates_On_Debt_Facilities_Re_Organisation_And_Business_Outlook.html

iSOFT Group Limited (ASX:ISF) Company Updates On Debt Facilities Re-Organisation And Business Outlook

Sydney, Sep 30, 2010 (ABN Newswire) - iSOFT Group Limited (ASX:ISF) has today lodged its Annual Report and audited financial statements for the year ending 30 June 2010. In addition, it announces the following to the market.

Debt facilities re-organisation

iSOFT and its banking syndicate have agreed on the terms of a re-organisation of the Company's senior debt facilities. The Senior lenders have issued to the Company a fully underwritten, credit approved and binding commitment setting out the terms on which the senior lenders have agreed to continue to extend the Group's existing senior debt facilities, including remodeled financial covenants as well as the provision of a new senior revolving debt facility of up to GBP40 million.

Securing the Company's debt structure is the first of several steps being undertaken by the Board of iSOFT to establish a more appropriate capital structure for the Company.

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http://www.i2p.com.au/article/electronic-transfer-prescription-etp-release-11-draft

Electronic Transfer of Prescription (ETP) Release 1.1 draft

Australia’s first national electronic prescription system has moved a step closer following the release of updated draft specifications. The suite of documents plans for a national framework and will be available for public comment until 15 October 2010.

The latest release expands on previous versions in three key areas, extending the transfer of prescriptions to a wider range of care settings including hospitals and residential care facilities, and addressing instances where the medications are supplied based on informal instruction from a prescriber before a formal prescription (owing script) is provided. It also introduces the transfer of fully electronic prescriptions signed with a prescriber’s digital signature.

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http://www.theaustralian.com.au/business/industry-sectors/telstra-ceo-david-thodey-to-take-nbn-deal-to-shareholders-by-mid-2011/story-e6frg9hx-1225931647586

Telstra CEO David Thodey to take $11bn NBN deal to shareholders by mid-2011

• Mitchell Bingemann
• From: The Australian
• September 29, 2010 11:05AM

Telstra wants access to the wireless spectrum to evolve its Next G mobile network. Picture by AFP Source: AFP

TELSTRA wants to finalise the terms of its $11 billion national broadband network deal by this Christmas, its CEO said today.

David Thodey, the chief executive of the telecommunications giant, said he would then present the NBN participation deal for a shareholder vote by the first half of 2011.

It was towards that end, Mr Thodey told investors at its annual strategy day in Sydney, that Telstra hoped to finalise the terms of its participation by the end of this year.

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http://www.theaustralian.com.au/australian-it/telecommunications/tony-abbott-demands-cost-analysis-for-the-national-broadband-network/story-fn4iyzsr-1225932115248

Tony Abbott demands cost analysis for the National Broadband Network

• From: AAP
• September 30, 2010 8:40AM

THE federal government expects legislation paving the way for the NBN to be introduced to Parliament before the end of the year.

But the Opposition will insist Labor also provides a cost-benefit analysis for the $43 billion initiative.

The cost of building the network has drawn criticism from Mexican telecommunications billionaire Carlos Slim Helu.

Mr Slim said the cost, which equated to $7000 for every home, was too high and that the government should be using a multi-platform approach, instead of relying on fibre-optic technology.

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http://www.theaustralian.com.au/australian-it/nbn-fails-to-win-support-from-business-which-doesnt-understand-its-economic-vision/story-e6frgakx-1225930197092

NBN fails to win support from business, which doesn't understand its economic vision

• Andrew Colley
• From: The Australian
• September 28, 2010 12:00AM

THE federal government has conceded that its NBN vision is failing to win business support.

Parliamentary Secretary Senator Kate Lundy acknowledged the problem during a panel session at the World Computer Congress in Brisbane last week.

After speaking on the government's technology-centric citizen engagement model, Senator Lundy faced pointed observations from Mark Toomey, founder and chief executive of technology consultancy, Infonomics.

Mr Toomey told the senator several key business groups did not understand the economic vision of the NBN.

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http://www.theaustralian.com.au/australian-it/long-wait-for-service-providers-on-nbn-interconnect-information/story-e6frgakx-1225930245675

Long wait for service providers on NBN interconnect information

Mitchell Bingemann

From: The Australian

September 28, 2010 12:00AM

THE telecoms industry is awaiting the release of information on interconnection points in the $43 billion National Broadband Network.

Service providers also want to know whether monolithic data centres will be needed to handle the expected growth of data-intensive content.

More than 5000 telephony exchanges are used now to deliver internet and voice services over Telstra's copper network, but when the NBN's fibre network is rolled out and available to 93 per cent of the population, these exchanges will be replaced or upgraded into more than 200 interconnection points, or hubs, where fibre from premises will terminate and connect into backhaul networks required to move data nationally.

From these points, retail service providers will deliver services such as internet, voice and video through the fibre network to as many as 80,000 premises. The telecoms industry has been waiting for several months for information from NBN Co on where these points will be located and their physical layout.

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http://www.smh.com.au/technology/technology-news/vital-nbn-legislation-caught-up-in-senate-delays-20100927-15ssl.html

Vital NBN legislation caught up in Senate delays

Lucy Battersby

September 27, 2010 - 8:39AM

The legislation supporting the national broadband network is unlikely to reach the Senate before the last week of October and still relies on the support of an unpredictable minor party senator.

And legislation forcing property developers to lay fibre in new estates lapsed when the last parliament was prorogued, according to the Senate Bills List, and would need to be reintroduced into the House of Representatives where the balance of power is now held by independents and minor parties.

Crucial telecommunications legislation amendment bills and the fibre bill were missing from Senate and House legislation lists for this week.

-----

http://www.theaustralian.com.au/news/world/the-un-is-to-appoint-an-astrophysicist-to-be-the-first-contact-for-any-aliens/story-e6frg6so-1225929540635

The UN is to appoint an astrophysicist to be the first contact for any aliens

• Jonathan Leake
• From: The Sunday Times
• September 26, 2010 12:50PM

WHEN aliens arrive on Earth, they will no longer have to worry about who will greet them.

The United Nations, tackling head-on the problem of what to do if an alien says “take me to your leader”, is poised to designate a specific individual for the task.

Some would argue that the job should fall to the US president, the leaders of Russia or the European Union. Others might suggest the Pope. One thing is certain: humanity's lack of a leader would not make a good impression.

Instead the UN is set to select an obscure Malaysian astrophysicist who is head of its little-known Office for Outer Space Affairs (Unoosa).

-----

Enjoy!

David.

I Had Not Realised Our Broadband Was as Good As It Seems to Be.

A key component of e-Health infrastructure is reliable, reasonably fast and ideally ubiquitous broadband.

I spotted this report a day or so ago and decided to go to the source:

Downloads grow by 50%

Aaron Cook

September 21, 2010

AUSTRALIA'S appetite for the internet continues to grow and the number of wireless internet connections has soared in the last year, a study has found.

A report released yesterday by the Bureau of Statistics shows the amount of data downloaded in the June 2010 quarter increased by more than 50 per cent compared to the same period a year earlier.

In the same period, the number of wireless broadband connections increased by 70 per cent to nearly 3.5 million, while the number of fixed-line broadband connections rose slightly to 4.2 million. The amount of data downloaded every three months is now 11 times higher than March 2005 and 126 times higher than March 2002.

Full article here:

http://www.smh.com.au/technology/technology-news/downloads-grow-by-50-20100920-15jtz.html

The source information is here:

http://www.abs.gov.au/ausstats/abs@.nsf/mf/8153.0?OpenDocument

8153.0 - Internet Activity, Australia, Jun 2010

Latest ISSUE Released at 11:30 AM (CANBERRA TIME) 20/09/2010 Released Today

NOTES

INTRODUCTION

• The Internet Activity Survey (IAS) collects details on aspects of internet access services provided by Internet Service Providers (ISPs) in Australia.
• This release contains results from all ISPs operating in Australia as at 30 June 2010.
• Active subscribers are defined as subscribers who have accessed the internet or paid for access to the internet during the three months ending 30 June 2010. Counts of subscribers are not the same as counts of people/organisations with internet access, as subscribers may have accounts with more than one ISP or multiple accounts with a single ISP.
• This is an electronic release of Internet Activity, Australia. More detailed and historical information is available in the accompanying datacubes.
• This is the first release of wireless connections to the internet via a mobile handset (please see Appendix 1).

HIGHLIGHTS

• At the end of June 2010, there were 9.6 million active internet subscribers in Australia.
• The phasing out of dial-up internet connections continued with nearly 92% of internet connections now being non dial-up. Australians also continued to access increasingly faster download speeds, with 71% of access connections offering a download speed of 1.5Mbps or greater.
• Digital subscriber line (DSL) continued to be the major technology for connections, accounting for 44% of the total internet connections. However, this percentage share has decreased since December 2009 when DSL represented 47% of the total connections.
• Mobile wireless (excluding mobile handset connections) was the fastest growing technology in internet access, increasing to 3.5 million in June 2010. This represents a 21.7% increase from December 2009.

---- End Extract. (Do see site for a great graph of the changes over time).

What I found interesting was the rapid phase out of the old dial-up, the rise in fixed broadband and the staggering rate of growth in wireless internet.

I have to say it seems to me while the NBN will be pretty amazing we really do have something that is pretty useful while we wait!

David.