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."

Wednesday, August 31, 2011

A Range of Perspectives On Personal Health Records (PHRs). Views From The UK and The US.

There has been continuing discussion this week on just what the right approach to patient empowerments with PHRs is.

First from the UK we have.

HealthSpace up for review again

17 August 2011 Shanna Crispin

Yet another review is being carried out into the viability of the HealthSpace organiser, which gives patients access to their Summary Care Record if it exists and they have an ‘advanced’ account.

Figures obtained by eHealth Insider show that the number of people using the NHS service to access their SCR has fallen by more than 50% since the beginning of the year.

In February, 60 patients a month were using an advanced HealthSpace account to see their record, but this has now fallen to just 25 a month.

A DH spokesperson told EHI the low usage was due to the site’s limited functionality and the lengthy registration process for an advanced account, which was introduced because of security concerns.

She also said: “The business case to enhance HealthSpace is under review in the context of efforts to make it easier for patients and citizens to easily and securely access services that meet their needs.”

Last week, the Cabinet Office launched an Open Data consultation on making government and public services information more ‘transparent’ to the public.

It once again presented wider online access to medical records as a key element in the government’s plans, claiming that this would “enable service design and delivery to be changed radically, reducing cost and improving quality.”

More here:

http://www.ehi.co.uk/news/mobile/7100/healthspace-up-for-review-again

There is an expanded UK based discussion here:

Put another record on

Free standing personal health records have failed to live up to the claims made for them; but other models are starting to have an impact in the UK. Shanna Crispin reports.

17 August 2011

A couple of years ago, there was significant hype about IT putting patients “in charge” of their own health by giving them control of their health records.

The talk sounded strange, given that patients have been able to jot down appointments and other notes about their health since the invention of pen and paper. It wasn’t clear what using an online space, store, or vault was supposed to add.

So it doesn’t seem surprising that some of the early personal health record products have fallen by the wayside. Google announced earlier this summer that it was pulling the plug on Google Health, due to a lack of public demand.

The service was launched in 2008 and allowed users to input data from their own at home devices, simple food and exercise charts, or test results.

Announcing the service’s demise, a post on Google’s official blog said: “There has been adoption among certain groups of users like tech-savvy patients and their caregivers, and more recently fitness and wellness enthusiasts.

“But we haven’t found a way to translate that limited usage into widespread adoption in the daily health routines of millions of people.”

Tied in, tied down

Yet personal health records are working for some people with a specific use for them. For example, the Ki Fit unit produced by company Ki Performance has an online subscription service that allows people to purchase the package with an armband to monitor activity and sleep.

The information is then loaded onto an online PHR, which users can use track their health and progress. It’s mainly intended for the growing number of people aiming to lose weight and mirrors similar online services, such as those offered by Jenny Craig and Weight Watchers.

Those looking to get seriously fit are another big market, with a number of companies offering services similar to the Nike+ running tracker.

On the medical front, Peter Singleton, director of Cambridge Health Informatics and principal research fellow at University College London, says that for a PHR to be successful, it needs to provide a link between patients and their clinicians.

In the US, this has led to the development of the ‘integrated’ PHR model – where users can enter data and share it with their clinician, and vice-versa – and the ‘tethered’ model – in which a PHR is linked to a particular institution of service.

Examples include My HealtheVet for war veterans. Users can input their personal information, activity and order medication. Clinicians are also able to access the account with approval from users.

In the civilian world, the Kaiser Permanente My Health Manager allows users to e-mail physicians, order prescriptions, view test results and make appointments, as well as view their records. And the Cleveland Clinic offers My Chart, where users can also book appointments and see lab results from the clinic when they are available.

Professor Don Detmer from the department of health sciences at the University of Virginia told eHealth Insider in an email these models are a “real breakthrough” and could turn out to be the “killer application” like Google’s role in the search engine world.

“Clearly, with ageing populations plus more chronic illness [and] more sophisticated care regimens for cancer and so on, having this kind of way to keep the patient at the centre of their care is very exciting.”

More here:

http://www.ehi.co.uk/insight/analysis/785/put-another-record-on

From the US we have this editorial.

In search of a role for PHRs

August 26, 2011 | Jeff Rowe, HITECH Watch

It’s a chicken-or-egg question: Will doctors adopting EHRs lead to a rise in the use of Personal Health Records (PHRs), or will increasing consumer demand for personal health information force reluctant doctors to go digital?

We’ve been inclined to believe that, over time, consumer demand will be the key to the HIT transition, but some experts seem to think it’s the other way around.

As this article puts it, policymakers and HIT observers note the slow rise in PHR use, but they suggest the reason is that, for one thing, patient information is still available only in fragmented form.

In the eyes of one HHS official, patients "can't easily get their information in an electronic form to flow into" a PHR. "If they're trying to use a stand-alone product and type it in all by hand, that's tough. When it becomes ... easy to download their information, I foresee interest in that area growing."

We don’t doubt there is probably some validity to this expectation, but it does smack a bit of a “field of dreams” approach to the HIT transition.

More here:

http://www.healthcareitnews.com/blog/search-role-phrs

Here is the article referred to.

EHR use by doctors will foster personal health record uptake

Tech companies looking to sell consumer IT products need to build off current technologies instead of creating devices

A lack of electronic medical data from doctors, complicated setup processes and the static nature of personal health records (PHRs) have caused U.S. consumers to shun the products. But PHR use should increase as more doctors use electronic health records (EHRs) and tech vendors develop offerings that are easier to use.

PHR use "is not incredibly high, but it is growing," said Lygeia Ricciardi, senior policy advisor for consumer e-health at the U.S. Department of Health and Humans Services. She cited a 2011 study from consulting firm Deloitte that found usage stands at 11 percent, a 3 percent increase from the 2008 survey.

Consumers interested in PHRs face compartmentalized offerings with enterprise IT vendors looking to unite the silos, said Liz Boehm, principal analyst, customer experience for health care and life sciences, at Forrester Research.

Entities that pay a person's health care claims, such as a health insurance provider, offer PHRs containing claim information, but lack clinical data like lab results, said Boehm. Doctors, using health care software from companies including GE and Epic Systems, can offer PHRs that include clinical data. These records prove "less useful," though, since they cannot link to a patient's pharmacy or another health care provider's system.

Microsoft's HealthVault PHR service, launched in 2007, attempts to bridge the gap between health care payer and provider systems, she said. HealthVault's objective is for doctors, pharmacies and other care providers to "feed their data into this record that is centered around the consumer."

Google also offered a PHR product, Google Health, but in June the company announced that it would end the service on Jan. 1, 2012. In a blog post, the company attributed its decision to Google Health's "limited usage."

Federal government mandates that require doctors to migrate to EHRs from paper-based systems will help solve the data issue, Ricciardi said. With "more providers coming online and with more access to digital information for consumers," she expects to see a "spillover effect" that will boost PHR adoption.

Linking EHRs to PHRs will "absolutely" increase PHR use, said Boehm. A doctor's involvement "fundamentally changes what the PHR is and what's being offered."

.....

However, a static PHR isn't "as compelling as file cabinet plus cool, interactive stuff," she said. People need a reason to access their PHR besides to add data.

"They want things they can do with their information," she said. "They want interactive applications, games, things that engage them in their health. There are more reasons to actually access and use your health information if more of these tools were out and about."

People need to see value in using a PHR and that proposition remains "pretty unclear," said Boehm.

"Labs results and prescription refills are the number-one and number-two reasons people go to their Kaiser PHR," she said, referencing the PHR offered by health care consortium Kaiser Permanente.

Read the full article here:

http://www.techworld.com.au/article/398518/ehr_use_by_doctors_will_foster_personal_health_record_uptake/

We also had the same points being made hee

Cincinnati patients logging on to see records

Business Courier - by James Ritchie , Staff Reporeter

Date: Friday, August 26, 2011, 6:00am EDT

James Ritchie

Staff Reporter

Tens of thousands of Cincinnati patients are experiencing firsthand the federal government’s push for higher health care quality as they get access to their health records online.

They’re logging in to perform such functions as getting test results, asking for prescription renewals and making appointments.

TriHealth Inc. officials said this week they’ve signed up more than 30,000 patients in their physician practices to MyChart since the launch a year ago of the patient portal software, made by Epic Systems Corp.

More here (subscription required).

http://www.bizjournals.com/cincinnati/print-edition/2011/08/26/cincinnati-patients-logging-on-to-see.html

The conclusion from all this seems pretty clear to me.

Consumers will engage with PHRs that provide channels of communication for them to and from their clinician especially if it will save them time and inconvenience to have simple health issues without the need to visit a surgery etc.

We would do much better in patient engagement if we developed systems with functionality that supported these sorts of activities. I recognise that there may be additional costs for the practitioners involved in setting up and operating such services and these costs and relevant time compensation should be offered if the Government is convinced such patient / provider interaction makes clinical and economic sense.

Just whipping up a registration screen for a national system that does not support these outcomes puts us on a course that is fundamentally different to the rest of the world. Before doing this we need to be very sure the US and UK and wrong and NEHTA/DoHA is right!

David.

Tuesday, August 30, 2011

It Looks Like The NEHTA CEO Recognises He Has a Tiger By the Tail. Well Done - Now To Let Go!

The following article appeared a few days ago.

It's like putting a man on the moon

Published on Tue, 23/08/2011, 03:02:31

By Yasmin Noone

No goal is too big when you have inspiration.

CEO of the National E-Health Transition Authority (NEHTA), Peter Fleming, has likened the once thought impossible but successful job of putting a man on the moon to one other major task currently at hand – the creation of the Personalised eHealth Record (PCEHR) system for all Australians.

During the Health Infomatics Conference in Brisbane, earlier this month, Mr Fleming described the establishment of the eHealth system as a massive “challenge”. But, he said, once overcome, it will significantly change the world in which we live and make a huge difference to the health care system of the future.

“With an ageing population and increasing costs, we do have to do something to address where we are at today,” Mr Fleming said.

"The world doesn’t remain stagnant and nor can we.”

Developing and implementing the new eHealth system is a “dive in the sand”, likened “to putting a man on the moon”.

“We are getting to a point where we can realise the dream. It is for all of us to pick up on that [goal] and make it successful. This is our big chance to make a difference.

“…We must aim towards that. We can’t do it as an individual. We must do it together.”

PCEHR’s are expected to be a secure, electronic record of an individual’s medical history, stored and shared in a network of connected systems. It will make information such as test results, discharge summaries, vaccination and medication histories and compressive medical records available to a range of health and care professionals.

The record is also meant to be accessible from anywhere throughout Australia.

It's a matter of privacy

The looming eHealth d-date that NEHTA is working towards is the 1 July 2012. This is when consumers will be able to register for a PCEHR.

However, despite the excitement circulating, many civil libertarians have expressed concern that the new system will free up the channels of information at the expense of an individual’s privacy.

Mr Fleming quelled the issue during his presentation, saying that the consumer will be able to control their own eHealth record as they will decide what information it contains, what information it should exclude (for example, mental or sexual health details) and who as access to it.

“There are also a number of controls and legislative controls that would ensure privacy as well. The consumer will be at the centre of the [eHealth record] and have access to the record but so will the professionals who have been given access to it.”

Small steps towards a big goal

One of the key steps which moved NEHTA closer towards its 2012 goal was the creation of the Healthcare Identifiers (HI) Service last year.

Lots more is found here:

http://www.australianageingagenda.com.au/2011/08/23/article/Its-like-putting-a-man-on-the-moon/YFBNQDGARA

It is really amazing to see this sort of stuff being sprouted by someone who should know a great deal better.

“During the Health Infomatics Conference in Brisbane, earlier this month, Mr Fleming described the establishment of the eHealth system as a massive “challenge”. But, he said, once overcome, it will significantly change the world in which we live and make a huge difference to the health care system of the future.

“With an ageing population and increasing costs, we do have to do something to address where we are at today,” Mr Fleming said.

"The world doesn’t remain stagnant and nor can we.”

I have just one question. Just what is the evidence that introduction of the PCEHR will make the least difference to these macro trends.

What is needed is the improve the quality, efficiency and safety of the care delivered by our hospitals, practitioners and the allied health sector. This involves putting in place systems to support all their care and business activities and facilitating communication of relevant information between these groups.

NEHTA would do a great deal more good in reaching the goals cited above focussing on getting the infrastructure in place to have all this work well.

With that done a provider to provider Health Information Exchange makes considerable sense as does allowing patients who are related to a specific practice or organisation access to information that can improve their involvement in their care in their care. This can only work however if a consumer is stably associated to a particular provider, otherwise the risk of confusion rises to unacceptable levels as does accountability and transparency.

There is simply no need to a large centralised system in following this model - unless it is to store a very basic emergency care record for those who want one.

A progressive, incremental and planned approach can skin this cat! A ‘big bang’ politically driven rush at an ill-defined goal is just not sensible.

Whether any sense actually prevails we are expecting to see any day now with the release of the updated and revised PCEHR ConOps.

It will be very interesting to see just how much improved the new version is and if it appears by the end of the month.

David.

Heavens This Does Seem Like An Awful Lot of Money! I Wonder Where It Is Going?

The following appeared today.

NEHTA grabs half of $400m records spend

THE National E-Health Transition Authority has collared an estimated $200 million so far for the 18-month run-up to the Gillard government's personal e-health records launch next July 1, with more money to come.

The Transition Authority received some $110m in base funding for e-health standards work between January 2011 and June 2012, plus separate Personally Controlled Electronic Health Record contracts worth $90m from the Department of Health.

A third tranche of these funds is due in October.

This contrasts with just under $200m for four private-sector projects including the building of the system, three lead implementations and nine e-health pilots to be finished in the same period.

Only $2.3m has been allocated to help local software providers redevelop their products through the Transition Authority's GP desktop panel.

The authority's funding and spending have come under scrutiny in the Senate from Queensland Liberal Sue Boyce.

Senator Boyce is still waiting for Health to answer 11 questions on notice relating to the PCEHR program due by July 22.

An authority spokeswoman brushed off concerns that the organisation still had been developing specifications when the government selected contractors to build the system using existing products and standards.

The Accenture-led consortium will receive $77m for delivering the national infrastructure in time for Health Minister Nicola Roxon's deadline for a working system.

The authority spokeswoman said it was "contributing to an eventual PCEHR for Australia through high-level e-health architectures and blueprints, and determining the 'baseline' for the implementation and development of e-health solutions".

"The PCEHR is based on standards, and will leverage relevant international and Australian specifications to ensure an interoperable solution is achieved, to minimise the complexity and cost of adoption within the sector," she said.

"The NEHTA standards catalogue is in production, and will be available in the coming months.

“It will combine the detailed design of the PCEHR and lessons learnt from the lead implementation sites in relation to functional and operational aspects of the application of standards.”

Heaps more here:

http://www.theaustralian.com.au/australian-it/e-health-records-bill-to-exceed-200m/story-e6frgakx-1226124857282

The full article is well worth a careful read for the details it has.

I have to say I have no idea just what all this money is being spent on - given the scope of the Accenture led PCEHR delivery tender seems to cover a pretty complete delivery of the project.

The explanations quoted as being provided by DoHA and NEHTA sound like waffle to me.

It is also interesting that NEHTA’s 2010 Full Year spend was about $88 Million according to the annual report to support about 200 FTE’s and who knows how many contractors. Amazingly 29% of the staff were involved in Solutions Development. I wonder what solutions those 60 or so people are working on?

No matter how you look at this there is a heck of a lot of money being spend on some not very obvious activities at the Wave 1 and Wave 2 sites.

It is also worth noting we still do not have the PCEHR Standards and we still await finalisation of a contract between Standards Australia and DoHA for this year's e-Health work.

Anyone who has some detailed facts on all the non-obvious spending is welcome to comment to enlighten us all!

David.

Monday, August 29, 2011

Weekly Australian Health IT Links – 29th August, 2011.

Here are a few I have come across this week.

Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

The main news of the week seems to be that we have had another ‘Petronius Arbiter / Charlton Ogburn’ moment with NSW Health and a new re-organisation is under way. It really does remind one of the quote:

“We trained hard, but it seemed that every time we were beginning to form up into teams we would be reorganized. Presumably the plans for our employment were being changed. I was to learn later in life that, perhaps because we are so good at organizing, we tend as a nation to meet any new situation by reorganizing; and a wonderful method it can be for creating the illusion of progress while producing confusion, inefficiency, and demoralization.”

The point is picked up here by a UNSW Health Academic.

http://www.smh.com.au/opinion/politics/endless-tinkering-makes-a-healthcare-paradise--but-for-the-patients-20110825-1jcbu.html

Endless tinkering makes a healthcare paradise - but for the patients

Jeffrey Braithwaite

August 26, 2011

Opinion

Restructuring healthcare has been criticised everywhere for being disruptive and costly, but it hasn't stopped governments doing it. I have lost count of the number of reorganisations of the NSW health system, particularly after 16 years of Labor mismanagement.

The latest round, announced on Wednesday, slashes 150 management jobs to redirect $80 million to frontline hospital services. Will it do anything to improve the health of your family?

The best research says each substantial reorganisation puts people in the system back by at least 18 months. They often generate angst for patients and staff. Everyone takes their eye off the care they should be providing and neglects the decisions they should be making, instead obsessing over organisational arrangements. Organisational chart-itis, you could call it.

- End Quote.

All I can say it is hard to disagree. There really is a need to get is right and just leave things alone in an organisational sense so people can focus on what they are meant to be doing.

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http://www.theaustralian.com.au/australian-it/government/nsw-creates-it-agency/story-fn4htb9o-1226121421258

NSW creates IT agency

  • Karen Dearne
  • From: Australian IT
  • August 24, 2011 4:53PM

THE NSW Government will establish a new agency, eHealth NSW, to plan and co-ordinate all health IT activities statewide.

It is part of a major restructure for NSW Health announced by Health Minister Jillian Skinner today that will slash 300 head office and middle-management roles to "free up more than $80 million” for frontline services.

Ms Skinner said eHealth NSW would drive innovation, improve implementation of "vital” e-health initiatives, and provide IT support to facilities across the state.

The changes are based on recommendations made in the Director-General’s Governance Review, released today.

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http://www.computerworld.com.au/article/398423/nsw_ehealth_agency_established_under_department_restructure

NSW eHealth agency established under department restructure

The agency, to be implemented by the year's end, will improve implementation of e-health projects and provide support to local districts and facilities

The NSW government has moved to restructure the Department of Health and has established a new agency, eHealth NSW, to reflect the growing role of technology in health provision.

According to NSW health minister, Jillian Skinner, the agency will drive innovation, improve implementation of electronic health initiatives and provide support to the local health Districts and their facilities.

The restructure has also resulted in the elimination of 200 middle management positions to free up more than $80 million for front-line services and provide better support for local health Districts.

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http://delimiter.com.au/2011/08/25/nsw-creates-health-it-agency/

NSW creates health IT agency

The New South Wales State Government has opened a new page in its long and troubled history implementing electronic health solutions, committing yesterday to creating a dedicated agency to service the area, amid a much wider shake-up of the health sector in general driven by its new Coalition Government.

The state’s director-general of health, Dr Mary Foley, yesterday handed down a landmark report (PDF) into future governance arrangements for the state’s health department, with new Health Minister Jillian Skinner immediately welcoming the report and pledging to implement its recommendations. Among a number of other conclusions, the report noted that eHealth should be recognised as “the way of the future” in healthcare. However, it noted, NSW wasn’t currently making the most of its opportunities.

“In NSW, the current ICT governance model can be regarded as a ‘half-way house’, with staff and functions spread between the department, which has a strategic role, Health Support Services, which is responsible for rolling out major corporate and clinical systems, and area health-based ICT services which are currently located in the clusters,” the report states.

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http://www.zdnet.com.au/nsw-govt-consolidates-e-health-strategy-339321032.htm

NSW govt consolidates e-health strategy

By Luke Hopewell, ZDNet.com.au on August 25th, 2011

The New South Wales Department of Health has announced plans to restructure its e-health operations into a single agency before the end of the year, in a bid to make NSW the leading state in Australia for e-health delivery.

The new eHealth NSW agency will be made up of fragments of the NSW Department of Health and Health Support Services to deliver a "whole-of-NSW Health" approach to e-health delivery.

"In NSW, the current ICT governance model can be regarded as a 'half-way house', with staff and functions spread between the department, which has a strategic role, Health Support Services, which is responsible for rolling out major corporate and clinical systems and Area Health Service-based ICT services," the government said in its report into agency governance released yesterday (PDF).

The report added that NSW eHealth will develop a master plan complete with delivery dates and realistic timelines for the roll-out of projects like personally controlled e-health records, telehealth initiatives and e-prescribing systems.

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http://www.scmagazine.com.au/News/267946,e-health-records-a-nightmare-says-auscert.aspx

E-health records a 'nightmare', says AusCERT

By Darren Pauli on Aug 24, 2011 3:29 PM

Filed under Risk

Health records need to be more secure than bank data.

The Government's plan to introduce electronic health records is a "nightmare" for security according to the head of industry group AusCERT.

According to Grahame Ingram, information security risks were amplified because of the highly sensitive nature of patient data held under the e-health scheme.

"It is a nightmare scenario," Ingram said. "That they think they have the security to safeguard the data is just a nightmare."

The Government had compared e-health security to systems used by major banks, but to Ingram, that fell short.

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http://www.cso.com.au/article/398610/online_health_records_risk_from_malware/?fp=4&fpid=959105

Online health records at risk from malware

It's the same problems as banking, but different, says AusCERT

  • Stilgherrian (CSO Online (Australia))
  • — 25 August, 2011 20:34

AusCERT general manager Graham Ingram has questioned the wisdom of Australia's National E-Health Strategy plans to make medical records available online, pointing to the difficulty of securing end-users' computers.

"I do not believe that personal health records should be available over the internet to end machines until they can secure them," Ingram told the Security 2011 Expo and Conference in Sydney this week.

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http://www.pharmacynews.com.au/news/time-for-government-to-pick-partners-who-will-deli

Time for Government to pick partners who will deliver e-health to patients

The Health of the Nation series is an independent project by the Weekend Australian’s journalists. It surveyed Australians about key health questions. The published results on electronic health records should have the Gillard Government worried.

It is time the Government picked true partners to ensure the success of Personally Controlled Electronic Health Record (PCEHR), rather than trying to please all groups.

With a $466M budget allocation on the PCEHR before 1 July 2013, a low uptake will be highlighted just before a Federal election expected in September 2013. Many health and consumer organisations are sitting on the sideline giving negative commentary and even blocking progress. These groups have invested none of their own funds in e-health, but the Guild on the other hand is one of the very few organisations putting its money where its mouth is and backing the project. That does not mean our support is being acknowledged by the Federal Government.

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http://www.theaustralian.com.au/australian-it/government/diagnosis-good-for-e-health-rollout-brad-cable-says/story-fn4htb9o-1226119242682

Diagnosis good for e-health rollout, Brad Cable says

THE man steering the $500 million e-health record rollout, Brad Cable, says that next July "you and I will have the ability to log in and actually see our own personal record and be able to give GPs and others access to it".

Accenture's local health and public service head, Cable says he's not fazed by the complexity and tight deadline for delivery of the national system.

"If we hadn't had experience doing e-health records elsewhere it would be quite daunting," he said.

"But (federal Health Minister) Nicola Roxon noted they'd looked to select us based on our track record and what we bring is fundamental to being able to meet what they want and in that timeframe."

Last week, the Gillard government gave an Accenture-led consortium that includes Oracle, Orion Health and Telstra contracts totalling $77m for the build of its personally controlled e-health record program.

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http://www.theaustralian.com.au/australian-it/e-health-plan-smokescreen-for-id-card/story-e6frgakx-1226119986266

E-health plan 'smokescreen for ID card'

THE Gillard government's $500 million e-health record program is a smokescreen for a national identity scheme linking social welfare databases, claims Australia Privacy Foundation chairman Roger Clarke.

Dr Clarke said the program was a guise to mask the creation of an ID regime in the health sector, following past failed attempts to introduce national identity cards.

"If the personally controlled e-health record falls over and the smokescreen disappears, the bureaucrats won't care," Dr Clarke told The Australian.

"Because they will have achieved their goal of a centralised patient identification regime and everything behind it, such as the individual healthcare identifiers, will continue.

"IHIs are an enabling mechanism for linkage between agencies, allowing the creation of virtually centralised national databases."

An IHI was assigned to everyone on the Medicare database last year to support the program, but the system is not yet operational.

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http://www.theaustralian.com.au/news/health-science/workers-staying-silent-on-mental-health-with-bosses-kept-in-the-dark/story-e6frg8y6-1226121570551

Workers staying silent on mental health, with bosses kept in the dark

THE stigma surrounding mental illness remains strong enough for nearly four in 10 sufferers to not disclose the condition to their employers.

And even for those who do, understanding and support from employers and managers is severely lacking, a study by Sane Australia reveals.

The Working Life and Mental Illness study, to be published today, which surveyed 520 people with a mental illness, finds the majority don't believe their manager understands mental illness and its impact in the workplace.

"Fewer than half of managers (43 per cent) were said to understand how it affected people in the workplace," the report says, with only 30 per cent of sufferers offered flexible working arrangements.

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http://www.itnews.com.au/News/267626,telstra-e-health-role-under-agimo-scrutiny.aspx

Telstra e-health role under AGIMO scrutiny

Does the eHealth records plan meet data centre procurement guidelines?

Plans to use Telstra's cloud computing offering to store elements of the Federal Government's personally controlled e-health record (PCEHR) are in limbo after it was discovered they do not yet meet whole-of-government procurement guidelines established by the Department of Finance and Deregulation.

The Department of Health and Ageing is in discussions with the Australian Government Information Management Office (AGIMO) - a subset of the finance department - over how use of Telstra's secure infrastructure-as-a-service would align with guidelines mandating government departments use a whole-of-government endorsed data centre supplier.

Telstra was among the eight parties included in Accenture's successful consortium bid for the infrastructure portion of the $466.7 million records project. However, it has not been named as a supplier to AGIMO's whole-of-government data centre panel.

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http://www.australianageingagenda.com.au/2011/08/23/article/Its-like-putting-a-man-on-the-moon/YFBNQDGARA

It's like putting a man on the moon

Published on Tue, 23/08/2011, 03:02:31

No goal is too big when you have inspiration.

CEO of the National E-Health Transition Authority (NEHTA), Peter Fleming, has likened the once thought impossible but successful job of putting a man on the moon to one other major task currently at hand – the creation of the Personalised eHealth Record (PCEHR) system for all Australians.

During the Health Infomatics Conference in Brisbane, earlier this month, Mr Fleming described the establishment of the eHealth system as a massive “challenge”. But, he said, once overcome, it will significantly change the world in which we live and make a huge difference to the health care system of the future.

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http://www.cio.com.au/article/398098/doha_confirms_next_round_pcehr_funding_negotiations/

DoHA confirms next round of PCEHR funding in negotiations

The third round of funding for the project will be allocated to the National e-Health Transition Authority (NeHTA) by November 2011

The Federal Department of Health has confirmed it is in negotiations for the third tranche of funding to be allocated to the National e-Health Transition Authority (NeHTA) for the $466.7 million Personally Controlled Electronic Health Record (PCEHR) project.

Speaking to Computerworld Australia, a spokeswoman for the Department of Health and Ageing (DoHA) said negotiations were progressing in line with the end of the previous stage with a new allocation to be made by November this year.

The spokeswoman could not comment on the exact amount of funds to be allocated to NeHTA, but said it would be dependent on contract deliverables and used to build upon the work completed so far.

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http://www.theaustralian.com.au/australian-it/primary-health-drops-300m-hcn-sale/story-e6frgakx-1226119922754

Primary Health drops $300m HCN sale

  • Karen Dearne
  • From: Australian IT
  • August 22, 2011 7:07PM

MEDICAL software maker HCN is off the auction block as Primary Health Care scraps plans to sell-off its technology division.

Instead, the company will implement a new three-year strategic plan "to capitalise on, and be a beneficiary of, the upcoming e-health change in Australia".

The future for HCN, market leader for doctors' desktop systems, has been in doubt since May when Primary confirmed it may sacrifice the asset to pay down debt.

It's understood managing director Ed Bateman's medical centre and pathology lab group was hoping to raise up to $300 million.

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http://www.techworld.com.au/article/398013/medicare_local_one_month_technology_behind_brisbane_first_facility/

Medicare Local one month on: The technology behind Brisbane's first facility

E-health records, CMS database key to the future

The first Medicare Local in Australia will play a key role in the adoption of electronic health records.

With the Lutwyche site up and running, CEO of Metro North Brisbane Medicare Local, Abbe Anderson, is turning her attention to expansion and the personally controlled health record (PCHR).

“We are one of the key providers behind the electronic health records,” she said.

“The types of things we’re testing out locally is enrolling general practices so we help them to get their Individual Healthcare Identifiers, so all of us in Australia have one of these but they need to be put into the system and used, and it’s one of the big challenges to organise this.”

Anderson, spoke to Computerworld Australia about the IT challenges that come part and parcel with being the first Medicare Local opened by the Federal Department of Health and Ageing.

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http://ehealthspace.org/news/gillard-plugs-medicare-locals

Gillard plugs Medicare Locals

Prime Minister Juila Gillard has hailed the axing of general practice divisions and establishing Medicare Locals as a gravitational shift in Australia’s health system administration.

Nineteen Medicare Locals have already been established, with more on the way. The organisation is designed to shift the focus of the health system from hospitals to primary and community-based care.

According to the prime minister, there is no “one size fits all” for Medicare Locals. “What works in Western Sydney won’t necessarily work in Bunbury, which is why locally-run organisations are looking at the health needs of their communities and targeting services to meet those needs,” she said in a statement.

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http://www.mjainsight.com.au/view?post=computers-may-predict-deaths&post_id=5929&cat=news-and-research

Computers may predict deaths

COMPUTER analysis of routine blood tests can predict which hospital patients are likely to experience a critical event the next day, according to preliminary Australian research.

Melbourne researchers used a computer program to examine six million blood tests taken from patients in the wards and emergency department of the Austin Hospital in the past 5 years, and combined this data with hospital records of critical events.

“We wanted to see if the blood tests contained patterns of abnormalities … to predict whether a patient would, the next day, die, go to intensive care, or receive a MET [medical emergency team] call”, said Professor Rinaldo Bellomo, director of intensive care research at Austin Health.

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http://www.theaustralian.com.au/national-affairs/nbn-cost-to-widen-the-digital-divide/story-fn59niix-1226120000176

NBN cost to 'widen the digital divide'

THE company rolling out the National Broadband Network wants the ability to increase prices for business broadband and super-fast services by up to 5 per cent more than inflation for three decades, prompting warnings of an end to the era of falling communications prices.

While NBN Co has proposed charging retailers such as Optus and Telstra $24 a month for access to the cheapest entry-level and most popular services, it is also planning to seek approval from the competition regulator to be able to increase prices by up to 5 per cent more for other services.

Opposition communications spokesman Malcolm Turnbull said the NBN was going to make broadband access less affordable and widen the digital divide. "It's a poor deal for taxpayers and an even worse deal for consumers," Mr Turnbull said yesterday.

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http://www.aph.gov.au/house/committee/ic/NBN/report/Dissent%20final.pdf

NBN speeds not needed for e-health

The high speeds of the National Broadband Network are not needed to implement e-health and telehealth programs, a dissenting report from Liberal Senators concludes.

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http://www.smh.com.au/technology/sci-tech/stars-fade-as-universe-starts-to-run-out-of-gas-20110821-1j4ru.html

Stars fade as universe starts to run out of gas

Deborah Smith

August 22, 2011

GALAXIES are running out of gas - a discovery that explains why fewer stars are being born now than in the past. The culprit for this dimming of the lights appears to be the mysterious dark energy that pervades the cosmos and is pushing it ever faster apart.

A CSIRO astronomer, Robert Braun, said that star formation peaked early in the universe's history, about 8 to 10 billion years ago, then began to decline.

At first the drop-off in star birth was slow. ''Now it's really plummeting,'' Dr Braun said.

To find out why, he and his colleagues looked back in time with the Mopra radio telescope near Coonabarabran. They compared galaxies that existed between 3 and 5 billion years ago with those today, and found the older ones had much more hydrogen gas in them - the stuff from which stars are born.

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Enjoy!

David.

AusHealthIT Poll Number 85 – Results – 29th August, 2011.

The question was:

Are The Planned Risk Managment And Governance Frameworks for the PCEHR Adequate?

For Sure

- 0 (0%)

Probably

- 2 (7%)

Probably Not

- 3 (11%)

Of Course Not

- 21 (82%)

Votes 26

A stunningly clear cut vote. This project is not being managed as it should be!

Again, many thanks to those that voted!

David.

Sunday, August 28, 2011

I Think It Is Time For A Little Free For All Feedback and Commentary After 2000 Posts!

I happened to be checking the Dashboard for the blog yesterday - to check if I had failed to process any comments that had been submitted. To my considerable surprise I noticed a milestone had passed and I had missed it!

What I read was :

Australian Health Information Technology

2,007 Posts, last published on Aug 27, 2011

Good heavens that seemed like a lot of posts!

Looking at the statistics since inception we find:

Total Visits to the Blog have numbered 282,516

Total Page View have numbered 483,082

Currently about 300 people receive e-mail notification of posts, about 135 people follow the blog on Twitter and there are 680 or so followers via RSS feeds and the like.

Anyway that is all OK and has happened since the first post on March 05, 2006.

Of course the blog needs to try and look forward and see how it can better serve those who bother the read every once in a while.

Sitting on this side it is really interesting to note that number if comments and reader pageviews seem to spike dramatically when ‘controversial’ posts are put up. Last Monday, for instance, recorded 1097 pageviews with 597 visits - which is about 3 times average!

Fully recognising I am likely to attract some with firm likes and others with equally firm dislikes what I would l like is a sense of what people find useful and what is not useful. Equally I would like get feedback on where coverage is lacking and needs to improve - and of course the reverse.

There is no point doing this in a vacuum and just becoming a ‘prominent e-Health dissenter’! I would much rather be seen as trying to foster rational and open discussion of the ferociously difficult issues that face Australian e-Health and point to some constructive ways forward.

For mine, I would also like to see thoughtful differing perspectives sent along that I can post as ‘guest blogs’ and which can foster an improvement is current understanding of where we are and where we are heading. Any sensible offerings I will be happy to post with no changes.

Anyway over to you. An e-mail address is available here:

http://www.blogger.com/profile/06902724829795199526

Of course all comments are welcome - anon or not!

As a last point I would like to highlight the recent submission made by the Australasian College of Health Informatics to the recent review of the PCEHR ConOps.

The link is here:

ACHI Response to Draft PCEHR Concept of Operations (May 2011, updated June 2011)

The reason I raise this document is to point out that the only serious body of senior Health Informaticians in Australia - with close to 50 members - has a very substantial number of real concerns with the direction the PCEHR Program is heading so while some others may believe I have ‘wandered of the reservation’ there is good evidence that this is simply not true and that actually my views are rather mainstream among those who have some reasonable expertise in the domain.

Anyway, the issue at hand here is to try and get some feedback that can improve the value and utility of the blog to those for whom the future of e-Health in Australia is an important matter!

I look forward to whatever comes.

David.