The Lack Of Health Sector Wide Knowledge and Understanding Bites NEHTA Hard. Pretty Pathetic Really.

The following popped up today:

States not ready for e-Health system

• by: Karen Dearne
• From: The Australian
• July 19, 2012 6:56AM

GENERAL practitioners will have to wait up to three years to receive secure discharge summaries digitally signed by hospital doctors following more delays to the Gillard government's e-health system.

State and territory health departments say they are not ready to use healthcare providers' 16-digit unique identity numbers created for the national system to verify the identity of doctors or other medical staff creating a patient's discharge summary.

Healthcare providers individual identifiers - dubbed HPI-Is - were created and assigned to all registered doctors two years ago as part of the Healthcare Identifiers service launch, which also saw unique 16-digit identifiers allocated to every Australian enrolled on the Medicare database.

Use of local hospital or state health agency identity numbers instead of a uniform national identifier will impact their use for authentication and audit purposes within the personally controlled e-health record system.

The ability to accurately identify individual healthcare providers, health organisations and consumers using the PCEHR system is key to securely exchanging electronic information and reducing the potential for errors - either through assigning records to the wrong patient or sending documents to the wrong doctor.

User verification is supposed to be provided through the not-yet-available National Authentication Service for Health (NASH), which is also supposed to provide an audit trail of all access to a patient's electronic record.

Delivery of the NASH is subject to ongoing negotiations between the contracted supplier, IBM, and the Health department after the PCEHR system launched without it on July 1.

Health chief information officer Paul Madden yesterday called for comment from stakeholders on a proposal to abandon the mandatory requirement to include HPI-Is in discharge summaries in the near to medium term.

Lots more of the saga is found here:

http://www.theaustralian.com.au/australian-it/government/states-not-ready-for-e-health-system/story-fn4htb9o-1226429582355

Here is a slightly more technical summary of the issue from NEHTA:

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ISSUE

The current Nehta specification and proposed Australian Technical specification for discharge summaries includes a mandatory requirement for an HPI-I.
Jurisdictions and lead implementation sites have difficulty in obtaining HPI-I’s for their providers, and have been unable to secure funds to store HPI-I’s in their systems.
Jurisdictions have estimated a 1-3 year horizon for the implementation of HPI-I’s.
As a result, it will take a considerable time for discharge summaries to be available in the PCEHR if the HPI-I remains a mandatory requirement.

BACKGROUND

Nehta and the NCAP have been reviewing the opportunity for a number of quick wins for increasing the clinical utility of the PCEHR through the jurisdictions.  These opportunities have been presented by the NCAP to the Nehta Board.  A key opportunity in most jurisdictions is the implementation of an interface from the hospital discharge summary process into the PCEHR.  Queensland, South Australia, Victoria, NSW, the ACT and the NT have all expressed a desire to move forward with discharge summaries.

Jurisdictions raised the issue of the steps they would have to go through to implement the HPI-I’s into the discharge summary.  A series of workshops, facilitated by the NCAP and attended by jurisdictions, Doha and Nehta concluded that by relaxing the conformance requirement of a mandatory HPI-I on discharges, that jurisdictions would then be able to build the necessary infrastructure to send discharges to the PCEHR. 

It is noted that while the requirement of a HPI-I is relaxed, there remains a mandatory requirement for a Provider Identifier of some nature.  This identifier may be an identifier supplied by the healthcare facility associated with the individual provider.  It may be of any form (e.g. Numeric, Alpha-Numeric, etc).  The identifier must be unique to the facility, for example a concatenation of the local identifier linked with an OID derived from the facility’s HPI-O or ABN.

A clinical impact and safety assessment has concluded that there is no introduced clinical risk by relaxing this conformance point.

----- End Extract

So it seems that no-one at NEHTA has noticed that, as far as most of the States are concerned, use the Health Identifier Service is distinctly optional - and they will get round to it sometime in the rather ill-defined future.

It should be noted that without Individual as well as Provider Identifiers flows of information both to AND FROM the NEHRS / PCEHR are made more problematic. How can an internal hospital system use B2B to request PCEHR records if it does not handle the HI Service?

You can read my comments on feeder systems  being an issue from last year here:

http://aushealthit.blogspot.com.au/2011/10/part-nehta-is-going-to-struggle-with.html

What is not clear to me - reading this - is just how a particular discharge summary - with a local identifier - can be safely merged with a PCEHR record. It is not clear to me if the IHI remains mandatory (looking at the V1.3 specs it seems not) and if all the hospital systems are able to use this identifier.

An obvious question is, of course, if the IHI is not mandatory just why is that and how is that decision justified?

Despite the words from NEHTA Clinical Safety I think this needs some careful development of test cases to make sure any interactions between the Hospitals and the PCEHR occur exactly as expected with a high degree of reliability.

The failure to take a health system wide view - when working with a so called ‘nation system’ - just shows how far out of touch some are.

What exactly are NEHTA playing at with all this?

David.

I Am Having A Bad Case Of Cognitive Dissonance With This - The Government Can’t Have It Both Ways.

In the last few days there have been a number of articles on the Government’s desire to access historical web and phone data.

Government defends web spy powers

Date: July 13, 2012

Dylan Welch and Ben Grubb

THE Gillard government has defended a plan to force telcos to store the internet and phone data of all Australians for up to two years, saying it is needed to allow our intelligence and police agencies to effectively target organised criminals and terrorists.

''In this day and age, an age where governments all around the world are grappling with the challenges of terrorism and organised crime, it is important that our relevant agencies have access to the information that they need,'' the assistant Treasurer, David Bradbury, said.

The Coalition, however, has refused to throw its support behind the controversial data-retention scheme, with its legal spokesman, George Brandis, who also sits on the committee reviewing the proposal, only saying he would ''examine the issues carefully''.

His response was sparked by a Fairfax Media report, which stated the scheme was being considered as part of a review of national security legislation by a parliamentary committee.

More here:

http://www.smh.com.au/technology/technology-news/government-defends-web-spy-powers-20120712-21yvu.html

At the same time we have an enormous song a dance about how secure and private information flowing back and forth to our NEHRS / PCEHR record is going to be.

While opinions vary there are certainly some experts who are already a little concerned about the general security of the system.

See here for example.

E-health record will be hacked, says AusCERT

Written by Nayantara Mallya, Chillibreeze on Monday, March 12, 2012 10:18

news One of Australia’s top IT security organisations has warned that the Federal Government’s flagship e-health records project is likely to be broken into, with Australians’ medical and identity information to be used for fraud and other criminal activities.

AusCERT, Australia’s Computer Emergency Response Team, which is not associated with the Government, in its submission to an inquiry about the legislation dated in January (PDF), criticised the Government’s Personally Controlled Electronic Health Records (PCEHR) Bill (2011). In its commitment to protecting the privacy and security of Australian Internet users, AusCERT has expressed concern that miscreants could potentially use the PCEHR for identity theft and fraud. The submission was first reported by the AustralianIT.

AusCERT opines that enabling accessibility to personal identifying information in the form of the PCEHR from personal computers over the Internet will only worsen an ongoing problem that will make Australians vulnerable to fraud and identity theft. The submission focuses on the use of untrustworthy end point computers and mobile devices, which when compromised, will enable attackers exert full control over the PCEHR to look at or change its contents with the same privileges as the owner or authorised users.

Vastly more detail here:

http://delimiter.com.au/2012/03/12/e-health-record-will-be-hacked-says-auscert/

So what we have here is the following.

1. The Government wants to be able to get at and track any internet activity we have undertaken in the last 2 years.

2. The PCEHR is claimed to be secure but some are not so sure.

3. You are going to be using the Government ‘hackable’ internet to send your private personal information to and from the PCEHR.

Whether you are comfortable with all this depends on your view about whether ‘the Government is always here to help’ or not. For mine, I would be carefully considering before putting any information in the NEHRS / PCEHR that I seriously wanted to remain private.

As always it is your call, but I just wonder how the claims of great security and a desire from Government to be a legal ‘hacker’ when it feels it needs to be, actually gel together.

David.

Please Pour Yourself A Large Steadying Scotch Before Reading. It Will Help The Pain.

The following appeared today.

http://www.theaustralian.com.au/australian-it/government/e-health-delivering-on-its-rollout-commitments/story-fn4htb9o-1226427500101

E-health 'delivering on its rollout commitments' says Paul Madden

• by: Karen Dearne
• From: The Australian
• July 17, 2012 12:00AM

FUNDING of $135 million for the National E-Health Transition Authority will support a new work program over the next two years following its delivery of Australia's e-health foundations.

But the health department cannot yet provide any details of NEHTA's forward work plan allocated $67m in the recent budget -- a sum to be matched by the states and territories under Council of Australian Government funding arrangements.

Health chief information officer Paul Madden says NEHTA has "delivered" specifications for all foundation capabilities, including infrastructure and services.

Mr Madden said The Australian was wrong to suggest $1 billion had been spent on the national e-health program since former health minister Nicola Roxon unveiled her personally controlled e-health record vision in mid-2010.

The department insists the PCEHR program has been completed on time and within the original $467m budget, despite the slow launch and lack of many key components.

Mr Madden said $380m in COAG funding for NEHTA's work program during the period included e-health foundations that were "leveraged" for the PCEHR but would have been developed anyway, so this sum should not be included in any accounting of costs.

"The money that's gone to NEHTA historically and NEHTA's e-health activities started well before any announcement of the PCEHR," he said.

"They've been working on a whole range of things that were not necessarily (aimed) towards a specific individual e-health record (the original concept endorsed by COAG) and certainly not the PCEHR.

"These include the Healthcare Identifiers, the Australian Medicines Terminology and secure messaging.

"So, even if we hadn't developed the PCEHR, those expenses would have continued because COAG had decided to develop them."

Separately, the Gillard government has spent $777m on specific PCEHR-related activities since July 2010, including $352m in new forward funding.

Mr Madden said of the $234m allocated in the budget over the next two years, $161.6m was "operational funding for the PCEHR".

"It shouldn't be categorised as development, (our position is) we will operate this system and gain experience with it; there are no functional additions, there's no catch-up (included) -- it's to operate the PCEHR," he said.

This allocation will also finance NEHTA to provide some "specific support and testing arrangements" for PCEHR, on top of the COAG funding for its new work agenda.

Health lowered its targets for the number of consumers registered for a PCEHR in the budget to 500,000 by the end of the current financial year and 1.5 million by the end of 2013-14; originally, it targeted half a million participants by June this year.

Meanwhile, the National Partnership Agreement on E-Health, under which COAG funds NEHTA, expired at the end of last month.

Mr Madden said a new intergovernmental agreement was "still being developed"

There is a lot more here:

http://www.theaustralian.com.au/australian-it/government/e-health-delivering-on-its-rollout-commitments/story-fn4htb9o-1226427500101

(Well worth buying a digital pass for the full gruesome details!)

Let us now consider what was promised two years ago (from a recent blog)

http://www.aushealthit.blogspot.com.au/2012/05/its-time-to-check-what-we-were-promised.html

Here is the press release - (I have highlighted the important and not delivered bits in italics):

Personally Controlled Electronic Health Records for All Australians

Australians will be able to check their medical history online through the introduction of personally controlled electronic health records, which will boost patient safety, improve health care delivery, and cut waste and duplication.

11 May 2010

Australians will be able to check their medical history online through the introduction of personally controlled electronic health records, which will boost patient safety, improve health care delivery, and cut waste and duplication.

The $466.7 million investment over the next two years will revolutionise the delivery of healthcare in Australia.

The national e-Health records system will be a key building block of the National Health and Hospitals Network.

This funding will establish a secure system of personally controlled electronic health records that will provide:

• Summaries of patients’ health information – including medications and immunisations and medical test results;
• Secure access for patients and health care providers to their e-Health records via the internet regardless of their physical location;
• Rigorous governance and oversight to maintain privacy; and
• Health care providers with the national standards, planning and core national infrastructure required to use the national e-Health records system.

The full press release is here:

http://www.health.gov.au/internet/budget/publishing.nsf/Content/budget2012-hmedia04.htm

And later in the same blog Ms Roxon claims:

This extract from a 2010 interview is telling:

MELINDA HOWELLS: Nicola Roxon says half a billion dollars is a big commitment.

NICOLA ROXON: Governments of past have put off making the decision to do this and our focus will be absolutely on these stages and of course there is business plan for the stages that can come after that. This investment, however, will give the momentum to taking electronic health records that step closer to reality in Australia.

Full interview here:

http://www.abc.net.au/worldtoday/content/2010/s2897298.htm

All I can say is that I, for one, struggle to align what was promised and what then happened.

Let us all know if you can explain how all this can all be true.

David.

The PCEHR Is Still Not Fixed!

Logged on at 6:15pm Monday July 16.

Still get this while wanting to see Medicare Services Overview.

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Error Details
An error has occurred processing your request.

-----

Hardly what is expected of a 1/2 billion dollar National E-Health System.

What a farce! It just was not ready.

David.

Update 10:30pm 17/07/2012

Guess what? Still not fixed!

D.

Weekly Australian Health IT Links – 16th July, 2012.

Here are a few I have come across the last week or so.

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

General Comment

A week late, but we were able to register this week for a NEHRS / PCEHR and it seem we now have 1/10000 individuals registered. It will take a good while before the ‘network effect’ kicks in and the record is actually useful at this rate.

Otherwise the announcement on mental e-health is really a good thing at the top level. I hope the implementation is also well conducted.

Many other topics covered - with some very interesting information on a e-Health system is Israel.

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http://ehealthspace.org/news/2022-people-register-pcehr

2022 people register for PCEHR

Posted Fri, 13/07/2012 - 14:51 by Josh Gliddon

Almost two weeks into the PCEHR, and just over 2000 individuals have registered for a personally controlled electronic healthcare record, up from around 800 at the beginning of this week.

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http://www.businessspectator.com.au/bs.nsf/Article/healthcare-spending-GDP-database-medical-costs-Med-pd20120709-VZSSB?OpenDocument&src=sph

PRODUCTIVITY SPECTATOR: Your money and your life

Jackson Hewett

Published 7:33 AM, 9 Jul 2012 Last update 7:33 AM, 9 Jul 2012

Three hundred and six.

That’s the number of people who signed up last week to the government’s new program to slash the cost of our medical spending.

It was a very soft launch for the Personally Controlled E-Health Record but the motivation behind it is right. An easily accessible database that ensures medical professionals have access to all of our medical activities should, if utilised correctly, reduce the enormous amount of waste and duplicate activities that drain federal and state health budgets. It also should help reduce mistakes caused by patients forgetting what previous symptoms they’ve had or drugs they’ve taken.

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http://www.brisbanetimes.com.au/it-pro/government-it/slower-than-predicted-start-for-personal-ehealth-records-20120709-21qw4.html

Slower than predicted start for personal e-health records

Date July 9, 2012 - 1:38PM

Only 320 people signed up for an electronic health record five days after the Federal Government's much anticipated July 1 e-health launch.

With numbers like this, the Personally Controlled Electronic Health Record project, which aims to streamline patient medical records to facilitate treatment, is unlikely to meet its own target of registering 500,000 users by July 1 next year.

Australians wanting to consolidate their health records including medications, allergies, immunisations, doctors’ and hospital notes and prescriptions, can apply online at ehealth.gov.au.

A slow, incomplete start was predicted in May for Australia's most ambitious e-health project to date.

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http://www.australiandoctor.com.au/news/latest-news/e-health-security-concerns-blight-launch

E-health security concerns blight launch

9 July, 2012 Kate Newton

The Federal Government’s e-health records system came under renewed last week as it launched to the public, with patients struggling to sign up and critics questioning its security.

The first stage of the personally controlled electronic health record — or PCEHR — began on 1 July, with people able to register for their own record.

GPs and other health providers cannot access the records yet as it will still be months before their software is compatible.

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http://www.mjainsight.com.au/view?post=steve-hambleton-jumping-the-e-health-gun&post_id=9884&cat=comment

Steve Hambleton: Jumping the e-health gun

THE Personally Controlled Electronic Health Record was launched last week. It is probably the softest launch of a major government initiative in Australian political history.

Why? Because it is not ready. Not by a long shot.

For months, the AMA has been warning the government that the PCEHR is not ready. Patients are not ready. Doctors and other health professionals are not ready. Hospitals are not ready. The health system is not ready.

I was one of a group of GP leaders who met with Health Minister Tanya Plibersek just before the launch to explain in person our concerns about the lack of readiness for the PCEHR.

We told her we want the PCEHR to work. We want it to work for our patients and for ourselves. We see the electronic health record as a key productivity tool in health.

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http://www.couriermail.com.au/news/no-apostrophe-name-glitch-hits-e-health-portal/story-e6freon6-1226420413179

No apostrophe name glitch hits e-health portal

• by: Carleen Frost
• From: The Daily Telegraph
• July 09, 2012 12:00AM

IT'S a new, electronic portal where Australians can sign up to keep records of their medial history online - but not if your surname is O'Reilly, M'Gregor or D'Angelo.

The federal government owned up to an embarrassing blunder that blocks people with apostrophes from signing up to their new e-health service.

It follows concerns that people with other special characters in their names are also being refused access due to a glitch in the system.

A spokeswoman for the Department of Health and Ageing said staff were aware of the problem with apostrophes but denied there had been issues with other special characters like hyphens.

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http://www.theaustralian.com.au/australian-it/auditor-general-must-audit-e-health-coalition/story-e6frgakx-1226422011869

Auditor-General must audit e-health: Coalition

• by: Karen Dearne and Fran Foo
• From: The Australian
• July 10, 2012 12:00AM

PRESSURE is building for the Auditor-General to examine the cost and performance of parties involved in the Gillard government's personally controlled e-health record program after a dismal launch last week.

Opposition e-health spokesman Andrew Southcott said that given "almost $1 billion of taxpayers' money has been spent or allocated for this in the past two years, it would be prudent for the Australian National Audit Office to examine the PCEHR program".

IT projects were "notorious for costing a lot more than expected and delivering a lot less than expected, and this seems to be in that category".

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http://www.medicalobserver.com.au/news/call-for-secure-messaging-as-coalition-demands-ehealth-audit

Call for secure messaging as Coalition demands e-health audit

10th Jul 2012

The government has been urged to focus its attention on developing secure messaging systems for GPs and other doctors in the wake of last week’s jittery e-health records system launch.

Shadow parliamentary secretary for primary healthcare Dr Andrew Southcott told MO the government should have spent the past two years developing secure messaging and other “incremental steps” rather than going for the “big bang, blockbuster approach” by launching e-health records.

Dr Southcott said he would write to the Attorney General to ask that the Australian National Audit Office examine how the government had spent “almost $1 billion” developing the records system.

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http://www.theaustralian.com.au/australian-it/government/nehta-knew-of-pcehr-delays/story-fn4htb9o-1226422820967

NEHTA knew of PCEHR delays

• by: Karen Dearne
• From: Australian IT
• July 11, 2012 12:00AM

ALMOST all the functionality of the new personally controlled e-health record system is delayed until at least August, the National E-Health Transition Authority's head of the PCEHR program admitted four days before the go-live.

"At the moment, we are in the final stages of the production build-out and final verification testing," Andrew Howard told a vendors' webinar on June 27.

"Everything is on track for a successful launch (of the consumer portal and online registration system) over the weekend."

But Mr Howard said plans for the release of the provider portal were not yet settled.

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http://www.theaustralian.com.au/news/health-science/sideshow-obstructs-e-health-traffic/story-e6frg8y6-1226424814989

Sideshow obstructs e-health traffic

• by: Karen Dearne
• From: The Australian
• July 14, 2012 12:00AM

THERE is a truck trundling across Australia that should be pulled over and its owners charged with false and misleading advertising.

It's the Model Healthcare Community Roadshow, and it claims the Gillard government's $1 billion personally controlled e-health record guarantees "your health e-info travels with you".

Although that is indeed the aim of modern electronic health systems, the PCEHR is a repository containing a static, point-in-time medical summary uploaded by your GP, and possibly a few "event summaries" from other practitioners.

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http://www.australiandoctor.com.au/news/latest-news/the-conversation-is-starting

The conversation is starting....just4docs

13 July, 2012 Dr Kerri Parnell

Australian Doctor is developing a new online community exclusively for doctors called just4docs.

Many of you already comment on the Australian Doctor website or talk about our stories with colleagues. In the near future you will be able to continue that dialogue on a secure social network called just4docs.

Over recent months, a small group of GPs has been helping this secure doctor-only community take shape. The time has now come to widen the conversation and if you want to be the first in line to join, we would love you to register your interest.

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http://www.australiandoctor.com.au/in-depth/news-review/beyond-the-e-health-record

Interaction beyond the e-health record

9 July, 2012 Kate Newton

Israel's largest health provider offers e-health services to 3.8 million users, giving patients and doctors the opportunity to interact.

While the Federal Government struggles to get its e-health service off the ground, a similar service in Israel is treating over a million people each month.

Clalit, Israel’s largest provider of health services, launched its e-health wing in 2009, with patients and doctors able to interact through multiple layers of online services.

The service gives Clalit’s 3.8 million patients access to their full medical record — including diagnoses, lab results with simple explanations, and current prescriptions — and allows doctors to easily share those records with specialists and other health professionals.

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http://www.medicalobserver.com.au/news/gp-creates-skype-site-for-telehealth-consults

GP creates Skype site for telehealth consults

12th Jul 2012

Mark O’Brien

A MELBOURNE GP, fed up with not being able to find a specialist to conduct telehealth consultations, has launched a free website designed to connect doctors via the Skype video-conferencing program.

The website allows practitioners interested in telehealth to register their specialty, location and Skype address; search the resulting database for others to connect with; browse registered practitioners with an interactive map; and features a forum and instant messaging.

The creator, Dr Jonathan Brown, said he had received dozens of registrations in the first week and he hoped the site would help other GPs struggling to make telehealth consultations.

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http://www.theaustralian.com.au/australian-it/the-eyes-have-it-for-disabled-gamers/story-e6frgakx-1226425191392

The eyes have it for disabled gamers

• From: AFP
• July 13, 2012 10:49AM

RESEARCHERS in Britain had built a device using mass-produced video gaming equipment that lets disabled people control a computer with just their eyes -- with a price tag of under $US30 ($29.60).

The gadget comprises two video game console cameras, costing less than $US10 apiece, attached outside the line of vision to a pair of ordinary glasses, reported the team from Imperial College London.

The cameras relay the eye's movements to an ordinary computer, wirelessly over WiFi or via USB, and used one watt of power, they wrote in the Journal of Neural Engineering

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http://www.arnnet.com.au/article/429937/evolving_ehealth/?fp=4&fpid=1382389953

Evolving eHealth

eHealth is finally making its way out of the realm of imagination and into reality. But is the hype surrounding eHealth justified?

• Patrick Budmar (ARN)
• 09 July, 2012 14:59

Often viewed as a pipedream, eHealth is finally making its way out of the realm of imagination and into reality. But is the hype surrounding eHealth justified? PATRICK BUDMAR finds out.

As advancements continue to be made with computer technology, and the Internet becomes more commonplace in our daily work and private lives, transformation is expected to occur in many traditional work sectors.

For example, the retail industry underwent some growing pains in recent years as it was pulled into the digital age, along with the music and film industry. Another sector that is expected to follow in their footsteps is the healthcare industry under the oft quoted “eHealth” moniker.

Comment: Note that the article really does not answer the question it poses as far as I can tell.

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http://www.theaustralian.com.au/national-affairs/state-politics/springborg-springs-motion-on-health-payroll-cabinet-documents/story-e6frgczx-1226424326536

Springborg springs motion on health payroll cabinet documents

• by: ROSANNE BARRETT
• From: The Australian

HEALTH Minister Lawrence Springborg has ambushed Queensland's Labor Opposition on the floor of parliament, demanding it authorise the release of confidential Cabinet documents.

Former Liberal National Party leader Mr Springborg called a snap motion this morning, calling for Opposition leader Annastacia Palaszczuk to hand over legal advice to the government assessing potential financial recovery options for the health payroll debacle before the next parliamentary sitting.

The motion was passed using the LNP's huge majority.

The previous Bligh government obtained legal advice on its options over the botched implementation of the IBM-WorkBrain payroll system, which the Auditor-General last year deemed the worst state government failure he had reported.

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http://ehealthspace.org/news/e-mental-health-gets-new-plan-and-110-million-funds

e-Mental Health gets a new plan and $110 million in funds

Posted Tue, 10/07/2012 - 10:27 by Will Turner

The federal government has announced it will invest $110.4 million over the next four years to build a “mature online mental health care environment” as part of its new E-Mental Health Strategy.

The strategy, released in conjunction with the launch of the e-mental health website mindhealthconnect, outlines the government’s approach to e-mental health and its main areas of investment.

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http://www.smh.com.au/digital-life/mobiles/smartphone-stethoscope-in-with-a-chance-20120707-21nqx.html

Smartphone stethoscope in with a chance

Date July 8, 2012

Tim Barlass

A MEDICAL device that could saves the lives of millions of Third World children is the Australian entry in an international competition to find software solutions to global problems.

The digital stethoscope is attached to a smartphone, which listens to and digitises a pneumonia patient's breathing sounds and patterns. Those patterns are then compared against a medical database using cloud technology to deliver an automated diagnosis and treatment plan via an app on the smartphone.

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http://www.computerworld.com.au/article/430047/queensland_institute_medical_research_seeks_data_centre_services_/

Queensland Institute of Medical Research seeks data centre services

New facility will house hierarchical storage management offering and servers

• Hamish Barwick (CIO)
• 10 July, 2012 09:42

The Queensland Institute of Medical Research (QIMR) is seeking a data centre construction partner to build a new facility as it prepares for increased storage needs, according to a request for information.

The new data centre will house a hierarchical storage management (HSM) offering and server infrastructure. According to tender documents, a suitable room has been found at QIMR but a fit out is needed to turn the room into a data centre.

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http://www.smh.com.au/digital-life/consumer-security/most-embarrassing-blunder-government-contractor-paid-1m-for-esecurity-alerts-service-loses-8000-subscribers-personal-information-20120709-21q86.html

'Most embarrassing' blunder: government contractor paid $1m for e-security alerts service loses 8000 subscribers' personal information

Date: July 9, 2012 - 10:21AM

Ben Grubb

Deputy technology editor

A federal government contractor paid more than $1 million to deliver e-security alert services to Australians has lost 8000 subscribers' personal information in the postal system.

AusCERT, which was paid $1,199,484.52 by the federal government to run staysmartonline.gov.au between July 18 2008 and June 30 2011* lost subscribers' data after posting it to the Department of Broadband, Communications and the Digital Economy (DBCDE) on April 11 when its contract to run the alerts service ended.

In an email to the site's 8000 subscribers sent at about 6pm on Friday, the "Stay Smart Online Team" said information that had "gone missing" on the DVD included subscribers' user names, email addresses, memorable phrases and passwords, which it said were "unreadable" (stored as a cryptographic hash).

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http://www.businessspectator.com.au/bs.nsf/Article/big-data-analytics-retail-sector-business-technolo-pd20120712-W53A4?OpenDocument&src=edbyo&ir=3

TECHNOLOGY SPECTATOR: Time for a Big Data diet

Supratim Adhikari

Published 11:04 AM, 12 Jul 2012 Last update 11:19 AM, 12 Jul 2012

The current buzz around ‘big data’ is almost enough to give the ‘cloud’ a run for its money but amid the grand promises that seem to accompany every piece of technology a clear definition of just what makes data ‘big’ can be hard to find.

Well, the simplest description would be that if the amount of data that you need to process exceeds the capability of your database systems, you’ve got big data. This may seem a tad simplistic but it is accurate. Volume is really the name of the game given the massive amount of data generated and collected by organisations every day.

This volume is closely aligned to the other two Vs in this equation – velocity and variety. Velocity refers to the speed at which the data can be analysed and variety points to the multitude of data points from where the information is flowing in.

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http://www.smh.com.au/technology/technology-news/government-defends-web-spy-powers-20120712-21yvu.html

Government defends web spy powers

Date: July 13, 2012

Dylan Welch and Ben Grubb

THE Gillard government has defended a plan to force telcos to store the internet and phone data of all Australians for up to two years, saying it is needed to allow our intelligence and police agencies to effectively target organised criminals and terrorists.

''In this day and age, an age where governments all around the world are grappling with the challenges of terrorism and organised crime, it is important that our relevant agencies have access to the information that they need,'' the assistant Treasurer, David Bradbury, said.

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Enjoy!

David.

AusHealthIT Poll Number 130 – Results – 16th July, 2012.

The question was:

Now We Have Seen The NEHRS / PCEHR Do You Believe The Australian Public Has Received Value For Its Money ($500m+ so far)?

Most Definitely

-  3 (6%)

Probably

-  1 (2%)

Probably Not

-  4 (8%)

No Way

-  38 (82%)

Votes : 46

A very clear response with 90% or so saying we had not had value for the funds expended.

Again, many thanks to those that voted!
Please note : Suggestions for future polls always welcome.

David.

It Really Looks Like The Right and Left Hands Of E-Health Have Not Co-Ordinated The Story. They Have No Explicit Plan And Are All Over The Place.

The following very long piece appeared in the Saturday Health Section of the Australian yesterday.

Sideshow obstructs e-health traffic

• by: Karen Dearne
• From: The Australian
• July 14, 2012 12:00AM

THERE is a truck trundling across Australia that should be pulled over and its owners charged with false and misleading advertising.

It's the Model Healthcare Community Roadshow, and it claims the Gillard government's $1 billion personally controlled e-health record guarantees "your health e-info travels with you".

Although that is indeed the aim of modern electronic health systems, the PCEHR is a repository containing a static, point-in-time medical summary uploaded by your GP, and possibly a few "event summaries" from other practitioners.

It's unclear how a hospital will upload a discharge summary after surgery or a visit to an emergency department, just as it's uncertain how specialists will contribute their summaries.

That's so as each person's record is supposed to be "curated" by a single, nominated provider, usually their GP.

It's also unclear how long it will take to update individual records. It's certainly not in real time.

Doctors have made very plain their concern they will be unable to rely on the PCEHR as accurate, up-to-date and complete.

The last point is certainly tricky as it's impossible to ascertain that every healthcare provider you encounter has the capacity or the will to contribute to your record. It's a voluntary system for providers as well as patients.

Take, for example, an emergency admission following a sudden collapse. You're fortunate enough to land in a hospital with good internal e-health systems and a specialist who is already communicating electronically with their colleagues and local doctors through secure messaging systems.

How will the PCEHR help in this situation? It won't.

When you arrive in emergency the receiving doctors will be able to access only a brief health summary from your most recent GP visit, perhaps six months or a year ago.

What about the "X-rays, pathology, scans" proudly emblazoned on the truck's side, implying they too can be uploaded to your record? They can't.

Efforts to provide access to diagnostic imaging through the PCEHR are yet to begin. Work on creating the technical standards and processes for handling diagnostic images, reports and requests is scheduled to start sometime next year.

Worse, it appears the initial versions will provide images in the PDF format only. That's better than nothing but unlikely to please medical professionals already exploring new worlds of computer-assisted technologies as well as those doing 3-D modelling of surgery plans for patients.

And what about pathology? Again the best doctors can expect is a summary of test results, in static form. That means doctors won't be able to dynamically monitor variations.

Instead, they will need to open each result separately, perhaps print out the report, and then work out the changes and trends themselves, much as they do at present.

Pathologists warn that the summary nature of PCEHR information poses particular challenges, as pathology results need to be interpreted in the context of other test results, both normal and abnormal, with a normal result just as important as an abnormal one.

Any omission of results from the record may inadvertently lead to wrong conclusions and wrong diagnoses, thereby compromising patient care.

Lots more here:

http://www.theaustralian.com.au/news/health-science/sideshow-obstructs-e-health-traffic/story-e6frg8y6-1226424814989

The second half of the article then goes on to explain how systems which are in-place, proven and working are being harmed and replaced by the push from a presently worse than useless system ‘from the Government’.

One colleague had the following reaction.

“It's a pretty powerful and very provocative article. I'm sure it will be widely circulated electronically in addition to all the hard copy readers. It could have the effect of dramatically slowing down the e-Health momentum OR it could act as a real wake-up call to the Minister to exercise real leadership and employ some common sense thinking about how best to fix the PCEHR fiasco.”

My feeling is that no one is taking any account of the harm the PCEHR Program is doing to our current e-Health providers and worse that the messaging about e-Health is now hopelessly confused. We have the wandering truck promising the earth while down on Planet Earth it is well known this is all going to take years to make any difference - and the Minister and other senior people are all saying just that.

Again we have an excessive simplification of a debate which is not all that simple. Simply saying ‘e-Health’ is good and opposing ‘e-Health’ is bad misses the point that there is good evidence based e-health and what is going on with the PCEHR which is the extravagant opposite in every sense. I strongly support the former and oppose the latter - despite what you might read elsewhere.

What is missing in all this is the Government actually levelling with stakeholders and providing a real plan of what is foreshadowed over the next few years and the business case and evidence to support that plan.

Dream on David I guess.

David.

It Seems The PCEHR Is Not Handling Things All That Well. I Just Had Another Look And Found It Was Not Working Properly.

Since it was a week since I had signed up - I thought - time to have another look and see if anything has changed. (About 1.00pm AEST)

Well it has and not in a good way.

When I had a look at my Personal Summary all seemed well. Self-entered data present and correct. All good so far.

Then I decided to click on Medicare Services Overview.

The last time I tried this - I was given a list of the four data categories (PBS Information, Medicare Claims etc.) and told that there was no information yet available on each.

This time I got the little ‘whirling starburst’ which then kept going and going. After an age (30+ seconds at least I got the following:

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Error Details

An error has occurred processing your request.

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Well it seems that something is being tweaked, changed or whatever - but the error message is hardly useful! No idea about if the error was known about, was being fixed and when things might be fixed.

At least the system didn’t totally crash! Not a good look for all this money.

Will try again next week and report back.

David.
Addendum - Checked at 6.35pm. No change so bug fixing seems to be on Public Service hours.
D.