The Office Of The Australian Information Commissioner Provides Submissions Received On PCEHR Enforcement Guidelines.

The following appeared a few days ago - with a few late submissions.

eHealth record system – OAIC Enforcement Guidelines – August 2012

Submissions to this consultation closed on 18 September 2012.

Background

The Personally Controlled Electronic Health Records Act 2012 (PCEHR Act) establishes the personally controlled electronic health (eHealth) record system and provides for its regulatory framework.

The PCEHR Act provides that the Information Commissioner (the Commissioner) is the independent privacy regulator for the eHealth record system and gives the Commissioner the power to investigate alleged contraventions of the Act and pursue enforcement mechanisms that are appropriate in the circumstances of the case.

The PCEHR Act also requires the Commissioner, by legislative instrument, to make guidelines relating to the exercise of his enforcement powers under the PCEHR Act or a power under another Act that is related to such powers. The Privacy Act 1988 (Privacy Act) is a related Act. The Commissioner is required to have regard to these guidelines when exercising his enforcement powers.

The draft of the Personally Controlled Electronic Health Records System – Enforcement Guidelines for the Information Commissioner 2012 (draft Enforcement Guidelines) set out the Commissioner’s general approach to the exercise of enforcement and investigatory powers under both the PCEHR Act and the Privacy Act. The guidelines also set out some of the factors the Commissioner may have regard to in determining the appropriate enforcement response.

To assist the public consider the draft Enforcement Guidelines and prepare comments, the OAIC published a consultation paper (PDF) in August 2012. The draft Enforcement Guidelines are available in PDF, RTF and Word versions.

Submissions received

The following submissions on the draft Enforcement Guidelines are presented as received by the OAIC with redactions to remove personal information not relevant to the submission. If you have difficulty accessing a submission please contact us for an alternative version.

1. Australian Dental Association Inc. (.pdf)
2. Australian Federation of AIDS Organisations Inc. (.docx)
3. Information and Privacy Commission (New South Wales) (.doc)
4. Consumers Health Forum of Australia (.docx)
5. Health Services Commissioner (Victoria) (.doc)
6. Office of the Information Commissioner (Queensland) (.doc)
7. The Royal Australian & New Zealand College of Psychiatrists (.pdf)
8. Australian Medical Association (.rtf)
9. NEHTA - National E-Health Transition Authority (.pdf)
10. Australian Medical Students' Association (.pdf)
11. Australian Information Industry Association (.pdf)
12. Medical Software Industry Association (.docx)
13. Australian Privacy Foundation (.pdf)
14. Avant Law Pty Ltd (.txt)

Here is the direct link:

http://www.oaic.gov.au/news/consultations.html#enforcement_guideline

I think it would be fair to say that most who responded were reasonably happy with what the OAIC was suggesting. Interestingly a substantial number of respondents felt the need to a clear consumer and practitioner friendly explanation of just what the actuality and implications of all this is.

Before discussing what others thought - the only area I am concerned about that does not appear to be covered is the mandatory reporting of all breaches so the public know just how well things are working. How this is done - and with what protections for small accidental breachers does not really concern me. I just believe there should be full public transparency and it seems to me this is not achieved with what is proposed.

On the submissions it is clear the Australian Privacy Foundation is not at all happy!

This paragraph makes their views clear - bottom of page 1 in bold!

“The APF does not agree with the Commissioner’s proposed approach to eHealth record system enforcement. The OAIC’s draft Enforcement Guidelines set out the Commissioner’s proposed approach in a clear but  unhelpful manner. It informs the community that the OAIC’s approach to PCEHR system security is founded on complex, opaque, and potentially discretionary information security and privacy rules and risk assessments. The Office has consistently failed to embark on responses to address problems at a systematic level. Rather the OAIC (formerly the Office of the Privacy Commissioner) has restricted considerations to the individual case, and that effectively in secret. The role outlined for them in the eHealth record system OAIC Enforcement Guidelines instrument would not be effective against systemic risk mitigation design flaws. The community cannot rely upon or trust measures outlined in the instrument for PCEHR system participants. “

On a different tack it is clear the Medical Software Industry Association is concerned about the interaction of the OAIC Commissioner and the System Operator (The Secretary of the Department of Health) who they feel has rather been made too ‘impregnable’ in terms of responsibility and accountability for things going wrong.

This paragraph makes their concern pretty clear (Page 6)!

“This may not instil confidence in the final exercise of power, as it could appear to be self-regulatory where the party being reported on provides the report. It could be said to result in  “…supervision of the sheep by the wolves, for the benefit of the wolves …”. The  OAIC stated in its submission in respect of the PCEHR Concept of Operations, that it is appropriate for the System Operator to hear complaints but not be final arbiter. Management and rule setting functions should be separate from accountability and oversight functions.”

I am not sure at all this issue has been addressed by anyone to date.

Both NSW and Queensland are a little concerned about the practicalities of the interaction between State and Federal laws.

From NEHTA we had an interesting paragraph (Page 2):

“Sections 4.4 and 4.5 of the Enforcement Guidelines refer to ‘health practitioner(s)’. NEHTA submits that the term ‘health professional(s)’ should be used rather than ‘health practitioner(s)’. This is because access to a consumer’s PCEHR will be available to a broader group of healthcare staff than qualified health practitioners. Other health professionals who may be afforded access to a consumer’s PCEHR will include authorised users such as administrative staff. Further, the term ‘health professional(s)’ is used in existing PCEHR system collateral and NEHTA submits that wherever possible, the language and terminology used in relation to the PCEHR system should be consistent across all materials.”

Some would surely say this is rather to broad and I would tend to agree.

NEHTA also seems to want a tougher approach to poor behaviour.(Page 4):

“General approach to complaints

NEHTA acknowledges that the Information Commissioner’s preferred approach to complaints is to use investigative powers and processes outlined in Part V of the Privacy Act and, wherever possible, the Information Commissioner will aim to facilitate conciliation between the complainant and the respondent as a primary dispute resolution model.

However, we note that the PCEHR Act gives the Information Commissioner new enforcement powers that it does not currently have under the Privacy Act. This includes the power to apply to a Court for an order that a person who is alleged to have contravened a civil penalty provision pay the Commonwealth a pecuniary penalty.

NEHTA submits that in some circumstances it will be wholly appropriate to use the enhanced enforcement powers without attempting conciliation, such as when responding to severe non-compliance. These enhanced enforcement powers reflect the will of the Parliament, as informed by extensive community consultation. The PCEHR System introduces a new way of collecting, using and disclosing a consumer’s health information that must be protected by multiple layers of security including technical and physical measures as well as legislative penalties. NEHTA submits that by using these enforcement powers in a measured way, the Information Commissioner will be acting in line with community and Government expectations.”

I have to say it is hard to argue with this view and it may be that this view fits with rather well with my opening comments on the need to be fully informed about what is going on.

The next step is to see if there is any official response to these suggestions! I am not holding my breath.

David.

It Seems For Some At NEHTA The Night Of The Long Knives Has Arrived

Lots of rumours are going around about the sacking of virtually all contractors from NEHTA and the roles and functions of NEHTA are wound back.

Of course I am told none from the executive ranks are suffering!

To date no official announcements - but that is hardly unexpected.

Look forward to people sharing what they have been told and how many of their mates / colleagues are affected.

Will be an interesting test for the blog and its readers to get the news out.

The more specific information on what is cut and what impact it will have the better!

David.

I Think We Need To Work Out Just What We Mean By E-Health. The Confusion Is A Major Distraction.

This blog post has been triggered as a result of a discussion with a colleague and the NEHRS / PCEHR.

The comments that triggered my thinking is this:

Me: “Glad your glass is 1/2 full. Same as the likelihood of the EU getting its debt under control in my view - but there you go!

If you can provide one bit of evidence that the approach planned with the PCEHR will actually work I will consider a switch...10,000 users in 3 months etc. does not reflect a great future to me.

 Right now a billion dollars and a lot of people praying. But, as they say, 'Hope is not a strategy'.

Correspondent: “I can only agree about the state of the land – don't misunderstand - it’s just that I don't tend to think PCEHR when I talk e-health – PCEHR is just not part of the operational e-health mix.

I was just saying that e-health (in its full and traditional and broad reading) is now a growing part of the health system discussion – which is for the good. Problem is that PCEHR has made everyone stop looking at what is happening in e–health and instead just focus on it. But you know that!”

I wonder if we should more often simply  talk about 'true' e-health whilst also still holding those delivering PCEHR to account for what they have said they were going to do?”

This is why I think being clear we are talking about? We need to do a little better than talking about ‘real’ or ‘true’ e-Health in one breath and then suggest the NEHRS is not really part of the greater concept.

The reason it that any real progress requires at least some level of political understanding and consent, and if we are loose with terminology the political class may not be able to properly understand those things that are worthy of support and those that should not be supported of funded.

It is also important, to me and many others, that distinction is drawn between those thinking the NEHRS is a conceptually and operationally flawed program and drawing from this some idea that these people are somehow opposed to e-Health. This is of course arrant nonsense.

To me a useful way of distinguishing between ‘good’ and ‘bad’ e-Health is probably to assess the evidence for whatever the proposed initiative is. On this sort of basis electronic records, standards, secure messaging, coding, information exchange, analytics and so on are on the good side and politically driven, industry distorting, mega programs are probably bad.

Essentially I want to see those things that are likely to really improve clinical care be supported and those things that are extravagant, wasteful and evidence of benefit free curtailed. To me the NEHRS is a sideshow that is distracting from the main game.

We want the politicians to support and fund the good - so we need to be clear what we are on about.

What do others think?

David.

Weekly Australian Health IT Links – 2nd October, 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 quite interesting week with many companies announcing progress with various initiatives - some NEHRS related and some not.

The NEHRS Program remains very low key with virtually no users and with September now over we are beginning to wonder when a real impact will be seen - September having been promised as the time GP / NEHRS integration would all be up and working.

The HealthSMART post mortem seems to have had its last episode and we can only hope other States learn from what had happened!

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www.cio.com.au/article/437618/cios_back_e-health_despite_slow_start/

CIOs back e-health despite slow start

• Byron Connolly (CIO)
• 27 September, 2012 13:03

Two prominent healthcare CIOs have backed the federal government’s national e-health initiative despite early teething problems and slow uptake across Australia.

As of midnight 24 September, only 10,577 Australians had registered for a personally controlled electronic health record (PCEHR) scheme – up from around 5000 in mid-August – since its launch on July 1, according to the Department of Health and Ageing (DoHA).

Around 90 per cent had registered online, despite some reports that users are frustrated with the arduous process of enrolling to access a single record of their medical history, gathered from multiple systems.

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http://www.oaic.gov.au/news/consultations.html#enforcement_guideline

eHealth record system – OAIC Enforcement Guidelines – August 2012

Submissions to this consultation closed on 18 September 2012.

Background

The Personally Controlled Electronic Health Records Act 2012 (PCEHR Act) establishes the personally controlled electronic health (eHealth) record system and provides for its regulatory framework.

The PCEHR Act provides that the Information Commissioner (the Commissioner) is the independent privacy regulator for the eHealth record system and gives the Commissioner the power to investigate alleged contraventions of the Act and pursue enforcement mechanisms that are appropriate in the circumstances of the case.

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http://www.computerworld.com.au/article/437225/visionstream_wins_71_million_contract_royal_adelaide_hospital/

Visionstream wins $71 million contract with Royal Adelaide Hospital

Network to provide 150Tbps of switching capacity for state-of-the-art new hospital.

• Adam Bender (Computerworld)
• 24 September, 2012 10:58

Visionstream will build network infrastructure for the new Royal Adelaide Hospital to be completed in 2016, under a $71 million deal announced today with design and construction partners Hansen Yuncken Leighton Contractors Joint Venture. Visionstream is a subsidiary of the Leighton Telecommunications Group.

Under the deal, Visionstream will provide all core, distribution, edge switching and wireless access points in the hospital. It will install an IP PABX unified communications system, including wired and wireless handsets, as well as a wireless real-time location system to track patients and equipment.

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http://www.futuregov.asia/articles/2012/sep/25/focus-and-future-e-health-new-south-wales/

Focus and Future of eHealth in New South Wales

By Sumedha Jalote | 25 September 2012

The government of New South Wales in Australia launched an ambitious US$1.5 billion (AUD$1.4 billion) eHealth agenda in June this year in a bid to improve the current health system across the state.

FutureGov met with Steven Boyages, Medical Director, eHealth NSW during the recent Healthcare Information and Management Systems Society (HIMSS) conference in Singapore to discuss the progress of NSW’s future plans for eHealth.

“In Australia, at the national level, there’s a big project around electronic health records which is rolling out infrastructure, operating standards and architecture,” said Boyages. “The next level is managing what we are going to plug in to that grid to have a functional purpose.”

“The state governments are building many hospital based systems for electronic finance, patient administration, clinical reporting, and clinical documentation and information to assist in the day-to-day care,” Boyages explained.

“These two levels will start to integrate, and the hope is that the information that we collect at one point of care can then be shared at multiple points of care.”

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http://www.theaustralian.com.au/news/features/new-site-helps-patients-find-doctors/story-e6frgabx-1226475630240

New site helps patients find doctors

• by: Sue Williams
• From: The Australian
• September 21, 2012 12:00AM

DOCTORS have rarely been the greatest of entrepreneurs. By their very nature, they tend to be risk-averse. "And that is understandable," GP Marcus Tan says, "because when doctors take risks, people can die."

Tan, however, is something of an exception. A committed angel investor, providing capital for start-ups, the Perth-based practitioner has started healthengine.com.au, a national directory listing doctors, specialists and allied professionals with whom patients can book appointments online. Predictably, medical professionals were initially cautious to enrol. But with patients embracing it quickly, and in rapidly growing numbers, more doctors are paying the monthly $90 fee to join.

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http://delimiter.com.au/2012/09/25/victoria-starts-airing-its-it-dirty-laundry/

Victoria starts airing its IT dirty laundry

news The Victorian State Government has over the past month started holding hearings which touch in depth on the wide-ranging IT project delivery issues which have resulted in the state’s departments and agencies broadly failing to deliver ten major IT projects over the past half-decade.

Australia’s state governments are currently facing a systemic failure to deliver major IT projects, with initiatives in Queensland, New South Wales and Western Australia all failing over the past several years. In the case of Queensland, the state’s catastrophic payroll systems overhaul at Queensland Health was notorious enough that it attracted a great deal of public interest and contributed to the downfall of the incumbent Labor Government at this year’s state election.

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http://www.itnews.com.au/News/316351,scattered-authority-doomed-healthsmart.aspx

Scattered authority doomed HealthSMART

By John Hilvert on Sep 25, 2012 7:00 AM

Public sector probity rules under fire.

The Victorian Government's $360 million whole-of-health IT modernisation was scuttled by a complex three-way delivery arrangement that devolved project responsibility, according to a pair of former iSOFT executives.

Appearing before the Victorian Parliament’s Public Accounts and Estimates Committee back in August, James Rice and Gary White — both now with CSC, after its buyout of iSOFT last year —revealed their thoughts on Victoria's HealthSMART initiative.

The official transcript of their appearance before the committee was released last week. (pdf)

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http://www.futuregov.asia/articles/2012/sep/28/aust-develops-world-first-e-health-supply-catalogu/

Aust develops world-first e-health supply catalogue

By Shahida Sweeney | 28 September 2012

Under a “world-first” initiative, the National E-Health Transition Authority (NEHTA) is helping develop a National Product Catalogue (NPC) that fully integrates suppliers’ medical and product information electronically.

In future, suppliers tendering for public health sector contracts will need to publish their product data in the NPC.

At present, WA Health in Western Australia and NSW Health in New South Wales are using NEHTA’s eProcurement service – while drawing on NPC data to ensure the right products are ordered and delivered.

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http://www.hp.com/hpinfo/newsroom/press/2012/120925a.html

Australia’s Medibank Health Solutions Selects HP to Accelerate Delivery of New Services

HP Converged Infrastructure boosts efficiency and uptime for healthcare provider

SYDNEY, Australia, Sept. 26, 2012 — HP today announced that Medibank Health Solutions (MHS) has selected HP Converged Infrastructure to deliver efficient, cost-effective healthcare services to a growing number of customers.

MHS provides telephone- and web-based healthcare services as well as walk-in wellness clinics for organisations across Australia. After being acquired by Medibank Private, Australia’s largest private insurance company, MHS experienced rapid growth, resulting in a five-fold increase in staff and greater demand for its services. However, MHS’ existing IT infrastructure was unable to meet performance and availability requirements associated with this upswing in demand.

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http://www.asianhhm.com/press/pressrelease_archives.asp?PID=763

InterSystems Awarded 2012 Frost & Sullivan Asia-Pacific Healthcare IT Company of the Year Award

Singapore
Sep 27, 2012

Frost & Sullivan recognizes InterSystems for delivering innovation and "extraordinary client value" to leading Asia-Pacific healthcare organizations

InterSystems Corporation, a global leader in software for connected care, today announced it has been awarded the prestigious 2012 Frost & Sullivan Asia-Pacific Healthcare IT Company of the Year award for the "extraordinary client value it has delivered in the Asia-Pacific healthcare IT space."

In selecting InterSystems for the award, global research firm Frost & Sullivan employed both qualitative and quantitative benchmarking criteria in the following three areas: Excellence in Growth Strategy & Differentiation, Degree of Innovation in Business Process, and Leadership in Customer Value and Market Penetration.

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http://www.zedmed.com.au/Data/Sites/1/media/media-release--zedmed-achieves-pcehr-compliance.pdf

MEDIA RELEASE

27 September 2012

Zedmed achieves PCEHR compliance

Zedmed Medical Software continues to be at the forefront of eHealth developments, being the first to achieve access to the Personally Controlled eHealth Records (PCEHR) directly through their medical software.

For general practitioners using Zedmed, this means accessing the PCEHR to view and upload clinical documents will be simple, with no additional software required. “We are proud of our recent developments and are excited to provide users with the confidence they need to become eHealth compliant” General Manager of Zedmed, Grant Williamson said.

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http://ehealthspace.org/news/ihe-seminar-addresses-pcehr-challenges

IHE seminar addresses PCEHR challenges

Posted Wed, 26/09/2012 - 13:37 by Will Turner

IHE Australia is holding a seminar for healthcare providers and IT vendors to address the practical challenge of exchanging health information in the new PCEHR environment.

According to IHE Australia’s event manager, Bernie Crowe, the one day event on October the 10th has two main goals. One is helping clinical leaders understand the array of technical aspects to sharing health information electronically, and bringing them together with IT vendors who provide the software and solutions to achieve this end.

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http://www.smh.com.au/national/health/websites-rating-doctors-just-patient-clamour-20120925-26jfz.html

Websites rating doctors just 'patient clamour'

Date September 26, 2012

Amy Corderoy, Rachel Browne

WEBSITES that rate doctors and other health professionals are unconstructive and often ''patients shouting among themselves'', according to a patient feedback expert.

The health insurer NIB yesterday faced a barrage of criticism from doctors and other medical practitioners over its planned ''whitecoat'' website, which will enable people to rate and compare healthcare providers.

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http://www.theaustralian.com.au/australian-it/new-storage-systems-repair-ramsays-care/story-e6frgakx-1226480527680

New storage systems repair Ramsay's care

• by: Jennifer Foreshew
• From: The Australian
• September 25, 2012 12:00AM

RAMSAY Health Care's expansion in recent years meant its infrastructure was operating at full capacity, which impacted the performance of its core applications and the efficiency of its hospitals.

The group's 69 healthcare facilities across Australia used both an SAP enterprise resource planning application to manage financials and clinical product ordering, as well as the MEDITECH patient management system.

Hospitals and day surgeries required the systems to be online around-the-clock to allow product managers to order vital medical supplies and administration staff to record and update patient information and to process transactions.

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http://www.computerworld.com.au/article/435492/nbn_won_t_close_broadband_gap_say_advocates_rural_communities/

NBN won't close broadband gap, say advocates for rural communities

Rural areas likely to remain disadvantaged, officials tell ACCAN conference.

• Adam Bender (Computerworld)
• 05 September, 2012 14:51

Even with the National Broadband Network (NBN), more work remains to bridge the digital divide between regional and metropolitan areas in Australia, said advocates for rural communities at the the Australian Communications Consumer Action Network (ACCAN) conference in Sydney.

The NBN will help address the rural/urban digital divide but it won’t close the broadband gap, the advocates said.

“The rollout of the NBN and the increasing importance of the digital economy present both opportunities and challenges for regional and remote Australia,” said the independent Regional Telecommunications Review Committee (RTRC) chair, Rosemary Sinclair. “There continues to be a risk that people in regional Australia are left further behind unless we really stay on the case.”

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http://www.heraldonline.com/2012/09/25/4288947/research-and-markets-australia.html

Research and Markets: Australia - Digital Economy - E-Health - Initiatives, Pilots and Projects

Published: September 25, 2012 

DUBLIN — Research and Markets (http://www.researchandmarkets.com/research/vpfhfw/australia) has announced the addition of the "Australia - Digital Economy - E-Health - Initiatives, Pilots and Projects" report to their offering.

E-health where key killer applications utilise truly high-speed broadband networks are starting to emerge. The Australian Government is a leader in strategic trans-sector thinking, is linking e-health developments to the National Broadband Network.

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http://news.ninemsn.com.au/national/8538499/senate-should-pass-privacy-bill-committee

Senate should pass privacy bill: committee

19:23 AEST Tue Sep 25 2012

The Senate should pass new privacy laws that strengthen the enforcement powers of the Privacy Commissioner, a parliamentary committee says.

The bill passed the lower house of federal parliament where it had been introduced by Attorney-General Nicola Roxon as the most significant reform since the Privacy Act was first introduced in 1988.

The new measures include tighter regulation of the use of personal information for direct marketing, a modernised credit reporting system, tighter rules in sending personal information outside of Australia, and imposing a higher standard of protection for sensitive information such as health-related information, DNA and biometric data.

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http://www.theaustralian.com.au/australian-it/government/coalition-seeks-softer-privacy-law/story-fn4htb9o-1226481307783

Coalition seeks 'softer' privacy law

• by: Andrew Colley
• From: Australian IT
• September 26, 2012 12:00AM

COALITION senators will seek to limit company exposure to fines up to $1.1 million for privacy breaches contained in new laws currently before by parliament.

A spokesman for shadow attorney-general George Brandis said that Liberal senators would recommend softening parts of the bill around company liability for privacy breaches following a strong backlash from the industry, particularly the internet sector.

If passed in their current form, the new laws would give the Federal Privacy Commissioner the ability to seek court ordered fines against companies and large organisations of up to $1.1m in cases of severe or repeated privacy breaches.

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http://www.zdnet.com/ibms-watson-being-put-to-the-test-in-healthcare-7000004725/

IBM's Watson being put to the test in healthcare

Summary: One of the leaders from the IBM Watson team discusses how the supercomputer could transform the way doctors make decisions.

By Rachel King for Between the Lines | September 24, 2012 -- 21:05 GMT (07:05 AEST)

SAN FRANCISCO -- IBM's Watson supercomputer might be best known by most people for winning Jeopardy, but the science behind the system is getting so much stronger that we could see the technology being implemented in various industries worldwide soon.

Rob High, vice President and chief technology officer for Watson Solutions within the IBM Software Group, cited healthcare as a prime example while speaking at the DataWeek 2012 Conference on Monday afternoon.

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http://www.smh.com.au/technology/sci-tech/electronic-implants-dissolve-in-body-20120928-26ouq.html

Electronic implants dissolve in body

Date September 28, 2012

Nicky Phillips

Science Reporter

Electronic devices that disappear without a trace; they sound like science fiction.

But engineers have developed a range of ultra-thin electronic components, including transistors, wireless power coils, sensors, diodes and a digital camera, that can dissolve in water or bodily fluids within minutes.

The "transient electronics" could be used as medical implants that can be reabsorbed harmlessly by the body, as sensors to measure temperature changes in the environment and in consumer devices to reduce the amount of electronic waste in landfill.

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http://afr.com/p/technology/when_the_internet_wakes_up_will_wMU2qbsCMf0ROrXIx2VX2O

When the internet wakes up will it kill us?

25/09/2012

Dan Falk

In the world of sci-fi movie geekdom, August 29, 1997, was a turning point for humanity: on that day, according to the Terminator films, the network of US defence computers known as Skynet became self-aware – and soon launched an all-out genocidal war against Homo sapiens.

Fortunately, that date came and went with no such robo-apocalypse. But the 1990s did bring us the world wide web, which is now far larger and more “connected” than any nation’s defence network. Could the internet “wake up”? And if so, what sorts of thoughts would it think? And would it be friend or foe?

US neuroscientist Christof Koch believes we may soon find out – indeed, the complexity of the web may have already surpassed that of the human brain. In his book Consciousness: Confessions of a Romantic Reductionist, published earlier this year, he makes a rough calculation: take the number of computers on the planet – several billion – and multiply by the number of transistors in each machine – hundreds of millions – and you get about a billion billion, written more elegantly as 10 to the 18th. That’s a thousand times larger than the number of synapses in the human brain (about 10 to the 15th).

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Enjoy!

David.

AusHealthIT Poll Number 138 – Results – 1st October, 2012.

The question was:

Is Government / NEHTA Being Transparent Enough Regarding Progress With The NEHRS / PCEHR?

Of Course  4% (2)

Probably  0% (0)

Probably Not  9% (4)

They Are Excessively Secretive  83% (39)

I Have No Idea  4% (2)

Total votes: 47

Very interesting and clear cut response. The vast majority believe they are not being given reasonably transparency.

Again, many thanks to those that voted!

David.

Rightly, Usability Is Getting More Airtime Again. We Need More Work In The Area ASAP.

The following appeared a few days ago.

5 health IT insiders offer their takes on EHR usability

By Bernie Monegain, Editor

Created 09/17/2012

EHR usability is suddenly front and center, now that usability testing is part of the EHR certification criteria for meaningful use Stage 2. We talked with diverse industry insiders for their take on what is critical to user-centric design and what the usability factors might mean to healthcare and to the healthcare IT market. Here is a sampling of some of the topics on their minds.

1. Data entry. The biggest complaint is data entry, says JiaJie Zhang, director of the ONC’s SHARP project, charged with finding ways to make EHRs easier to use. “Nobody wants to become a data-entry clerk,” Zhang says. “Their job is to take care of patients, and data entry so far is not optimized. It involves many, many issues here. It is basically the repetition. If you enter this one here, you have to enter it again in a different place. It should be automatic.”
2. Errors. “There is unprecedented interest in EHRs by physician community – driven by meaningful use – there’s no question about that,” says Robert Tennant, senior policy advisor for the Medical Group Management Association (MGMA). However, physicians are worried they might select a product that turns out to be hard to use, and take away from the time they spend with patient, he says. “I really think it’s a good step for ONC to start pushing the vendors toward more user-friendly systems," he adds, "because if they’re not easy. It slows the clinician down. It can frustrate them. It could lead to errors."

The other points are found here:

http://www.healthcareitnews.com/news/five-health-it-insiders-offer-five-takes-ehr-usability

We also had this appear.

It's time to publicly compare EHR usability, IOM group says

September 20, 2012 | By Julie Bird

The world of electronic health records needs to open itself up to critical comparisons and earnest user evaluation if it wants to avoid formal regulation by the Food and Drug Administration, according to a discussion paper released this month by the Institute of Medicine.

Not only is there nowhere for health IT users to share publicly their experiences with different products, but vendors often prohibit users from sharing screenshots or otherwise publicly discussing EHR problems, notes the paper, "Comparative User Experiences of Health IT Products: How User Experiences Would Be Reported and Used."

The result, according to the discussion group?

"After a decade of development and experience, EHRs and other health IT products have not advanced sufficiently; nor have they been adopted widely and enthusiastically, in step with other consumer products such as smartphones and iPads," wrote the authors, convened by the IOM to analyze the issue. "With EHRs, unlike other consumer product areas, there has been little opportunity for cross-vendor comparison, which has stifled the evolution of this technology."

More here:

http://www.fiercehealthit.com/story/its-time-publicly-compare-ehr-usability-iom-group-says/2012-09-20

Here are the links provided:

To learn more:
- here's the IOM paper
- check out the Booz Allen Hamilton report

Sadly it would be hard to say the present NEHRS / PCEHR has followed all that has been suggested here. A dinosaur would be closer to the mark.

David.