Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Friday, August 23, 2013

Scotland Shows How Incremental Improvement In E-Health Can Make A Positive Difference.

The following very interesting article appeared a little while ago.

Scots deploy Key Information Summary

15 August 2013   Rebecca Todd
More than 60% of Scottish GP practices are live with the new Key Information Summary for patients with complex care needs.
Nearly 20,000 KIS records have already been created and the full roll-out is expected to be complete in three weeks.
KIS programme manager Jonathan Cameron said all the country’s Emis practices are live with the new service and around one third of INPS practices.
The KIS is an extension of Scotland’s Emergency Care Summary.
It contains information from the GP practice including; patient demographics; details of staff involved in the care of the patient; main diagnosis and current issues; carer and support details; and recommended actions for out of hour’s clinicians.
It is designed primarily to support patients with long term conditions, but Cameron said anyone can have one.
Their creation involves the GP sitting with the patient to discuss their ‘anticipatory care plans’ and deciding together whether the information should be shared via a KIS.
This could include someone’s end of life wishes.
Clinicians working in NHS 24 and out-of-hours services can access the information via an embedded button in their systems, which is also being added to clinical portals in acute trusts.
More here:
You can read about the progress being made here:
Here is a short summary of the KIS system:

What is a Key Information Summary (KIS)?

Key Information Summary (KIS) has been designed to support patients who have complex care needs or long-term conditions.
KIS allows important patient information such as those listed below to be shared with health care professionals in unscheduled care in the NHS 24, A&E, Scottish Ambulance Service, Out of Hours, Hospital and Pharmacy environments.
  • future care plans
  • medications
  • allergies
  • diagnoses
  • patient wishes
  • carer and next of kin details
In the future, KIS will also be used in scheduled care for patients with long-term conditions; for example, for those who regularly visit renal clinics.
More here:
This really looks like the sort of approach to gradual e-Health deployment and use we should look at very much harder.
David.

Thursday, August 22, 2013

This Is A Really Messy Outcome That Seems To Have Happened When People Were Opted-In To A Shared EHR.

The following appeared a little while ago.

Patient lost £18,000 legal battle over GP medical records

Sara Tenneson faces paying hefty legal costs after she tried to have confidential information removed from her file
The retired garden historian's experience is a cautionary one for NHS patients who think they control what's on their medical records.
In a pilot scheme NHS England recently began quietly uploading patient records from 100 GP surgeries, although the information commissioner warned the health service "there is still a lot of work to be undertaken to ensure that all of the obligations of the Data Protection Act will be met before national roll-out ... can begin."
Some are disturbed by the strategy to go "digital by default". Andrew Miller, chair of the Commons science and technology committee, wrote to Cabinet Office minister Francis Maude with concerns that "as public services go online, the government may not keep up with advances in technology and that inadequacies in government software may lead to security vulnerabilities".
The NHS is of particular concern as patient data is supposed to be anonymised. Martyn Thomas, vice-president of the Royal Academy of Engineering and chair of the IT policy panel of the Institution of Engineering and Technology, told the committee that personally identifiable data in medical records could be matched against other datasets. "That has been demonstrated time and time again. Therefore, the notion of useful anonymised personal data is an oxymoron."
Phil Booth, co-ordinator at patient privacy group medConfidential, said that though the changes are "momentous", not enough has been done to explain what they mean for patients. "A few breezily-worded leaflets in your GP's waiting room isn't proper notification for the systematic hoovering up of confidential information from 50 million peoples' medical records. So much for choice and consent – patients are deliberately being kept in the dark."Challenging the medical establishment's ownership of her patient record left Sara Tenneson without access to a regular GP. Her plight is at the heart of a tussle between bureaucrats and the public, with ministers publishing draft guidance for citizens to be able to remove "data whenever (they) want".
Her ordeal began in September 2011, when Tenneson's GP wrote a referral letter to a hospital consultant about her treatment which included information on a traumatic episode imparted to her previous GP in 1995, but which she was unaware was still on her medical record.
Fortunately, having sight of the letter before it was sent, and extremely shocked that it had been included, she asked the practice to remove it, as it had ''no relevance.'' The information was removed, and a revised letter was sent.
More of the saga here:
This is a very, very sad saga which it is important for all of us with an interest in Australian e-Health are aware of.
Clearly if you are going to have an opt-in approach, which we might just see from a desperate Government if the PCEHR is not being used a year from now, you need to ensure everything that goes to the record is seen and approved by the patient. It is as simple as that!
David.

Coalition Health Policy Announced Today. E-Health Not Mentioned Much!

This was released today.

Tony Abbott - The Coalition's policy to support Australia's health system

The Coalition’s Policy to Support Australia’s Health System will tackle chronic diseases, provide faster access to newly approved medicines, invest in Australia’s medical workforce and prepare the health system for the demographic changes ahead.
A healthier Australia means a stronger and more productive Australia.
The last Coalition government delivered a world class health system underpinned by a growing, strong economy. The Coalition has the experience to deliver real changes to our health system and to ensure those changes are sustainable into the long term.
The Coalition’s Policy to Support Australia’s Health System will:
  • Deliver greater community involvement in the management and responsibility of local hospitals;
  • Restore the independence of the Pharmaceutical Benefits Advisory Committee (PBAC) and restore integrity to the Pharmaceutical Benefits Scheme listing process so that medicines can get to patients faster;
  • Provide the Health Minister with authority to list medicines recommended by the PBAC that do not cost more than $20 million in any of the first four years of its listing;
  • Bring forward the proposed roll-out of the National Bowel Cancer Screening Programme;
  • Develop a new National Diabetes Strategy as well as provide $35 million to find a cure for Type One Diabetes;
  • Restore the Private Health Insurance Rebate as soon as we responsibly can;
  • Deliver a more efficient funding model for hospitals through activity-based funding
  • Strengthen primary care by providing $52.5 million to expand existing general practices for teaching and supervision and invest $119 million to double the practice incentive payment for teaching in general practice;
  • Provide 500 additional nursing and allied health scholarships for students and health professionals in areas of need as well as $40 million for 400 medical internships;
  • Review the Medicare Locals structure to ensure that funding is being spent to support frontline services.
Our approach to health will be careful, collegial and consultative. We will work with the states and territories in delivering a world class health system.
By contrast, Kevin Rudd’s own former health minister described his approach to health reform as “cynical” and potentially “a disaster”.
With demand for health services expected to grow, we want to direct more resources to the frontline and remove unnecessary bureaucracy. We believe this is possible as the Commonwealth now has 18 separate health agencies in addition to the Department of Health.
Our approach to direct more resources to the frontline is in stark contrast to the $1.6 billion in cuts – some of which were retrospective – with which Labor hit our state hospitals.
By cutting waste, streamlining bureaucracy and providing strong and competent leadership, we can then provide much-needed resources to areas such as the provision of dental services to disadvantaged and vulnerable members of the community.
The Coalition has a proud record of strong and capable leadership in health.
As part of the last Coalition government, we delivered a Medicare Safety Net, a four-fold increase in medical research funding, a strong private health insurance industry that took pressure off the public system, a Medicare dental scheme for those with a chronic disease and the largest investment in mental health in Australian history at the time.
The best guarantee for a strong and sustainable health system is proper management of the budget and the economy by a government that can live within its means. Only the Coalition has demonstrated it can deliver this.
The Coalition’s Policy to Support Australia’s Health System is part of our Real Solutions Plan to build a stronger Australia and a better future for all Australians.
Here is the link:
Seems the e-Health Program is not big enough to attract much attention - or is what they have to say going to be negative? Would have been nice to hear something solid?

In the full .pdf of the policy a review of the PCEHR is mentioned.

http://tonyabbott.com.au/LinkClick.aspx?fileticket=DRbioW4-J0w%3d&tabid=86


Page 15:

"Health professionals will be increasingly reliant on effective e-health tools to better
coordinate care, particularly for patients with complex health conditions. Unfortunately, the Labor Government has failed to deliver on its Personally Controlled Electronic Health Record (PCEHR).


Despite the $1 billion price tag, only 4,000 records are reported to be in existence. In recent weeks, the clinical advisers for Labor's e-health record program have quit
en masse, leaving the Federal Government's flagship programme floundering with virtually no clinical oversight.


If elected, the Coalition will undertake a comprehensive assessment of the true status of the PCEHR implementation. In government, the Coalition implemented successful incentives to computerise general practice and will continue to provide strong in principle support for a shared electronic health record for patients.The Coalition will again work
with health professions and industry to prioritise implementation following a full
assessment of the current situation."

 The ALP also does not seem to mention the issue. See here:

http://www.alp.org.au/betterhealth

Seems like both sides detect a need to say very little.

David.

Wednesday, August 21, 2013

NEHTA Clinical Lead Resignations Round Up And Some Thoughts On Implications For The Future.

I had heard some rumours on this news Tuesday afternoon and these were confirmed when this came in early Wednesday  August 14, 2013:

Peter Fleming to NEHTA staff:

Dear Colleagues,
This announcement is to inform you that Dr Mukesh Haikerwal AO will soon be stepping aside from the role of National eHealth Clinical Lead and Head of Clinical Leadership and Stakeholder Management with NEHTA.
I would like to acknowledge the tremendous expertise that Dr Haikerwal has contributed to eHealth in Australia. For many years he has been a tireless advocate to turn the eHealth vision into reality, with the Personally Controlled Electronic Health Record system now being well established and moving into a new phase. Dr Haikerwal will no doubt continue to advocate for the transformative ability of technology to improve healthcare delivery and outcomes for all Australians, and indeed worldwide in his role as Chair of the World Medical Association.
Over the past months, Dr Haikerwal and I have been in discussions with the Department of Health and Ageing about the way NEHTA and governments engage with healthcare providers, peak bodies, consumers, vendors and other key stakeholders who are playing a role in transforming healthcare delivery through eHealth.
This discussion aligns with NEHTA’s shift in focus from designing and building national eHealth infrastructure to implementing and supporting adoption of eHealth. As we are reaching the conclusion of these discussions, Dr Haikerwal has advised me that he sees this as the right time for him to step aside from the leadership role with NEHTA he has held for the past six years.
Mukesh brought to NEHTA the advocacy for a clinically led national eHealth programme and built a strong network of clinical leads who are experts across the entire Australian clinical landscape. This network, together with the internal Clinical Unit Mukesh developed, were successful in embedding clinical perspectives and needs into the design of NEHTA specifications which directly support the uptake of eHealth systems which are being implemented today. It is this tireless effort in the years of design which has provided a solid foundation for years to come. Mukesh will officially finish at NEHTA on 22 August.
On behalf of NEHTA, I wish Mukesh the very best in his future endeavours and look forward to continuing our dialogue on eHealth in the future.
The Executive team are meeting next Wednesday to discuss changes to NEHTA’s structure that arise from Mukesh’s departure and other recent changes. I anticipate these changes will be finalised and communicated shortly thereafter.
Regards
Peter
The first press coverage was found here:

Mukesh Haikerwal leads NEHTA exodus

  • by: Fran Foo
  • From: Australian IT
  • August 14, 2013 4:39PM
THE National E-Health Transition Authority has been rocked by the departure of top clinical lead Mukesh Haikerwal alongside other senior executives working on the e-health records project.
Sources told The Australian that several clinical leads, including Nathan Pinskier and Chris Pearce, have also resigned.
Dr Haikerwal, a former Australian Medical Association president and NEHTA's head of clinical leadership and stakeholder management, will officially leave on August 22.
He has been instrumental in promoting the benefits of the $628 million personally controlled e-health record system, especially in trying to woo doctors to adopt the platform.
Lots more here:
Next we had a good few on the next day:

Shock mass departure of NEHTA leads

15th Aug 2013
FOUR of the most senior clinical leads of the National E-Health Transition Authority (NEHTA) have quit following a massive breakdown in relations between the authority and the Department of Health and Ageing, sources confirmed today.
The shock departure included the man widely regarded as the figurehead of the personally controlled e-health record (PCEHR) former AMA president Dr Mukesh Haikerwal and clinical leads, RACGP e-health standing committee members Dr John Bennett, Dr Nathan Pinskier, as well as Dr Jenny Bartlett.
All were understood to have had contracts which expired in August. A fifth clinical lead Melbourne GP Dr Chris Pearce told MO he had quit “not even remotely disgruntled”. Rather, he made the decision to concentrate on his research.
Lots more here:
Next we had this from the AMA.

Dr Haikerwal NEHTA resignation raises serious concerns about clinical input to PCEHR

15/08/2013
AMA President, Dr Steve Hambleton, said today that the resignation of Dr Mukesh Haikerwal, head of clinical leadership and stakeholder management, from the National Electronic Health Transition Authority (NEHTA) raises serious concerns about clinical input to decision-making in the implementation of the Personally Controlled Electronic Health Record (PCEHR).
The resignations of Dr Haikerwal, a former AMA President and NHHRC Commissioner, and other clinical leads, including Dr Nathan Pinksier, come amid reports that the Department of Health and Ageing (DoHA) is taking over engagement with the medical profession and IT industry over the design of the PCEHR.
Dr Hambleton said that the AMA has long advocated that the success of the PCEHR depended on how it met clinical needs.
Lots more here:
Then we also see the News Limited view:

Angry doctors quit over e-health system

  • SUE DUNLEVY
  • News Limited Network
  • August 15, 2013 10:14PM
THE government has been rocked by the mass resignation of doctors advising it on its troubled $1 billion e- health system.
The system barely functions a year after it was launched and this week former AMA president Dr Mukesh Haikerwal and Dr Nathan Pinksier and two other advisers quit in frustration.
Although 690,000 Australians have signed up for an e-health record the Department of Health has admitted only 5427 patient records have been provided by doctors.
"There is less than a 0.5 per cent chance that doctors or hospitals will find something of clinical relevance if they consult these records," Australian Medical Association chief Dr Steve Hambleton said.
"There are over 600,000 blank records which are of no use to anybody," he said.
Lots more here:
Last for the day here:

Dr Mukesh Haikerwal resigns from NEHTA Clinical Lead

Dr Mukesh Haikerwal has resigned his position as the national clinical lead for the National E-Health Transition Authority (NEHTA), and will finish the role on August 22, and NEHTA confirmed this morning that deputy clinical lead Dr Nathan Pinksier and Dr Chris Pearce have also quit.
However a spokesperson from the Department of Health and Ageing (DOHA) today confirmed that clinical engagement remains a top priority both for NEHTA and in other DOHA eHealth initiatives.
“We are continuing to work with NEHTA to revisit consultation and clinician arrangements to ensure that the Department takes a fresh look at the design of the PCEHR system and consults with those who will engage with it,” the spokesperson said today.
“The Department of Health and Ageing is taking the lead in the consultation with medical peak bodies and industry sectors, such as the new ICT Industry Consultative Forum bringing together more than 120 industry organisations next week and the PCEHR Peak Bodies Workshop next month,” the DOHA spokesperson said.  
More here:
Interestingly this was all not covered by the SMH or Age as far as I could find.
We then got official reaction from NEHTA.

Statement from Dr Mukesh Haikerwal AO

Created on Friday, 16 August 2013
On Tuesday 13 August 2013, I tendered my resignation from NEHTA effective Thursday 22 August 2013.
I have been with The National E-Health Transition Authority (NEHTA) as National Clinical Lead since the 2007 Boston Consulting Group report.
I am a passionate advocate for health and healthcare and maintain my fervent belief that eHealth will transform the way we receive care and practice medicine. My decision to move on from my role with NEHTA has not been made lightly, and of course there is never a ‘good time’ to take this step.
However, with the eHealth system now in its current place and moving into a different phase, this is the right time for me to step aside.
More here:
and some more in depth coverage here:

Doctors quit NEHTA en masse

16 August, 2013
The top team of clinical experts behind the billion dollar e-health record system have quit en masse, leaving the Federal Government's flagship program floundering with virtually no clinical oversight.
Among the first to go was NEHTA's head of clinical leadership Dr Mukesh Haikerwal (pictured), the former AMA president, who has been the medical face of the personally controlled e-health records (PCEHRs) for the last six years.
But other key players are also understood to have quit from the executive of NEHTA's so-called "clinical unit".
These include Melbourne GP Dr Nathan Pinskier, a member RACGP's national standing committee on e-health, and Dr John Bennett.
Australian Doctor also understands that Dr Jenny Bartlett, a former executive on the Australian Council for Safety and Quality in Health Care, has left along with Dr Chris Pearce - although the reasons behind their decision to stand down are unclear.
More here:
The comments on this post are fascinating and make it clear that there are many who are less than impressed with the whole program.
Also we have here:

Doctors ready to pull plug on eHealth

Published on Fri, 16/08/2013, 08:43:39
By Julian Bajkowski
Australia’s long and troubled efforts to create a functioning national system of electronic health and medical records system is once more close to collapse.
The Australian Medical Association has expressed serious concerns over clinician input into the project following the shock resignation of highly respected clinical representative Dr Mukesh Haikerwal from the National eHealth Transition Authority (NeHTA) this week.
Other crucial clinical advisors, including Dr Nathan Pinksier and other clinical leads are also understood to have quit signalling a severe breakdown in relations between doctors and Department of Health and Ageing.
A loss of confidence by doctors in either DoHA or or NeHTA would, in practical terms, shut-off political life support for the circa $1 billion Personally Controlled Electronic Health Record (PCEHR) project because the scheme cannot work unless doctors voluntarily agree to use it.
The urgent warning from the AMA in the wake of the clinicians’ walk out now puts substantial pressure on DoHA’s high profile secretary, Jane Halton, to personally intervene to get the project back on-track.
More here:
And here:

 ‘Souring relations’ spurred mass quit of NEHTA leads

16th Aug 2013
THE AMA has questioned the future medical viability of the personally controlled electronic health record (PCEHR) after the shock departure of five senior clinical advisers including the scheme’s most vocal proponent Dr Mukesh Haikerwal.
The mass resignation of National E-Health Transition Authority (NEHTA) clinical leads this week came amid reports of souring relations between the advisors and the Department of Health and reports that the department was taking an increasingly central role in the rollout.
The other resignations were RACGP e-health standing committee members Dr John Bennett and Dr Nathan Pinskier, as well as Dr Jenny Bartlett. Melbourne GP Dr Chris Pearce also quit but he told MO his decision was because of a desire to concentrate on research.
Lots more here:
Each of these articles provides a slightly different take on what has happened - and a worth reading in full - but the conclusion seems to be that this event is something of a watershed even in the life of the PCEHR.

For the last few months Dr Haikerwal and his colleagues (along with the AMA and the RaCGP) have been saying they are not happy with the way the PCEHR was evolving and the lack of clinical involvement in the overall process. NEHTA and DoHA did respond to this to some degree but apparently the response was either too little too late, not credible or not the right response and we have then seen what we seen.

There were also concerns about the fundamental design and its ultimate suitability for purpose.

What I also find very interesting is the degree of coverage these resignations have obtained. To me either this means that the journalists see an important statement being made here or it is recognised that we are in an election campaign and that this issue might just be important and get a run - especially with all the recent Government advertising on the topic.

There is another take on what is needed from Dr Edwin Kruys found here:
http://doctorsbag.wordpress.com/2013/08/21/how-to-save-the-pcehr/
Very sensibly he has a major focus on Governance - a line I have pushed for years now!

Another point that has not been mentioned as far as I know is that the current Deloitte’s Refresh of the National E-Health Strategy now has a real opportunity to see if some worthwhile improvement can now be planned. If ever there was a time for a full review - along in my view with a full review of the PCEHR Program by the Auditor General - it is now. It seems to me that without major change the whole thing is doomed.
I am interested in knowing what others think will be the outcome going forward.
David.

Tuesday, August 20, 2013

The National Press Club Health Debate Next Tuesday Might Be Fun. Looks Like E-Health Is Seriously On The Coalition Radar.

This release appeared late last week:

Labor’s $1 billion E-Health Debacle

16 August, 2013
Labor’s implementation of an e-health patient record is a $1 billion disappointment.  With nearly $1 billion spent on the program, it has failed to deliver anywhere near what the Labor Government promised.
The e-health program has been shown to be more about politics than about policy and more about spin than about outcomes for patients.
“Australian Doctor has reported that there are only 4,000 e-health records in existence.  At a cost of $1 billion that works out at $250,000 per record,” said Peter Dutton.
“This latest development proves this government is incapable of delivering on e-health.  It speaks volumes about Labor’s incompetence,” he added.
Apart from the very low take up rate, the system itself is deeply flawed.  The Government has been throwing good money after bad, spending money getting Medicare Locals to sign people up to a program that does not yet have basic clinical protocols in place, let alone support from clinicians.
“The Coalition continues to provide in-principle support for e-health, but shares the concern of many in the sector about Labor’s incompetence in managing the process,” said Mr Dutton.
The previous Coalition Government achieved significant improvements in the computerisation of general practice, from 17 per cent to over 94 per cent, by working with the profession and implementing effective policy. 
“If elected, the Coalition will assess the true status of the PCEHR implementation and again work with health professionals and the broader sector to provide real results on this important reform for patient care,” Mr Dutton said.
The e-health debacle follows a pattern of waste and incompetence from the Labor Government.  It joins the ranks of catastrophically mismanaged programs such as pink batts and school halls.
It also follows Labor’s failure to deliver on its much promised GP Super Clinics and the 16 Early Psychosis Prevention and Intervention Centres which never materialised.
The release is found here:
There is some commentary and background here:

Coalition slams Labor’s “$1bn e-health debacle”

news Shadow Health Minister Peter Dutton has taken a pickaxe to the Federal Government’s Personally Controlled Electronic Health Record (PCEHR) scheme, claiming the costly project was “more about spin than about outcomes for patients”.
The project was initially funded in the 2010 Federal Budget to the tune of $466.7 million after years of the health industry and technology experts calling for development and national leadership in e-health and health identifier technology to better tie together patients’ records and achieve clinical outcomes. The project is overseen by the Department of Health and Ageing in coalition with the National E-Health Transition Authority (NEHTA).
However, last month the Government revealed it had failed to meet it initial 500,000 target for adoption of the system, with only close to 400,000 Australians using the system at that point.
At the time, University of Western Australia software academic David Glance severely criticised the scheme. “… even if the government had met the target of 500,000, it would have been a meaningless gesture,” Glance wrote at the time. “The vast majority of those who have signed up, if they ever get around to logging in, will be greeted with an empty record.”
“Given the lack of active participation on the part of GPs, as well as the lack of public hospital systems to integrate with PCEHR, there’s little evidence to suggest that this is going to change any time soon … GPs still struggle to see the benefit of spending time curating shared records when the legal liabilities are still unknown but are potentially severe.”
Just last week The Australian newspaper revealed that NEHTA had lost a number of senior executives, including clinical lead Mukesh Haikerwal.
“The question is simply: If these experienced clinicians and e-Health ‘experts’ thought the PCEHR was a winner would they be bailing out at this time?” wrote prominent Australian e-health blogger David More in response to the news. “Surely they would want to be around for the kudos and rewards that would flow from a successful program?”
“The answer is really easy. Those who are leaving know vastly more than you about the program and its risks and benefits – and yet they want out. It makes it totally clear this is a lemon on which no more time should be wasted by you or your colleagues until [The Royal Australian College of General Practitioners] and the [Australian Medical Association] are convinced – and say so and it is properly redesigned and fixed, so that the PCEHR is now both useful, safe and fit for purpose.”
More here:

Election 2013 Health Policy Debate

The Hon Tanya Plibersek MP Vs the Hon Peter Dutton MP

August 27, 2013

11.30am - 1.30pm

Here is the link:
Both Sky News and ABC News 24 typically carry these events live.
See here for example:
It will be great fun to see what is actually said on the day.
Given where the betting markets are at present on the outcome of the election I suspect what Mr Dutton has to say will be pretty important, given the press release above.
David.

Monday, August 19, 2013

Weekly Australian Health IT Links – 19th August, 2013.

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

There was really only on story last week with the implosion of the NEHTA Clinical Leads program and increasing clarity on the respective roles of NEHTA and DoHA in the e-Health domain.
Other blogs will consider the implications of all this and provide a round-up.
-----

Dr Haikerwal NEHTA resignation raises serious concerns about clinical input to PCEHR

15/08/2013
AMA President, Dr Steve Hambleton, said today that the resignation of Dr Mukesh Haikerwal, head of clinical leadership and stakeholder management, from the National Electronic Health Transition Authority (NEHTA) raises serious concerns about clinical input to decision-making in the implementation of the Personally Controlled Electronic Health Record (PCEHR).
The resignations of Dr Haikerwal, a former AMA President and NHHRC Commissioner, and other clinical leads, including Dr Nathan Pinksier, come amid reports that the Department of Health and Ageing (DoHA) is taking over engagement with the medical profession and IT industry over the design of the PCEHR.
Dr Hambleton said that the AMA has long advocated that the success of the PCEHR depended on how it met clinical needs.
“The PCEHR simply will not be effective if doctors – the people who patients trust most with their health care – do not have a say on what goes on the electronic medical record and how that information is accessed and used, and by whom.
-----

Mukesh Haikerwal leads NEHTA exodus

  • by: Fran Foo
  • From: Australian IT
  • August 14, 2013 4:39PM
THE National E-Health Transition Authority has been rocked by the departure of top clinical lead Mukesh Haikerwal alongside other senior executives working on the e-health records project.
Sources told The Australian that several clinical leads, including Nathan Pinskier and Chris Pearce, have also resigned.
Dr Haikerwal, a former Australian Medical Association president and NEHTA's head of clinical leadership and stakeholder management, will officially leave on August 22.
He has been instrumental in promoting the benefits of the $628 million personally controlled e-health record system, especially in trying to woo doctors to adopt the platform.
The PCEHR has had several staunch critics, including Geraldton, West Australia GP Edwin Kruys.
-----

Doctors ready to pull plug on eHealth

Published on Fri, 16/08/2013, 08:43:39
By Julian Bajkowski
Australia’s long and troubled efforts to create a functioning national system of electronic health and medical records system is once more close to collapse.
The Australian Medical Association has expressed serious concerns over clinician input into the project following the shock resignation of highly respected clinical representative Dr Mukesh Haikerwal from the National eHealth Transition Authority (NeHTA) this week.
Other crucial clinical advisors, including Dr Nathan Pinksier and other clinical leads are also understood to have quit signalling a severe breakdown in relations between doctors and Department of Health and Ageing.
-----

John Mathews: Benefits of sharing

John Mathews
Monday, 12 August, 2013
FROM at least the time of Hippocrates, the medical profession has advanced its knowledge of disease, prognosis and treatment by pooling information about patients with similar histories.
Doctors built their reputations as they acquired new knowledge and skills, helping them to attract more patients.
That “small business” model, with practitioners competing for patients, was nevertheless leavened by a cooperative commitment to share expertise through teaching and publication. Until well into the 20th century, that model was sustained — patients who could afford it would pay the doctor directly, while those who couldn’t pay would depend on the charity of a doctor or hospital, with clinical records the property of the doctor and/or the hospital.
-----

Federal departments start shedding jobs

ABC Updated August 15, 2013, 7:45 pm
Around 700 public service jobs will be axed in coming months, as the belt is tightened across two major federal departments.
The Department of Agriculture, Fisheries and Forestry (DAFF) has told its staff that it is looking at losing 300 positions.
The Department of Health and Ageing (DoHA) says 400 full-time jobs must go.
In an email to all DoHA staff, departmental secretary Jane Halton said everyone would need to work together to urgently save money.
-----

Technical Error in CDA Implementation Guides for ETP, PCEHR

Posted on August 13, 2013 by Grahame Grieve
There’s a technical error that runs through most of the CDA implementation guides that we have, including ETP, and other pcEHR related ones.
-----

Practice prods GPs to get with the e-program

13th Aug 2013
STAFF at a South Australian practice who have signed up a quarter of their patients for a PCEHR have urged other practices to get behind the system.
Practice manager Dr Sim Hee Neoh of Whyalla’s The Surgery, on the SA coast near Port Augusta, said that although the process was initially time consuming, the e-health records were proving to be a valuable resource for both staff and patients.
“We started with NEHTA about a year ago as one of 65 practices asked to participate in the PCEHR,” Dr Neoh told MO.
“It does take time, particularly with the records that have been there for a long time. They accumulate a lot of rubbish. For example, the medication list often needs to be cleansed.”
-----

It was an IT disaster: what happens now?

Date August 16, 2013

Sylvia Pennington

Shape up or ship out was the warning delivered to prime contractor IBM following the release of a Royal Commission report into Queensland Health's infamously botched SAP payroll system.
Premier Campbell Newman has announced the vendor won't be allowed to enter any new contracts with the state until it lifts its governance and contracting practices. Mr Newman has called on IBM to deal with staff adversely named in the report and asked for Crown Law and Public Service Commission advice on what action can be taken against former public servants who played key roles in the debacle. IBM has denied it is responsible for all of the disaster.
Minister for Information Technology Ian Walker will respond to the report's other recommendations when Parliament next sits. Meanwhile, chief information officers and those responsible for such high-risk, wide-ranging, multimillion-dollar technology decisions could be forgiven for wondering about the professional and personal impact of such debacles.
We take a look at four failed ICT projects where king-sized cock-ups led to courtroom consequences:
------

Smartphone device to detect faulty heart rhythms could reduce strokes

Researchers from the University of Sydney have found that a smartphone-based screening device paired with a web-based prediction facility can detect atrial fibrillation (AF) with a 97 per cent accuracy.
AF is often asymptomatic and undiagnosed and is responsible for around a third of all strokes.
The team ran a trial in ten community pharmacies using the device, the AliveCor Heart Monitor for iPhone (iECG) which uses an iPhone with special case to take a single-lead ECG reading. The trial is now continuing in a number of Sydney-based General Practices.
Researcher Nicole Lowres, whose work was funded by the Heart Foundation, says the team planned to use a handheld ECG for the project but the AliveCor device was a better option.
-----

Webinar: Embedding clinical safety in medical software implementations

Posted on August 13, 2013 by Grahame Grieve
Tomorrow I’m giving a webinar for MSIA members called “Embedding clinical safety in medical software implementations”. MSIA members can consult their MSIA releases for webinar details.
In this webinar, I’ll be looking at clinical safety from a vendor/system developer point of view
I’m going to be focusing on the real world challenges faced by people who make decisions about how systems will work. Usually this is vendor architects and analysts, but can also include developers, in-house teams, and government architecture and purchase teams.
(Now delayed until Sept)
-----
Mapping technology can assist in combatting Australia’s mental health challenges by pinpointing specific regions most in need of funding and resources, according to a geo-health expert. In light of new figures that 45 per cent of Australians aged 16-85 years will experience a common mental health-related condition, Geographic Information System (GIS) technology has emerged as a tool to determine exactly where medical services are required to address and treat the issue.
-----

Alarms may not work with NBN

Date August 13, 2013 - 9:20AM

Stuart Corner

NBN Co still doesn't know how more than a million analog-connected devices such as medical pendants and security alarms will continue to be supported when the Telstra copper network is replaced with an NBN fibre connection to homes.
There is no guarantee the telephone service provided by the NBN will provide end-to-end support for the devices. And there are no processes yet to ensure that when a retailer sells services to a customer, it is fully cognisant of any such legacy services and needs to ensure ongoing operation.
The termination boxes – the network termination device (NTD) – to be installed in all NBN-connected homes are fitted with two analog phone ports, known as Uni-V, and  four ethernet data ports, Uni-D. Any alarm services would need to be provided as ''over-the-top'' (OTT) using one of the two Uni–V ports.
-----

New Microsoft Windows 8.1 to launch on October 18

  • From: AFP
  • August 15, 2013 6:57AM
A TWEAKED version of Microsoft's Windows operating system which restores the "Start" button missed by users and updates other features will be available on October 18, the company said Wednesday.
Windows 8.1 will be offered as a free download to those already using Windows 8, and comes in response to a lukewarm reception to the operating system introduced last year aimed at serving both mobile devices and PCs.
A full retail version of Windows 8.1 will also be available on the same date.It will lauunch on October 18 in the US (October 19 AEST).
-----

Broken planet hunter Kepler telescope still on a mission

  • From: AFP
  • August 16, 2013 10:03AM
NASA says it cannot fix its hobbled planet-hunting Kepler Space Telescope and is considering what sort of scientific research it might be able to do at half-capacity.
"Today, we are reporting we do not believe we can recover three-wheeled operations, or Kepler's original science mission," said Paul Hertz, NASA Astrophysics Division director.
"So the Kepler project is turning its attention to studying the possibility of two-wheeled operations," he said, referring to the wheels the craft uses to orientate itself.
The unmanned spacecraft launched in 2009 on a search for rocky planets orbiting in the habitable zones of Sun-like stars - in other words, planets like Earth that might contain life elsewhere in the Milky Way galaxy.
-----
Enjoy!
David.