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."

Tuesday, September 24, 2013

Telehealth Looks To Be On A Bit Of A Roll At Present - Especially With Evidence Being Provided Of Some Success.

All sorts of interesting things have appeared this week. First we had.

Telehealth can cut costs for cancer patients

17th Sep 2013
TELEHEALTH consultations for cancer patients significantly reduce travel and accommodation costs, an analysis of a Queensland model has found.
Researchers led by the director of the department of medical oncology at the Townsville Hospital, Associate Professor Sabe Sabesan, reviewed 605 teleoncology consultations conducted with 147 patients.
They compared the cost of providing the services with estimated expenses associated with face-to-face care.
Projected costs included anticipated aeromedical retrievals as well as the likely travel and accommodation required for patients, specialists and patient escorts.
These figures were matched against the cost of setting up the model of care, including the purchase and maintenance of equipment and staff costs.
The results, published last week by the MJA, revealed a total net saving of more than $320,000.
…..
MJA 2013; 199(6):414-17
More here
Then we had a US report covering another Australian study.

Telehealth reduces healthcare use, but produces too many alerts

September 20, 2013 | By Susan D. Hall
Self-monitoring along with nurse oversight helped reduce care costs by $2,931 per person among patients with chronic obstructive pulmonary disease (COPD) in an Australian study published in Telemedicine and e-Health.
Participants were taught to measure their blood pressure, weight, temperature, pulse, and oxygen saturation levels daily and transmit that information by telephone to a secure website, monitored by a nurse. There were fewer emergency room visits and hospital admissions among the telehealth group--nearly half as many--vs. a control group, though not at a statistically significant level. However, the cost savings added up from the use of fewer resources, according to the paper.
In addition, the telehealth participants reported increased confidence in their ability to manage their condition and less anxiety.
However, a review of health failure patients treated by a Massachusetts home health agency monitoring similar data found only three percent of alerts were associated with ED visits and hospitalizations. Because the nurses had to follow up on every alert, that meant they spent a lot of time trying not to miss the few meaningful alerts, according to a second study at Telemedicine and e-Health.
Many of the false alarms were generated when patients did a poor job of taking their vitals. Meanwhile, 22 percent of cardiac-related ED visits and hospitalizations had no alerts associated with them. The study points to anxiety as a key predictor of ED visits and hospitalizations among heart-failure patients, a factor that must be addressed, the authors said.
More here:
We also have this:

Mental-health help goes online

Mystrength.com is there to help those who can’t wait to see a therapist

Sep 13, 2013, 4:00am MDT
Reporter- Denver Business Journal
The digital revolution let people with physical ailments visit websites such as WebMD and diagnose their own conditions for the past 10 years. But Scott Cousino saw what it couldn’t do — help Americans with mental-health ailments aid themselves without a therapist.
In 2010, Cousino — an online-education professional who had overcome a bout of severe depression in his 20s — began working on myStrength.com. The website provides mental-health checks, affirmations and other supplemental help to people whose therapists aren’t available.
Three years later, eight community behavioral-health networks in Colorado use the website, it’s expanded to six other states and officials from the National Council for Community Behavioral Healthcare have created an exclusive relationship with the Denver company to advance the use of technology as a mental-health treatment extender.
“It’s like taking your therapist home with you. It empowers consumers to take charge of their treatment,” said Rick Doucet, CEO of Community Reach Center, which serves about 13,000 people in Adams County. “We haven’t seen the end of what technology can do to help us.”
Mental health is the No. 1 disability in the United States, affecting 25 percent of Americans at some point in their lives. Nearly 20 percent of employer health costs are tied to it, and untreated symptoms can hurt productivity and lead to many missed work days.
MyStrength.com takes evidence-based resources and turns them into interactive tools. Users are asked to tell the site about their energy levels, can complete e-learning curriculum about depression, can track their mental-health state, and post inspirational and spiritual photos or messages that help them.
More here:
Last for now we come back to Australia.

Push to expand telehealth MBS items

13 September, 2013 Paul Smith
The Federal Government is under pressure from a state health minister to extend Medicare rebates to GPs for telehealth consultations with public hospital specialists.
Under current rules, MBS items for GPs to sit in on telehealth consultations can only be claimed when the specialist is in private practice.
However Queensland Health Minister Lawrence Springborg says the arrangement is unfair -- both to GPs and public hospital patients -- and is calling for the system to be revamped.
"Medicare funds are for consultations with doctors with a right of private practice," Mr Springborg said.
"It excludes patients under the care of public hospital specialists which is unfair given that, if you are a private hospital patient under the care of the same GP, maybe the same specialist, you get access [to the telehealth rebates]."
Following the introduction of the telehealth items two years ago, GPs have sat in on more than 32,000 video conferencing consultations with specialists.
More here:
Really quite a busy week in the telehealth area and nice to see there is a lot of reporting of actual clinical and benefits trials.
David.

Monday, September 23, 2013

Weekly Australian Health IT Links – 23rd September, 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

A surprisingly interesting week with e-Health getting some attention - in part due to the e-Health heir apparent being left out of the ministry and the senior health minister being so relaxed that he has been given Sport as well as Health and the Assistant Minister - Senator Nash - appearing to need a lot of briefing since having not apparently been all that involved in Health to date.
It is interesting to note that as of Sunday we still do not have an updated website for the Health Minister. I wonder when that will happen?
Now remember DoHA does not exist - it is now just DoHS or DoHaS!
-----

Sector calls for transparency and end to mistakes in PCEHR

MEDICAL experts and industry players have urged Tony Abbott to rectify the national e-health record system's "significant mistakes and missed opportunities" and ensure transparency is a key plank in its delivery.
In the lead-up to the election, Mr Abbott vowed to overhaul the cumbersome personally controlled e-health record (PCEHR) program, calling for a review.
Details on who will conduct the review and its parameters are still scant as Mr Abbott only yesterday announced his frontbench, to be sworn in tomorrow.
Peter Dutton has been appointed health minister, as expected, while Nationals NSW senator Fiona Nash is assistant health minister.
Andrew Southcott, previously opposition parliamentary secretary for primary healthcare and the Coalition's e-health spokesman, missed the cut.
-----

$1 billion e-health system rejected by doctors as 'shambolic'

September 19, 2013
Sue Dunlevy National Health Correspondent
AUSTRALIA'S billion-dollar e-health system is in danger of becoming an expensive white elephant with doctors refusing to use it.
A key clinical adviser to the government who quit in frustration last month has described the system as "shambolic".
And the medical software industry says the body running the system, the National E-Health Transition Authority, lacks the skills to do the job and warns patient safety could be at risk.
Dr Mukesh Haikerwal who resigned in frustration from work on the e-health record says he's uploaded 150 patient records on to the system but "no-one can read it".
Patients who want a hospital or specialist to see their e-health record have to take their own ipad to the consultation to show the record because hospitals and specialists don't have the software to read it.
-----

I’m still an advocate for PCEHR: Haikerwal

19th Sep 2013
DR MUKESH Haikerwal remains an advocate for the government’s personally controlled e-health records (PCEHR) system despite serious concerns about the accuracy of clinical records and the system’s useability.
Dr Haikerwal, who recently quit his post as NEHTA’s chief clinical lead, told MO the system was still “some time off” being a reliable, useful and widely accessible resource for doctors, and there remained much to be gained from the work already completed.
“We all know there are issues with the program and project that need to be fixed up but the positive side is that there is something to be worked from and built on,” he said.
-----

New health minister: Abbott announces changes

16th Sep 2013
OUR new health minister is announced while the news is not so good for doctor frontbenchers as Tony Abbott names his new ministry.
Peter Dutton will be officially sworn in as Australia’s new health minister this week after Prime Minister-elect Tony Abbott confirmed this afternoon that the bulk of his Opposition front bench would be retained in the cabinet.
Mr Dutton had been widely anticipated to hold on to health, having served as shadow health minister for the last six years but in an unexpected move he will also hold the portfolio of minister for sport.
However, there will be some change to the management of the health portfolio, with shadow parliamentary secretary for primary healthcare and former surgical registrar, Dr Andrew Southcott, among the few Opposition frontbenchers to be dropped.
-----

Optimism over Coalition’s ministry

17th Sep 2013
HEALTH groups remain optimistic about the prospects of the Coalition ministry, despite criticism of the lack of standalone portfolios for mental health and science
The Mental Health Council of Australia (MCHA) has called on Prime Minister-elect Tony Abbott to ensure mental health remained a priority “despite removing it as a dedicated portfolio”
“We hope that the new Abbott government recognises that mental health cuts across traditional portfolio boundaries,” MHCA CEO Frank Quinlan said.
“The urgent establishment of the promised review by the National Mental Health Commission will provide an important opportunity to bring true reform to this complex area of public policy.”
-----

Man sent someone else's eHealth details

September 17, 2013
An Adelaide man who was mistakenly sent another person's confidential eHealth login details says he is concerned about the apparent privacy breach.
The man, who wishes not to be identified publicly, says he got an email from the National eHealth Record System operator about having successfully registered.
But he says he had made no such application.
-----

Aussie eHealth record data mishap defended by Department of Health

Summary: A report claiming that data is being leaked from the government's eHealth records system is being denied by the Department of Health on the basis that it never sends out passwords, and certainly never in plain text.
By Michael Lee | September 18, 2013 -- 07:17 GMT (17:17 AEST)
The Australian Department of Health has moved to allay concerns over the alleged leak of confidential eHealth login details, stating that even if it had mistakenly sent login details to the wrong person, they are useless without further details.
On Wednesday morning, an unnamed Adelaide source told ABC News that he had mistakenly been sent an email from the National eHealth Record System Operator that appeared to be intended for someone else with the same last name.
The unnamed man claimed to have been sent a "private login password", leading to speculation that the eHealth system was securing patient records using plain text passwords. Such practices are deemed insecure by modern standards for a number of reasons, including the fact that most email communications are insecure, and that passwords are often reused by users across several services.
-----

National e-health still has a future despite problems: CIOs

Under fire national program lacking the right policy framework for broad adoption
Technology heads in the healthcare sector continue to back the federal government’s controversial and slow moving national e-health record program, saying it has a future despite lacking the critical mass it needs to succeed.
As of July 31, 612,391 Australians had registered for an e-health record, according to a recent National E-Health Transition Authority (NEHTA) report. A further 4500 organisations had registered in the personally controlled e-health record (PCEHR) system and 4585 shared health summaries had been uploaded as of 22 May.
The scheme has come under fire in recent months. In July, Australian Doctor polled 514 general practitioners with two-thirds indicating they will not take part. Earlier this week, a man was accidentally sent another person’s e-health details.
-----

Tough times continue for pharmacists

E-health
Jessica Gardner
Outgoing Pharmacy Guild of Australia president Kos Sclavos has called on the new Coalition government to support a national e-health record system that would allow pharmacists to play a greater role in the management of medications and improve patient outcomes.
Mr Sclavos, who will step down from the Guild presidency in October after eight years at the helm, said the current maintaining of e-health records was an opt-in system. For the prescription of certain drugs, he supported an opt-out program that would allow pharmacists to identify if drugs were being inadvertently or deliberately misused.
“Pharmacists are the medication experts,” he said. “A more interventionist approach to some parts of the health system could generate big savings.”
-----

Hefty privacy fines on way, GPs warned

16 September, 2013 Antonio Bradley
GPs are being warned to review the way they handle patient information ahead of a law change next year that brings with it potential fines of $340,000 per practitioner.
The large fines, which can reach $1.7 million per practice, are the pointy end of a new privacy law which comes into effect in March and applies to all businesses and their staff.
Though GPs are not expected to be fined, the potential is still there, particularly for those practices that send patient data overseas for transcription or storage.
The new law for the first time requires all practices to have a privacy policy that describes how information is collected and used, and that gives details on how patients can complain about a breach of privacy.
Currently, general practices are only required to have a privacy policy if they wish to be accredited.
-----

Labor’s legacy

17th Sep 2013
AS THE curtains close on one of Labor’s most difficult periods in government, Byron Kaye looks back over six years of health programs, promises and problems.
A week before the Australian electorate ended Labor’s tumultuous six-year reign, Tanya Plibersek did something out of character. The normally unflappable health minister showed signs of frustration. The woman who would have marked two years in the portfolio in December was spruiking her party’s health record when she all but admitted that the bad feeling towards her party’s policies was starting to bite. “It just drives me crazy,” she said.
Ms Plibersek was being asked by MO about the $600 million-plus GP Super Clinics program and its favoured status among Coalition and doctor ranks as a symbol of Labor’s big promises, flawed delivery and inadequate consultation with industry. The pink batts scheme. The rort-friendly school halls program. GP super clinics...
Not as far as Ms Plibersek was concerned.
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Setting health data connectivity on FHIR

As eHealth is adopted around the globe and a multiplicity of eHealth software programs proliferates, the adoption of health data interchange standards has become more and more important.
Australian health technology expert Graham Grieve has been deeply involved in the development of healthcare standards for over a decade, and in 2009 was awarded the HISA Don Watson Award for Effectiveness in Health Informatics in 2009 in recognition of his work.
Grieve is one of the architects of a new health information standards framework called FHIR (Fast Health Interoperable Resources) which will be released for trial in coming months, with one of the first large-scale tests to be performed in Sydney in October at a ‘connectathon,’ where developers and health information professionals attending will trial the new system.
The Connectathon will be on Sunday October 27, just before the annual International HL7 Interoperability Conference 2013 (IHIC 2013) which will be held on Oct 28th and 29th at the North Sydney Harbourview Hotel.
-----

Push to expand telehealth MBS items

13 September, 2013 Paul Smith
The Federal Government is under pressure from a state health minister to extend Medicare rebates to GPs for telehealth consultations with public hospital specialists.
Under current rules, MBS items for GPs to sit in on telehealth consultations can only be claimed when the specialist is in private practice.
However Queensland Health Minister Lawrence Springborg says the arrangement is unfair -- both to GPs and public hospital patients -- and is calling for the system to be revamped.
"Medicare funds are for consultations with doctors with a right of private practice," Mr Springborg said.
"It excludes patients under the care of public hospital specialists which is unfair given that, if you are a private hospital patient under the care of the same GP, maybe the same specialist, you get access [to the telehealth rebates]."
-----

Telehealth can cut costs for cancer patients

17th Sep 2013
TELEHEALTH consultations for cancer patients significantly reduce travel and accommodation costs, an analysis of a Queensland model has found.
Researchers led by the director of the department of medical oncology at the Townsville Hospital, Associate Professor Sabe Sabesan, reviewed 605 teleoncology consultations conducted with 147 patients.
They compared the cost of providing the services with estimated expenses associated with face-to-face care.
Projected costs included anticipated aeromedical retrievals as well as the likely travel and accommodation required for patients, specialists and patient escorts.
-----

Telehealth reduces healthcare use, but produces too many alerts

September 20, 2013 | By Susan D. Hall
Self-monitoring along with nurse oversight helped reduce care costs by $2,931 per person among patients with chronic obstructive pulmonary disease (COPD) in an Australian study published in Telemedicine and e-Health.
Participants were taught to measure their blood pressure, weight, temperature, pulse, and oxygen saturation levels daily and transmit that information by telephone to a secure website, monitored by a nurse. There were fewer emergency room visits and hospital admissions among the telehealth group--nearly half as many--vs. a control group, though not at a statistically significant level. However, the cost savings added up from the use of fewer resources, according to the paper.
In addition, the telehealth participants reported increased confidence in their ability to manage their condition and less anxiety.
However, a review of health failure patients treated by a Massachusetts home health agency monitoring similar data found only three percent of alerts were associated with ED visits and hospitalizations. Because the nurses had to follow up on every alert, that meant they spent a lot of time trying not to miss the few meaningful alerts, according to a second study at Telemedicine and e-Health.
-----

New health recall portal launched

GS1 Recallnet Healthcare, an electronic product recall notification management system for therapeutic goods, has been launched with the support of the National E-Health Transition Authority (NEHTA).
GS1 Recallnet Healthcare is an online portal designed to improve patient safety by streamlining the management of product recall and non-recall notifications.
GS1 Australia’s CEO, Maria Palazzolo said it was designed to provide an electronic product recall notification management system in the Australian healthcare sector to improve patient safety by enhancing the speed, efficiency and accuracy of the recall process for therapeutic goods.
“Therapeutic product recalls always present a significant challenge to the Australian healthcare industry and this portal will improve the therapeutic product recall notification process for the benefit and safety of all Australians,” she said.
-----

Robots starting to feel the love

Date September 19, 2013

Mark White

Machines have been used to help dementia sufferers with some amazing results.
Thomas would sit still all day at his aged-care home. The 82-year-old had not spoken for two years. Staff would serve him coffee and leave him be.
One day, a group of researchers led by Wendy Moyle, from Queensland's Griffith University, were running a test involving a Paro robot seal called Millie. They had been used in Japan to help children with developmental disorders, and to comfort victims of the 2011 tsunami. Professor Moyle wondered if a Paro could improve the quality of life for dementia sufferers by making them less anxious - the seals are covered in antibacterial plush fur and sensors, and squirm and squeal when stroked.
-----

More Australian Privacy Principles released for consultation

Deadline for replies is 21 October
The next set of draft Australian Privacy Principle (APP) guidelines have been released for public feedback by the Office of the Australian Information Commissioner (OAIC).
APPs 1 to 5 were published in August. This covered new requirements for agencies and enterprises about how they manage personal information, including the requirement to have a clearly expressed and up-to-date privacy policy.
Australian Information Commissioner Professor John McMillan said the guidelines outline how the OAIC will interpret and apply the APPs which come into law on 12 March 2014.
Australian Privacy Commissioner Timothy Pilgrim said the second stage of these draft guidelines gives guidance about new requirements for agencies in how they use or disclose personal information, undertake direct marketing activities and send data off-shore.
-----

Octfolio software to help manage asbestos

A NEW software platform aims to help map, manage and eradicate asbestos, the deadly building material.
Octfolio's asbestos information management software launches this week along with a supplementary website.
The platform has been in development for three years and beta versions are already in use with Ergon Energy, Byron Shire Council and the Department of Finance and Deregulation.
Octfolio is owned by investment outfit Tulla Group, founded by one-time Elders Resources chief executive Kevin Maloney who is also Tulla chairman.
-----

Gaming may improve older player's memory

Date September 15, 2013

Elizabeth Lopatto

Video games, largely considered the province of the young, may help the elderly, according to a study looking to boost memory among those ages 60 and older.
A car-racing game played for 12 hours helped 60- to 85- year-old players improve their memory and attention span, and the effects lasted for six months, according to research published in the journal Nature.
Nintendo, the Kyoto, Japan-based maker of the Wii console, and closely held Posit Science of San Francisco, are among companies that have targeted the elderly and baby boomers with video games meant to improve their minds. Video games may offer the same memory benefits that games such as Sudoku have shown in population studies, said Maria Carrillo, the vice president of medical and scientific relations at the Chicago-based Alzheimer's Association.
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Digital charts slower than pen and paper

13 September, 2013 Dr Elizabeth Lord
Electronic hospital charts might look snazzy, but they are "significantly more time-consuming" than old-fashioned paper-based systems, Canadian researchers say.
An Ottawa Hospital study found doctors who completed their patient's record electronically took 40 minutes longer on average than those who used the time-honoured paper and pen.
Surveys confirmed doctors were unconvinced the electronic records had done anything to streamline their documentation processes.
"Physicians participating in the study were not satisfied with the electronic medical record and they did not see more patients by using it," the researchers wrote in the Emergency Medicine Journal.
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What went wrong with the NBN

September 21, 2013
David Ramli and James Hutchinson
The National Broadband Network Company was to be the Labor government’s crowning achievement in the vein of Medicare and the Snowy River Dam Project.
Where high speed broadband was traditionally restricted to corporate networks and international links, Labor would connect it to 93 per cent of homes and businesses, from the sandstone manors of Bellevue Hill to the valleys of Tasmania and everywhere in between.
But four years on the reality is murkier. Its founding chief executive has been pushed out the back door while the entire telecommunications industry is despondent.
The current chairman Siobhan McKenna – despite attempts to confront the company’s mismanagement – has been earmarked for replacement.
-----

Bionic eye shines light on darkness

Date September 16, 2013

Bridie Smith

Science Editor, The Age

For the first time since they lost their sight, Australian patients given a bionic eye have been able to see their environment.
The three patients trialling early prototype devices have been able to locate shapes on a screen after the device's camera was connected with a stimulator to produce an image using 20 electrodes.
Previously, Dianne Ashworth, Murray Rowland and Maurice Skehan had seen only flashes or spots of light as each of the 20 electrodes in their 24-electrode bionic eye were activated for testing.
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Google promises new thinking for health company, Calico

  • AFP
  • September 19, 2013 3:00PM
GOOGLE is launching a new company focused on health and well-being, and hinted at cooperation with long-time rival Apple in the venture.
A Google statement said the company, Calico, would put a particular focus on "the challenge of aging and associated diseases."
Arthur Levinson, chairman and former chief executive of the biotech firm Genentech and chairman of Apple, will be Calico's chief executive and a founding investor.
Announcing the new investment, Google CEO Larry Page said: "Illness and aging affect all our families. With some longer term, moonshot thinking around healthcare and biotechnology, I believe we can improve millions of lives."
-----

Coming soon to you: the information you need

Date September 18, 2013 - 6:53AM

Drew Turney

The day when your hat can extrapolate your mood from your brain activity and make a spa appointment on your behalf may not be far away.
The next big thing in the digital world won't be a better way for you to find something. If a confluence of capabilities now on the horizon bears fruit, the next big thing is that information will find you.
Welcome to contextual search, a world where devices from your phone to your appliances will join forces in the background to make your life easier automatically.
Contextual, or predictive search, started with the now-humble recommendations pioneered by companies such as Amazon – where metadata applied behind the scenes led you to products with similar attributes via pages that made helpful suggestions such as "customer who bought this also bought...".
-----
Enjoy!
David.

The Abbott Government Is Already Going The Wrong Way In Health. Not A Good Sign.

This appeared today.

Commonwealth agencies to be cut by Abbott Government

  • Steve Lewis
  • News Limited Network
  • September 22, 2013 10:00PM
AGENCIES responsible for tackling obesity, capital city planning and security advice on asylum seekers are to be slashed as Tony Abbott takes the axe to Labor's reform agenda.
…..
The Coalition will also begin unwinding key "nanny state'' agencies such as the Australian National Preventative Health Agency, established to lead the national fight against obesity, alcohol abuse and tobacco use.
Health Minister Peter Dutton has been critical of ANPHA's decision to spend $500,000 on a study into a potential "fat tax" despite neither side of politics supporting such a move.
…..
Two major health agencies - the Australian Institute of Health and Welfare and the year-old National Health Performance Authority - are under review and could have their combined budgets - of around $40 million a year - slashed.
…..
Scrapping ANPHA will leave the Government open to criticism that it's not taking seriously a raft of key health challenges - including the growing obesity challenge and tobacco and alcohol control.
But Mr Dutton is determined to slash hundreds of millions of dollars in bureaucratic expenses and is reviewing the ongoing role of the AIHW - which provides a national service on health and welfare statistics.
The National Health Performance Authority - established in 2011 to provide uniform statistics on the performance of hospitals and other health facilities - could also be absorbed back into the health department.
Full article is here - I have extracted Health related bits and left the rest out.
If this is the quality of what we are going to see from Mr Dutton and his team I am very worried. Evidence based health policy is only possible when you have an organisation like the AIHW crunching the statistics. Continued support of Preventative Care is really a no-brainer and you can be sure that without the ANPHA improvement of hospital performance and costs will be that much harder.
Compared with the billions spent in the health system these cuts are just the wrong target in my view. Now the PCEHR might be a better item to consider - or is that already coming?
David.

Sunday, September 22, 2013

I Am Suffering Considerable Cognitive Dissonance Reading About Australian E-Health These Days. What Do We Really Need To Happen?

A couple of interesting articles appeared last week.
First we had:

Sector calls for transparency and end to mistakes in PCEHR

MEDICAL experts and industry players have urged Tony Abbott to rectify the national e-health record system's "significant mistakes and missed opportunities" and ensure transparency is a key plank in its delivery.
In the lead-up to the election, Mr Abbott vowed to overhaul the cumbersome personally controlled e-health record (PCEHR) program, calling for a review.
Details on who will conduct the review and its parameters are still scant as Mr Abbott only yesterday announced his frontbench, to be sworn in tomorrow.
Peter Dutton has been appointed health minister, as expected, while Nationals NSW senator Fiona Nash is assistant health minister.
Andrew Southcott, previously opposition parliamentary secretary for primary healthcare and the Coalition's e-health spokesman, missed the cut.
About 650,000 people have registered for an e-health record but only 0.6 per cent or 4000-odd shared health summaries exist. These records are created by a patient's GP and contain diagnoses, allergies and medications.
Mr Dutton, a vocal critic of the PCEHR, has described Labor's implementation of the PCEHR as a $1 billion disappointment.
"With nearly $1 billion spent on the program, it has failed to deliver anywhere near what the Labor government promised," he said last month. "The e-health program has been shown to be more about politics than about policy and more about spin than about outcomes for patients."
Pharmacy Guild national president Kos Sclavos said it supported the concept of an audit "because there have been some significant mistakes and missed opportunities".
Mr Sclavos said the Guild would make a detailed submission to the e-health review. It will be centred on three elements: patient issues, pharmacy issues and system issues. "Community pharmacies provide a range of professional services that focus on screening and risk assessment as well as the monitoring of chronic conditions.
"To date, the information collected cannot be uploaded to the PCEHR. This is a gap that must be addressed," he said.
Mr Sclavos said the Coalition's review could result in changes to the PCEHR and the role of community pharmacy. He said his members "need a clear path on the future of the system and at present there are many unknowns".
Australian Medical Association president Steve Hambleton said "We're not happy with the uptake or the process of the PCEHR ... Everyone agrees that e-health has great potential to improve patient healthcare with increased instances of sharing key information about patients but we need to find out why we haven't got there."
More transparency was vital in order to gauge the true situation with the PCEHR.
Dr Hambleton said the system was too cumbersome for doctors and could lead to errors.
Lots more here:
Second we have this.

$1 billion e-health system rejected by doctors as 'shambolic'

September 19, 2013
Sue Dunlevy National Health Correspondent
AUSTRALIA'S billion-dollar e-health system is in danger of becoming an expensive white elephant with doctors refusing to use it.
A key clinical adviser to the government who quit in frustration last month has described the system as "shambolic".
And the medical software industry says the body running the system, the National E-Health Transition Authority, lacks the skills to do the job and warns patient safety could be at risk.
Dr Mukesh Haikerwal who resigned in frustration from work on the e-health record says he's uploaded 150 patient records on to the system but "no-one can read it".
Patients who want a hospital or specialist to see their e-health record have to take their own ipad to the consultation to show the record because hospitals and specialists don't have the software to read it.
Fifteen months after e-health was launched - 888,825 Australians have signed up for an e-health record but by last month doctors had loaded only 5427 health summaries on to the system.
Only hospitals in the ACT and South Australia can currently access the record, although more are scheduled to come on board next month.
Some of the medication records loaded on to the record by the government are wrong and Dr Haikerwal says this could have grave consequences for patients who could be misdiagnosed.
The AMA says doctors or hospitals trying to use the records have less than a 0.5 per cent chance of finding anything clinically relevant.
Last month, four of the clinicians advising the government quit in frustration.
The mounting problems with the system come as it emerged that the cost of Britain's failed e-health system has reached 10 billion pounds.
However, a spokeswoman for the Department of Health said it was wrong to compare Australia's e-health record with Britain's which managed the entire stay for every patient seen or admitted to hospital all the way to their billing system.
Health Minister Peter Dutton who was sworn in on Wednesday has pledged to undertake a "comprehensive assessment" of Australia's e-health record.
Lots more here:
Third we have this.

I’m still an advocate for PCEHR: Haikerwal

19th Sep 2013
DR MUKESH Haikerwal remains an advocate for the government’s personally controlled e-health records (PCEHR) system despite serious concerns about the accuracy of clinical records and the system’s useability.
Dr Haikerwal, who recently quit his post as NEHTA’s chief clinical lead, told MO the system was still “some time off” being a reliable, useful and widely accessible resource for doctors, and there remained much to be gained from the work already completed.
“We all know there are issues with the program and project that need to be fixed up but the positive side is that there is something to be worked from and built on,” he said.
“There is stuff out there now that exists because of the work that has been done over the years. It just has to be in a format that is useful for clinicians.”
His comments followed News Limited reports that quoted him labelling the PCEHR as a “shambolic” system containing potentially incorrect patient medication histories.
He told MO that in at least one case a patient had been given the medication record of another patient sharing the same name.
A GP could conceivably see someone with a PCEHR that said they were taking something like olanzapine (Zyprexa) and say, ‘oh, you have schizophrenia, are you taking these tablets?’ Dr Haikerwal said.
If they did not have schizophrenia then the GP may unnecessarily upset them or give them a medication they don’t need, which is not a good thing, he added.
Dr Haikerwal said there was much work to be done to support and reassure doctors to get them to embrace the PCEHR.
Lots more here:
Last we have this:

National e-health still has a future despite problems: CIOs

Under fire national program lacking the right policy framework for broad adoption
Technology heads in the healthcare sector continue to back the federal government’s controversial and slow moving national e-health record program, saying it has a future despite lacking the critical mass it needs to succeed.
As of July 31, 612,391 Australians had registered for an e-health record, according to a recent National E-Health Transition Authority (NEHTA) report. A further 4500 organisations had registered in the personally controlled e-health record (PCEHR) system and 4585 shared health summaries had been uploaded as of 22 May.
The scheme has come under fire in recent months. In July, Australian Doctor polled 514 general practitioners with two-thirds indicating they will not take part. Earlier this week, a man was accidentally sent another person’s e-health details.
Meanwhile, industry has called for the Abbott government to fix the troubled system. Before he was elected on September 7, Tony Abbott vowed he would seek a review of the struggling e-health program.
Mal Thatcher, CIO at Mater Hospital, said the scheme has not yet reached the critical mass it needs to succeed and is lacking the right policy framework for broad adoption.
“That includes the need for strong ongoing engagement with the entire health ecosystem whether by NEHTA or the current system operator in DoHA. Unfortunately, in my experience at least, engagement has not been nearly effective enough.”
Thatcher also said access to and use of the PCEHR has to be “symbiotic” with clinical practice and electronic medical record systems to convince clinicians that it’s worthwhile. He added that clinicians need to trust the quality and currency of the data and industry needs to articulate a tipping point for adoption.
Bill Vargas, CIO at the Sydney Children’s Hospitals Network, told CIO clincians' time is fairly precious given their heavy workload, so they have to convinced that using these systems will give them benefits as well as for the patient.
Vargas believed that more than half the population and health organisations have to be using the national system for it to reach critical mass.
“This will ensure that information gives a holistic picture of a person’s health record and makes it useful for the ongoing care of the patient.”
Despite some doctors baulking at the system or indicating they will not take part, Vargas believes consumers will drive uptake as they will request that their doctor is connected and contributes to their e-health record.
“In discussion with consumers, in particular parents of young children, they have an expectation that this will occur in the future or else they will seek doctors who are connected to e-health,” said Vargas.
Vargas said the benefits of sharing appropriate and concise clinical information between treating clinicians for the benefit of the patient should “no longer be an argument.”
“The potential reduction in clinician incidents by having information about current medications, allergies, diagnostic results or medical conditions would be a great benefit to the patient and the health system,” said Vargas.
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When taken as a whole it seems to me a few things emerge pretty clearly - other than some of the headlines not quite reflecting what the articles are saying.
First there does not seem to be a single commentator who is of the belief that the status quo is even alright - let alone ideal.
Second there is a pretty strong view that without major changes in the system and a great deal of work to reshape the NEHRS / PCEHR to be both valuable to / and supportive of clinicians getting their work done it will fail.
Third there seems to be a view that adoption will be driven by consumers. I suspect this is not correct as in its present incarnation the system does not do what patients most value (appointment making, repeat scripts, secure messaging to their doctor etc.)
Fourth there is a pretty clear recognition that the way the Program has been led and delivered has been ill-conceived and not clinician friendly.
What is missing is any real clarity as to what should and needs to be done to address the problems as they have been articulated.
I have my own ideas (which I have rabbited on endlessly about) - but would be very interested to hear just what people believe should be the actual outcomes of the promised review of the whole effort.
Over to you. I look forward to some new ideas on the way forward that can snatch victory from the jaws of defeat!
David.

AusHealthIT Poll Number 184 – Results – 22nd September, 2013.

The question was:

Will The SA Health EPAS Project Struggle When Attempting To Implement In The Large Adelaide Teaching Hospitals?


No Way 5% (2)

Probably Not 5% (2)

Possibly 22% (9)

Yes, It Will Be Hard 49% (20)

I Have No Idea 20% (8)

Total votes: 41

This is a pretty unclear outcome. But it seems a large number recognise there is a real risk here, and a surprising number are without a view.

Again, many thanks to those that voted!

David.