Australian Telehealth Gets A Couple Of Discussions and Reviews. Well Worth A Browse.

This appeared a just few days ago.

How new technology is changing access to health care in Australia

• November 24, 2013 12:00AM

FROM a smartphone app that scans your vital signs to doctors treating their far distant patients through "face time" on their tablets or computers, technology is changing the way thousands of Australians access health care.

General Practitioner Ashley Collins is stationed more than 1000 kilometres from his patient but he can get a blood pressure reading without laying a hand on the company director.

Using a video link and a portable machine owned by the patient he can measure blood glucose, pulse rate, body temperature, cholesterol and even get an ECG measurement.

When he's completed his diagnosis he faxes a script to the chemist nearest his patient.

Dr Collins, from Temorah in central western NSW, uses a specialised computer to deliver this care but from next year he says patients will be able to do this from their mobile phone.

Already there are new devices including ultrasounds, ECG monitors, mirocroscopes and dermatascopes that can view skin cancers and blood pressure monitors that can be plugged into a smartphone.

A picture of an inner ear or throat taken on a smart phone can help a doctor diagnose and infection.

One app even allows you to scan your vital signs just by placing the phone on your forehead to measure heart rate, and body temperature.

Telemedicine Australia GP Dr Collins is part of a network of 15 general practitioners and 270 specialists providing telemedicine to thousands of patients around Australia.

There is no Medicare rebate for the GP service he provides at a cost of $50 a session, a problem he thinks Medicare and health funds should remedy.

Lots more here:

http://www.news.com.au/technology/how-new-technology-is-changing-access-to-health-care-in-australia/story-e6frfrnr-1226766888253

Second I noticed this a few days ago.

Telehealth: The healthcare and aged care revolution that can pay for the whole NBN

Nick Ross ABC Technology and Games Updated 20 Sep 2013 (First posted 19 Sep 2013)

Australia will spend over $10 trillion on healthcare over the next thirty years - much of it on aged care. If the new NBN-related health applications make a tiny dent in that figure, they would pay for the whole NBN. And revolutionise healthcare for all.

In the toxic fact-free zone that represents the bulk of National Broadband Network discussion, most people would be shocked to know that the NBN is likely worth building for the healthcare benefits alone - especially for the old and infirm. And the NBN doesn't just offer a healthcare revolution, it's likely to save tax payers billions of dollars every year. Most important of all, however, is the notion that these new-generation 'Telehealthcare' applications are only viable using the current Fibre to the Home broadband policy and not the Coalition's alternative. Could it be that convalescing old ladies, who have never used a computer in their lives, are the pin-up girls for fibre-based broadband?

Meaningless phrases and numbers

Many people are sick of hearing nebulous terms like 'superfast broadband' and jargon like 'jigabits per second' and 'download speeds.'

Telehealthcare ignores all of that and treats the NBN like the infrastructure that it is - a network which provides a medical-grade, reliable connection to each home and a complete standardisation of equipment - i.e. 'one box and one interface for everyone' - instead of the hotchpotch, 'every-situation-is-different' situation that we have today.

Why is this important?

Australia's ballooning health spend

According to the Australian Institute of Health and Welfare, the country spent over $121bn on healthcare between 2009-10. The following year it surpassed $130bn and it's been rising at six per cent each year - twice the growth rate of GDP.

Healthcare expenditure currently makes up 10 per cent of GDP but analysts Mark Dougan from Frost and Sullivan says that, "At the current rate, in perhaps about ten years or so, it will hit 15 per cent of GDP - mostly from public sources." He points out that this growth rate is "unsustainable."

According to South Australia Health's October 2012 report:

At the time we released the 2007 South Australian Health Care Plan, if SA Health had continued spending at the same rate, then by 2032 the entire State budget will be consumed by Health alone. Our efforts to reduce growth in demand has now pushed this back to 2038. Slowing the growth in demand, however, must be accompanied by providing more efficient services in order to deliver a balanced budget...

Peter Croft from Allocate (healthcare) Software adds, "Most State governments have identified a point in the future where the growth in funding for health is going to consume the entire state budget."

The problem is that improvements have to come from efficiency gains and not spending cuts. As Stephen Duckett and Cassie McGannon said recently in The Conversation:

Reducing health spending growth will not be easy. As Grattan's Game-changers report last year showed, Australia already has one of the OECD's most efficient health systems, in terms of life expectancy achieved for dollars spent. Sweeping cuts to health funding, or shifting costs to consumers, could have serious consequences. Blunt cost-cutting risks reducing health and well-being, and could ultimately lead to higher government costs due to illness, increased health-care needs and lower workforce participation.

What do we spend the money on?

The Australian Institute of Health and Welfare published the following:

On an average day in Australia...

• 342,000 people visit a GP
• 6,800 people are transported by ambulance; a further 900 are treated but not transported
• 71,000 km are flown by the Royal Flying Doctor Service and 107 evacuations performed
• 23,000 people are admitted to hospital (including 5,000 for an elective surgery)
• 17,000 people visit an emergency department at larger public hospitals

So how much does do these things cost?

Pages and pages more here:

http://www.abc.net.au/technology/articles/2013/09/19/3852140.htm

Both these article describe some good things that are happening now which seems rather better than we are presently getting now from the PCEHR for a great deal less money!

The second article contains many examples and a discussion of where the NBN fits in the telehealth story in considerable detail.

Definitely one for the files.

David.

Seems E-Health Got A Run In Question Time Today. A Liberal Dorothy Dixer No Less.

This just popped up on my feed.

Annabel Crabb ‏@annabelcrabb 6m

Zero! says Health Minister Peter Dutton. Because the previous Government forgot to organise it!

Annabel Crabb ‏@annabelcrabb 7m

How many constituents in Deakin would be able to turn up at emergency and have their e-records available? was the question.

Annabel Crabb ‏@annabelcrabb 8m

Question to Peter Dutton on how the whole e-health thing is working out.

Now I wouldn’t like to be reading tea-leaves but it is hard not to wonder what the PCEHR Review has been telling him. The question was from a Liberal Member and was clearly to give Mr Dutton an opportunity to comment on the PCEHR.

Make of that what you will.

David.

The AIIA Is Worried That The Gravy Train May Be Ending With Respect To The PCEHR.

The Aust. Information Industry Association’s (AIIA) Submission for the PCEHR Review is now available.

Here is the link.

http://c.ymcdn.com/sites/www.aiia.com.au/resource/collection/F22C309D-816A-467D-9A09-473D98C7F3A2/13122PCEHRresponseAIIAFinal.pdf

The summary is short and sweet.

OVERVIEW

AIIA strongly supports the advancement of Australia’s ehealth agenda. In this context we support the  development of an electronic health record that consumers can use to share their health related  information with relevant clinicians across the health sector.

Noting the considerable investment that has already been committed to building the PCEHR the AIIA  supports this important asset to drive achievement of Australia’s ehealth objectives and quality healthcare outcomes.

AIIA strongly encourages the Government to leverage this critical infrastructure in the pursuit of a more efficient, effective and patient centric healthcare system. We do not support any consideration that investment into PCEHR be abandoned. Rather we strongly believe there is scope to open the system to innovation and mainstream third party applications (products and services) of value to clinicians and patients. In this regard we believe the ICT industry has a key role in realizing the return on the PCEHR investment

----- End summary

There are then a good few pages of comments on what has gone wrong, which are pretty interesting and identify many issues.

The additional comments are relevant as well:

Additional comments

We would also make the following additional comments.

Concerns have also been raised in relation to:

·         Inadequate project management disciplines to support execution of the project.

·         The complexity of relationships between DOHA, NEHTA and conformance and compliance arrangements (e.g. the CCAGG) has also resulted in a lack of transparency and clear accountability. This also needs to be addressed

·         The role and authority of the Independent Advisory Committee (IAC) has been ambiguous and while industry has been pleased to be involved, it has been unclear how the IAC has contributed to the PCEHR implementation process.

-----

All one can say about all this is that there are a huge governance issues that remain unaddressed.

The recommendations at the end are as follows.

Suggested improvements to accelerate adoption of the platform

As noted in the Overview to this submission, AIIA strongly supports the need to advance a digitally  driven ehealth agenda, including the implementation of an electronic health record. This is imperative to keep pace with global ehealth developments and essential to ensuring the competiveness and sustainability of the Australian health system against the imperative of our demographics.

On this basis  AIIA supports the ongoing development of the PCEHR but makes the following suggestions to drive the content and usability necessary to make it a valued product/service for clinicians and patients.

1. Improve the value of information in the PCEHR.

This will require a health care industry wide focus

on tackling high priority information domains such as medications management, shared health  summaries, pathology, diagnostic imaging , specialist letters and discha rge summaries.

2. To drive consumer take up transition the PCEHR to an opt-out scheme.

This needs to be done at an  appropriate time when the underlying PCEHR solutions and information content are at a reasonable  level of maturity.

In the meantime continued effort is necessary to target take up by key and high use cohorts (e.g. aged, chronically diseased, newborns, indigenous). Simplification of the registration process is also strongly advised.

3. Drive increased clinical use of the PCEHR, through a combination of improved system usability and content and by adjusting other longer term levers such as linking clinical accreditation to the use of electronic health records.

4. Improve the quality, usability and scope  of clinical and consumer technology applications.

This  requires

•  Addressing the cost and red tape associated with external developers linking applications to the PCEHR infrastructure
•  Opening up repository based solutions
• Development of consumer portals to facilitate streamlined integration with PCEHR compliant solutions.

5. Implement a properly considered and sustainable commercial model for key stakeholders involved in the scheme (including government, clinicians and the IT industry).

This is necessary to stimulate innovation and drive sustainable IT investment in the national ehealth agenda.

• Opening up the PCEHR platform will allow third parties to create many different provider and consumer portals across different platforms (smartphones. Tablets, smart TVs’ T-Box, X-Box etc). The official PCEHR provider and consumer portals are obstacles to wider adoption because there cannot be a one size fits all approach to a user interface. Enabling  mobile  based front - end solutions that are distributed through traditional app stores also offers a mechanism for software developers to be remunerated for their innovation.

Opening up the presentation layer and allowing innovative new front end and specialised interfaces to be created will drive innovation, improve usability and increase adoption by clinicians and consumers.

6. Implement more representative and transparent governance of the PCEHR (and national ehealth)  program, including greater industry, clinical and  consumer representation on key governance  forums and more effective engagement of jurisdictions to support  implementation of the program  at scale.

7. Implement a formal , transparent and authoritative change management  process that is developed and executed with industry involvement.

8. Clarify the role and authority of the Independent Advisory Committee (IAC) specifically in terms of how it contributes to the PCEHR  roll out and future development.

9. Strengthen key project management  and communication  disciplines.

In addition to the above suggestions we reiterate  the need to maintain and enhance PCEHR information  exchange foundations (as noted in the body of this submission)

----- End Submission.

So what the AIIA is saying is the PCEHR is a badly governed, unloved dog, needs a lot of fixing but we should continue on. I wonder who would really want that to happen? (Hint - maybe the Big End of the IT Town who can provide all the services!)

Or am I just too cynical?

David.

Australian College of Rural And Remote Medicine Comments On The PCEHR. Very Interesting Indeed.

This submission was released a few days ago.
Here is the link:
https://www.acrrm.org.au/files/uploads/PCEHR%20Submission%2022.11.13.pdf
Here is the summary:

Summary of ACRRM position on eHealth

ACRRM supports the introduction of Shared Electronic Health Records as a strategy to address the current fragmentation of medical information spread across different locations and providers. This is especially important for rural and remote patients, who are often required to travel to access specialist services, and who are most likely to be transferred away from their local community in the event of a medical emergency or serious illness.

Two new health reports released this week – General practice activity in Australia 2012-13 and A decade of Australian general practice 2002-03 to 2012-13 – confirm the key role of GPs as leaders in primary care in Australia and the preferred first port of call for Australians. GPs must be engaged as a critical player in any ehealth reform. Rural and remote GPs must be specifically supported. It is this group who are faced with the most severe workforce shortages, have the highest patient to doctor ratios and are the most time poor.

The emphasis on the role of the GP in ehealth is appropriate; however more consideration of the role of consultant specialists, nurses, Aboriginal health workers and allied health professionals in their use of electronic records is needed.

General Practitioners strive to provide safe, effective and high quality care within the constraints of a patient consultation. The clinical source of ‘truth’ for patient information today is the patient’s notes, that are either on paper (rare in General Practice now, but still the norm in consultant specialist practice) or in the clinician’s own clinical information system (CIS) or a combination of both.

Currently, the PCEHR is a designed as a tool to share information among providers as determined by the patient. The patient controls what information is shared and which clinicians have access to the information.

When the patient receives care from a range of providers, having access to a tool that provides all the relevant patient information in a concise and reliable format, to all clinicians responsible for the care of that patient, ultimately benefits the patient and the healthcare providers.

This is especially important for rural GPs who provide ongoing care in the (physical) absence of specialists, but often supported with specialist advice via telephone or more recently telehealth arrangements.

EHealth needs to support the sharing of relevant clinical information to relevant healthcare providers responsible for the care of the patient. If this cannot be done in a patient controlled repository then another repository or redesign of the existing solution should be considered.

ACRRM considers that shared electronic health records and the use of secure messaging should be the cornerstone of team based care – which in regional rural and remote areas can be facilitated and optimised via telehealth arrangements. Referral, shared care and handover of patient care can be meaningfully supported by electronic clinical documents, including:

•          Referrals and specialist letter (including versions for telehealth purposes),
•          Hospital discharge summaries,
•          Aged Care transfer documentation,
•          Pathology orders and results,
•          Diagnostic imaging orders, results and images and
•         Prescription and supply of medications (including dispensed medicines) and home medication reviews.

ACRRM considers that there has been reasonable progress in the implementation of a number of foundations to support eHealth nationally. But in recent years there has arguably been an overemphasis on the implementation of the PCEHR at the expense of the broader roll out of the eHealth foundations.

This gap in functionality and red tape being experienced with the implementation of the eHealth foundations needs to be remedied before further investment is made in the national sharing of electronic patient medical records.

ACRRM recommends investment in national infrastructure including a simplified National Authentication system. The College recommends that success is rewarded, and that meaningful use is incentivised. Strengthen investment in clinical information systems (Specialist, GP, Diagnostic Services, Allied Health, Aged Care and Hospital)

Incentivise specialist uptake of eHealth records and continued support of standardised secure messaging and clinical information exchange between care providers.

ACRRM recommends an overhaul of eHealth governance and leadership arrangements to improve transparency, accountability, consultation, strategic development, and implementation. Apply a standards based approach, involve ACRRM and industry and focus on meeting clinical needs, streamlining care and facilitating shared care and handover of care.

----- End summary.

I was very pleased to note how close the recommendations matched my six key points. Even the choice of words is close!

Submission From Dr David G More To PCEHR Review - November 2013

Summary Recommended Way Forward.

1. Major overhaul of leadership and governance of the e-health program to improve strategy, direction setting, standards setting, stakeholder engagement and consultation and transparency.

2. Investment in Clinical Systems (GP, Specialist, Diagnostic, Allied, Aged Care and Hospital) to be strengthened with continued support of  standardised Clinical Messaging and Clinical Information Exchange between care providers. Emphasis on private sector provision where appropriate

3. Continued support of national e-Health Infrastructure (IHI, Terminology, SMD etc.) under the governance cited in Point 1.

4. Competitive development of standards compliant regional health information exchanges to optimise information flows and access for clinicians.

5. Support for voluntary patient access and engagement with clinician systems to facilitate patient / clinician communication, information sharing and co-operation. 

6. Progressive rapid phase out of the current PCEHR as points 2 to 5 are realised. This should happen as quickly as possible given the patient safety risks associated with data quality, incompleteness etc.

----- End quote.

To me what they are saying is that the basics are not yet anywhere near good enough and that is the priority. Could not agree more.

I was really pleased to see the leadership and governance issues get a big emphasis.

I guess it was probably a big ask to hope for a ‘shut it down’ recommendation

All in all a good read.

David.

Just So You Know Where Your E-Health Dollar Is Going! Amazing....

Astonishing stuff for a totally discredited plan. Remember this expenditure is going on under the Coalition as they are reviewing things. Seen in a Canberra coffee shop in the last 2 weeks!

Surely this might have been paused until decisions were made?

David.

Weekly Australian Health IT Links – 2nd December, 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 one issue this week - reading the views of others on the PCEHR.

It now seems the Enquiry might take a little longer than expected - and just squeak in before the end of the year - when there is just no news happening.

I do hope we get some sort of outcome before the New Year rolls round….

The top entry below has a great set links to all the responses we have found.

-----

http://www.healthbase.info/pcehr/page27/page27.html

Personally Controlled Electronic Health Record

On 3rd November 2013, newly appointed Commonwealth Health Minister Peter Dutton announced a review of the PCEHR, appointing a 3 member panel headed by Richard Royle Executive Director of the UnitingCare Health group in Queensland and assisted by Dr Steve Hambleton, President Australian Medical Association and Andrew Walduck, Chief Information Officer of Australia Post. An invitation for submissions was sent on 12th November to individuals and organisations who had made prior submissions to PCEHR design or legislation inquiries. The invitees were asked to focus on the following areas:-

• The gaps between the expectations of users and what has been delivered
• The level of consultation with end users during the development phase T
• he level of use of the PCEHR by health care professions in clinical settings
• Barriers to increasing usage in clinical settings
• Key clinician and patient usability issues
• Work that is still required including new functions that improve the value proposition for clinicians and patients
• Drivers and incentives to increase usage for both industry and health care professionals
• The applicability and potential integration of comparable private sector products
• The future role of the private sector in providing solutions
• The policy settings required to generate private sector solutions

A number of submissions to the PCEHR Review have been publicly released through other channels, and some of those links are collated here.

-----

http://www.medicalobserver.com.au/news/doctors-accused-of-secretive-ehealth-control

Doctors accused of secretive e-health control

27th Nov 2013

Andrew Bracey

A STOUSH has erupted over the level of control doctors should have over personally controlled e-health records (PCEHR) with the AMA accused of taking a “secret doctors' business” approach to patient data.

The accusation, from the Consumers Health Forum of Australia (CHF), followed the release of the AMA’s submission to the review of the billion dollar program being carried out at the request of Health Minister Peter Dutton.

AMA president Dr Steve Hambleton is involved in the review, which is due to report to Mr Dutton in mid-December.

In its submission to the review, the AMA criticised the level of patient control over information in the record arguing that “patient control of health information presents practical clinical limitations for the treatment of the patient, even for the most skilled medical practitioner”.

-----

http://www.racgp.org.au/yourracgp/news/reports/201311pcehrreview/

Reports, submissions and outcomes

RACGP submission to personally controlled electronic health record review panel

27 November 2013

The Royal Australian College of General Practitioners (RACGP) has provided input to the personally controlled electronic health record (PCEHR) review panel on the issues impacting general practice and GP’s use of the PCEHR. Representing the vast majority of Australia’s general practice profession with over 23 600 members working in or towards a career in general practice, the RACGP is in the optimum position to deliver input to government and other stakeholders on what the RACGP sees as a project that has the potential to affect the delivery of primary healthcare across Australia.

-----

http://theconversation.com/electronic-health-records-review-set-to-ignore-consumer-interests-20563

28 November 2013, 2.47pm AEST

Electronic health records review set to ignore consumer interests

Merle Spriggs

Research Fellow at the Children's Bioethics Centre at the University of Melbourne and at Murdoch Childrens Research Institute

Disclosure Statement

Merle Spriggs has conducted research funded by the Institute for a Broadband-Enabled Society (IBES), University of Melbourne. In 2010 and 2011, she has had travel and accommodation paid for on her behalf by the National E-Health Transition Authority (NEHTA) to attend round table discussions on the Personally Controlled Electronic Health Record (PCEHR).

The rollout of the Australia’s Personally Controlled Electronic Health Record (PCEHR) has encountered various problems since its inception. But it all got worse when the new health minister, Peter Dutton, recently ordered a review of the project. Unfortunately, it seems consumer interests may be neglected in the inquiry.

The PCEHR contains a summary of your health information such as diagnoses, allergies and medications. It’s expected to improve health outcomes, save time and money, reduce medical errors, and allow people to be more involved in their own care.

Whether you choose to have a record is up to you, as is what goes into it, and who can access it. This secure online record, according to the eHealth website, can be shared with your doctors, hospitals and other health-care providers “to provide you with the best possible care”.

-----

http://coiera.com/2013/11/29/submission-to-the-pcehr-review-committee-2013/

Submission to the PCEHR Review Committee 2013

November 29, 2013

Professor Enrico Coiera, Director Centre for Health Informatics, Australian Institute of Health Innovation, UNSW

Date: 21 November 2013

The Clinical Safety of the Personally Controlled Electronic Health Record (PCEHR)

This submission comments on the consultations during PCEHR development, barriers to clinician and patient uptake and utility, and makes suggestions to accelerate adoption. The lens for these comments is patient safety.

The PCEHR like any healthcare technology may do good or harm. Correct information at a crucial moment may improve care. Misleading, missing or incorrect information may lead to mistakes and harm. There is clear evidence nationally and internationally that health IT can cause such harm [1-5].

-----

http://www.theaustralian.com.au/technology/forum-slams-doctor-pcehr-e-health-record-control/story-e6frgakx-1226769779430

Forum slams doctor PCEHR e-health record control

• Fran Foo
• The Australian
• November 27, 2013 3:57PM

THE Consumers Health Forum has slammed the Australian Medical Association's proposal for full doctor control over e-health records but backed calls for the system to be opt-out.

The AMA yesterday said that the information held in the $1 billion personally controlled e-health record system couldn't be trusted as patients, not clinicians, had control over their data.

In its submission to the PCEHR review, the peak health body said that if the PCEHR was an opt-out service, it would boost consumer participation.

But according to CHF spokesman Mark Metherell, the AMA's demands to drop patient control was "a refusal to accept that the world has moved on from the 'secret doctors' business" of paper-based records that patients rarely see".

-----

http://www.hisa.org.au/news/148479/HISA--HIMAA-release-their-joint-submission-to-the-PCEHR-inquiry.htm

HISA & HIMAA release their joint submission to the PCEHR inquiry

Wednesday, 27 November 2013  

Posted by: Sam Bruinewoud

Representatives of HISA and HIMAA recently submitted their report to the PCEHR inquiry. The report is based on the responses of e-health professionals in the extended networks of the two organisations to a survey they co-created.

HISA and HIMAA wish to extend our appreciation and acknowledgement to the 673 individuals who contributed to this survey.

(Thanks also to the 4 people who are primarily responsible for all this question writing and analysis work; you know who you are – you rock!)

The report is now available to view here on our website.

-----

http://www.theaustralian.com.au/technology/make-health-record-system-opt-out-says-ama/story-e6frgakx-1226769258128

Make health record system 'opt-out', says AMA

• Fran Foo
• The Australian
• November 27, 2013 8:53AM

CLINICIANS cannot trust the information held in the $1 billion national e-health record system as patients are able to amend their own data, Australia's peak health body says.

The Australian Medical Association said the personally controlled e-health record system should be an opt-out -- not opt-in -- service to boost consumer participation.

It said the personally controlled aspect of the e-health record system was a double-edged sword.

"The AMA supports individuals taking responsibility for their own health and recognises that personally controlled electronic health records could empower and encourage patients to do this," the AMA said in its submission to the government's PCEHR review.

-----

https://ama.com.au/media/too-much-personal-control-reduces-effectiveness-pcehr

Too much personal control reduces the effectiveness of the PCEHR

26/11/2013

AMA Vice President, Professor Geoffrey Dobb, said today that the overriding emphasis on ‘personal control’ of the Personally Controlled Electronic Health Record (PCEHR) has stalled its implementation.

The AMA’s views on the way forward for the PCEHR are detailed in its submission to the Federal Government’s Review of the PCEHR, released today.

Professor Dobb said that there should have been equal emphasis on clinical utility in the development of the PCEHR.

-----

http://www.racgp.org.au/yourracgp/news/fridayfacts/29-11-2013/

Fridayfacts newsletter: 29 November 2013

RACGP’s submission to PCEHR review panel

In its submission to the Personally controlled electronic health record (PCEHR) review panel, the RACGP has called for the adoption of 10 key recommendations it believes will better facilitate the development and adoption of the PCEHR into clinical practice. The submission, written in response to the Federal Government’s call to review the PCEHR after it came under fierce public and professional scrutiny, highlights the issues impacting general practice and GPs’ use of the current PCEHR system. The RACGP has always believed that improved accuracy, availability and timeliness of communication will lead to better health outcomes. Whilst the PCEHR has held this promise, its success is dependent on appropriate clinical input at all stages of development to ensure it is fit for purpose

-----

http://www.nehta.gov.au/media-centre/nehta-publications/guides/519-ehealth-clinicians-user-guide

eHealth Clinicians User Guide

This eHealth Clinicians User Guide includes material that is relevant to both general practices and private specialist practices, however other healthcare professionals, e.g. allied health and in aged and community care, may also find this guide useful.

The eHealth Clinicians User Guide supports medical practices in navigating the complexities of eHealth (including the national eHealth record system) from planning, preparation, registration and implementation through to meaningful use. It covers key eHealth topics of interest to medical practices (including quality improvement) and focuses on the foundation products (e.g. Healthcare Identifiers, NASH, Secure Message Delivery), the national eHealth record system and other functionality currently available and being released by software vendors. Importantly it includes practical step-by-step implementation advice.

-----

http://www.hisa.org.au/news/148487/A-new-evaluation-activity-from-ACHI-PES.htm

A new evaluation activity from ACHI PES

Wednesday, 27 November 2013

Posted by: Sam Bruinewoud

A request from Dr Chris Bain

Subject: ACHI Program Evaluation Subcommittee - Biannual Evidence Review

ACHI PES have recently announced a biannual HI evidence review.

The first one will be on "Patient accessible healthcare records”

To contribute to this review they are seeking articles (or links to them) that demonstrate:

· high quality research

· interesting methodologies or

· interesting / useful outcomes

from amongst the peer reviewed and grey literature on the specific topic of "Patient accessible healthcare records”

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http://www.zdnet.com/poor-data-and-systems-hamper-health-service-delivery-7000023542/

Poor data and systems hamper health service delivery

Summary: Disjointed and outdated systems, poor data quality and project failures are hampering health initiatives in New Zealand.

By Rob O’Neill | November 24, 2013 -- 20:19 GMT (07:19 AEST)

Efforts to boost collaboration across regional health authorities in New Zealand have been stymied by a lack of robust data and poor information technology, the Auditor-General has found.

A new audit report (pdf) has found a “widespread awareness” of issues of data quality in the sector leading to a lack of confidence in the data available.

A lack of robust data leads to imprecision and inaccuracy, the report says. This, in turn, can lead to false assumptions, followed by poor decision-making.

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http://www.computerworld.com.au/article/532833/australian_privacy_commissioner_won_t_taking_softly_softly_approach_privacy_reforms/

Australian Privacy Commissioner won’t be taking “softly, softly approach” with privacy reforms

Timothy Pilgrim will be able to seek civil penalties of up to $1.7 million for companies if there is a serious breach of privacy

• Hamish Barwick (Computerworld)
• 26 November, 2013 11:34

Australian Privacy Commissioner Timothy Pilgrim has warned enterprises and government agencies that he won’t be taking a “softly, softly approach” to privacy investigations when his new powers come into effect on 12 March 2014.

Under the Privacy Amendment (Enhancing Privacy Protection) Bill 2012 which was passed by Parliament in November 2012, Pilgrim will be able to seek civil penalties of up to $340,000 for individuals or up to $1.7 million for companies in the case of a serious breach of privacy.

Speaking at the iaapANZ Privacy Summit in Sydney this week, Pilgrim said he had been asked by people if he will take a cautious approach after implementation of the privacy reforms.

“I have never been known to be subtle so the answer to that question is probably no,” Pilgrim said.

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http://www.smh.com.au/digital-life/digital-life-news/medical-examinations-used-to-access-your-private-information-20131126-2y7t9.html

Medical examinations used to access your private information

Date November 27, 2013

Leanne Nicholson

Under the Privacy Act's Information Privacy Principles you must be told why your personal information is being collected and whether it can be given to anyone else.

Private information of thousands of Australian jobseekers harvested through medical examinations and stored for profit has raised legal and applicant concerns about the protection and use of personal data.

Australia's largest publicly-listed health and risk management provider, Konekt, has collected the personal data of jobseekers since 2007 through medical examinations on behalf of private companies and government agencies as part of employment selection processes.

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http://www.medicalobserver.com.au/news/labor-spent-4m-on-ml-ad-blitz-in-last-days-of-power

Labor spent $4m on ML ad blitz in last days of power

25th Nov 2013

Byron Kaye

THE Department of Health and Ageing spent $4 million advertising Medicare Locals and e-health in the last month of the Labor government, a Senate hearing has been told.

The expenditure, which averages more than $100,000 a day, was revealed in a Senate estimates hearing last week as new health minister Peter Dutton prepared sweeping reviews of both Labor-led initiatives.

The $10 million, two-year publicity blitz was first revealed in the May budget as Labor contemplated electoral wipeout amid consistently poor polling.

Asked last week how much of that money had already been spent, department communications boss Adam Davey told a Senate estimates hearing it had spent $4,066,393 in the 2013—14 financial year. He confirmed the money was spent between 1 July and the start of the election campaign on 6 August, when the government went into caretaker mode, a period of 37 days. Most of the money, $3,678,758, was spent placing advertisements in media.

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http://www.smh.com.au/it-pro/government-it/confidential-briefing-nbn-unlikely-to-meet-coalitions-deadline-20131128-hv3tp.html

Confidential briefing: NBN unlikely to meet Coalition's deadline

Date November 29, 2013 - 12:01AM

David Braue

Exclusive

The Coalition’s national broadband network model will prove inadequate for many businesses, is poorly planned and is unlikely to be completed on time, according to NBN Co’s internal analysis for the incoming Abbott government.

Obtained by Fairfax Media, the analysis casts doubts over the timing and cost-effectiveness of the government’s proposed fibre-to-the-node model, highlighting numerous legislative, construction and technical challenges likely to blow out the Coalition’s 2016 and 2019 delivery deadlines.

The draft document also slashes revenue projections important for the project’s commercial viability by up to 30 per cent by 2021.

Under the Coalition policy, fibre optic cables would be installed to nodes, or street cabinets. From there, existing copper wires would complete the connection to homes and businesses.

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http://www.smh.com.au/it-pro/government-it/ziggy-switkowski-warns-of-more-nbn-cost-blowouts-as-services-of-the-future-in-doubt-20131129-hv3wv.html

Ziggy Switkowski warns of more NBN cost blowouts as services of the future in doubt

Date November 29, 2013 - 10:12PM

David Braue

The chairman of the national broadband network has warned of further cost blowouts in rolling out fibre-optic cables throughout the country, while an NBN Co analysis warns the Coalition’s ‘‘cheaper, sooner’’ network would strip up to $1.8 billion from its projected revenues.

New details of the draft document prepared by the NBN Co for the incoming government also reveal the slower transmission speed under the new model would compromise the provision of telehealth, distance education, internet TV and other business applications.

NBN Co executive chairman Ziggy Switkowski told a Senate hearing on Friday the Coalition’s $20.4 billion costing for the project could be proved wrong.

 ‘‘When you go out into the field, you talk to contractors, you look at the stats around how the work is being done, [it] confirms that the costs are higher than people had hoped they would be,’’ he said.

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Enjoy!

David.