This Is A Very Useful Update On What Works (Or Not) With E-Health. Must Read Material.

This popped up a little while ago:

Health Information Technology: An Updated Systematic Review With a Focus on Meaningful Use

Spencer S. Jones, PhD; Robert S. Rudin, PhD; Tanja Perry, BHM; and Paul G. Shekelle, MD, PhD

Abstract

Background: Incentives offered by the U.S. government have spurred marked increases in use of health information technology (IT).

Purpose: To update previous reviews and examine recent evidence that relates health IT functionalities prescribed in meaningful use regulations to key aspects of health care.

Data Sources: English-language articles in PubMed from January 2010 to August 2013.

Study Selection: 236 studies, including pre–post and time-series designs and clinical trials that related the use of health IT to quality, safety, or efficiency.

Data Extraction: Two independent reviewers extracted data on functionality, study outcomes, and context.

Data Synthesis: Fifty-seven percent of the 236 studies evaluated clinical decision support and computerized provider order entry, whereas other meaningful use functionalities were rarely evaluated. Fifty-six percent of studies reported uniformly positive results, and an additional 21% reported mixed-positive effects. Reporting of context and implementation details was poor, and 61% of studies did not report any contextual details beyond basic information.

Limitation: Potential for publication bias, and evaluated health IT systems and outcomes were heterogeneous and incompletely described.

Conclusion: Strong evidence supports the use of clinical decision support and computerized provider order entry. However, insufficient reporting of implementation and context of use makes it impossible to determine why some health IT implementations are successful and others are not. The most important improvement that can be made in health IT evaluations is increased reporting of the effects of implementation and context.

Primary Funding Source: Office of the National Coordinator.

The full free text is available from here:

http://annals.org/article.aspx?articleid=1811028

These two paragraphs summarise where we would seem to be with the bold making it clear there is much more to do!

“Although the health IT evaluation literature base is expanding rapidly, we are concerned that there has not been a commensurate increase in our understanding of the effect of health IT or how it can be used to improve health and health care. Study questions, research methods, and reporting of study details have not sufficiently adapted to meet the needs of clinicians, health care administrators, and health policymakers and are falling short of addressing the future needs of the health care system.

Nevertheless, some broad conclusions can be drawn. Most studies of CDS report positive or mixed-positive results, and existing systematic reviews of specific CDS systems are mostly positive with respect to changes in processes of care (28–33). We conclude that CDS generally results in improvements in the processes targeted by the decision support. If neutral or negative results are reported in new studies of CDS, these results are more likely to be because of specifics of the particular intervention, context, or implementation than an indication that the general construct of computerized decision support is not a beneficial IT functionality for improving health care quality. The same is true for CPOE: Most evaluations have reported positive or mixed-positive effects, and most existing systematic reviews likewise conclude that CPOE reduces medication errors (34–35). We can conclude that CPOE effectively decreases medication errors. Health care providers should be encouraged to adopt CDS and CPOE, and future studies of CDS and CPOE should concentrate on how to make them work better rather than testing the hypothesis of whether they work at all. In contrast to this, the evidence base on other functionalities, such as patient care reminders or patient specific education, have small numbers of studies, and any new studies add proportionately much more to our existing knowledge, both about the general construct of the functionality plus the potential for context and implementation sensitivity of the effects. The lack of reporting about key elements of context and implementation of health IT was noted in the review by Chaudhry and colleagues, and despite calls then and more recently for better reporting on context and implementation—and even suggestions for specific items to report on (36–37)—we still find that crucial elements of context and implementation are missing from most published health IT studies.”

Well worth a read.

David.

A New Collection On The Audit Commission on the Health Sector. Need To Know.

First a reminder of the CEHA web site listing many, many submissions.

National Commission of Audit – some submissions related to healthcare

Go here:

http://ceha.org.au/?p=92

You can spend ages reading all the views.

As for the new news from last week.

First we have:

http://www.smh.com.au/federal-politics/political-news/gps-oppose-insurers-covering-cost-of-visits-for-fear-of-switching-20140112-30osv.html

GPs oppose insurers covering cost of visits for fear of switching

Date January 13, 2014

Dan Harrison

Health and Indigenous Affairs Correspondent

Doctors have expressed concern that proposals to allow private insurers to pay for GP visits might encourage people to change doctors, undermining continuity of care.

On Friday, Health Minister Peter Dutton opened the door to lifting the long-standing ban on private health insurers paying for GP services, sparking concerns from consumer advocates and health economists that a change could accelerate a shift to a two-tiered health system, where those who can afford private cover receive better care than those who cannot.

The nation's largest health insurer, Medibank Private, has been pushing for the change for several months, arguing that treating medical conditions earlier would reduce the need for more expensive hospital treatment later.

In November, the company began a trial with medical centre manager IPN in which six of its Brisbane medical centres provide Medibank members with enhanced GP services, including a guaranteed appointment within 24 hours and after hours home visits, for no out-of-pocket costs. Medibank is not paying IPN for the services directly but is contributing to ''administrative and management costs''.

Next we have:

http://www.pharmacynews.com.au/news/latest-news/fee-for-service-the-future-expert

Fee for service the future: expert

13 January, 2014 Nick O'Donoghue

Charging consumers a fee for services is likely to be a key part of the future of community pharmacy in Australia, a specialist business consultant believes.

Paul Rowe, managing director of The Business Squad, a pharmacy business sales and consulting firm, forecast the fee for service future for the profession in a comment posted on the Australian Pharmacists’ LinkedIn group page.

Mr Rowe’s comments came in response to an article published by Pharmacy News, in which John Bronger, PSA NSW branch president, and former Pharmacy Guild of Australia national president, warned that the profession was facing into a tough year.

“It’s as simple as this,” he said. “If pharmacy doesn’t embrace the ‘business’ of pharmacy, it is going to be a very tough year.”

Next we have:

http://www.theage.com.au/comment/long-overdue-debate-on-medicare-a-healthy-thing-20140113-30qma.html

Long overdue debate on Medicare a healthy thing

Date January 14, 2014

Terry Barnes

We must be prepared to think the unthinkable to ensure Medicare survives.

This month, a short paper I wrote for the Australian Centre for Health Research think tank, exploring the reintroduction of the Hawke government's 1991 modest co-payment for GP services - updated to $6 from the $3.50 of two decades ago - has created something of a stir.

Apparently, I'm single-handedly destroying an Australian national institution, Medicare. Alternatively, I'm a stalking horse for the coyly silent Abbott government, proposing what the federal Labor opposition labelled ''a tax on taking sick children to the doctor''. Suggesting a matching co-payment could be charged by public hospital emergency departments for GP-type services, to deter avoidance, raised further ire. ''Save Medicare'' rallies are being organised against what's merely an industry think tank proposal, not federal government policy.

Most of the news reports and commentary about the proposal have been critical. Two excellent articles, however, by The Age's economics editor Peter Martin and health academic Jennifer Doggett particularly deserve a respectful response.

Last we have:

http://www.smh.com.au/national/health/senate-to-grill-audit-chiefs-on-health-rebate-and-negative-gearing-20140112-30osw.html

Senate to grill audit chiefs on health rebate and negative gearing

Date January 13, 2014

Dan Harrison

Health and Indigenous Affairs Correspondent

Senators plan to question the Abbott government's commissioners of audit on proposals to slaughter the political ''sacred cows'' of the private health insurance rebate and the negative gearing tax concessions blamed for putting home ownership out of reach for a generation of Australians.

The commissioners, including Business Council of Australia president Tony Shepherd and former Howard government minister Amanda Vanstone, are expected to appear on Wednesday before a Senate committee convened to investigate the audit.

The commissioners have been given open-ended terms of reference to produce a plan for the Coalition's aim to return the budget to a surplus equivalent to 1 per cent of gross domestic product.

This happened on the 15^th January 2014 and the transcript is found here:

http://parlinfo.aph.gov.au/parlInfo/search/display/display.w3p;query%3DId%3A%22committees%2Fcommsen%2F39e9705b-104e-47d4-acd1-59c8935280fc%2F0000%22

The politicking seen in this transcript is really off-putting I have to say.

The bottom line with all this seems to be the Audit Commission has health in its sights but has not decided just what it is going to do!

We will all just have to wait and see!

David.

A Very Interesting Review Of Older Individual’s Views On The PCEHR. Very Interesting Indeed!

This appeared a few days ago.

Seniors reluctant to share PCEHR with all health professionals

By Natasha Egan on January 15, 2014 in Consumers, Health & medical, Technology

Most senior Australians are willing to grant their GP, specialists, hospital medical staff and emergency workers full access to their electronic health record but are not inclined to do so for other health professionals or carers, according to a study targeting over-65s in regional Australia.

Education is therefore needed about the importance of all health professionals having a full picture of a patient’s health, says a co-author of the paper, which was recently published in the International Journal of Medical Informatics.

The La Trobe University pilot study on the views of elderly regional Australians of personally controlled electronic health records (PCEHR) involved 80 seniors from Bendigo in Victoria. The bulk of the participants, which were recruited at local Probus clubs catering to active and retired professionals, were aged 60 to 79 (84 per cent) and most were female (62 per cent).

The study found that the vast majority of respondents were in favour of giving their usual GP full access to their PCEHR (95 per cent) and most were also willing to grant full access to specialists (85 per cent), hospital medical staff (79 per cent), and emergency personnel (78 per cent).

Just over half of participants thought family members (53 per cent) should have full access to their eHealth record, however, fewer than that felt it suitable for diagnostic laboratories (48 per cent), pathology staff (46 per cent), allied health professionals (45 per cent), pharmacists (44 per cent), and carers (29 per cent) to have full access to their online health information.

Much more here:

http://www.australianageingagenda.com.au/2014/01/15/seniors-reluctant-share-pcehr-health-professionals/

Here are the study recommendations:

“Recommendations

To increase the adoption of the PCEHR among regional dwelling older Australians, the authors have recommended measures including computer access points in GP practices, print-out facilities, reassurance about security, and increased awareness about the benefits of sharing health record content with various health professionals.”

There is further coverage here:

Elderly reluctant to share health records with pharmacists

15 January, 2014 Nick O'Donoghue

Australians aged over-65 would prefer family members and pathology lab staff to have access to their Personally Controlled Electronic Health Record (PCEHR) than pharmacists, a study reveals.

The research, published in the International Journal of Medical Informatics, found that 95% of elderly Australians said they would be happy to give their GP full access to their PCEHR, while just 44% said pharmacists should have access to the document, the Australian Ageing Agenda reported.

The authors from La Trobe University used a self-administered questionnaire, distributed to members of a community club for active business and professional retirees, to gauge their views on the PCEHR.

More here:

http://www.pharmacynews.com.au/news/latest-news/elderly-australians-reluctant-to-share-health-reco

There is an abstract to the actual study found here:

http://www.ijmijournal.com/article/S1386-5056%2813%2900248-7/abstract

This is a very interesting study showing the barriers that need to be overcome to get decent levels of participation in the PCEHR - if you think that is a good thing.

That 25% or so of this group lack internet access seems to me to be a barrier that will be hard to overcome as will the education of this cohort in computer use.

Well worth a read of the articles above and the full text if you have access.

David.

Will There Be Any Improvement In Technology Project Governance Any Time Soon? Not If We Don’t Start Learning From Experience!

This appeared a few days ago.

Australian IT project failures spark new ICT governance standard

Date January 14, 2014 - 1:39PM

Trevor Clarke

65 to 85 per cent of IT projects fail to meet their objectives, run significantly late or cost far more than planned, says Minter Ellison partner Paul Kallenbach. Photo: Stephen Morton

The frequent failure of major IT projects across the country such as the Queensland Health payroll debacle has spurred Standards Australia to release an updated standard for IT governance.

The 24-page long standard was developed by the Standards Australia Technical Committeeand aims to guide leaders during major IT projects.

"The standard was prepared due to continuing failures of major IT projects to deliver expected value. The aim was to bring home the need for action from boards and senior business executives who are responsible for the overall governance of the organisation," said Standards Australia chief executive, Dr Bronwyn Evans.

"If organisations want to obtain maximum value from their investment, governance of IT projects should not be left to the IT department alone."

The new standard replaces a 2010 standard with updated guidance informed by the growth in cloud computing and social media use. It includes a recommended governance framework and encourages the highest levels of leadership to take responsibility for project success.

Over the years, IT market observers have been dismayed at the number of projects that have either failed completely or exceeded their budgets and deadlines.

The Queensland Health payroll disaster is arguably the poster child IT project failure in Australia at the moment. But it is joined by many other high-profile examples. The ATO's Change Program also ran over budget and over time, while a 2011 Victorian Ombudsman's report into 10 projects in the state including the myki card found each failed to meet expectations and added an additional $1.44 billion in costs.

Standards such as this are useful, says Minter Ellison partner Paul Kallenbach, but it's "the application of good IT project governance that has proved challenging".

Lots more here:

http://www.smh.com.au/it-pro/business-it/australian-it-project-failures-spark-new-ict-governance-standard-20140114-hv88k.html

There is also coverage here:

IT Governance Standard to benefit consumers and organisations

Categories: Standards, Telcommunications and Internet

IT governance is not a readily accessible issue for consumers yet the decisions made by most organisations about information technology (IT) can have great later significance, as is evident in a number of Australian IT project failures. IT supports organisations’ core functions and so IT investment choices and the contribution of IT to business capability and performance often play a significant role for future success.

Standards Australia has published a significant New Standard for IT Governance to support governance leaders in guiding major IT projects. Organisations undertaking significant IT projects will find this the ‘go-to” document when it comes to linking governance and management. Consumers Federation of Australia (CFA) has a representative on the Standards Australia Technical Committee IT-030 IT Governance which was responsible for the development of the standard.

AS/NZS 8016:2013 Governance of IT enabled projects offers a model of engagement between an organisation’s governing body and management.  The objective is to facilitate improved results for business projects that involve investment in new or changed IT capabilities (these projects are often referred to as ‘IT enabled projects’ or ‘IT projects’).

More here:

http://consumersfederation.org.au/it-governance-standard-to-benefit-consumers-and-organisations/

Here is the link to the Standard.

http://infostore.saiglobal.com/store/Details.aspx?ProductID=1696546&gclid=CKnbrrOYibwCFYZLpAodWnwAFw

Here is all that is available for free - the rest will cost you about $100.

AS/NZS 8016:2013

FOREWORD

 This Standard provides guidance to assist those at the highest level of organizations in the effective governance of IT enabled projects; these are projects that deliver IT enabled business capability and outcomes.

IT supports the core functions of most organizations. Investment in IT and the contribution of IT to the business capability and performance of the organization often play a significant role in the achievement of strategic plans.

Governance of IT, including significant investments in IT, is part of sound corporate governance and is needed to meet ASX guidelines. Governance in this context is not IT management but it is supported by the organization’s management system.

The mechanisms employed to govern IT enabled projects should be informed by the organization’s reliance on IT and its strategy, as well as its size and risk appetite. An item relating to an IT crisis on a board agenda could be a sign of weak or immature framework for the governance of the IT enabled project, and often the resulting decision-making will occur in isolation and will address the symptoms rather than the cause.

The guidance provided in this Standard comprises principles and a model. The principles are those defined in AS/NZS ISO/IEC 38500:2010, Corporate governance of information technology, and this Standard offers guidance on the application of the principles to IT enabled projects.

It provides guidance on the way governing bodies can own and lead the governance of IT enabled projects while providing support to those with delegated authority to deliver these projects. This Standard focuses on the governance of projects in which IT is an enabling tool for delivering value to the business. The governing body of an organization will determine what is of value to that organization; however, the value arising from an IT enabled project could include—

(a) competitive advantage through delivery of new services;

(b) improvements in organizational efficiency;

(c) cost reduction;

(d) effective risk management; and

(e) compliance with legislation and regulations.

Governance of IT enabled projects can provide governing bodies with a better understanding of the organization’s risk profile. Mobile devices, ‘apps’ and ‘cloud’ services can be purchased with ease by business management, and often without consulting the management responsible for the business’s IT or without understanding the potential implications for the organization’s IT strategy. Business projects underpinned by these technologies could escape consistent oversight, and decisions could be made that are neither aligned with an overall business strategy for IT nor subject to consistent oversight.

Digital and social media opportunities are currently being discussed in terms of business strategy, as well as in terms of the challenge of calculating and monitoring return on investment. This is a changing world where, if the board does not provide leadership, the consequences will be costly to rectify, and competitive opportunities could be lost.

This Standard does not prescribe or define specific management practices required for IT enabled projects, since these practices are already well defined in other sources. However, by focusing on the principles for governance of projects and behaviours that contribute to project success, this Standard provides guidance that is applicable to all organizations. It is the responsibility of governing bodies to satisfy themselves that the appropriate behaviours and mechanisms are in place within the organization.

----- End Forward.

The sad thing about all this is that most of what is being talked about is Project Governance Management 101 (Involve the Company Executive, ensure project is part of clear business and IT Strategy, have clear Executive Sponsor, have clearly measurable project plan and deliverables and ensure appropriate scope of each work parcel, ensure IT leadership has business nous etc.) and despite all this being very well known we keep seeing huge problems!

Here is a fun discussion of the causes of all these - The slides say it all!

http://faculty.washington.edu/ocarroll/infrmatc/managing/howto/

Informatics Training for CDC Public Health Advisors

How to Cause Information Technology Disasters

Instructor: William A. Yasnoff, MD, PhD

Teaching method(s): Lecture/discussion

Topics to be covered:

• Risks of Information Technology
• Types of Disasters
• Effective Disaster Strategies: Management
• Effective Disaster Strategies: Technical
• Paradigm for Disaster Avoidance

Learning objectives:

By the end of this session, students will:

• Understand the sources of risk in the development of new information systems
• Describe at least four management strategies for creating disasters
• Describe at least four technical strategies for creating disasters
• Utilize an effective paradigm to minimize likelihood of information technology disasters

Handouts:

• Instructional Materials
• Johnston DC: I.R.S. Admits Lag in Modernization; Urges Contract Plan. NY Times 1/31/97, p. A1.
• Oz E: When Professional Standards are Lax: The CONFIRM Failure and its Lessons. Communications of the ACM 1994;37(10):29-36.

References & suggested readings

• Ennals R. Executive Guide to Preventing Information Technology Disasters. Berlin: Springer-Verlag, 1995.

----- End Course Outline.

Note the dates of the references - none of this is new news! It just needs people to actually follow what is known about how to avoid these issues. One very good thing to do is make sure political interference and pressure is properly managed!

David.

Weekly Australian Health IT Links – 20th January, 2014.

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

Again a pretty quiet week with not much apparently going on except ongoing efforts to alienate Indonesia with one wag is now terming the effort ‘Sovereign Blunders’ and a lot of cost cutting ideas being floated by the Commission of Audit.

Sadly if seems the new Australian Standard to assist in preventing major IT disasters might be just a bit late! Maybe things will improve after this is out there.

I wonder how much it costs to get a copy?

-----

http://www.smh.com.au/it-pro/business-it/australian-it-project-failures-spark-new-ict-governance-standard-20140114-hv88k.html

Australian IT project failures spark new ICT governance standard

Date January 14, 2014 - 1:39PM

Trevor Clarke

65 to 85 per cent of IT projects fail to meet their objectives, run significantly late or cost far more than planned, says Minter Ellison partner Paul Kallenbach

The frequent failure of major IT projects across the country such as the Queensland Health payroll debacle has spurred Standards Australia to release an updated standard for IT governance.

The 24-page long standard was developed by the Standards Australia Technical Committee and aims to guide leaders during major IT projects.

"The standard was prepared due to continuing failures of major IT projects to deliver expected value. The aim was to bring home the need for action from boards and senior business executives who are responsible for the overall governance of the organisation," said Standards Australia chief executive, Dr Bronwyn Evans.

"If organisations want to obtain maximum value from their investment, governance of IT projects should not be left to the IT department alone."

Here is the release:

http://www.standards.org.au/AnalyticsReports/131218%20AS%20NZS%208016%20IT%20Governance%20MR%20final.pdf

-----

http://consumersfederation.org.au/it-governance-standard-to-benefit-consumers-and-organisations/

IT Governance Standard to benefit consumers and organisations

Categories: Standards, Telcommunications and Internet

IT governance is not a readily accessible issue for consumers yet the decisions made by most organisations about information technology (IT) can have great later significance, as is evident in a number of Australian IT project failures. IT supports organisations’ core functions and so IT investment choices and the contribution of IT to business capability and performance often play a significant role for future success.

Standards Australia has published a significant New Standard for IT Governance to support governance leaders in guiding major IT projects. Organisations undertaking significant IT projects will find this the ‘go-to” document when it comes to linking governance and management. Consumers Federation of Australia (CFA) has a representative on the Standards Australia Technical Committee IT-030 IT Governance which was responsible for the development of the standard.

AS/NZS 8016:2013 Governance of IT enabled projects offers a model of engagement between an organisation’s governing body and management. 

-----

http://www.afr.com/p/technology/tech_executive_leaves_queensland_nDu1CEifKtWDgIIfzUin6H

Tech executive leaves Queensland in turmoil after unexpected departure

PUBLISHED: 17 Jan 2014 14:19:

Paul Smith

The sudden resignation of the executive charged with fixing the Queensland government’s controversy-plagued IT operations is a blow to efforts at ­cleaning the mess that led to the health ­payroll debacle, technology experts say.

Department of Science, IT, Innovation and the Arts executive director of ICT renewal Glenn Walker resigned just nine months after he commenced in the role, ITNews reported on Friday.

The news is a major setback for ­Queensland IT Minister Ian Walker, who wanted Mr Walker to ­implement a ­comprehensive IT plan ­following two highly critical inquiries into its ­technology systems.

The Queensland government in December lodged a statement of claim against IBM in the Supreme Court to seek compensation for the failure of its payroll system, which is expected to cost taxpayers up to $1.2 billion. Mr Walker was responsible for implementing measures that would reduce risks in the state’s tech ­purchasing and implementation, and improve the ­performance of its ­technological ­systems.

-----

http://www.australianageingagenda.com.au/2014/01/15/seniors-reluctant-share-pcehr-health-professionals/

Seniors reluctant to share PCEHR with all health professionals

By Natasha Egan on January 15, 2014 in Consumers, Health & medical, Technology

Most senior Australians are willing to grant their GP, specialists, hospital medical staff and emergency workers full access to their electronic health record but are not inclined to do so for other health professionals or carers, according to a study targeting over-65s in regional Australia.

Education is therefore needed about the importance of all health professionals having a full picture of a patient’s health, says a co-author of the paper, which was recently published in the International Journal of Medical Informatics.

The La Trobe University pilot study on the views of elderly regional Australians of personally controlled electronic health records (PCEHR) involved 80 seniors from Bendigo in Victoria. The bulk of the participants, which were recruited at local Probus clubs catering to active and retired professionals, were aged 60 to 79 (84 per cent) and most were female (62 per cent).

-----

http://www.pharmacynews.com.au/news/latest-news/elderly-australians-reluctant-to-share-health-reco

Elderly reluctant to share health records with pharmacists

15 January, 2014 Nick O'Donoghue

Australians aged over-65 would prefer family members and pathology lab staff to have access to their Personally Controlled Electronic Health Record (PCEHR) than pharmacists, a study reveals.

The research, published in the International Journal of Medical Informatics, found that 95% of elderly Australians said they would be happy to give their GP full access to their PCEHR, while just 44% said pharmacists should have access to the document, the Australian Ageing Agenda reported.

The authors from La Trobe University used a self-administered questionnaire, distributed to members of a community club for active business and professional retirees, to gauge their views on the PCEHR.

-----

http://www.theaustralian.com.au/news/health-science/contact-lens-glucose-sensors-a-sweet-solution-for-diabetics/story-e6frg8y6-1226804215694

Contact lens glucose sensors a sweet solution for diabetics

• AP
• January 17, 2014 11:50AM

GOOGLE has unveiled a contact lens that monitors glucose levels in tears, a potential reprieve for millions of diabetics who have to jab their fingers to draw their own blood as many as 10 times a day.

The prototype, which Google says will take at least five years to reach consumers, is one of several medical devices being designed by companies to make glucose monitoring for diabetic patients more convenient and less invasive than the traditional finger pricks.

The lenses use a minuscule glucose sensor and a wireless transmitter to help those among the world's 382 million diabetics who need insulin keep a close watch on their blood sugar and adjust their dose.

The contact lenses were developed during the past 18 months in the clandestine Google X lab that also came up with a driverless car, Google's Web-surfing eyeglasses and Project Loon, a network of large balloons designed to beam the internet to unwired places.

-----

http://www.smh.com.au/technology/sci-tech/australian-researchers-hail-new-costeffective-gene-sequencing-machine-20140115-30tqy.html

Australian researchers hail new cost-effective gene sequencing machine

Date January 15, 2014

Julia Medew

Health Editor

Leading Australian researchers say thousands of Australians are set to benefit from the acquisition of new machines that can sequence a whole human genome for about $1000.

The Garvan Institute of Medical Research says it is one of the first in the world to acquire technology capable of sequencing genomes for that price, making it possible to do around 350 genomes a week or 18,000 a year – a "massive increase" on what is currently being done in Australia.

Unlike commercial DNA tests being routinely used already, the Garvan's new Illumina machines will sequence about six billion base pairs in a person's DNA – the complete set of genetic information we inherit from our parents.

-----

http://www.smh.com.au/digital-life/digital-life-news/new-devices-and-special-glass-claim-to-thwart-germs-on-phones-tablets--but-do-they-work-20140116-30vw6.html

New devices and special glass claim to thwart germs on phones, tablets - but do they work?

Date January 16, 2014

Ben Grubb

Deputy technology editor

Your smartphone may be your best friend, but it is also probably teeming with germs. According to recent research conducted in Britain, there's a one-in-six chance it has faecal matter on it, most likely put on it after you've visited the toilet (one-third of respondents to an Australian survey admit to using a phone there).

After all, our smartphones, like our hands, can be good surfaces for common bugs - such as golden staph, influenza and the cold virus - to rest on. And if those bugs come into contact with our eyes or mouth, they can potentially lead to sickness.

We wash our hands when we've been to the toilet and before we cook, but we never ever wash our phone.

-----

http://www.cbsnews.com/news/administration-taps-accenture-to-take-over-healthcaregov/

Administration taps Accenture to take over HealthCare.gov

The Obama administration is granting the consulting firm Accenture a contract worth between $90 million and $100 million for maintenance of the federal Obamacare website HealthCare.gov, two sources familiar with the contract told CBS News.

Accenture will replace the original lead contractor responsible for the site, CGI, whose contract is expiring. The contract leaves the consulting firm responsible for the continued construction and maintenance of the site, with a special emphasis on “back-end” portions of the site that handle the transfer of data from users to insurers.

Accenture will also work with QSSI, the contractor that was appointed in late October to lead efforts to fix HealthCare.gov after its disastrous launch.

-----

http://www.australiandoctor.com.au/news/latest-news/is-it-wise-to-let-patients-read-their-notes

Is it wise to let patients read your notes?

16 January, 2014 Paul Smith

Giving patients immediate access to doctors' medical notes following a consultation is being touted as a new standard of care following a US study.

The year-long OpenNotes study involved sending 20,000 patients a secure message following consultations with their GPs inviting them to read the doctor's notes via an online portal.

Jan Walker, from the Beth Israel Deaconess Medical Centre, in Boston, US, said many doctors had been wary of the project, concerned about increased workflow and what she described as an "avalanche" of questions from patients about the information in their medical notes.

-----

http://nrgpn.org.au/index.php/56-hot/105-the-six-dollar-medicine

Coalition hits the ground reviewing

Written by David Guest

Published: 12 January 2014

Commentary by David Guest

The new Coalition government hits the ground reviewing.

The report on the troubled PCEHR project has been delivered to the Minister but not released. On 16 December 2013 it was announced that Professor John Horvath, former Australian Chief Medical Officer, would review the Medicare Locals. Submissions to the review closed on 20 December.

A number of organisations have already been abolished or absorbed by other Federal Departments. Gone are the Department of Science, the Climate  Commission, the Foreign Aid Agency, AusAid ( Australian Agency for International Development), the Clean Energy Finance Corporation, the Immigration Health Advisory Group and the National Adoption Advisory Group. Federal government support for the Murray Darling Basin Authority and the Marine Parks Authority has been reduced. The funding for the legal aid services (Aboriginal and Torres Strait Islander Legal Services, Community Legal Services and the Family Violence Prevention Legal Services) has been drastically cut.

-----

http://www.theage.com.au/technology/technology-news/breastfeeding-mothers-get-help-from-google-glass-and-small-world-20140118-311s3.html

Breastfeeding mothers get help from Google Glass and Small World

Date January 19, 2014

Lucy Battersby  Julia Medew

New mothers struggling with breastfeeding may soon have the latest technology at their disposal to get expert help at any time of day.

The Melbourne office of an innovation company called Small World is about to conduct a Google Glass trial with the Australian Breastfeeding Association that will effectively allow their telephone counsellors to see through the eyes of mothers while they breastfeed at home.

The company is looking for 10 Victorian women expecting to give birth in February who want to trial the high-tech glasses for six to eight weeks to receive breastfeeding coaching. During that time, participants would receive training through their glasses on the fundamentals of breastfeeding. The gadget will display prompts, allowing mothers to keep their hands free to nurse their baby.

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http://www.healthintersections.com.au/?p=1836

Guest Post: FHIR Ballot Process

Posted on January 16, 2014 by Grahame Grieve

GE have asked for another round of FHIR balloting. See here and here. I don’t have time to commit my thoughts to the blog in a measured way – it’s very hard to comment rationally on this matter, and I don’t have time. So instead, Lloyd McKenzie volunteered this as a guest post:

The FHIR Management Group and the FHIR Governance Board will be making the determination of whether to go back to ballot during one of their face-to-face meetings at the WGM next week.

A few things to keep in mind:

• All balloters *have* had a two-week chance to review the dispositions of all ballot comments (not just their own) and the specification has been up to date reflecting those changes. Thus far, only one balloter  has indicated an issue with any of the resolutions, and it looks like we can resolve that.
• In parallel with that opportunity for review by balloters, every page in the specification has undergone QA for style, formatting, etc. So most, if not all, minor readability issues resulting from the changes should now be cleaned up.
• The DSTU specification is a draft. It will change and will continue to evolve.

Technically, the ballot has more than met the HL7 requirements to pass. The question is whether it would be in the interest of implementers to hold the specification back for another 6 months to go through another round of balloting, subsequent updates, QA and publication. I’m far from convinced that is the case.

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http://www.rustreport.com.au/issues/latestissue/australian-privacy-act-amendments-loom-large/

Australian Privacy Act amendments loom large

January 13, 2014

Australian Privacy Act changes smell of SOX

Australian organisations risk financial and reputational damage if they fail to meet the challenges of this year’s Australian Privacy Act changes warns Centrify Regional Director APAC Matt Ramsay. Taking effect from March, the Privacy Amendment (Enhancing Privacy Protection) Act 2012 implements a new set of harmonised privacy principles to regulate the handling of personal information by both Australian businesses and government agencies. Enacted in 2002, the SOX law strengthened compliance standards for US public company boards, management and public accounting firms by requiring top managers to individually certify the accuracy of financial information, applying more severe penalties for fraudulent financial activity.

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http://prwire.com.au/pr/41388/austin-health-finalist-at-victorian-public-healthcare-awards-for-implementation-of-health-iq-s-queue-manager

Austin Health finalist at Victorian Public Healthcare awards for implementation of Health IQ’s Queue Manager

Austin Health was recognised at the 2013 Victorian Public Healthcare awards for its leadership in innovation for optimising healthcare through e-health and communications technology. The project, ‘E-queuing at Austin Health Specialist Clinics’, saw Health IQ’s Queue Manager successfully implemented in their outpatients department and at the Olivia Newton-John Cancer and Wellness Centre.

Queue Manager was first implemented at Austin Health in September 2012 and its significant benefits have already captured the attention of the healthcare community within the few months since.

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http://www.smh.com.au/it-pro/business-it/pc-shipments-mark-worst-decline-in-pc-market-history-with-10-per-cent-drop-in-2013-20140113-hv88n.html

PC shipments mark 'worst decline in PC market history' with 10 per cent drop in 2013

Date January 13, 2014 - 1:47PM

Aaron Ricadela

Personal computer shipments fell 10 per cent in 2013, marking the worst-ever decline after lacklustre holiday sales underscored how consumers and businesses are shunning machines for mobile devices, two research firms said.

Manufacturers shipped 315.9 million units, returning to 2009 levels and making it the "worst decline in PC market history", researcher Gartner said in a statement late last week. IDC also said shipments had a record decline.

US consumers omitted PCs from their holiday shopping lists while buyers in Asia opted for smartphones and tablets. More computing tasks are moving to websites and applications tailored for wireless gadgets, rather than software installed on laptops and desktops. The annual drop eclipsed the previous record decline of 3.9 per cent in 2012, Gartner said.

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http://www.theaustralian.com.au/news/world/microsoft-on-the-threshold-of-deleting-appalling-windows-8-software/story-fnb64oi6-1226801466263

Microsoft on the threshold of deleting 'appalling' Windows 8 software

• Murad Ahmed
• The Times
• January 14, 2014 12:52PM

MICROSOFT plans to cut its losses on Windows 8, the latest version of the software that runs the majority of the world's computers, jettisoning the brand in an attempt to appease millions of disgruntled users.

Industry sources believe the world's biggest software company will announce a new operating system, codenamed "Threshold", at an event in April.

It is understood that ultimately Microsoft will call the system Windows 9 - a move, nonetheless, away from the Windows 8 brand that executives believe has become irreparably damaged by poor sales and scathing customer reviews.

The company will also make a number of changes to the system's design and functionality. It will go on sale in 2015, far earlier than many anticipated.

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Enjoy!

David.