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."

Saturday, November 08, 2014

Weekly Overseas Health IT Links - 08th November, 2014.

Note: Each link is followed by a title and 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.
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CIOs: EHR usability to get worse

Posted on Oct 31, 2014
By Bernie Monegain, Editor
Worries over the usability of electronic health records have escalated recently -- in tandem, it seems, with their broad adoption. Now comes research from Frost & Sullivan that confirms this, and suggests that EHR usability challenges are likely to get worse before they get better.
Top problem: Information retrieval. It's nearly impossible for physicians to get the right information at the right time from their EHRs. They need it at the point of care. When it's not there, it's not merely frustrating. It puts patients at risk.
In Frost & Sullivan's analysis, "EHR Usability – CIOs Weigh in On What’s Needed to Improve Information Retrieval," Principal Analyst Nancy Fabozzi posits that as EHR data expand, the retrieval problem will get worse.
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CHIME sees 'troubling' signals for MU

Posted on Oct 31, 2014
By Neil Versel, Contributing Writer
As we head into Congress' lame-duck session after Tuesday's midterm election, the national policy agenda for healthcare CIOs will revolve around meaningful use, cybersecurity, ICD-10 and patient safety.
Of most pressing concern to the College of Healthcare Information Management Executives is the start of Medicare penalties in 2015 for hospitals failing to meet meaningful use standards.
At the CHIME 2014 Fall CIO Forum, CHIME Vice President for Public Policy Jeff Smith noted that a surprisingly low number of healthcare providers had successfully achieved Stage 2 meaningful use, and called the trend "troubling."
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HIT professionals must have 'customer empathy' when creating software

October 31, 2014 | By Katie Dvorak
To create software that works, health IT professionals need to have "customer empathy," according to Todd Dunn, director of innovation for Intermountain Healthcare's I.S. Organization.
Often, IT professionals proclaim that "users don't know what they want," Dunn writes at InformationWeek Healthcare. But that statement is untrue, he says.
There is a great gap that needs to be filled between healthcare professionals who approach design with customer empathy and professionals who do not, he adds.
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CIO Survey: EHRs are Still Slow, Time-Consuming

October 30, 2014
Despite significant progress in electronic health record (EHR) adoption, the road is still paved with pitfalls for many providers, according to new analysis from research firm Frost & Sullivan.
The survey was in conjunction with the College of Health Information Management Executives (CHIME), and primarily targeted CIOs working in mid-to-large sized community hospitals. Frequently highlighted customer pain points include: slow and inaccurate information retrieval from EHRs as well as difficulty in finding and reviewing data, both of which result in productivity losses for clinician end-users as well as potential risks to patient safety; inability to create targeted queries or easily access unstructured data such as clinician notes; and time-consuming data entry tasks.
Specifically, when it came to searching EHRs, respondents said that EHRs are too slow, and the rudimentary search functionality and poor usability of them are more important causes of search problems than lack of end-user training or clinician dislike of technology.
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ICD-10 Is Ready To Serve

10/30/2014 09:06 AM
Jonathan Elion
Commentary
ICD-10's benefits can be defined in just a few simple phrases. It's time to get on board.
With Halloween just around the corner, physicians may find it comforting to know that ICD-10 does not need to be on our list of scary things.
We've all heard so much about ICD-10, I think we're getting a bit numbed to the subject, and some of us may be having trouble separating fact from fiction. Of course, many doctors are -- and should be -- concerned about running a business (namely, their practice), and they wonder how all this will impact their bottom line. But I want to focus instead on ICD-10 as it impacts the clinical side of our profession.
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IT Vendors Come Together to Battle against Ebola

OCT 29, 2014 11:40am ET
Electronic health record systems are not the only information technologies being leveraged in the fight against the Ebola outbreak. A coalition of IT vendors has been established to distribute free information and timely updates on Ebola through mobile and web-based apps to healthcare professionals and consumers worldwide.
Health eVillages, a program of the not-for-profit Robert F. Kennedy Center for Justice and Human Rights and Physicians Interactive which provides mobile devices that include specialized medical reference content and clinical decision support tools to clinicians in developing countries, has launched the collaborative effort.
Under the partnership, Physicians Interactive will distribute information on Ebola through its free Omnio mobile and MedAlert Pro messaging applications. In addition, the Healthways, MedHelp, WELVU and Univadis platforms will be used by the coalition to reach healthcare providers in the U.S. and globally with breaking news, recommendations and guidelines related to the treatment of Ebola.
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Study: EHR users incur greater administrative burden

October 28, 2014 | By Marla Durben Hirsch
Electronic health records increase physicians' administrative burdens rather than decrease them as expected, according to an article in the International Journal of Health Services.
The researchers, professors of public health at the City University of New York and lecturers at Harvard Medical School, evaluated data from the Center of Studying Health System Change's 2008 Health Tracking Physician Survey of 4,720 physicians of various specialties. They found that the average doctor spent 8.7 hours a week (16.6 percent of working hours) on administrative work. They also found that this burden lowered doctor's morale.
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Marc Probst: It feels like Washington isn't listening to us

October 30, 2014 | By Dan Bowman
Intermountain Healthcare CIO Marc Probst is never one to mince words. As a member of the Office of the National Coordinator for Health IT's policy committee, for instance, Probst has been an outspoken advocate for the implementation of standards to drive interoperability in health IT.
"We're still not dealing with the root foundational issues [for interoperability]--the standards," Probst said at the College of Healthcare Information Management Executives' annual fall forum in San Antonio, Texas, this week. "We talked about it in the last policy committee meeting and at the joint meeting, and I think, again, people are starting to get the concept that we need to do it, but we're taking way too much time and going about. It needs to be directed and it needs really strong leadership, but right now that's a little hard to see--based on what's happened at ONC over the past few weeks--that that leadership exists."
In part 1 of an exclusive interview with FierceHealthIT, Probst talks about the ONC's ongoing leadership trials and tribulations, as well as the Meaningful Use program.
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Epic goes live at Cambridge

28 October 2014 Sam Sachdeva
Cambridge University Hospitals NHS Foundation Trust has gone live with its Epic electronic patient record system as part of a £200m IT overhaul.
The go-live marks the first implementation of the American supplier’s EPR in the UK. When Cambridge chose Epic ahead of Allscripts and Cerner, the decision was seen by many as one of the most important NHS IT procurements in recent years.
Dr Keith McNeil, the trust’s chief executive, said the planned go-live date of 25 October was postponed due to “some system issues”, which were resolved in time for a go-live at 2am the next day.
"We look forward to what will be the most exciting endeavour we have ever been involved in,” he added in a statement on the trust website. "We are forging the way for patient safety, not only for Cambridge University Hospitals but for the NHS as a whole."
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The Promise of Health IT Is Suffering Under the Reality of Washington

by David LeDuc Thursday, October 30, 2014
Health care systems around the world are being challenged by aging populations, chronic illness and revolutionary -- but expensive -- treatments. Addressing these issues is increasingly dependent on information, as health care is a data-rich, knowledge-driven industry. And yet, the regulations governing health data were developed at a time when the telephone and typewriter were among the most advanced technologies being used in most doctor's offices.
First, let's consider what's at stake. Applying health care data analytics, delivered in a digestible manner when and where it is needed, can lead to faster treatments coming to market, enhanced patient engagement and increased adherence to care plans, as well as reduced fraud -- all of which not only promise to improve the health of our nation's population, but also lower costs for patients and providers by eliminating needless procedures.  
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AMA tool shows areas in need of care

Posted on Oct 29, 2014
By Bernie Monegain, Editor
The American Medical Association launched what its leaders call a first-of-its-kind tool aimed at helping physicians and other healthcare providers improve patient access to care.
The AMA’s Health Workforce Mapper is an interactive tool that illustrates the geographic locations of the healthcare workforce in each state, including health professional shortage areas, hospital locations, as well as other related trends. It highlights areas where the number of healthcare professionals could be expanded to boost patient access to care close to home.
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Cleveland Clinic releases list of top medical innovations for 2015

October 29, 2014 | By Katie Dvorak
January is only a few months away but Cleveland Clinic is already looking to the New Year with today's release of its list of top medical innovations for 2015.
Among the technologies and developments Cleveland Clinic sees taking off are a mobile stroke ambulance, painless blood testing and an intra-operative radiation approach for breast cancer, according to an announcement from the clinic.
A panel of physicians and scientists at Cleveland Clinic compile the list each year.  
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Karen DeSalvo to 'maintain leadership' at ONC, agency says

October 29, 2014 | By Dan Bowman
Just call Karen DeSalvo the once and future National Coordinator for Health IT.
ONC, in a Health IT Buzz blog post published Tuesday afternoon, said that DeSalvo, in fact, will not step down as National Coordinator--as the agency announced Oct. 23-- but instead will "maintain her leadership of ONC" while also serving as acting assistant secretary of health with the U.S. Department of Health and Human Services.
To that end, according to the post, DeSalvo will continue to serve as chair of the Health IT Policy Committee. Additionally, she will continue to lead efforts to finalize the interoperability road map.
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Google's New Fit App Plays Well With Strava, Runkeeper and Others

Google's Fit app tracks physical activity and weaves in data from other apps.
IDG News Service | Oct 28, 2014 12:10 PM PT
Google is aiming to keep its users healthy—and away from Apple—with a new app that takes a broader view of fitness tracking.
Google Fit, released Tuesday, will use the sensors in Android phones to track and organize people’s walking, biking and running activity. Users can set goals and check their progress from within the app on their smartphone, as well as on the web, tablets, and Android Wear smartwatches.
Mobile fitness apps are a dime a dozen these days, but Google is trying to add value by letting Fit act as a hub for third-party apps like those from Strava, Withings and Runkeeper. Fit users can access data gathered by those apps within the Fit app, instead of having to switch between them. That functionality makes Google Fit the prime competitor to Apple’s HealthKit, a software platform for iOS 8 that lets third-party apps share their data with Apple’s Health app.
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Survey: Patient Portal Usage Growing Despite Reservations

October 28, 2014
A new survey of hospital and healthcare IT executives reveals that adoption of patient portals is growing even if they aren’t sold on the benefits of these engagement efforts.
The survey, conducted by the Chicago-based Healthcare Information Management and Systems Society (HIMSS) Analytics, reveals a positive picture of the patient engagement requirements of Stage 2 meaningful use which require eligible hospitals and eligible providers to have five percent of their patients view, download, and transmit (VDT) their health data. More healthcare provider organizations are adopting patient portals, much of it facilitated by the electronic medical record (EMR) vendor.
Patient engagement is more than just today’s hot topic – it is foundational to the future of healthcare,” HIMSS Analytics research director, Brendan FitzGerald, said in a statement.  
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CCHIT Announces It Will End Operations by November 14

OCT 28, 2014 2:43pm ET
The Certification Commission for Health Information Technology (CCHIT) today announced that it is winding down all operations, effective immediately, with all work slated to end by November 14, 2014. According to CCHIT, customers and business colleagues have been notified and its staff is assisting in the transition.
CCHIT was established in 2004 through a collaboration with three HIT associations—HIMSS, the American Health Information Management Association, and the National Alliance for Health Information Technology (now defunct)—to provide certification services for health IT products and education for healthcare providers and IT developers. In October 2005, the Department of Health and Human Services contracted with CCHIT to develop certification programs for electronic health records and health information exchanges.
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AMA worried about ONC 'gap'

Posted on Oct 28, 2014
By Bernie Monegain, Editor
The American Medical Association released a statement Monday that points to the organization's concern over the recent departure of key leaders from the Office of the National Coordinator for Health Information Technology. The ONC exits most recently include the coordinator herself, Karen DeSalvo, MD.
"The American Medical Association understands that Karen DeSalvo is leaving her post as the National Coordinator for Health Information Technology to do important work in public health," said AMA President Robert Wah, MD, in the statement.
"DeSalvo's departure, in addition to those of several other senior staff including the Deputy Director of the Office of the National Coordinator for Health IT Jacob Reider, which was also announced last week, leaves a significant leadership gap which could jeopardize the growing momentum around interoperability," Wah noted.
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Predictive analytics in healthcare pose unique challenges

October 28, 2014 | By Susan D. Hall
Looking to take a page from Amazon, Netflix and Google, investors have poured $1.9 billion into companies pursing predictive analytics in healthcare, though predicting the best course of treatment is significantly different than recommending a book or movie, according to a new Rock Health report.
"Even if we had the technology to address interoperability issues, solve privacy concerns, and process unstructured data, hundreds of thousands of factors influence health--many of which medical science still can't explain. Additionally, health outcomes aren't instantaneous. Without an effective, closed-feedback loop, algorithms struggle to continue to learn and improve," Rock Health's Teresa Wang writes in a blog post.
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Beacon Community programs face barriers to success, report says

October 28, 2014 | By Susan D. Hall
An evaluation of four Beacon Community projects found some common issues and barriers, according to a paper at eGEMs (Generating Evidence & Methods to improve patient outcomes.
The paper looked at commonalities among the projects, including structure, people, technology, tasks, and sustainability.
The four projects include:
  • txt4health, a service using text messaging used in Detroit, New Orleans, and Cincinnati Beacon Communities to help patients to better manage their health and to control or prevent diabetes.
  • Southern Piedmont Beacon Community in North Carolina's avatar used to educate patients and conduct administrative intake for the Women, Infants, and Children (WIC) Program.
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NHS plan ‘turning point’ for IT - Kelsey

24 October 2014   Sam Sachdeva
NHS England’s Five Year Forward View could provide a “turning point” for the information revolution, Tim Kelsey has said.
The plan, released yesterday by NHS England and other national bodies, identifies “exploiting the information revolution” and “accelerating innovation” as two enablers for its ambition to close the NHS funding gap.
It argues the gap, which could otherwise reach £30 billion by 2020-21, can be closed by reducing demand on the NHS by improving public health and increasing efficiency across the service by implementing new models of care.
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Johns Hopkins Medicine Leads Online Ebola Learning Module Development

OCT 27, 2014 1:01pm ET
Johns Hopkins Medicine has been tasked by the Centers for Disease Control and Prevention to lead a group designing an interactive web-based learning program that will guide healthcare workers, nurses and physicians through government-approved protocols to aid clinicians as they care for patients who may be at risk of contracting the Ebola virus.
The program will train healthcare providers in three critical areas: proper donning of personal protective equipment, the safe removal of gear, and active monitoring skills. All three modules will be available for free on the CDC’s website in the coming weeks and later available to iOS users on iTunes U, the world’s largest online catalog of free educational content.
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Big data becomes tool in Ebola battle

by Rob Lever
Nine days before Ebola was declared an epidemic, a group of researchers and computer scientists in Boston spotted the hemorrhagic fever beginning to spread in Guinea.
By scouring the Internet for clues from social media, local news reports and other available online data, the algorithm developed by HealthMap had an early picture of the deadly disease moving across West Africa.
"Official agencies tend to be more cautious about these announcements, so public communication tends to lag," said Clark Freifeld, who co-founded HealthMap in 2006 at Boston Children's Hospital.
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How the Military's EHR Reboot Will Impact Interoperability

Scott Mace, for HealthLeaders Media , October 28, 2014

A massive government procurement will speak volumes about the market share, and clout, of one lucky electronic health records system technology. The rest of the healthcare IT industry will be living with the ramifications of the Department of Defense's decision for years to come.

In much of tech, market share plays an outsize role in determining which standards get adopted. The dawn of the Internet was never supposed to be based upon TCP/IP, but instead on OSI protocols, which blue-ribbon committees carefully crafted to be the best possible foundation for open networks. But then TCP/IP grabbed all the market share and there was nothing left for the OSI protocols to do but fade into history.
The same thing may be about to play out in electronic health records. While the Office of the National Coordinator reboots its various blue-ribbon committees, and struggles to adapt to losing its deputy, Jacob Reider MD, and the loan of its chief, Karen DeSalvo to the administration's response to Ebola, a massive government procurement will speak volumes about the market share, and clout, of one lucky EHR technology.
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Post-Discharge Procedures Do Not Reduce Readmissions

OCT 27, 2014 7:49am ET
Beefing up post-discharge procedures, including using interactive voice monitoring technology, did not significantly reduce the number of patients with congestive heart failure or chronic obstructive pulmonary disease who were readmitted to the hospital or who visited emergency departments.
That’s the finding of a new study from the American Journal of Managed Care.
"A comprehensive hospital-based intervention failed to reduce 30- or 90-day readmissions as well as ED visits for patients with CHF or COPD, compared with usual care," authors Ariel Linden and Susan W. Butterworth concluded. "It did, however, reduce 90-day mortality among COPD patients. Our results suggest the need to continue to experiment with new interventions targeting readmissions — in particular, those focused on building collaborative relationships between hospitals and community-based providers. In the interim, our results point to a challenging road ahead for hospitals seeking to decrease readmissions for chronically ill patients and avoid financial penalties."
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Google Trends promising for health research, but needs more transparency

October 27, 2014 | By Katie Dvorak
While Google Trends has the potential to help with access to population data on behavior and its link to health and healthcare, it needs to be more transparent to be a useful tool, according to a new study.
Researchers from Yale-New Haven Hospital performed a review of healthcare literature using Google Trends to examine the platform's potential and how others in healthcare are using it, according to the study, published in PLOS ONE. Two independent reviewers identified studies using Google Trends for healthcare research from MEDLINE and PubMed. Those studies then were broken down into four topics: infectious disease; mental health and substance abuse; other non-communicable diseases; and general population behavior.
Twenty-seven percent of the articles used Google Trends for casual inference, 39 percent for description and 34 percent for surveillance, according to the authors.
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Combining HIE, eRx database to EHRs improves med list accuracy

Beth Walsh
Oct 23, 2014
Combining the data of EHRs, a commercial medication database and a community health information exchange increased the accuracy of patients' medication lists, according to a study published in the American Journal of Managed Care.
Researchers analyzed EHR data for 858 patients who were admitted at two New York hospitals in the same healthcare system between September 2010 and April 2011. The patients were prescribed a total of 7,731 medications.
Physicians at the hospitals were able to access the EHRs, HIE and database. When researchers compared data from the three sources with medication lists that were compiled by patients and verified, they found that EHRs captured 80 percent of patients' medications accurately; the commercial medication database accurately captured 45 percent; and the HIE accurately captured 37 percent.
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Hospital Study Offers Solutions to 'Alarm Fatigue'

2.5 million beeps, bleeps sounded in one month at one U.S. medical center
WEDNESDAY, Oct. 22, 2014 (HealthDay News) -- Monitoring devices among intensive care patients set off 2.5 million alarms in one month at a U.S. hospital, a new study of "alarm fatigue" shows.
Alarm fatigue occurs when hospital staff become desensitized to the constant beeps and bleeps of alarms, and either ignore them or turn them off. The problem has been identified as a major issue by The Joint Commission, which accredits U.S. hospitals.
"There have been news stories about patient deaths due to hospital staff silencing cardiac monitor alarms and alerts from federal agencies warning about alarm fatigue," study senior author Barbara Drew, a professor in physiological nursing at the University of California, San Francisco, said in a university news release.
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Recap of Q3 2014 Federal Health IT Activity

by Helen R. Pfister, Susan R. Ingargiola and Dori Glanz, Manatt Health Solutions Monday, October 27, 2014
The federal government continued to implement the HITECH Act, enacted as part of the American Recovery and Reinvestment Act, during the third quarter of 2014. As implementation of HITECH's programs begin to wind down, more than $25 billion in incentive payments have been made to providers to spur electronic health record adoption, and more than 90% of eligible hospitals and 75% eligible professionals have adopted and are using EHRs as a result.
At the same time, interoperability and electronic health information exchange between EHRs remains a major challenge, and privacy issues continue to be a central focus for policymakers and regulators. With the amount of HITECH funding available to drive change diminishing, the federal government will be turning to new levers to continue driving adoption of health IT tools to enable real-time coordination and management of care for patients and consumers. Below is a summary of key developments and milestones achieved between July 1 and Sept. 30.
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Enjoy!
David.

Friday, November 07, 2014

Not Something To Boost Confidence In Hospital Software. Need Clarity That Full Fix Has Been Delivered!

This story started running around the middle of last week.

Health software brings risk of death

Date October 27, 2014 - 7:12AM

Tony Moore

A new software program installed to manage medication doses at nine Queensland hospitals is likely to kill a patient within the next month, a Queensland Health risk report says.
Last Friday's report on the Metavision Intensive Care program advised the state government that the likelihood of the program causing preventable loss of life "is assessed as likely and expected to occur within the next month".
Health Minister Lawrence Springborg confirmed the report, which described the likelihood of a patient death at 60-90 per cent, to Fairfax Media on Sunday.
Concerns over the software were identified in the past month by the directors of the Intensive Care Units at the Princess Alexandra, Royal Children's and Royal Brisbane and Women's Hospital.
The software, designed to regulate the doses of medicine given to patients, was first introduced in 2013 and implemented at the Royal Brisbane and Women's Hospital as recently as September this year.
"Since implementation, monitoring of patient records by pharmacists has revealed several potentially serious prescription errors specifically caused by the system," the report says.
"While no events have resulted in actual patient harm, they are considered to be near misses with a high potential to recur."
The system was manually over-ridden by Queensland Health on Friday, and medical charts are being reviewed daily by intensive care unit medical teams.
Lawrence Springborg agreed a serious problem had been identified.
Lots more here:
There was also coverage here:

Dosage software deemed 'deadly'

27 October, 2014
A new computer program that helps manage patients' medication at nine Queensland hospitals could prove deadly, a Queensland Health report says.
The risk report says the Metavision Intensive Care program could cause preventable loss of life within the next month, Fairfax Media reports.
The software is designed to regulate doses of medication given to patients but drugs have allegedly been mixed up or continued when they should have stopped.
It was manually overridden by Queensland Health on Friday after the report was published.
Health Minister Lawrence Springborg has confirmed the risk report, which put the likelihood of a patient death at 60 to 90%.
More here:
A more detailed article appeared later in the week:

Doctors say critical Queensland Health software bug treatable

A software glitch that hit the system used to dispense medications to hospital patients in Brisbane’s public Metro North Hospital and Health Service has again put Queensland Health’s technology performance in casualty after the state’s Nurse’ union and Labor Opposition hit out at life threatening dangers revealed in an internal risk report.
The computer bugs affected software supplied by iMDsoft for Metro North’s Metavision Intensive Care system and came to light after risk assessment provided to the state government warned there was a 60 per cent to 90 per cent chance of preventable death occurring over the period of a month if left unaddressed.
The serious near miss and subsequent manual intervention has put health services across Australia on alert over how potential problems and associated risks of eHealth systems are managed as most states pursue the big technology rollouts.
The issue of the Metavision implementation hit Queensland’s state Parliament on Tuesday with the Labor Opposition launching into the Newman government over what was being done to tell patients about the risks of the IT system being used to prescribe medication to them.
Predictably, the flurry of questions prompted a succession of reminders of the Bligh government’s now globally infamous software disaster of the Queensland Health Payroll that chewed through $1 billion was slammed in a subsequent Royal Commission and resulted in IBM being banned from government work in the state.
Politics aside, doctors and the software company at the centre of the controversy say the very fact that the problems were detected is in itself a salutary lesson about how risks surrounding such problems can and should be managed.
Lots more here:
What seems to be good here is that an error has been identified, a workaround developed and a permanent fix to the software has been developed.
It is worth visiting the company web-site which is found here:
The company certainly has an impressive client list and I strongly suspect the Company has far too much to lose to not swiftly rectify whatever the core issue is.
This rather has the sense of a bit of a ‘storm in a teacup’ while at the same time clearly needing to be fully understood and fixed!
David.