Here is the planned programme for the day.
http://www.aph.gov.au/~/media/02%20Parliamentary%20Business/25%20Senate%20Estimates/add1415/ca.pdf
Here is the link to watch live:
http://www.aph.gov.au/News_and_Events/Watch_Parliament
Go to Community Affairs Committee.
Enjoy!
David.
Wednesday, February 25, 2015
Tuesday, February 24, 2015
It Is Interesting To See What Is Happening With A State Wide EHR in Alberta. Talk About A Slow Burn.
This web site was pointed out to me last week:
Here is the description from the home page:
Welcome to Alberta Netcare
Alberta Netcare is the name for all the projects related to the provincial Electronic Health Record (EHR) — a secure and confidential electronic system of Alberta patients' health information.
This website has resources for the Alberta public, Alberta health care providers, and people outside of Alberta who are interested in learning more about this innovative initiative. Please read the section below "How to Use this Website" to find information that will be most relevant to you.”
The web site is interestingly dated 1995-2015. So this has been underway for 20 years or so.
Before going further some basics.
Alberta is a province of Canada with a population of a little over 4 million.
Here is some background to the Health System from Wikipedia:
“Health care
Alberta provides a publicly funded health care system, Alberta Health Services, for all its residents as set out by the provisions of the Canada Health Act of 1984. Alberta became Canada's second province (after Saskatchewan) to adopt a Tommy Douglas–style program in 1950, a precursor to the modern medicare system. Alberta's research institutions and hospitals give AHS the title of third-best-run hospital centres in the world for Edmonton and Calgary, and fourth-best research institution, referring to the University of Alberta's health campus.[92]
Alberta's health-care budget was $171.9 billion during the 2013–2014 fiscal year (approximately 45% of all government spending), making it the best funded health care system per-capita in Canada. [93] Every hour more than $1.9 million was spent on health care in the province in 2013. In 2014 this went up to $2.4 million an hour, totalling $210 billion when both private donations and government spending are accounted for.[94] Per person in Alberta, $51,220 was spent on in the health-care sector.”
This figure is to be compared with Australia where the total expenditure (Govt. and Private) according to the AIHW is $A147 Billion per annum for about 24 million people- so they are big spenders!
For the EHR we have this description:
Alberta Netcare: Created in Alberta for Alberta Health Professionals
How does the EHR work?
The EHR is not a single database, but rather a network of data repositories and information systems. Each has an important function and together they form the provincial EHR.
Clinical data is collected through point-of-service systems (in hospitals, laboratories, testing facilities, pharmacies, and clinics), and is sent through secure messaging to the provincial repositories and information systems. When a health professional logs on to the EHR through the Alberta Netcare Portal, and searches for a patient record, the portal retrieves all of the available information from the provincial systems and presents it as a unified patient record.”
The current status page is very interesting.
Current Status: When Will Alberta Netcare be Complete?
Drug Domain: near complete
Approximately 95% of the expected drug dispenses from community pharmacies are successfully entered into the EHR. 96% of Alberta's community pharamacies are actively submitting their dispense data.
Currently health professionals view medication profiles through the Alberta Netcare Portal viewer. Two projects are underway to deliver medication information directly to local systems, which will eliminate the need for health professionals to open the Alberta Netcare Portal to view the information. Read more about System to System for EMR and System to System for Pharmacy.
The next major development for this domain will be to introduce electronic prescribing or e-Prescribe, which will see community physicians entering a prescription into the EHR, and pharmacies dispensing against that prescription. This e-prescribe function will be piloted in late 2013.
Laboratory Domain: near complete
Approximately 99% of all public and private laboratory facilities are submitting information to the EHR. Currently, Alberta Netcare is working on a Laboratory Information System Standards and Terminology Adoption project, which will standardize the transmission of data to the EHR, and will improve the quality and reliability of laboratory data.
Diagnostic Imaging Domain: near complete
The Diagnostic Imaging project (involving X-rays, ultrasounds) achieved a 100% filmless environment for all hospitals in Alberta in 2009. These images were made available province-wide through the implementation of a Provincial Image Viewer in June 2011. In 2013d Alberta Health Services completed the selection and implementation of a provincial voice recognition system and a provincial diagnostic imaging 3D reconstruction application. Approximately 92% of diagnostic imaging facilities are providing information to the provincial EHR. Read more about Diagnostic Images in the EHR.
Shared Health Record: underway
The Shared Health Record will introduce additional information to the EHR, such as patient encounters and immunization records from community sites. The Shared Health Record will also allow two-way communication between physician offices and the EHR, enabling clinicians to download EHR information to update their local systems. Read more about the Shared Health Record.
Physician Office Automation: underway
Automation of primary care physician offices is a key component of a complete provincial EHR. Currently, 77% of eligible physicians are being funded to adopt Electronic Medical Record systems, which will allow them to fully participate in the EHR.
Personal Health Portal: underway
In May 2011, a website was launched to provide a source of trusted health information and health management tools. As it evolves, a personal health record function will be introduced, allowing Albertans to create their own secure online health records. These personal health records will be enhanced to receive information from the provincial EHR. Read more about MyHealth.Alberta.ca.
The EHR is a dynamic network of systems, each designed to collect and contribute information from the various health system domains. The EHR is constantly evolving in response to the changing needs of the health system, and drawing upon new technologies as they emerge.
Since the EHR is made up of a number of systems, the status or the "level of completeness" of the EHR is expressed in relation to each domain. Alberta Netcare has made excellent progress in the drug, laboratory and diagnostic imaging domains, with content and functionality near completion. The EHR will continue to implement enhancements to improve patient care, however, it is expected that the majority of required functionality will be complete by 2020.
----- End Extract.
Further browsing revealed that only clinicians can access the portal based record - and can’t access their own record - and if the individual want to know what the record contains they can request a printout!
Also all records are derived automatically from the various services in Alberta picking up data from pharmacies, labs and radiologists.
This system looks to be the absolute opposite of the PCEHR - with no personal control or electronic access to the EHR that the doctor can access!
Well worth a browse around the whole site. Does anyone know of any published evaluations of clinical effectiveness?
David.
Monday, February 23, 2015
Weekly Australian Health IT Links – 23rd February, 2015.
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
The big news this week is the change of the CEO at Telstra with David Thodey being replaced by Andy Penn. What will be interesting will be to see if emphasis remains on e-Health remains.
The other big news is the schism that has occurred between HL7 and Standards Australia. What a mess.
Otherwise a very quiet week with still with no news from the new Health Minister on the PCEHR.
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New Telstra chief Andy Penn has a challenge in taking investors along for the ride
- John Beveridge
- Herald Sun
- February 20, 2015
TELSTRA is set to ramp up its investment in Asia as Andrew Penn takes on the top role at the big telco.
While David Thodey has always had a stretch target for Asia to provide 20 per cent of Telstra’s revenue, the task of getting there will largely fall on Andrew Penn.
And Penn is almost uniquely qualified for that task.
As chief executive of AXA Asia Pacific, he was instrumental in building and operating a range of Asian wealth businesses before they were taken over by French parent company AXA.
At Telstra, he has also been in charge of offshore growth as well as looking after the company’s finances.
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Doctor-rating website using AHPRA records
18th Feb 2015
Flynn Murphy
AHPRA says a mysterious new website that lets patients anonymously rate their doctors is using the agency’s records without permission.
The DoctorInspector website – which bills itself as an “open crowdsource doctor rating site” – has been the subject of several complaints to the agency in the past weeks.
Many Australian health professionals – from GPs, to pharmacists, to radiographers – will now find an internet search for their name returns a DoctorInspector page dedicated to them. The page includes their AHPRA number, details, a star rating and reviews.
The site does not accept responsibility for the accuracy of its information, and doctors appear to have no way to correct its records and reviews, to remove themselves from the site or to contact the site’s owner.
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HL7 Australia announces new team for 2015
- 18 February 2015
Today HL7 Australia named two new part time staff to assist with the implementation of the HL7 Australia 2014-2015 Strategic Plan.
Associate Professor Trish Williams, Chair of HL7 Australia said, “We are delighted we have been able to attract two such experienced staff who are keen bring their expertise and energy to support the volunteer HL7 Australia Board and the HL7 user community. HL7 Australia works to supports the creation and effective use of e health standards in Australia and these new appointments will assist us enormously.”
Bridget Kirkham will be assisting with increasing HL7’s profile, membership, third party relationships and advocacy. Bridget has been working for not-for profits in health for over 30 years in Australia, the UK and the USA.
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New Zealand health boards to move to IBM cloud
New platform expected to improve reliability following a number of outages over the past two years
Up to 20 district health boards across New Zealand will roll out cloud infrastructure, which is expected to slash IT infrastructure costs across the group by $23.9 million over the next 10 years.
The boards are rolling out a National Infrastructure Platform (NIP), which will host applications and systems they use each day to deliver healthcare services to citizens. The move to the new platform – based on cloud services provided by IBM – will start in mid-2015 and is expected to take three years.
IBM and crown company, Health Benefits Limited (HBL) announced the agreement, with individual health boards now signing contracts to use the platform.
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IBM wins 'foundation' role for NZ health IT cloud
Summary: A deal announced between IBM and Health Benefits Ltd enables the consolidation of 40 datacentres down to just two.
New Zealand's National Infrastructure Platform (NIP) for health is moving to an IBM-managed cloud, enabling a massive consolidation of datacentre facilities in the sector.
Announced on Tuesday by government-owned Health Benefits Ltd (HBL) and IBM, the National Infrastructure Platform will host applications and systems that New Zealand's 20 district health boards (DHBs) use to deliver healthcare.
DHBs will migrate from 40 datacentres to just two IBM-managed facilities -- one in Auckland and the other in Christchurch.
The current datacentres vary in size, age, quality, and adherence to standards, IBM and HBL said in a statement. The two IBM-managed facilities will offer higher security classifications, better reliability, and higher service levels.
-----
Dropped health monitoring functions won't hinder Apple Watch sales
Apple reportedly ran into problems with some advanced features
Although the Apple Watch will offer fewer health features than initially planned, it's still expected to be a powerful contender in the wearables category when it goes on sale in April.
Problems with sensor technology forced Apple to shelve plans to have the device monitor blood pressure, stress levels and heart rate, according to the Wall Street Journal. The sensors recorded inconsistent measurements that were affected by factors like dry skin, hairy arms and how tightly the watch was worn, according to anonymous sources cited by the Journal. Instead of more advanced features, the watch will include a basic pulse-rate monitor.
Omitting these features isn't a "deal breaker" for buyers, said Ramon Llamas, research manager for wearables and mobile phones, at IDC. The appeal of the Apple Watch isn't limited to health and fitness tracking but includes communication functions like the ability to compose text messages and emails and make calls from the wrist, said Llamas.
-----
Hospital errors killing hundreds of thousands
Date February 19, 2015
Julia Medew
Health Editor
An Australian study published in 2011 showed many catastrophic healthcare errors were not being reported to authorities.
Hospitals in developed countries are accidentally killing hundreds of thousands of patients every year, a world-leading patient safety expert says.
Peter Pronovost, director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine in the US, says healthcare errors are claiming about 400,000 American lives every year - the equivalent of two jumbo jets every day.
Common errors include misdiagnoses, medication mistakes, infections due to poor hand hygiene, pressure ulcers from neglectful nursing and miscommunications in teams that lead to catastrophic oversights.
While many advances have improved safety over the past decade, Dr Pronovost said one of the biggest problems in hospitals today was an ever-increasing number of devices that do not talk to each other and distract health professionals from their most important tasks. This trend has occurred at the same time as budget cuts that have caused staff to work under maximum pressure with limited resources.
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Inside Healthdirect Australia with Colin Seery CEO
Posted Wed, 18/02/2015 - 10:51 by Josh Gliddon
There’s no question the internet is a key part of our lives, with many people turning to online resources for first line information about their health. However the massive array of resources available also gives rise to questions about the reliability of “Dr Google.”
In a bid to plug this informational hole, Healthdirect Australia has a range of services designed to provide Australians with access to trusted information and advice they need to manage their own health and health related issues.
According to Healthdirect Australia chief executive Colin Seery, the service was established as a COAG initiative and is funded by the federal government, along with most states and territories.
“Healthdirect Australia provides all Australians with access to health information and advice. No matter where people live, or what time of the day or night it is, they can talk to a health professional, find trusted advice online about the appropriate care for their health issue and find the closest local services that are open when they need them,” Mr Seery told eHealthspace.org.
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Electronic Health Records in the UK: Patient Access Remains a Hot Topic
The gradual adoption of electronic health record systems has been in the works in more than a handful of countries around the globe, from the Kingdom of Jordan to Canada and India, all with various levels of success and interoperability. However, in the European market at least, it seems that the UK is the most proactive country in this respect, being the country with the highest uptake of EHR in the region.
A year ago, UK Health Secretary Jeremy Hunt stated that the National Health System is projected to become completely dependent on EHR within the next 5 years, a development which will allow continuity of care to become more seamless and more effective, making it possible for a physician a patient has never met before to view their complete medical history and make accurate and meaningful assessments about what the best course of action for the patient’s condition is.
For insight into just what is important to doctors when it comes to tackling the transition from paper to electronic records, Creation Healthcare conducted a mini-study of online conversations among healthcare professionals, including more than 400 tweets posted since the beginning of 2014.
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The folly of the obsession with source code
20/02/2015
My favourite topic these days is the phenomenon of fundamentalist thinking. You don’t need to go to Iraq to find it, it’s all around us….
Recently I chanced upon a post entitled ‘Coding is not the new literacy’ by Chris Granger, who as far as I can tell is one of the smart young generation of start-up developers creating interesting new ways of doing software. I suspect he is not yet 30, going by his ‘about’ page. Not a bad post for a young guy. It essentially says the following:
- coding is ultimately the act of externalising our mental models into computer-understandable form
- the main game is building and refining those mental models
In his view, ‘modelling is the new literacy’. He says:
Modeling is creating a representation of a system (or process) that can be explored or used.
I happen to agree with this, and I would go so far as to say that if you think that coding is the main activity of understanding or formalising a solution to a problem, you are profoundly wrong.
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Australian Childhood Immunisation Register and Medicare DVA Benefits Report - February 2015 Release
Created on Tuesday, 17 February 2015
NEHTA has released the specifications for the Medicare - Australian Childhood Immunisation Register and Medicare DVA Benefits Report.
These specifications are intended for implementers who are designing and developing clinical information systems to parse, extract and process information contained within the Australian Childhood Immunisation Register and Medicare DVA Benefits Report clinical documents that have been retrieved from the personally controlled electronic health record (PCEHR) system using the business-to-business gateway.
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Jane McCredie: Taming Big Data
Jane McCredie
Monday, 16 February, 2015
WHEN we do a Google search, most of us are probably focused on the data we are trying to access.
We tend to be less aware that the very search terms we choose are in themselves data — information that can be used by corporations or governments to monitor everything from political movements to consumer behaviour.
Google search terms are just one element of so-called “Big Data”, the vast quantities of information being generated by our constant digital engagement.
At the end of last year, I wrote about the potential benefits of Big Data for public health, while also touching on the ethical issues this might raise.
As “digital epidemiology” begins to take its place in the public health armory, one group of researchers is arguing that the established rules for surveillance and research may no longer provide an adequate ethical framework.
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Postdoctoral Research Fellow or Research Fellow In Consumer Informatics
at Macquarie University
Macquarie University is a workplace like no other. From our inception we have crossed traditional boundaries. We developed the first electronic calculator for people with vision impairment, wireless internet technology and the Macquarie Dictionary. We were the first university in Australia to introduce childcare on campus and the first to appoint a female Vice-Chancellor. We were founded to be different, and we have always been at the forefront of changes to the way we work, live and learn.
We are recognised globally as one of Australia's leading research universities. We recently earned a 5-star rating in the QS World Rankings, including the highest rating for employability. We have been among the top-rated employers in the Australian Workplace Employers Index since it was founded 2010. We are, definitively, a world-class university for students and staff. We're investing heavily in new buildings, courses and staff, and collaborating with businesses here and around the world including Cochlear Ltd, Intel and the CSIRO.
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HISA Advisory Services
Short term advisory service designed for rapid response
» Provided by health experts and managed by HISA!
HISA Advisory Services draws from the skills of the most experienced clinical, academic and management members of HISA to provide input and opinion on a wide range of digital health and health workforce questions. Service specialty areas include:
- Primary care
- Aged care
- Medical imaging
- Nursing workflow
- Emergency discharge processes
- Medication management
- Data definition and collection design
- As well as many others
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Premier & Health Minister @camerondickqld seeing first hand the Telehealth services at the PA Hospital. #qldpol
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Getting patient notes right
19 February, 2015 Dr Simon Young
Every Friday, I go mountain biking with my best friend Tony, an orthopaedic surgeon. At the end of climbs, we catch our breath and catch up on the week. At the top of one hill, we gasped through this exchange:
"M [Tony's wife, also a hospital specialist] and I were arguing about GP referrals last night," Tony panted.
"Oh yes?" I wheezed.
"We agreed there is no compulsion to send GPs letters, but I argued that out of all the specialists, psychiatrists at least should do it."
"Um, Tony, have you or M ever read the [Medical Board of Australia's] code of conduct?"
"Ah ... nope."
Five years spent writing medicolegal reports have made me quite familiar with the code of conduct.
Tony and his wife need to look at section 4.2 — ‘Respect for medical colleagues and other healthcare professionals'
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All the bottom-line action
February 16, 2015
Mind Australia leverages Qlik to track and manage business KPIs
Qlik has announced that Mind Australia, a leading provider of community mental health services in Victoria and South Australia, is using QlikView to streamline reporting processes and provide managers visibility into how they are tracking against business targets and key performance indicators (KPIs) – all ultimately translating to how many people’s lives they’ve helped transform. Mind supports over 18,000 Australians with mental health issues by providing services that help them to live independent, productive, and purposeful lives through a range of community and residential services.
Qlik has announced that Mind Australia, a leading provider of community mental health services in Victoria and South Australia, is using QlikView to streamline reporting processes and provide managers visibility into how they are tracking against business targets and key performance indicators (KPIs) – all ultimately translating to how many people’s lives they’ve helped transform. Mind supports over 18,000 Australians with mental health issues by providing services that help them to live independent, productive, and purposeful lives through a range of community and residential services.
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Orange to spin off e-health subsidiary Almerys - report
Sunday 15 February 2015 | 13:53 CET | News
Orange is preparing to sel lits 64 percent stake in Almerys to its co-founder Global Services Sante (G2S), reports Les Echos, citing unnamed sources. Described as an amicable divorce, Orange found it too difficult to find synergies between its e-health division and Almerys, which specialises in health service data management.
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Hands-on review: Raspberry Pi 2
Date February 18, 2015 - 8:27AM
Gadgets on the go
The little PC that could just got a big upgrade.
The palm-sized Raspberry Pi isn't the only barebones PC out there, but it's certainly one of the most popular and has a vibrant developer community. With the latest upgrades the $41 Raspberry Pi 2 also offers excellent bang for your buck alongside more expensive barebones options.
We've seen several iterations of the Raspberry Pi since it was launched in 2012, but until now it's stuck with a lowly single-core 700MHz processor. The new Pi 2 is blessed with a quad-core 900MHz processor, accompanied by double the RAM at 1GB.
-----
Raspberry Pi: a $35 computer can do a lot
- Joanna Stern
- The Wall Street Journal
- February 18, 2015
OUR computers have become too easy to use.
Right out of the box, they’re ready to go. No installing operating systems, no typing into a command-line prompt like in the old days. We don’t even have to hit save anymore.
Most weeks, I’m the first to celebrate this and to say I miss nothing about the way it used to be. But not this week.
This week I’ve been using the $US35 Raspberry Pi 2, a bare-bones Linux computer no bigger than a juice box. And I’ve rediscovered something I had forgotten: the thrill of tinkering with a machine and its software. Of course, that thrill is accompanied, from time to time, with the urge to take a baseball bat to an inanimate object.
-----
Enjoy!
David.
Sunday, February 22, 2015
Three Weeks Ago I Suggested E-Health Standards in OZ Setting Was Stuffed. Now The Proof.
I published a blog on the first of the month with this title:
Sunday, February 01, 2015
It Looks Like E-Health Standards Setting In Australia Has Gone Down The Gurgler. Just Astonishing!
Here is the link:
Last week we then had this appear:
HL7 Australia announces new team for 2015
- 18 February 2015
Today HL7 Australia named two new part time staff to assist with the implementation of the HL7 Australia 2014-2015 Strategic Plan.
Associate Professor Trish Williams, Chair of HL7 Australia said, “We are delighted we have been able to attract two such experienced staff who are keen bring their expertise and energy to support the volunteer HL7 Australia Board and the HL7 user community. HL7 Australia works to supports the creation and effective use of e health standards in Australia and these new appointments will assist us enormously.”
Bridget Kirkham will be assisting with increasing HL7’s profile, membership, third party relationships and advocacy. Bridget has been working for not-for profits in health for over 30 years in Australia, the UK and the USA.
Paul Frosdick will be developing the education and certification programs to develop the skills and knowledge of the membership and the wider informatics community. In addition Paul will be helping re-establish local HL7 Standards Development governance and processes in accordance with HL7 International principles and practice. Paul brings a rich background in IHTSDO as a contributor and past committee member and a wide experience in clinical terminology, informatics and clinical safety.
The current agreement with Standards Australia for HL7 Standards development has been terminated. HL7 Australia will be announcing in the near future, the new arrangements for a comprehensive, localised HL7 Standards publication and maintenance process. HL7 Standards previous published by Standards Australia will continue to be available free-of-charge from http://www.e-health.standards.org.au/Home/Publications.aspx
Media Enquiries: Trish Williams, Chair HL7 Australia Tel: +61 8 6304 5039
Mob 0412 322 999
email: Chair@HL7.org.au
More here:
Paragraph 4 says it all.
This extract from a recent HL7 e-mail makes it even clearer:
“Dear HL7 Community member
The current agreement with Standards Australia for HL7 Standards development has runs its course and has been completed. In the near future, HL7 Australia will be announcing new arrangements for a comprehensive, localised HL7 Standards publication and maintenance process. HL7 Standards previous published by Standards Australia will continue to be available free-of-charge from
www.e-health.standards.org.au/Home/Publications.aspx.
www.e-health.standards.org.au/Home/Publications.aspx.
As discussed at the AGM, a plan has been put in place to move HL7 Australia forward in terms of HL7 member benefits and engagement, and HL7 standards development. HL7 Australia supports the HL7 user community by championing and coordinating the development of standards as well as facilitating good practice implementation and use. Australia is recognised as a world leader in the adoption and development of the HL7 family of standards fostering rich communication which leads to better health outcomes for Australians. HL7 is the local Affiliate of HL7 International, and membership represents more than 90% of the information system vendors serving health services.
Members of HL7 Australia and the Board have voiced concerns for some time about the governance and process used in standards development for HL7 standards. HL7 Australia is addressing this by developing a consistent and responsive HL7 Standards development process in Australia. This will mean we will be engaging more with you, the HL7 Australia Community, and be responsive to your needs and capabilities.
The guiding principles for the HL7 Australia standards development governance and process include:
- balance of influence in technical committees;
- development by consensus with formal resolution of all comments;
- transparency in committee meetings and proceedings;
- retention of HL7 Community derived IP for the benefit of the HL7 Australia membership;
- closer relationship between the HL7 International and HL7 Australia communities;
- adherence to HL7 International requirements for use of IP and registered trademarks;
- leveraging HL7 International processes and capabilities; and
- providing online resources for managing localised HL7 terminologies and implementation resources.
-----
Lots more covering the staff changes mentioned above follows.
A quick look at this link will show just how many Australian standards depend on HL7:
NEHTA and DoH should just hang their heads in shame that it has come to this.
HL7 should never have been forced - as they surely have been - into this announcement and position. Good on all involved for showing just how naked the claimed Australian emperors of e-Health are!
What a total fiasco.
David.
This Is An Oddly Scary Image Of Our New Federal Health Minister - Great Article Though!
This appeared in the Australian Magazine
Click image to enlarge.
Here is the link:
This is a somehow rather worrying image. What does she have in mind to do with that gloved hand?
I wonder what Ms Ley's media advisers were thinking?
On the other hand the article is very informative and interesting indeed.
David.
Click image to enlarge.
Here is the link:
This is a somehow rather worrying image. What does she have in mind to do with that gloved hand?
I wonder what Ms Ley's media advisers were thinking?
On the other hand the article is very informative and interesting indeed.
David.
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