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."

Wednesday, September 09, 2015

Yet Again The Health Department Has Made Life Harder For GPs With Poor Technology!



This appeared a few days ago:

My Aged Care site criticised for wasting GPs' time

3 September 2015
THE new national gateway for aged-care referrals is acting as a choke point for GPs trying to arrange care for elderly patients, doctors say.
The My Aged Care website and online referral system was to provide “equitable and timely access to aged care assessments and make it easier for older people to find aged care services and information”.
But major design flaws in the system launched on 1 July are said to be wasting doctors’ time and causing information about vulnerable patients to be lost.
Loss of information from GPs’ referrals is a “huge concern”, says Adelaide GP Dr Chris Bollen, who has taken feedback from numerous practices about the system. 
“There’s no way to know if your referral has been accepted, and where it’s gone to, no read on receipt function," he says. 
“The GP referrals go to the assessment team online. Then the next person takes that information and rings the older person or their carer, then an assessment is made and a referral is generated and sent to a regional assessment team or sometimes to a provider.  
“But the original GP referral stays with the My Aged Care people – it does not go to the end provider at all.” 
The RACGP has written to the Department of Social Services seeking a number of improvements, including a means of sending referrals electronically via a system that conforms to the Secure Message Delivery (SMD) system. 
“The website has created extra and unnecessary work for general practitioners due to lack of front-line GP input into the design and modus operandi,” RACGP president Frank Jones told Medical Observer.
“Proactive consultation with the profession would have saved time, effort and given the best outcome.”
The web-based system is not compatible with GPs’ electronic clinical data systems, forcing doctors to manually retype patient details to the new template in a “time-consuming and unnecessary exercise”, Dr Jones says. 
The RACGP said in its 11 August letter to DSS: “To be useable in the context of general practice, online methods of communication must link to or integrate with GPs’ electronic clinical and administrative systems.
…..
After the RACGP released its letter of concern publicly, the department responded yesterday with an acknowledgment “that a seamless interface supporting GPs and aged care providers is ideal”, Dr Jones said. 
“The RACGP is supportive of an online electronically based referral system for aged care and would welcome the opportunity to work with government to improve processes,” he says. 
The DSS has been contacted for comment.
Tags: 
More here:
Yet another e-Health farce led by the Department of Health. How about some testing and a pilot or two to locate the issues before full implementation? Really all one can do is despair!
David.

Tuesday, September 08, 2015

Government IT Strikes Again In Terms Of Waste Of Public Money. Will It Ever Stop?

This little ripper appeared a few days ago.

NSW Education Minister Adrian Piccoli defends 'complete disaster' IT system

Date August 31, 2015 - 6:40PM

Eryk Bagshaw

Education Reporter

The bungled roll-out of a new IT system across the state's public education system could have built up to  20 new schools, the NSW budget estimates committee has heard.
NSW Education Minister Adrian Piccoli​ was forced to defend the $531 million pilot Learning Management and Business Reform (LMBR) system at Parliament House on Monday as the state opposition accused him of implementing the largest waste of taxpayer funding in the Department of Education's history.
The LMBR system has been dogged by complaints and technical faults during its trial in 229 schools.
Last year leaked internal emails revealed that debt collectors had been engaged to threaten schools that failed to pay suppliers of the program which was designed to manage human resources, finance, student information and payrolls.
At the time the program was in disarray with under-trained, over-worked staff and principals describing it as a "complete disaster".
In March the same program was responsible for thousands of TAFE students being unable to enrol because of a computer glitch.
Despite the urgent need for new schools in the city and northern suburbs to cope with swelling demand, Mr Piccoli defended the half-billion dollar cost of the roll out. According to the Department of Education the average new public school should cost between $15 and $30 million.
"It is not a blow out," he told the committee. "You might think that $500 million is a lot of money but it is not in the context of a very large organisation."
"The original budget ($400 million under the previous  Labor government) did not budget for implementation."
The IT world has changed significantly since 2006, he said, adding that the NSW Department of Education, which has spent $100 billion over the past two decades, was one of the largest education department's in the southern hemisphere.
More here:
This is just a terrible saga. It seems the system roll out has taken virtually a decade, is delivering what must be described as basic commercial functionality (designed to manage human resources, finance, student information and payrolls ) and is costing a fortune!
One really wonders just when the NSW Auditor General will be having a look at all this and the lessons that must be learnt are revealed.
I have to say that to say that $500 million is not too much to provide basic IT functions to NSW Schools seems rather questionable to me. Think of some basic applications in the cloud and some PCs and connectivity with sensible support etc. I would be amazed if you could not halve the cost.
What do others think?
David.

There Needs To Be Full Public Disclosure On What Went On Here And How It Will Be Prevented In The Future.

This appeared a few days ago.

Row over staff who tried to delete Adelaide hospital records

  • The Australian
  • September 4, 2015 12:00AM

Michael Owen

Charges could be considered against four senior staff of a major Adelaide hospital who tried to delete a patient’s radiology record.
The Crown Solicitor’s Office was yesterday considering a report by South Australia’s chief medical officer, Paddy Phillips, into the allegedly illegal action at the Lyell McEwin Hospital in June. Once crown law has considered the matter, it may be forwarded to the Department of Public Prosecutions to consider charges.
A redacted copy of the report, provided to The Australian yesterday, found clear attempts had been made to erase the report but because of the integrity of the records system, it was not actually deleted.
“It wasn’t destroyed, it was separated, but it did make it invisible so it wasn’t seen on the record, which makes it effectively deleted,” Professor Phillips said yesterday.
South Australian Health Minister Jack Snelling ordered an investigation after radiologist Paul Newbold in July revealed that a report he placed on a patient’s record was erased. He described its removal as “very dangerous and very sinister”.
The radiologist’s comments were critical of the hospital and related to the ordering of tests and delays in reporting test results following the introduction of a new computer medical imaging system.
Professor Phillips said four hospital staff from middle management and higher “were involved in the separation of that medical record, or that radiology report, for that test from that individual patient’s record”.
More here:
There is also coverage of the matter here:

Four Lyell McEwin Hospital staff 'counselled' after changing medical record to remove doctor's criticism

Four staff members from Lyell McEwin Hospital in Adelaide have been "counselled" for removing a radiologist's comments about hospital management from a patient's medical record.
In July, Dr Paul Newbold revealed part of a patient's record was deleted and he believed the deletions were "very dangerous and very sinister".
The comments related to the ordering of tests and delays in reporting test results.
The hospital introduced a new computer medical imaging system called ESMI in May.
"That report has been erased, it's like I never left home, never drove to the hospital, never put that report in the medical record system," Dr Newbold said at the time.
Chief medical officer Paddy Phillips conducted a review of the situation and told 891 ABC Adelaide that it was "a serious issue".
He said the four people ranging from middle management and higher "were involved in the separation of that medical record, or that radiology report for that test from that individual patient's record".
"It wasn't destroyed but it was separated, but that did make it invisible so it wasn't seen on the record which makes it effectively if you like deleted."
"They tried to do something that was inappropriate. They now know that, they admit that they made a mistake and they have been counselled."
More here:
It is hard to believe that those involved in this sort of activity should be not both be named and dismissed - at the very least as an example to all staff that such activity is utterly forbidden and potentially very dangerous.
I look forward to the full release of the report done by Dr Phillips.
David.

Monday, September 07, 2015

Weekly Australian Health IT Links – 7th September, 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

A very interesting week with a new Strategy in Qld Health and news regarding the Privacy Commissioner and what is happening there.
It also seems that NSW Education has added to the list of Government Departments that have messed up a huge IT project.
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No AHPRA checks performed on 'best specialists'

Tessa Hoffman | 31 August, 2015 | 
The doctors behind a website claiming to list the country’s “best” specialists admit failing to obtain participating doctors’ permission and checking AHPRA to see if they faced sanctions before adding their profiles to the site.
Launched last week, Specialist Doctors — which lists about 750 doctors across numerous medical specialties — has been labelled elitist.
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My Aged Care site criticised for wasting GPs' time

3 September 2015
THE new national gateway for aged-care referrals is acting as a choke point for GPs trying to arrange care for elderly patients, doctors say.
The My Aged Care website and online referral system was to provide “equitable and timely access to aged care assessments and make it easier for older people to find aged care services and information”.
But major design flaws in the system launched on 1 July are said to be wasting doctors’ time and causing information about vulnerable patients to be lost.
Loss of information from GPs’ referrals is a “huge concern”, says Adelaide GP Dr Chris Bollen, who has taken feedback from numerous practices about the system. 
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World-class orthopaedic registry service to open in Adelaide

By admin E-Health & Technology Sep 02, 2015
A joint replacements registry is expected to become a model for medical management systems now it has new partners.
The project, to be set up buy the Australian Orthopaedic Association (AOA) in a new partnership with the South Australian Health and Medical Research Institute (SAHMRI)and the University of South Australia (UniSA), will create a leading registry management service for the medical industry.
Over 100,000 joint replacement operations are performed in Australia every year, and information on hip, knee, shoulder, elbow, wrist, ankle and spinal disc replacements will be recorded in the registry making it a leading resource model in the global medical community.
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Human Services' computers keep disabled out of work

Date September 1, 2015 - 11:30PM

Noel Towell

Reporter for The Canberra Times

Disabled Australians are prevented from getting into the workforce because faulty government computers cannot process their health checks, according to the Australian Greens.
Trouble with the ageing computer system at the Department of Human Services has created a backlog of disabled people waiting to complete online health-checks, the last requirement before they can take up paid employment.
Disability service providers have told Greens Senator Rachel Siewert that after spending time, effort and resources getting people into work and off benefits, the DHS logjam means their clients are marking time while they wait to start their new jobs.
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How new technologies are shaking up health care

September 2, 2015 1.31pm AEST
Health technology such as apps is changing doctor and patient interaction for the better.

Author

  1. Tim Usherwood  Professor of General Practice at University of Sydney
New tests and drugs have impacted health care for many decades. But we’re now seeing the emergence of completely different kinds of technologies that will radically alter how health care is both accessed and delivered.
In the past, patient and doctor, or other clinician, would generally meet in person. The clinician would employ the traditional process of seeking a history, undertaking physical examination and perhaps organising tests, to obtain details of the patient’s health-care needs and preferences.
The clinician would then relate this information to current knowledge of disease, prognosis and therapeutics, hopefully involving the patient, and together they would make decisions about a management plan.
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Qld Health on the hunt for super-CIO

By Paris Cowan
Sep 3 2015 11:42AM

Thatcher completes one-year stint.

Queensland is looking for an IT chief to lead its new consolidated electronic health division, after former chief health information officer Mal Thatcher completed his year on secondment.
The successful candidate for the vacant position will take over one of the most scrutinised and notorious IT environments in the country.
The health department is advertising the re-jigged role at the same time as its IT dirty laundry is once again aired in public, with a legal battle between the state government and its former payroll systems integrator IBM awaiting judgement in the Supreme Court.
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Health system to enter digital age

Friday 4 September 2015

The Queensland Government’s newly released eHealth Investment Strategy is set to bring Queensland’s health system into the digital age.
The strategy identifies future ICT requirements over the next 20 years to ensure the state’s health system can continue to provide essential services to Queenslanders.
It is predicted that future health ICT requirements are needed in four primary categories – clinical systems, business systems, ICT infrastructure and the digital future of Queensland Health. 
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Qld eHealth strategy to create 1000 jobs, minister says

$300m for ICT infrastructure
Queensland's new eHealth investment strategy will create around 1000 jobs, according to the state's health minister, Cameron Dick.
The strategy (PDF) outlines five key top-line investment priorities for the state's health system:
• Investing in ICT infrastructure that can "support contemporary systems and increase the mobility of the workforce";
• A contemporary desktop environment for end users;
• A secure environment for exchanging information and images, including information interoperability with other systems;
• replacing enterprise systems, including those for patient administration, finance and laboratories; and
• investing in electronic medical records and enabling digital hospitals.
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An easy introduction to Twitter

“It’s like being delivered a newspaper whose headlines you’ll always find interesting.” ~ Twitter
Yesterday I was at a conference in Brisbane, organised by the Australasian Medical Writers Association. I met some interesting people and learned a lot about writing from speakers like Dr Justin Coleman and Ben Harris-Roxas.
Interestingly, many speakers mentioned Twitter. Social media are essential if you want to bring a health message across. Twitter is also a great tool to connect and collaborate with others and learn new things. It’s my favourite social media platform.
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Even encrypted medical record databases leak information

Microsoft researchers warn that some encrypted databases used for medical records aren't so secure
A new study from Microsoft researchers warns that many types of databases used for electronic medical records are vulnerable to leaking information despite the use of encryption.
The paper, due to be presented at the ACM Conference on Computer and Communications Security next month, shows how sensitive medical information on patients could be pilfered using four different attacks.
Researchers discovered the sex, race, age and admission information, among other data, using real patient records from 200 US hospitals.
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Orion Health receives Healthcare IT Company of the Year Award

NZX-listed company awarded the 2015 Frost & Sullivan New Zealand Healthcare IT Company of the Year Award.
NZX-listed company Orion Health has been awarded with the 2015 Frost & Sullivan New Zealand Healthcare IT Company of the Year Award.
The awards, which are run by global growth consultancy Frost & Sullivan, seek to recognise businesses and individuals that have pushed the boundaries of excellence - rising above the competition and demonstrating outstanding performance in the New Zealand and Asia Pacific markets.
The recipients of the 2015 Frost & Sullivan New Zealand Excellence Awards were identified based on in-depth research conducted by Frost & Sullivan's analysts.
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Row over staff who tried to delete Adelaide hospital records

  • The Australian
  • September 4, 2015 12:00AM

Michael Owen

Charges could be considered against four senior staff of a major Adelaide hospital who tried to delete a patient’s radiology record.
The Crown Solicitor’s Office was yesterday considering a report by South Australia’s chief medical officer, Paddy Phillips, into the allegedly illegal action at the Lyell McEwin Hospital in June. Once crown law has considered the matter, it may be forwarded to the Department of Public Prosecutions to consider charges.
A redacted copy of the report, provided to The Australian yesterday, found clear attempts had been made to erase the report but because of the integrity of the records system, it was not actually deleted.
“It wasn’t destroyed, it was separated, but it did make it invisible so it wasn’t seen on the record, which makes it effectively deleted,” Professor Phillips said yesterday.
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Alcidion wins $1.75 million NT Health contract

Adelaide-based health informatics company Alcidion has secured a 60-month, $1.75 million contract with the Northern Territory Department of Health for the provision of best practice emergency department order sets at two of the territory's hospitals.
The Alcidion solution, Miya Orders, streamlines the emergency department workflow by providing guidance to doctors on the most clinically appropriate pathology tests to order for a patient, depending on the patient’s clinical presentation, such as whether they have chest pain or snake bite.
“For the most common clinical conditions, the system provides for junior doctors, and in some cases, nursing staff, to order tests for a patient as at the same level of expertise as a senior consultant with many many years of clinical experience,” explained Alcidion co-founder and CEO Ray Blight.
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Privacy policies for GPs

Being open and transparent with patients about how their personal information is handled by your GP practice is one of the best ways to build trust and confidence. It is also a requirement of the Privacy Act 1988. An APP privacy policy is a key tool for meeting APP 1’s objective of ensuring that APP entities manage personal information in an open and transparent way.
A version of this presentation was delivered by Alun Thomas at a webinar on 11 August 2015.
If you need assistance because the resource you need is not available in a format you can access, please contact us.
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Office of the Australian Information Commissioner — Update

Presentation by Timothy Pilgrim PSM, Acting Australian Information Commissioner to The Law Society of New South Wales Government Solicitors Conference, Sydney 1 September 2015.
Good morning.
I would like to begin by acknowledging the Gadigal people of the Eora Nation, the traditional custodians of this land and pay my respects to their Elders both past and present.
As solicitors in the Government field, many of you will have had cause to focus on the activities of the Office of the Australian Information Commissioner (OAIC) in the past year. You may even had direct dealings with us.
It is therefore not surprising that you may be wondering what is the current state of play with the OAIC and its future, and more specifically, the important jurisdictions of privacy and freedom of information (FOI) that we are responsible for.
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NSW Education Minister Adrian Piccoli defends 'complete disaster' IT system

Date August 31, 2015 - 6:40PM

Eryk Bagshaw

Education Reporter

The bungled roll-out of a new IT system across the state's public education system could have built up to  20 new schools, the NSW budget estimates committee has heard.
NSW Education Minister Adrian Piccoli​ was forced to defend the $531 million pilot Learning Management and Business Reform (LMBR) system at Parliament House on Monday as the state opposition accused him of implementing the largest waste of taxpayer funding in the Department of Education's history.
The LMBR system has been dogged by complaints and technical faults during its trial in 229 schools.
Last year leaked internal emails revealed that debt collectors had been engaged to threaten schools that failed to pay suppliers of the program which was designed to manage human resources, finance, student information and payrolls.
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Salesforce jumps into healthcare with a tailored cloud platform

It's all about managing patient relationships, the company says
Sales and marketing have long been Salesforce's proverbial bread and butter, but on Wednesday the CRM giant branched out in a new direction with a cloud platform tailored specifically for healthcare providers and patient data.
Aiming to help healthcare organizations manage their relationships with patients, the company's new Salesforce Health Cloud promises providers a complete view of each patient as well as the ability to engage them better across caregiver networks. Overall, the goal is to help providers make smarter patient-care decisions, the company said.
"We've been in healthcare from the beginning," said Joshua Newman, the company's chief medical officer and general manager of Healthcare and Life Sciences.
Originally, however, that mostly meant helping companies in the healthcare industry offer sales and service for medical devices or pharmaceuticals, for example.
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Careful technology selection vital for effective population health management

By admin E-Health & Technology Sep 02, 2015
With all the discussion around the ‘hot’ topic of population health management, the benefits for patients have become clear. Yet there still seems to be reluctance among some care providers to fully embrace it.
The core argument in favour of adopting a population health management strategy is that it improves patient outcomes. Pre-emptive steps can be taken to lift the overall health of certain groups, and patients can become more engaged in their own care.
However, there are some care providers who believe that the technology required to support a population health management strategy still has some way to go. They point out that, while the end goals are admirable, the practicalities are not quite in place.
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Telstra Health expands presence in Asia

Healthcare Innovation editors
August 28, 2015
Healthcare Innovation
Telstra Health, a division of Australian incumbent operator Telstra, is expanding its presence in Asia with new implementations of hospital electronic medical record systems in Malaysia and Thailand.
The company's integrated patient care system CloudMed Arcus Hospital Information System (Arcus) is now deployed at Sunway Medical Centre group, Penang Adventist Hospital group and Tung Shin Hospital's Western Medicine and Traditional Chinese Medicine wings in Malaysia.
Through a distributor, Convergence Systems, Arcus is also being delivered to Khon Kaen University Hospital in Thailand.
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Australia’s first children’s cancer website

By admin E-Health & Technology Sep 02, 2015
Cancer Australia, along with the Australian Government, has launched the first national children’s cancer website.
Health Minister Sussan Ley and Cancer Australia officially launched the Children’s Cancer Website at The Children’s Hospital at Westmead last week. Funded by the Australian Government, the website will bring together a range of new and up-to-date evidence-based information on children’s cancers.
The website was designed in consultation with parents and health professionals. It aims to be accessible and user-friendly, and enables parents and carers of kids with cancer to be better informed about their child’s illness.
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Medical applications leading advancements in 3D printing

August 31, 2015
Gartner research has shown 3D printing (3DP) technology has progressed rapidly in recent years, and that medical applications are leading to some of the most significant deployments of 3DP technology.
Gartner’s 2015 Hype Cycle for 3D Printing reveals that 3DP of medical devices has reached the Peak of Inflated Expectations, but certain specialist applications are already becoming the norm in medical care.
“In the healthcare industry, 3DP is already in mainstream use to produce medical items that need to be tailored to individuals, such as hearing aids and dental devices,” said Pete Basiliere, research director at Gartner.
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Data initiative a breakthrough but it’s not all smooth sailing

Data is the digital currency of our world and if managed well it can be used to unlock new sources of economic value, provide fresh insights and deliver better outcomes for society.
This era of big data presents incredible opportunities — smarter cities, stronger companies, new jobs and better medicine — but it also presents challenges. The establishment of the recently announced NSW government Data Analytics Centre is a unique opportunity for business, universities and the state ­government to forge a partnership and deliver on data-driven opportunities.
When the NSW Minister for Innovation and Better Regulation, Victor Dominello, announced his intention to establish the DAC he said its purpose was to liberate all of the government’s data — too often buried away in silos — and provide a centralised analytics and insight capability for government decision making.
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NBN will boost GDP by 1.8%: new study

The National Broadband Network (NBN) will likely deliver a substantial benefit to Australia’s economy, according to a newly released study which also found that the greatest economic benefits will be derived from telehealth and teleworking.
According to the study, the NBN can boost Australian GDP by about 1.8%, and real household consumption - a measure of national welfare - by about 2.0%, additional to a “non-NBN environment”. Accounting for NBN debt-servicing requirements, growth in real household consumption reduces slightly to 1.4%.

The economic benefits of the NBN are established in a whitepaper published by the Centre for Energy-Efficient Telecommunications (CEET) at the University of Melbourne, based on a PhD study.  CEET is supported by Alcatel-Lucent and the Victorian Government.
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Nano cell project: art meets science to make the invisible visible

Andrew Trounson

Armed with an Xbox game controller and an Oculus Rift virtual reality headset, 3D animator and artist John McGhee has found himself at the forefront of microbiology research and a world-first effort to put scientists inside human cells to “see” processes ­occurring in nano­scale, or one-billionth of a metre.
Already scientists and ani­maters have created “macro” three-dimensional virtual realities inside human bodies using data from MRI and CT scans in a process set to revolutionise how doctors examine and tell patients what is going on in their bodies.
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Data retention and the end of Australians' digital privacy

Date August 29, 2015

Quentin Dempster

Contributing editor

The digital privacy of Australians ends from Tuesday, October 13.
So, the fact that you visited a porn site or infidelity site Ashley Madison or 'jihadi' content sites, may in effect be discoverable without the need for a warrant. 
On that day this country's entire communications industry will be turned into a surveillance and monitoring arm of at least 21 agencies of executive government.
The electronically logged data of mobile, landline voice (including missed and failed) calls and text messages, all emails, download volumes and location information will be mandatorily retained by Australian telcos and ISPs.
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Enjoy!
David.

Sunday, September 06, 2015

There Are A Lot Of Submissions On The PCEHR And IHI Legislation. I Wonder When We Will Get A Government Response?

This appeared a few days ago.

Electronic Health Records and Healthcare Identifiers: Legislation Consultation - Public Submissions

  • Home
  • Resources
  • Electronic Health Records and Healthcare Identifiers: Legislation Consultation - Public Submissions
On 28 May 2015 the Department of Health published a discussion paper (Word 154 KB) outlining proposed legislative changes to the Healthcare Identifiers Act 2010 and the Personally Controlled Electronic Health Records Act 2012. Submissions were invited from interested parties by 5pm Wednesday 24 June 2015.
Here is the link:
According to the site there are 137 submissions to date.
The last submission was received on 28 July 2014.
It is now early September so the Department have had a good month or so to digest what they have been told.
In the past I have noticed that there has been virtually no response to submissions made to the Department on matters like the PCEHR and the IHI.
To me the test for the Department is to now develop a document outlining what they have been told by all the submissions and what they propose to do to address the concerns that have been raised.
For them to not do so will confirm to pretty much everyone that responding to requests for Submissions is just a waste of time.
I look forward to the analysis of the Submissions and an explanation of what will be addressed flowing from the Submissions. In a reasonable world the Department's response would have been released with the Submissions - but that would be expecting too much I suspect!
I passing I would note - having read a range of the submissions - that as far as those who have responded there are a very large number of problems which need addressing that have been raised.
The ACHI submission - Number 110 - provides a very useful guide to many of the issues and is well worth a browse to get a flavour.
Many I browsed continue to be pretty sceptical of just how well the PCEHR can be made to work and what it will actually deliver - and some a pretty hostile to the idea of opt-out while others are keen on the idea. Pretty much all respondents see some difficult issues which will need to be addressed.

I guess, however, I am dreaming in hoping to see a worthwhile response.
David.

AusHealthIT Poll Number 286 – Results – 6th September, 2015.

Here are the results of the poll.

Do You Think The Replacement Of NEHTA By The New Aust. Commission For eHeath Will Make A Positive Difference?

For Sure 3% (3)

Probably 6% (6)

Neutral 18% (18)

Probably Not 53% (52)

No Way 19% (19)

I Have No Idea 0% (0)

Total votes: 98

Looks like there is very little confidence that the proposed ACeH - in its present form - will make much difference.

Good to see such a great number of responses!

Again, many, many thanks to all those that voted!

David.