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."

Monday, January 18, 2016

Weekly Australian Health IT Links – 18th January, 2016.

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

Welcome to the New Year - I hope you have a good one!
Clearly the biggest news is this!

Current notices

  • Personally Controlled Electronic Health Record (PCEHR)
The Personally Controlled Electronic Health Record (PCEHR) system is being renamed The My Health Record system on Saturday 16 Jan 2016. The system will be unavailable on Saturday from 08:00AM to 09:45AM AEDT.
Looking around on Sunday 17 I also notice the NEHTA web site seems to be unreachable - I would what that is about? (Later fixed)
Other bits of news follow!
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GPs must upload PCEHR summaries for PIP

Paul Smith | 13 January, 2016 |
GPs will have to upload shared health summaries to the PCEHR in return for e-health PIP payments, Australian Doctor has been told.
Leaked details on the new requirements of the E-health Practice Incentives Programme emerged last month following a consultation by the Federal Department of Health in September.
It is understood that under the revamp, each practice will be required to upload a shared health summary onto the PCEHR for 0.5% of its standardised whole patient equivalents (SWPEs) each quarter.
Australian Doctor has been told this would mean each GP creating and uploading around five shared health summaries per quarter for the practice to meet the new requirement.
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Practices to lose thousands if GPs don't create PCEHR summaries

Paul Smith | 14 January, 2016 |
Practices will lose their entire e-health Practice Incentive Program payment if their GPs refuse to upload shared health summaries to the PCEHR, the Federal Department of Health has confirmed.
On Wednesday it emerged that the E-health Practice Incentive Porgramme requirements will be revamped.
From May, each practice will have to upload a shared health summary for 0.5% of its standardised whole patient equivalents (SWPEs) each quarter.
Australian Doctor has been told this would mean each GP creating and uploading around five shared health summaries per quarter for the practice to hit the target.
However, the health department says failure to hit the target will mean practices being denied the entire incentive payment — even if they meet the four other e-health PIP requirements.
The RACGP has blasted the reform, saying that practices cannot force GPs to upload the summaries.
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New ePIP rules ripe for 'gaming': RACGP

15 January 2016
GOVERNMENT plans to tie e-health practice incentive payments of $50,000 a quarter to GPs uploading a specified number of shared health summaries leaves "the door wide open" for "gaming the system", the RACGP says.
Under changes flagged in a Christmas Eve email from the Department of Health, practices will need to upload a shared health summary for 0.5% of the their "standardised whole patient equivalent" per quarter to maintain ePIP eligibility.
The RACGP says the policy misses its target because it aims incentives at practices rather than practitioners.
"Practices cannot directly influence the actions of practitioners," says chair of the college's expert committee on eHealth and Practice Systems, Dr Nathan Pinskier.
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Qld Health CIO reportedly stood down

Recruitment saga circles department.

By Paris Cowan
Jan 6 2016 12:04PM
Queensland Health has confirmed it has stood down two senior executives over allegations of nepotism, with recently appointed CIO Colin McCririck reported to be one of the officers out of a job.
Health released a statement revealing it has “stood aside two senior officers following an internal complaint regarding recruitment processes”.
A spokeswoman declined to comment further on any actions that will be taken in relation to the complaint, or to confirm the identities of those involved.
But the Courier Mail has reported that one of the two executives involved is CIO and chief executive of the state government’s new eHealth Queensland division, Colin McCririck.
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Two senior Queensland Health executives stood down

Two senior Queensland Health bureaucrats have been stood aside while the Crime and Corruption Commission investigates their behaviour in a staff recruitment matter.
The Courier-Mail reports deputy director-general of corporate services Sussan Middleditch and eHealth Queensland chief executive Colin McCririck are the two bureaucrats under investigation over allegations they “conspired to get one of their spouses a plum job”.
The department released a brief statement citing the investigation of “two senior officers following an internal complaint regarding recruitment processes”:
“The Department of Health will not be commenting on the current actions being undertaken in relation to the complaint.”
Queensland Health boss Michael Walsh is understood to have stood down the pair on New Year’s Day, after the CCC informed him of the investigation the day prior.
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NSW Health offers up 350k salary in hunt for CIO

New boss for the new year.

By Paris Cowan
Jan 5 2016 1:53PM
NSW Health’s IT wing, eHealth NSW, is advertising for a new boss after former CIO Michael Walsh left to take on the top job at Queensland Health.
The successful candidate will assume the dual titles of chief executive of eHealth NSW and CIO of the state’s public health system, and will report directly to NSW Health secretary Mary Foley.
The state is offering a salary of up to $352,000 to attract top candidates to the role.
eHealth NSW's inaugural chief executive, Walsh, left the agency in July after being selected to return to Queensland Health as director general.
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Small businesses shouldn't be excused on data breach reporting, experts say

Date January 8, 2016 - 3:19PM

Tim Biggs

Technology reporter / producer

Even small companies now collect masses of personal information.
New laws proposed by the Turnbull government would force some companies to notify Australians if their personal data is breached as the result of a hack or cyber attack, but some experts say the rules don't go far enough.
The exposure draft of the Privacy Amendment (Notification of Serious Data Breaches) Bill 2015, introduced at the end of last year, requires any company or government agency subject to the Privacy Act 1998 to make the notifications within 30 days, however this means any non-profit or company with less than a $3 million per year turnover is exempt.
Ty Miller, of computer security firm Threat Intelligence, says the $3 million provision is a "historical value", sorely in need of updating in an age where even the smallest start-ups are collecting reams of personal data.
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Report reveals scale of health record data breaches

392 million protected health records disclosed globally
A new Verizon report reveals the scale of data breaches affecting protected health information (PHI) records.
More than 392 million (PHI) records have been disclosed during 1931 data breach incidents, states the report, which draws on data dating back to 1994 but mainly focused on incidents between 2004 and 2014.
Alongside the health sector, the inaugural PHI Data Breach report includes breaches from industries such as agriculture, manufacturing, retail, finance, education and public service.
The report includes data from 25 countries, including Australia, although the majority of the data is drawn from the US.
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Digital disasters haemorrhage bucketfuls of public money

  • The Australian
  • January 16, 2016 12:00AM
It’s a type of childlike optimism — the idea that governments can achieve lots of good things through the creation of large-scale, all-embracing information technology platforms. We just need more data and more investment in IT systems, so the central planners will argue, and the benefits will flow forever.
Indeed, our Prime Minister is very much taken by the potentially transformative power of government investments in IT. “Right across the board, you will see there are measures to ensure that government is digitally transformed, so that it is nimble, so that you can deal with government as easily as you can with eBay or with one of the big financial institutions.”
Or take this statement of faith by an ex-Treasury official: “The adoption across all levels of government of uniform IT systems in the health and education sectors, allowing a client’s entire service history to be tracked. Bingo!
“Then each and every service provided will be recorded, for all time, and can be benchmarked for performance. No more students leaving school who can’t read without a clear audit trail. No more health specialists charging differing fees for the same procedure without sanction. In other words, let digital disruption loose in core public service provision to drive up quality and drive down costs and the number of poor outcomes for consumers.”
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Making FHIR work for everybody

Posted on by wolandscat
FHIR is the HL7’s modern approach to connecting components in the health computing space. Unlike the HL7v2 message approach, FHIR is oriented to enabling applications connect to back-ends. It has been running for a few years now, and is doing good work on how to use REST, terminology, and generally make the application programmers experience better.
It is also over-hyped. That’s not mainly the fault, as far as I can tell, of the core developers but more of an industry exhausted by attempts to make HL7v3 work, but still desperate for solutions. Some of the hype would have you believe that FHIR solves all health informatics problems; common sense says this is not true. A lesser version of the hype would have you believe that FHIR solves all interoperability problems in health. A superficial inspection shows this is also not true. Both versions of the hype are leading some vendors, providers and even some government programmes astray.
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Announcement: #FHIR publishing plans

Posted on January 16, 2016 by Grahame Grieve
At the Orlando meeting, the FHIR Management Group (FMG) made an important decision around the future plans for the FHIR specification.
In March 2015, the FMG decided to publish DSTU2 that covered the base infrastructure, and to plan to release a DSTU 2.1 that left the infrastructure unchanged, and filled out additional details around the Financial and workflow resources, for ballot in the May ballot.
We’ve been following that plan until the meeting in Orlando, but it was evident that we needed to reconsider our plans. There were two reasons why:
  • Resolving the issues around the workflow resources was taking longer than we hoped, and sticking to our plan would mean no connectathon testing of the redesign
  • There was ongoing pressure to make changes to resources that were frozen for DSTU 2.1
After consulting with as many stakeholders as we could, and considering the ramifications of waiting until the September ballot, FMG decided that we will no longer publish a DSTU 2.1 version. We will instead plan to ballot DSTU 3 in September, with a likely publication date late this year.
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The upwardly mobile future of healthcare

The healthcare sector as we know it is undergoing a full examination, with digital practices transforming the ways medical professionals interact with their patients. Today, doctors have immediate access to tools that enable them to review patient data on-the-go, access databases and applications outlining drug and treatment options at their fingertips, and ultimately heighten response-times and management programs for patients in need.
The high uptake of bring your own device (BYOD) and wearable devices across the healthcare sector is not only benefiting doctors with more flexible ways of working — it’s also enabling the provision of faster diagnosis and superior care.
Mobility solutions have already made significant inroads into the health sector, seamlessly driving interactions from hospital room, to office, to clinic. Although, like any new business IT policy, the successful rollout of BYOD in an environment as sensitive as healthcare requires some significant thought and consideration.
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ACT Health CIO Judy Redmond moves on after five years

Territory unveils packed IT schedule for successor.

The ACT government's health directorate is preparing to search for a new chief information officer after its IT leader of five years, Judy Redmond, vacated the position in December.
Warren Prentice, who previously was a program manager overseeing military platform integration at the Department of Defence, is serving as acting CIO following her departure.
Prentice has held various IT-related roles with the RAAF, Australian Army, Department of Foreign Affairs and Trade, the Attorney-General’s Department and Microsoft.
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This Connection is Untrusted

You have asked Firefox to connect securely to myhealthrecord.gov.au, but we can't confirm that your connection is secure.
Normally, when you try to connect securely, sites will present trusted identification to prove that you are going to the right place. However, this site's identity can't be verified.
What Should I Do?
If you usually connect to this site without problems, this error could mean that someone is trying to impersonate the site, and you shouldn't continue.
Good it now Seems to be Fixed!
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Google search puts NSW Medical Council on the wrong side of privacy laws

Shabby online redaction lands regulator in hot water.

A NSW tribunal has ruled that the state’s Medical Council breached privacy laws when it published what it thought was a redacted PDF document on its website, but in doing so revealed the hidden identities of a doctor and her son to Google's web crawling bot.
In April, the NSW Civil and Administrative Tribunal (NCAT) will decide what penalties to apply to the NSW Medical Council for inadvertently publishing the names online, following a legal spat over the doctor's registration that had wound up in 2009.
The previous case had been settled between the parties and a non-publication order barred anyone involved from identifying the doctor and her sick son in the context of the litigation.
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Centrelink and BoM glitches: Government technical problems blamed on 'chronic underfunding'

Date January 12, 2016 - 12:15AM

Noel Towell

Reporter for The Canberra Times

Computer glitches that raised more than 70,000 bogus welfare debts and the collapse of the vital weather bureau website are the result of "chronic underfunding" of government departments, the main public sector union says.
The Bureau of Meteorology said it recovered quickly after its main forecasting website crashed for several hours on Friday, as several bushfires burned around the nation.
Now the Community and Public Sector Union says there is a pattern of "computer glitches" emerging across the Commonwealth as cash-starved departments struggle to keep their systems functioning.
The BoM's website was hit with a "physical networking issue" early on Friday morning that prevented updates to its website, with the problems persisting well into the afternoon.
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NEHTA eHealth Software Developer Community Webinar Series - Webinar invitation and Survey

Created on Thursday, 14 January 2016
NEHTA is running a series of webinars for organisations developing software to support the national eHealth programme, including accessing the My Health Record system and the Healthcare Identifiers service.
We are pleased to invite you to join the Connecting your software to the My Health Record system – Process and Resources webinar.
Webinar
Connecting your software to the My Health Record system
Process and Resources
Wednesday 3 February 2016 1:30 pm (AEDT)
The Connecting your software to the My Health Record system webinar follows on from the first webinar Introduction to the national My Health Record system and will outline the steps for software developers to connect your system to the My Health Record system. It will also cover the resources available to support your implementation.
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Global Health clinches e-health contract with Adelaide PHN

Wednesday, January 13, 2016
Adelaide based Global Health (ASX:GLH) signed a new contract for its MasterCare Electronic Medical Record with the Adelaide Primary Health Network.
Adelaide PHN has a goal of improving health outcomes and commissioning services.
Global Health works with state and federal programs to seek productivity improvements and optimise patient outcomes.
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Global Health starts the year with two contract wins

e-health solutions provider Global Health has secured two major contracts – a $3 million five year contract with the ACT Mental Health, Justice Health and Alcohol & Drug Services (MHJADS) Electronic Clinical Record (ECR) project – and a contract with the Adelaide Primary Health Network (APHN) for the roll-out of MasterCare Electronic Medical Record (EMR).
The ACT Mental Health contract covers the licensing, implementation and ongoing support of the MasterCare Electronic Medical Record (EMR), MasterCare Data Warehouse software and reporting platform for the ACT Mental Health, Justice Health and Alcohol & Drug Services (MHJADS) Electronic Clinical Record (ECR) project.
MHJADS will use the MasterCare suite to integrate its clinical record management across all operations, and allows Alcohol & Drug Services and Justice Health Services to replace their paper-based clinical records, whilst Mental Health Services will benefit from an upgrade in their electronic clinical record capabilities.
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Latest products, services and ventures

January 10, 2016
The Rust Report has created a new section announcing just-released products, services and initiatives new to the marketplace. For information regarding possible listings please email newsdesk@rustreport.com.au
Orion Health launches Rhapsody Version 6.2
Orion Health, a leading population health management and healthcare integration company, has announced the release of Rhapsody Integration Engine Version 6.2. The new version of Rhapsody delivers a number of customer focused innovations to help users work smarter. Plus, it builds on the FHIR capabilities introduced in Rhapsody 6.1, the first integration engine to implement the new HL7® Fast Healthcare Interoperability Resources (FHIR®) standard. The Rhapsody dashboard has been enhanced to provide at-a-glance monitoring via multiple channels such as a tablet, smart phone, and monitor.
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What the NBN will look like in 2020

The national broadband network should presumably be rolled out by mid-2020 and the end result will inevitably dismay some and amaze others. It’s likely that the talk of selling NBN Co will be back on the agenda by then, along with a wholesale recognition of what this shallow version of the NBN truly represents.
By mid-2020 the NBN will have become critical infrastructure that underpins Australia’s slice of the $US1.36 trillion added to the global digital economy by the increased use of digital technologies globally. It’s a slice that will be significantly slimmer than what could have been garnered, courtesy of the deliberate manner in which the original NBN was hamstrung.
Public-private partnership
The NBN has polarised the nation and will fuel discontent for decades to come. It will certainly be seen as an object lesson in whether or not a government can be trusted to embark on large infrastructure projects without the overwhelming support of the major participants in the industry sector and a private industry partner.
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Enjoy!
David.

Sunday, January 17, 2016

Sadly You Can Be Sure Australian E-Health Is In For Much More Of The Same. How Hopeless.

A job add appeared a day or so ago:

Chief Executive Officer, Australian Digital Health Agency

  • Newly created statutory authority
  • Flexible location – Sydney, Brisbane or Canberra
  • Strategic leadership, innovation and engagement
The Australian Digital Health Agency will be fully operational on July 1, 2016. This Agency will assume strategic management and governance responsibilities for all national digital health strategy, design, development, delivery and operations. In doing so, the Agency will transition the activities and resources from the National E-Health Transition Authority and the system operation activities of the My Health Record currently managed by the Department of Health.
Reporting to a skills-based Board reflective of the health community, the CEO will initially focus on establishing and transitioning activities to the new Agency. Beyond that, the CEO will be responsible for the strategic leadership, engagement, collaboration, innovation and operations of the national digital health systems.
The Position
  • Lead strategic planning, stakeholder engagement  and operational excellence 
  • Implement the National Digital Health Strategy as directed by the Ministerial Council
  • Maximise the effective interoperability of the public and private digital health systems
  • Ensure clinical safety in the delivery of the national digital health work program
The Person
  • A dynamic and innovative leader, with complex change leadership experience
  • Able to formulate national strategies with a focus on delivery of outcomes  
  • An understanding of and ability to manage major IT programs
  • Exceptional stakeholder engagement skills
  • Able to effectively manage within the political, private and public sector environment
  • Independent and accountable in delivering the digital health outcomes
 CLOSING DATE: Sunday January 31, 2016
Here is the link to the ad:
Summary - we are looking for a political IT expert who is a good manager and who is good at engaging with stakeholders (unspecified).
We are also planning to pop all of NEHTA’s functions and the operational activities of the PCEHR under one organisational roof and are hoping the new leader will be good at everything from operations to strategy.
There seems to also be a need to lead strategic planning - scope unspecified.
Astonishingly what is missing is any mention of expertise or experience in e-Health related domains. A small oversight? What do you think?
So it looks like we will get another banker, or the like, for the role. The more things change the more  they seems to stay the same!
David.

AusHealthIT Poll Number 303 – Results – 17th January, 2016.

Here are the results of the poll.

The AFR Is Now Reporting That The Trials For The New E-Health System Will Last 3 Years. Has The DoH Now Really Lost The Plot? See http://www.afr.com/business/health/federal-healthcare-reform-a-major-shakeup-or-a-reviewfest-20160106-gm08x0

Yes 77% (37)

No 10% (5)

I Have No Idea 13% (6)

Total votes: 48

Again a pretty decisive poll. It seems most readers are rather concerned the DoH is not quite on top of its brief.

Again, many, many thanks to all those that voted in such a quiet week!

David.

Sunday, January 10, 2016

AusHealthIT Poll Number 302 – Results – 10th January, 2016.

Here are the results of the poll.

Holiday Poll : Is The Idea Of A National E-Health Records System Basically An Impractical And Expensive Nonsense?

Yes 76% (129)

No 19% (32)

I Have No Idea 5% (8)

Total votes: 169

Again a pretty decisive poll. It seems most readers are not all that enthusiastic about the concept of the PCEHR.

Good to see such a great number of responses!

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

David.

Note: Normal blogging will return next week if it seems anything is happening!

D.

Saturday, January 02, 2016

It Would Be Nice To Think That 2016 Will Not Be More Of The Same. I Wonder What The Chances Are?

While cleaning up over the holiday I found a photocopy of this commentary and wondered if it was still on line.
Amazingly it was:
So from late 2010 we read!

We cannot afford an e-health failure: national electronic health system

THE quality of Australia's electronic information infrastructure for its health sector is a barrier to the quality of our health system.
This infrastructure, called e-health, has been promised by both sides of politics during the past decade but hasn't been delivered.
That this hasn't happened matters because the delivery of safe, evidence-based and timely care requires information to flow accurately and reliably between those involved in the care of the patient. Additionally, it's important to have patients involved in reviewing and creating their own health information.
For years, management of financial records has been computer-based and communicated globally, but we struggle with health records. We can't obtain the improved efficiencies and effectiveness delivered to the financial sector until we crack e-health. Without such improvements the cost of health services is predicted to become unsustainable in the next decade or two.
This month The Australian has reported quite alarming, and accurate, information regarding what can only be interpreted as a significant failure in the governance and leadership of our e-health efforts in Australia.
For instance, an entity called the National E-Health Transition Authority -- which is meant to be central in delivering the electronic information infrastructure -- admits that, despite having had funding in the hundreds of millions of dollars in the past few years, it's largely failed to deliver.
A key NEHTA initiative, now recognised as having been very badly managed, is the development of a system to ensure users of the e-health infrastructure are properly identified and authenticated. This is critical as users will access sensitive private information.
For more than three years this project has defeated NEHTA internally. Now the authority is seeking external help to start again, essentially from scratch, as recommended in the 2008 Deloitte E-Health Strategy for Health Ministers. Who knows what effect this will have on the delivery of services, but it's certain to be significant.
Here's a second example of bungling. The Department of Health and Ageing has made substantial payments to GPs to encourage them to use a standard technology to facilitate information flows, but it co-ordinated so badly with NEHTA, which is meant to develop the standards, that tens of millions of dollars have been spent to no good purpose.
In my view these failures and the associated waste can be attributed to the incoherent and opaque arrangements for leadership and governance in place in the e-health sector.
That this is a big issue isn't news to anyone who's followed the progress of e-health in this country. In late 2007 the Boston Consulting Group reviewed NEHTA's progress for the NEHTA board and made the point that NEHTA was performing "in the red" on both stakeholder engagement and governance.
And while the Deloitte strategy has been widely welcomed by the sector and agreed by the Australian Health Ministers Council, progress on implementation of the governance and leadership recommended in this plan could only be described as glacial.
Despite what you may think, there's considerable political consensus at the leadership level on the need to make substantial progress in e-health. This seems to be at least one good thing to emerge from the recent election campaign.
As I read it, we have agreement from Labor, the Coalition and the Greens that introduction of reasonable levels of computerisation and electronic messaging within the health sector promises to have significant positive effects on quality, safety and efficiency within the sector, while recognising there are issues of information security and privacy that do need to be addressed.
This is a least a basic starting point for "moving forward".
Turning nice furry feelings and group hugs into real action is what's required.
We have a situation where the Prime Minister has expressed considerable frustration with progress in this domain. And when he was health minister, the present Opposition Leader expressed more than considerable frustration regarding what he was able to deliver in e-health.
The time to get this consensus working has well and truly come. The following steps are the key to long-term success.
First, develop, implement and fund an inclusive, responsive, authoritative and well-led governance entity, as recommended by both reports mentioned above. This body needs to work across the health sector, private and public, demanding accountability for funds expended at all levels for all projects.
Second, make clear that e-health is an enabling tool for what's needed for the health system. It's not an end in itself. E-health is an infrastructural element that will be crucial if we are all to have a safe, effective system that delivers improved quality of patient care, greater patient safety and improved economic efficiency and sustainability.
If we don't get the leadership, funding and governance of e-health right, the nation will be condemned to another lost decade rather like the one that's just passed, one with little real progress towards what was wished and hoped for and, indeed, what was promised.
It could have been a lot better, and it needs to be a lot better. Time is running short, so over to you, Ms Gillard and Mr Abbott.
David More is a medical specialist who has worked in the e-health area for more than 20 years. He blogs on the topic at  www.aushealthit.blogspot.com
The article is here:
To me the suggestions are still pretty close to the mark!
I will leave it to others to comment on just how fast we have progressed in the last half decade!
David.

Thursday, December 24, 2015

Seems Health Information Exchange Might Not Make The Scale Of Difference Hoped For.

This appeared a little while ago.

HIE not 'causally related' to cost improvements, care quality benefits

March 3, 2015 | By Dan Bowman
An examination of health information exchange research published this month in Health Affairs determines that despite an increase in the sharing of health data across organizations, benefits on costs and care quality are scarce.
For the study, the researchers--from the University of Alabama at Birmingham, Weill Cornell Medical College in New York and Indiana University--analyzed 27 articles that included 94 individual analyses. For each discrete analysis, the researchers then determined whether or not a beneficial relationship existed between the exchange of health data and the outcomes.
Overall, 54 analyses found beneficial effects of health information exchange. However, the researchers argued, of six studies that used designs with strong internal validity--those "capable of identifying causal relationships"--only two found beneficial results.
"Despite the abundance of observational studies finding a beneficial relationship between HIE and outcomes, there is currently no strong evidence to suggest that HIE is causally related to any widespread generalizable benefits," the authors said.
The authors submitted that most of the studies they examined focused on "first-generation" iterations of health information exchange systems, as well as on institutions where active HIE usage was low. Continued meaningful use of such systems, they added, could likely enable better evaluation adoption.
Lots more here:
Here is the published abstract:

Despite The Spread Of Health Information Exchange, There Is Little Evidence Of Its Impact On Cost, Use, And Quality Of Care

  1. Nir Menachemi3,*

Abstract

Health information exchange (HIE), which is the transfer of electronic information such as laboratory results, clinical summaries, and medication lists, is believed to boost efficiency, reduce health care costs, and improve outcomes for patients. Stimulated by federal financial incentives, about two-thirds of hospitals and almost half of physician practices are now engaged in some type of HIE with outside organizations. To determine how HIE has affected such health care measures as cost, service use, and quality, we identified twenty-seven scientific studies, extracted selected characteristics from each, and meta-analyzed these characteristics for trends. Overall, 57 percent of published analyses reported some benefit from HIE. However, articles employing study designs having strong internal validity, such as randomized controlled trials or quasi-experiments, were significantly less likely than others to associate HIE with benefits. Among six articles with strong internal validity, one study reported paradoxical negative effects, three studies found no effect, and two studies reported that HIE led to benefits. Furthermore, these two studies had narrower focuses than the others. Overall, little generalizable evidence currently exists regarding benefits attributable to HIE.
Here is the link:
Given that it would be hard to describe the PCEHR as much more than a pretty weak attempt at a Health Information Exchange - seems we really need to check that it is making a difference before spending too much more!

See also the first link from yesterday for confirmation of the view.

http://www.fiercehealthit.com/story/studies-hie-benefits-few-and-far-between/2015-12-18

Happy Christmas knowing that the PCEHR is probably a major ongoing waste of money!

David.

More Evidence That Health Information Exchange My Not Be All That Beneficial. Worth A Read.

This appeared a little while ago:

Health Information Exchanges Show Little Evidence of Benefits

MAR 27, 2015 7:42am ET
Though health information exchanges are supposed to improve the speed, quality, safety and cost of patient care, there is little evidence of these benefits in existing HIE studies.
That is the conclusion of a research paper, published in this month’s issue of the journal Health Affairs, in which researchers reviewed 27 studies looking for evidence that HIEs increased efficiency, reduced healthcare costs or improved outcomes.
While researchers found that 57 percent of published analyses reported some benefit from HIE, they also reported that articles employing study designs having strong internal validity—such as randomized controlled trials or quasi-experiments—were significantly less likely than others to associate HIE with benefits.
 “Among six articles with strong internal validity, one study reported paradoxical negative effects, three studies found no effect, and two studies reported that HIE led to benefits,” state the researchers. “Furthermore, these two studies had narrower focuses than the others.”
Two of the six studies found beneficial effects largely as a result of a reduction in diagnostic and imaging tests, associated costs or both, and these studies were based in a single clinic affiliated with an Indiana hospital or in one healthcare system in Israel. Overall, the paper found that “little generalizable evidence currently exists regarding benefits attributable to HIE.”
More here:
Here is the free abstract:

Despite The Spread Of Health Information Exchange, There Is Little Evidence Of Its Impact On Cost, Use, And Quality Of Care

  1. Nir Menachemi3,*

Abstract

Health information exchange (HIE), which is the transfer of electronic information such as laboratory results, clinical summaries, and medication lists, is believed to boost efficiency, reduce health care costs, and improve outcomes for patients. Stimulated by federal financial incentives, about two-thirds of hospitals and almost half of physician practices are now engaged in some type of HIE with outside organizations. To determine how HIE has affected such health care measures as cost, service use, and quality, we identified twenty-seven scientific studies, extracted selected characteristics from each, and meta-analyzed these characteristics for trends. Overall, 57 percent of published analyses reported some benefit from HIE. However, articles employing study designs having strong internal validity, such as randomized controlled trials or quasi-experiments, were significantly less likely than others to associate HIE with benefits. Among six articles with strong internal validity, one study reported paradoxical negative effects, three studies found no effect, and two studies reported that HIE led to benefits. Furthermore, these two studies had narrower focuses than the others. Overall, little generalizable evidence currently exists regarding benefits attributable to HIE.
Here is the link:
Looks like we will need to wait a little longer to be sure we have HIEs that are working or we need to carefully rethink what is likely to make a real positive difference.
David.