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."

Tuesday, August 16, 2016

I Think We Are Going To Need To Keep A Close Eye On The New CEO Of The ADHA. He Has A Clean Slate Here He Needs To Exploit For All Of Us!

This popped up just before I fell ill.

Appointment of CEO for the Australian Digital Health Agency

Minister for Health, Sussan Ley, has announced the appointment of Mr Tim Kelsey as the Chief Executive Officer of the Australian Digital Health Agency which is responsible for all national digital health services and systems.
 Page last updated: 01 August 2016
PDF printable version of Appointment of CEO for the Australian Digital Health Agency - PDF 337 KB

1 August 2016

Minister for Health, Sussan Ley, today announced the appointment of Mr Tim Kelsey as the Chief Executive Officer of the Australian Digital Health Agency which is responsible for all national digital health services and systems, with a focus on engagement, innovation and clinical quality and safety.

“Most importantly, the new Agency is the system operator for the Government’s recently launched My Health Record System which is a secure, online summary of people’s health information that can be shared with doctors, hospitals and healthcare providers with the permission of patients. This gives people more control of their health and care and with access to new digital apps and online services the Australian community is benefiting from the modern information revolution,” Minister Ley said.

“I am, therefore, delighted to announce that following an extensive national and international search Mr Tim Kelsey has accepted the permanent role of CEO to head up of the Australian Digital Health Agency. He is internationally regarded as a leader in digital health, in both the private and public sectors, and has a proven track record in delivery of digital health services.”

Ms Ley said that previously Mr Kelsey was the first National Director for Patients and Information in NHS England. This role combined the functions of chief technology and information officer with responsibility for patient and public participation, marketing, brand and communications for the national commissioner for health and care services. He was also the first chair of the National Information Board in England which successfully oversaw design of a new digital health strategy for the NHS.

Before becoming a director of NHS England, he designed and launched NHS Choices website – the national online information service which has transformed access to apps and mobile digital services for patients and citizens in England. In 2000, he co-founded Dr Foster, an organisation which pioneered public access to online information about local health services.

More recently, Mr Kelsey has been working with Telstra Health to focus on ways to use its technology capabilities to support transformation in the costs and quality of healthcare in Australia.

‘He is the right choice for the appointment as CEO of the Australian Digital Health Agency to further the Australian Government’s commitment to use digital health to create a world-class health system for all Australians,” Minister Ley said.

Mr Kelsey will commence in his new CEO role with the Australian Digital Health Agency in mid-August 2016.

Media contacts: Troy Bilsborough – 0427 063 150 Steve Block - 0428 213 264
Here is the link:
There are two useful articles to consider on all this:
First we have:

Care.data: gone but not forgotten

Care.data has been officially dead for more than a month, but its legacy is far from buried. Ben Heather takes another look at the fine detail of the Caldicott report that officially killed the programme and what it could mean for the future of sharing and handling of patient data.
On 19 July, with the nation’s eyes on the long-awaited Chilcot Iraq inquiry report, the end of the controversial care.data programme barely rated a mention.
The programme that damaged public confidence in the government’s handling on their personal health information died quietly.
The recommendations contained in the report that killed it, National Data Guardian Dame Fiona Caldicott’s review into health data security and patient consent, caused barely a ripple.
But as the summer window for public consultation on the recommendations rolls on, concerns are surfacing that care.data, or at least its ambition, are still alive and kicking.
While the report’s recommendations on greater data security and information governance have been lauded, the position on opt-outs and data collection have started to attract attention and some familiar concerns.
Sharing concerns
One dramatically worded online petition doing the rounds at the moment claims the government is now attempting “privatisation of your medical records, but this time without even telling us”.
More sober analysis from clinicians and privacy groups doesn't go that far, but does reveal worries that parts of care.data will endure at NHS Digital [until 1 August the Health and Social Care Information Centre], but with less opportunity for patients to opt out and weaker oversight.
They point to recommendations around data sharing, consent and opt-outs in Dame Fiona’s report, most of which the government has already indicated it is likely to back.
Retired GP Mary Hawking, who sat on the now disbanded general practice extraction service independent advisory group, says some of the Dame Fiona’s proposals would give NHS Digital wider discretion to gather and use confidential patient data.  
“There doesn’t seem to be anyone independent at all looking at how HSCIC [now NHS Digital] uses whatever data they chose and use it however they chose. They just had to say it is de-identified,” Hawking says.
Hawking says de-identifying data is “incredibly difficult” and became even more so as more and more de-identified data was linked and shared, potentially exposing patient’s sensitive health records.
Phil Booth, co-founder of privacy campaign group medConfidential, raises a similar point, arguing that much of the so-called anonymised data sent out to third-parties now is not fully anonymised, with a patient identity easily uncovered.
He says while the care.data brand is gone, the programme to gather and share a wider range of patient’s confidential health information is very much alive. “Care.data has crashed but the policy remains; they still want that data,” he says.
Dame Fiona’s report also recommends going further than care.data, removing the patients’ right to opt-out of this central collection altogether, he adds.
“HSCIC [NHS Digital] needs to be perfect if we don’t want to give people an opt-out. The opt-out is ultimate protection.”
Responding to question from Digital Health News, NHS Digital says all gathering of patient data is now, and will be in the future, subject to legal oversight.
This includes scrutiny by the standardisation committee for care information, which oversees the collection of data, and the data access advisory group, which oversees requests for data.
What information might be gathered and shared in future will be dependent on the outcome of consultation, the statement says. “It is vital that there is a full consultation and dialogue with the public and professionals before any implementation of the recommendations can take place.”
Lots more here:
Second we have:

Australia hires former head of controversial UK care.data plan

Tim Kelsey to head new Digital Health Agency

The Australian government's love affair with digitisation experts from the United Kingdom continues, with former National Health Service (NHS) digital head Tim Kelsey made boss of the antipodean Digital Health Agency (successor to the National e-Health Transition Agency).
The leave moves Telstra Health shy a director, since that was Kelsey's destination when he announced his resignation from the NHS in September 2015.
Kelsey quit the NHS after several years in charge of its highly-controversial care.data program, an data sharing operation that was criticised as privacy-invasive.
In 2014, he went on the record saying that “"no one who uses a public service should be allowed to opt out of sharing their records. Nor can people rely on their record being anonymised.”
The system was so popular among doctors that its bosses started switching from carrot to stick in 2014, saying laggards would have funding withheld.
By August 2015, a Cambridge University study noted care.data's failings: “mismanagement and miscommunications, inadequate protections for patient anonymity, and conflicts with doctors”. The boffins opined that requiring patients to opt-out was “unsuitable” and said there was a risk “to the trust between patients and general practitioners”.
More here:
Just a few comments:
First I hope Mr Kelsey is clear just how different GP in Australia and the UK is – especially with regard to contract obligations and private management.
Second I hope we will see proper public Privacy Impact Assessments on all new ADHA initiatives.
Third I hope he becomes an expert on all the reports done on NEHTA and understands just how different an organisation ADHA needs to be from NEHTA in terms of communication, stakeholder trust, communication and engagement as well as providing a dramatic improvement on transparency and openness.
I wish him great success and for him to fully deliver on the reasonable and useful promise e-Health has. Time will tell!
David.

Monday, August 15, 2016

Weekly Australian Health IT Links – 15th August, 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

Quite a busy fortnight  and lots of headlines to follow up. I hope you enjoy the browse!
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Appointment of CEO for the Australian Digital Health Agency

Minister for Health, Sussan Ley, has announced the appointment of Mr Tim Kelsey as the Chief Executive Officer of the Australian Digital Health Agency which is responsible for all national digital health services and systems.
 Page last updated: 01 August 2016
1 August 2016
Minister for Health, Sussan Ley, today announced the appointment of Mr Tim Kelsey as the Chief Executive Officer of the Australian Digital Health Agency which is responsible for all national digital health services and systems, with a focus on engagement, innovation and clinical quality and safety. 
“Most importantly, the new Agency is the system operator for the Government’s recently launched My Health Record System which is a secure, online summary of people’s health information that can be shared with doctors, hospitals and healthcare providers with the permission of patients. This gives people more control of their health and care and with access to new digital apps and online services the Australian community is benefiting from the modern information revolution,” Minister Ley said.
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Can UK digital whizz resurrect eHealth?

By Marie Sansom on August 3, 2016
The new agency responsible for e-health records has secured the services of the man who oversaw the design of a new digital health strategy for Britain’s National Health Service (NHS).
Tim Kelsey, who was the first National Director for Patients and Information in NHS England, will head up the Australian Digital Health Agency (ADHA), which came into being on July 1 this year.
He will lead national digital health in Australia, including resuscitating the troubled My Health Record system, where patient’s health records are shared between doctors, hospitals, healthcare providers and specialists, with permission from patients.
Kelsey’s CV shows a long-term commitment to transparency and forcing up healthcare quality by using data for public good but he has also been embroiled in some controversy in the past.
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Australia hires former head of controversial UK care.data plan

Tim Kelsey to head new Digital Health Agency

3 Aug 2016 at 23:22, Richard Chirgwin
The Australian government's love affair with digitisation experts from the United Kingdom continues, with former National Health Service (NHS) digital head Tim Kelsey made boss of the antipodean Digital Health Agency (successor to the National e-Health Transition Agency).
The leave moves Telstra Health shy a director, since that was Kelsey's destination when he announced his resignation from the NHS in September 2015.
Kelsey quit the NHS after several years in charge of its highly-controversial care.data program, an data sharing operation that was criticised as privacy-invasive.
In 2014, he went on the record saying that “"no one who uses a public service should be allowed to opt out of sharing their records. Nor can people rely on their record being anonymised.”
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Editorial: Census disaster dents trust in digital future

The Editor, The Courier-Mail
August 11, 2016 12:00am
A FUNNY thing about Australians is how cheerfully willing they are to participate in collective governance.
The unfunny thing is when that goodwill is completely shattered by something like the debacle of the 2016 Census.
Despite a slew of conspiracy theories about how our deepest secrets would be stolen by the new computerised Census, millions of people gave up their Tuesday evenings, their dinners, their TV shows, their homework supervision, their bedroom rituals, to sit down and fill in a form. That’s not typical of national responses to bureaucracy – the US has (usually largely ineffectually) to prod its citizens to even vote.
All those Australians trying to participate in the Census were rewarded by hours of frustration and of stress about the consequences of not completing that form.
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#FHIR is 5 years old today

Posted on August 11, 2016 by Grahame Grieve
Unofficial FHIR project historian Rene Sponk has pointed out that it’s exactly 5 years to the day since I posted the very first draft of what became FHIR:
Five years, on August 18th 2011 to be precise, Grahame Grieve published the initial version of FHIR (known as RFH at the time) on his website. The date of the initial version was August 11th – which is the reason for this post today. Congratulations to all involved for helping to create a success – FHIR has gained a lot of interest over the past few years, and a normative version will be published in the near future.
Wow. 5 years! Who would have thought that we’d end up where we are? I really didn’t expect much at all when I first posted RfH back then:
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#GottaCureEmAll – Pokemon GO teaches healthcare a big lesson

August 1, 2016
If we can believe what we are seeing, Pokemon GO is the world’s most effective, and most widespread, population weight loss intervention. Already, its users spend more time on the game than on other wildly popular mainstream social media platforms like Facebook, Snapchat and Twitter. Over the space of a few weeks, it has prompted millions of children and teens to get off the couch, turn off Netflix, leave the laptop in their bedroom, and walk out into the world to breath the fresh air. More than a few adults have done the same.
Healthcare should pay attention. While healthcare researchers are slowly coming to grips with ‘new’ ideas like gamification and social media to defeat obesity, the game industry has jumped the queue and may have already done it. Silicon valley has drawn down on its deep well of expertise in building large and complex software systems, and in embedding such systems into the real world. They have drawn on their deep experience with and understanding of the psychology of online social media, of what makes games ‘fun’, and what makes them ‘sticky’.
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Australia’s digital divide is leaving the rural community behind

JIM GALL, The Weekly Times
August 11, 2016 12:00am
THE recent experience of yet another drawn-out, clunky and non-transparent voting process to decide Australia’s 45th parliament has reminded me just how antiquated this country is in respect to our collection and management of data.
If Australia were run like a commercial business with even a modicum of marketing expertise, the election process would be simple, fast, transparent and educative for both candidates and voters.
The Australian Electoral Commission could send out an Electronic Direct Mail (EDM) to the electorate via their Customer Relationship Management (CRM) database with a live link to the AEC website profiling candidates in every electorate.
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Planning for privacy in health research

Australia August 8 2016
Information is critical to the conduct of health and medical research. Much of the time the information relates to individuals. Higher education institutions regularly collect, use, disclose and hold information, including health information, for research purposes. The richness and availability of information sources for research purposes, including digital data from the public domain, together with the ease with which data can cross jurisdictions, and the ability to mine and analyse it, all require researchers and human research ethics committees (HRECs) to engage directly with a complex range of multi-jurisdictional privacy obligations.
The challenges are even more onerous when health information is involved as it is considered to be more sensitive than other personal information (and is legally defined as such ). It is therefore afforded a higher degree of protection, which means there are more stringent obligations on individuals and entities who collect health information for research purposes. However privacy legislation also makes special provisions to permit the use of personal information in health and medical research where the public interest in the research activities substantially outweighs the public interest in the protection of privacy.
This article provides a recap of the privacy framework that applies to health information that is collected for research purposes and offers some practical insights into preparing for and managing privacy issues.
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11 August, 2016

At $42.50 per keystroke, ePIP’s EMR incentive might just bite

Posted by Jeremy Knibbs
Medical Director’s ePIP tool simplifies the new ePIP incentive so much you can earn about $42.50 for each tap of your keyboard
According to Medical Director’s Chief Medical Officer Dr Andrew Magennis, it takes only 200  keystrokes  per quarter for a  GP practice to earn the new ePIP incentive using Medical Director’s new ePIP tool.
In May, ePIP switched focus from practices having the communications capability to upload shared health summaries to them actually sending them to the MyHealthRecord (MHR) database. A practice can earn up to $50,000 per year if they send up to 0.5% of their SWPE (standardised whole patient equivalent) count in shared health summaries to the MHR database per quarter over one year.
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Brain-controlled robots and VR help paraplegic patients feel and move limbs again

The team behind the Walk Again Project wanted to teach paralyzed patients how to walk using robotic leg supports, but the results were much better than they expected.
By Kelly McSweeney for Robotics | August 12, 2016 -- 19:01 GMT (05:01 AEST) |
When the Walk Again Project was founded in 2013, an international consortium of scientists had an ambitious goal to teach paraplegic patients to walk using a brain-controlled robotic exoskeleton. But a year into the study, they were surprised to discover that the results were even better than they could have imagined: the patients could feel and move their legs again.
It's hard to say exactly which aspect of the therapy is responsible for the remarkable recovery, because the project involved a combination of three different setups. Additionally, the study only involved a small sample of eight patients. A comprehensive clinical trial will be necessary in the future, but the results are still quite ground breaking nonetheless.
All of the patients had been previously diagnosed as being completely paraplegic, but after long-term therapy with brain machine interfaces (BMIs), they all showed some improvement. After several years of being paralyzed, patients could feel and sometimes even move their limbs again. The treatment also improved bladder and bowel functions. One year after the start of the project, half of the patients recovered enough sensation and muscle control that their doctors upgraded their diagnoses from complete to partial paralysis.
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Webinar: Designing a workflow for registering patients for a My Health Record

Created on Tuesday, 09 August 2016
You are invited to attend a new webinar brought to you by the Australian Digital Health Agency (the Agency), and the Australian Association of Practice Managers (AAPM). This webinar is designed to provide targeted information and training on the My Health Record system to practice staff.
This webinar will take place on Friday 19 August, 1:00pm - 1:45pm AEST.
The webinar will cover the following:
  1. Design a practice system for registering new and existing patients
  2. Share success stories from other practices
  3. Create a practice-specific dialogue for registering patients
  4. Identify privacy and access restrictions for administration staff
  5. Discuss policies, consent, and standards appropriate to My Health Record
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Doctor 'TripAdvisor' bothers AMA

29 July, 2016 
A rate-my-doctor website, dubbed the 'TripAdvisor' of healthcare, has been welcomed by the federal government but met with caution from doctors.
Private health insurers Bupa and HBF have agreed to join the Whitecoat doctor directory and customer review website founded by rival nib - expanding its reach to about six million privately insured Australians.
The health funds say Whitecoat will promote competition and improve transparency among high-charging doctors.
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Hospitals line up to receive notorious SA health software

By Paris Cowan on Aug 4, 2016 12:21PM

Minister reveals future EPAS sites.

South Australia’s Health Minister Jack Snelling has revealed the list of hospitals next in line to receive the notorious EPAS patient records system under the state’s $421 million metropolitan rollout.
Despite the headaches caused by the electronic patient administration system (EPAS) over the past five years, Snelling told budget estimates this week he was confident the installation at the Lyell McEwin Hospital and Flinders Medical Centre in Adelaide’s suburbs would “probably go pretty smoothly”.
His comments come despite a concession that the health department will almost certainly have to go back to the state treasury in coming years to beg for more money to complete the late-running project.
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SA govt settles unlicensed software lawsuit

By Paris Cowan on Aug 4, 2016 4:20PM

Vendor agrees to renew licences rather than go to trial.

The South Australian government has managed to resolve its differences with hospital software provider Global Health, preventing a potentially messy Supreme Court trial set down for the end of this year.
The state has been locked in a legal spat with the Australian distributor of a legacy patient administration solution known as CHIRON since last year, over the health department's refusal to stop using the 1980s, out-of-license software in at least a dozen regional public hospitals. 
SA Health is the only remaining user of the long-unsupported product, and the vendor has complained that the continued installation represents an unwanted drain in its Australian resources.
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MedsASSIST hits two million recorded transactions

Monitoring system for medicines containing codeine has reached a significant milestone

More than two million transactions involving OTC medicines containing codeine have been recorded by pharmacists participating in the MedsASSIST program, reports the Pharmacy Guild of Australia.
And about 65% of community pharmacies have used MedsASSIST since its national roll out in March, says the organisation.
MedsASSIST is a real-time recording and monitoring system for medicines containing codeine, which was developed by the Pharmacy Guild in response to concerns about patient safety.
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What do we do with all this patient-generated health data?

3 August 2016
GEORGE ORWELL would be amused. Modern technology is watching us even more than he predicted — every step we make, every pill we take, every time we wake. And we can’t get enough.
Over one-fifth of Australians now track their health using a wearable device, and almost one-third with mobile phone apps. 
The trend is part of a larger shift towards patients wanting a more collaborative role in their healthcare, says Melbourne GP Dr Nathan Pinskier, who chairs the RACGP’s ehealth expert committee. 
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Outpatients’ telehealth program is saving time and money

on August 8, 2016 at 11:20 am
Senior Physiotherapist, Stephanie Carroll, walks us through the successful trial of a telehealth program being used in the Post Arthroplasty Review (PAR) clinic at St Vincent’s Hospital Melbourne (SVHM).
SVHM is responsible for approximately 700 joint replacements a year with each of these patients requiring routine reviews for up to ten years post surgery. SVHM provides an Elective Surgery Access Service (ESAS) which offers surgery to patients that have endured long wait times elsewhere. Often patients are required to travel long distances to attend their review appointments.
In 2008, a physiotherapy review clinic led by Advanced Musculoskeletal Physiotherapists (AMP) was established to assist with the increasing number of reviews traditionally completed by orthopaedic surgeons.
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MyHealth Record limited by quality of GPs’ e-records

Antony Scholefield | 2 August, 2016 | 
We keep hearing about the potential of the Federal Government’s MyHealth Record system, but a GP researcher has warned it will always be limited by the quality of GP software.
According to Dr Graeme Miller (pictured), medical director at the University of Sydney’s Family Medicine Research Centre, MyHealth Record had to be “dropped to the lowest common denominator” to accommodate low-quality systems.
In a bid to boost the system, the Sydney GP is calling for the government or the RACGP to introduce minimum standards for practice-based e-health record systems.
Dr Miller has co-written a policy brief for the Deeble Institute for Health Policy Research — a think tank that aims to develop objective publications on evidence-based health policy for policymakers — advocating the move.
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The “Uber-isation” of healthcare in Australia

  • Martin Kopp
  • The Australian
  • 11:35AM August 3, 2016
Australia’s healthcare industry is on the cusp of its “Uber moment”.
Smartphones, health apps, and wearables empower users to take more control of their health, and make better informed decisions. The days of simply tracking the number of steps taken have been replaced by analysis of blood glucose levels, heart signals, and automated reminders telling us to do more exercise. The list of new capabilities goes on.
Massive change is also underway in the healthcare industry. Vast stores of data can be mined to tailor treatments to better suit individual patients, and in some instances the cost of analysis and care have fallen dramatically. For instance, the cost of sequencing a human genome is US$99 — down from a cost of US$2billion the first time it was achieved.
Among researchers and life sciences companies, the understanding of genetics and genomics — and how they drive health, disease and drug response in each person — is advancing each day. This gives medical professionals insight into better disease prevention and enables more accurate diagnoses, safer drug prescriptions, and more effective treatments.
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Healthcare industry embracing the digital workspace

VMware says the digital workplace, or digital workspace, is making a big impact on the healthcare sector
Stuart Corner (Computerworld) 09 August, 2016 13:17
VMware says the digital workplace, or digital workspace, is making a big impact on the healthcare sector.
The terms ‘digital workplace’ and ‘digital workspace’ might appear synonymous, but Sumit Dhawan, senior VP and GM of desktop products at VMware, makes a very clear distinction. Digital workplace, he says is simply an acknowledgement of the fact that a person’s workplace is no longer a fixed location, but whatever physical location they are working, thanks to digital technology.
Digital workspace, on the other hand, is the umbrella term for all the technologies that make the digital workplace a reality.
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Instant digital medical records for every Australian: the future is almost here

Published: 02 August 2016

It’s the sensible step that will make every visit to the doctor a whole lot easier.

With the aim of no longer having to chase up records or re-order expensive tests, Medicare is looking to have a new online database that that will keep all your health records in one place.
The plan to digitize all medical records for Medicare patients is called My Health Record. It’s seen as a huge leap forward in patient care. Doctors and specialists will be able to access your health information from a single location.
The measure means your complete medical history will be on record, including things like all prescription medications, blood tests, scans results, and organ donor preference.
In an emergency, it could mean doctors will be able to make quick, more accurate decisions based on specific health history, even if the patient is unconscious and there’s not an immediate family member to speak to.
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1 August, 2016

Courses to raise digital awareness for doctors

Posted by julie lambert
The Health Informatics Society of Australia is offering a suite of new, self-paced online training courses for doctors to learn about the rapid technological changes overtaking the profession
Former society chair David Rowlands, who has developed the courses, stressed the goal was digital awareness rather than academic rigour.
“It’s about telling clinicians that they are now in a digital business, and in a hyper-connected world there are things you need to know.  Otherwise, mistakes can proliferate as quickly as good things can,” he told The Medical Republic.
“We are trying to raise awareness of key stumbling points and the critical success factors in digital health.”
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2 August, 2016

Planets start aligning for GP telemedicine

Posted by Jeremy Knibbs  
Telemedicine and tele-consultations might be set for a boom as the technology, commercial interest and doctor acceptance all start to kick in
GPs appear to be shifting their views on  tele-consultations with the technology being identified as the second most important technology that can help them improve patient outcomes in a survey released by Medical Director last week.
The only technology with greater immediate potential, was online booking services and appointment kiosks, with more than 30% of GPs saying this ranked as the No1 technology to engage with, closely followed by telemedicine on 24.65%.
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At $6000 a pair talking glasses give hope to the blind

  • The Australian
  • 12:00AM August 1, 2016

Rachel Baxendale

Retired teacher Harry Simon, 71, is heartbroken that blindness has robbed him of the ability to read to his four grandchildren, but new technology in the form of a ­wearable text-to-speech device may change that.
The OrCam device consists of a tiny camera and speakers attached to a pair of glasses, ­enabling the wearer to recognise faces and banknotes, or read a newspaper or menu simply by pointing a finger.
Mr Simon tried the glasses for the first time last week at the Royal Society for the Blind Canberra’s annual adaptive technology expo. He said they had the potential to significantly improve his life, giving him the freedom to receive information without ­having to go through the cumbersome process of scanning things with a smartphone text-to-audio app, or with a machine he has at home.
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Zebra Technologies: refine traditional asset management to digitise healthcare

  • The Australian
  • 12:00AM August 2, 2016

Supratim Adhikari

Healthcare is shaping up as the next frontier for digital technology, but that doesn’t mean we have to reinvent the wheel, according to Zebra Technologies’ senior technology director Wayne Harper.
While Australian healthcare is making strides towards digitalisation, Mr Harper says there’s room for improvement, especially when it comes to the quality and ­efficiency of patient care.
His solution is to repurpose the concepts refined for traditional asset management and make them applicable to the healthcare sector.
“It’s all technology that exists today, it’s proven and used in the enterprise and can be really useful in the healthcare space,” Mr Harper said.
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Enjoy!
David.

Sunday, August 14, 2016

I Really Think This Is A Major Procedural Error That Needs To Be Fixed With The myHR. What Is Happening Right Now Is Wrong I Believe.

As regular readers will know I spent a much too exciting few days in the Royal North Shore Hospital earlier this week!

I escaped a few days ago and yesterday decided to have a look at my My Health Record to see if anything had been uploaded as I result of my admission.

To my surprise, and with no discussion with me, I found a very detailed 8 page Discharge Summary had been uploaded to the My Health Record by not the clinical team but a Hospital Pharmacist.

What I don’t understand is, while the GP is meant to discuss what will be uploaded to a Shared Health Record with the patient there seems to be no such process for Discharge Summaries.

I am not all that concerned that this happened but I suspect that at least 2 patients I shared a room with for a while (one of each had a potentially stigmatising family undisclosed illness and the other of which may have disclosed to their clinicians some potentially problematic past history – and yes I am being vague deliberately) may have hoped for the opportunity to discuss the contents of the upload before it happened.

To me when a hospital pharmacist takes it upon themselves to upload such material with no discussion or warning, and with no consideration of material that might be reasonably be excluded, to avoid possible discrimination or embarrassment, we have moved a little over the top!

I don’t see the Government as being entitled, of right, to all this information without some discussion or consent with the patient.

When a person is mentally competent I see no reason for the upload not to be reviewed by the patient before it is uploaded – even if to allow them to know what is happening and block access later should they choose to. At the very least the patient should be told so they can review what has been uploaded – should they desire. I would have had no idea what had gone one had I not checked.

Much better to have an upload to the nominated GP and not indirectly to some monolithic Government system. Even more so after the Census debacle!

David.

AusHealthIT Poll Number 331 – Results – 14th August, 2016.

Here are the results of the poll.

Have You Noticed Real Progress Being Made In Public Hospital Clinical Computing In Your State? (Please leave comments in last poll comment section)

Yes 17% (12)

No 53% (37)

I Have No Idea 30% (21)

Total votes: 70

It seems the improvement I found at RNSH might be a bit isolated!

A good turnout of votes.

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

David.

Wednesday, August 10, 2016

Observations On A New Hospital EMR At RNSH From The Point Of View Of A Curious Patient!



Note: All these notes are based on discussions with a range of staff at various levels from Consultants to Ward Porters – overall probably chatted with 10-15 different people.

Was good to see pretty strong privacy focus – to the extent of taking some fast talking to get to be able to access my record!

All this is E&OE as I may or may not have accurately grasped what I had been told. (I was a might sick for a good part of the time!)

Key Points.

Initial Implementation was in A&E and have managed to become paperless with clinical charting, patient records, results (image integrated with text etc.). Implementation in the wards is quite recent (months)

Screens are impressively clear and high resolution – and speed is really good.

System works by selecting ward census then patient and then has lots of tabs down left side to move into different functionality.

I was easily able to look up my new results with no training at all so it works pretty intuitively!

The COWs are a feature. Residents and registrars glide them around and make notes and place orders as they see patients. Battery powered and fully secured with scrub-able illuminated keyboards and full size high-res screen on really secure trollies. (COW = Computer On WheelS)

WiFi for the computer system is everywhere and fast!

There appear to be secure Wi-Fi points for clinicals, byod, mob-xray, and data. As well an open guest account I assume I was not meant to use!

Acceptance of the system is broadly aged based and seems also very much related to the level of typing skills.

Was interesting to note placing a ‘request on the system’ was almost seen as having done what was requested and needed. The workload communication was widely used.

Negatives:

Some staff worried about privacy of the large screen census boards on the wards.

Senior staff can find navigation (menus can be rather deep) and system freezes frustrating.

Was a bit sad to see observations which were gathered by superb and very smart trollies being manually typed into the system rather than being interfaced!

Lessons:

Where possible specific tasks for senior staff might be set up as scripts.

It is important to minimise system unresponsiveness as this can frustrate staff.

Organisation of free text information is still a challenge. Reports are fine and findable – progress notes seem to be a different story – suffer rather from the PCEHR pile of notes issue.

It was not clear just how useful the search functions were.

Technology:

All the Clinical Ward PCs run an enterprise level version of Win 7 – but I did spot the odd Win XP screen in radiology.

Each PC is named and has a unique IP address and while many are wired at desks – the COWs all run wi-fi in the Hospital.

The number of terminals / COWS seems nicely over-provisioned – there is access everywhere that seem reasonable.

Security:

Log on is username / password to the relevant domain.

Once logged on the username does not expire but password does pretty quickly.

(user name is 8 or 10 digit staff number)

Home Nursing Service – Remote Visit Support:

Using a laptop the initial admission to the APAC Service was done on line to another copy of Cerner Millennium – over a remote WiFi link.

The laptop provided access to all information held in my record within the hospital – and worked well.

Overall:

This implementation is clearly a very complex EMR with very rich functionality that is really working pretty well indeed. I have often wondered would I ever see at least some of the potential I knew was possible actually delivered but this is not bad at all! It works, is capturing rich information and has essentially got rid of paper notes – except at present for medication charts.

What is now in place is clearly a key part of the nervous system of the Hospital.

Once the more advance information management issues are solved there is the basis of a really useful and important system here that will in all likelihood make a very positive difference to care. This is all much better than I dared hope!

Well done to all those involved in getting to this point!

David.

Sunday, August 07, 2016

AusHealthIT Poll Number 331 – Results – 7th August, 2016.

Here are the results of the poll.

The ADHA Is Apparently Planning 'Compulsory Health Records for all Australians' According To A Slide From HIC 2016. Do You Agree?

Yes 9% (9)

No 87% (88)

I Have No Idea 4% (4)

Total votes: 101

Seems that idiotic idea gets the big thumbs down!

A great turnout of votes.

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

David.

Blog Alert For When I Escape The Ancient And Honourable St Leonards By The Railway (RNSH)

I have been using my stay to have a lot of chats with the staff using the NSW Health EMR at Royal North Shore.

A lot of the feedback has been really, really encouraging indeed.

Summary: I think this system is really working and making positive difference!

Sure there are gripes and grumbles, but overall high marks indeed.

Lots more when I escape!!!

David.