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, June 05, 2017

Weekly Australian Health IT Links – 05th June, 2017.

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

Interesting week with a tender from the ADHA, more connectivity for the myHR and another collection of private sector initiatives.
Additionally we have a new blog on digital health to browse….
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Vision for a connected Australian Health System

Created on Wednesday, 31 May 2017
Australians and their clinicians want a seamless health system which delivers high quality, safe care through better sharing of information.
The Australian Digital Health Agency today has released a Request for Tender (RFT) to develop a Strategic Interoperability Framework for Australia.
Ms Bettina McMahon Executive General Manager, Government, Industry & Delivery will lead this important work, saying "Sharing patient information across the Australian healthcare system is a complex issue requiring the alignment of policy, workflow, patient information, even business models."
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The ADHA wants to link up all of Australia's health systems

By Allie Coyne on Jun 1, 2017 1:23PM

Under interoperable framework.

The Australian Digital Health Agency wants to create an interoperability framework for Australia's healthcare environment that would link up all systems in order to better share health data.
It has set itself an ambitious five to ten-year timeline to have digital interoperability across the healthcare system.
The agency has released a request for tender [pdf] for a "strategic interoperability framework" made up of digital technologies and standards that would create a seamless digital experience for those using healthcare services.
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Australian Digital Health Agency seeks to develop a national Strategic Interoperability Framework

The framework will provide the foundation for an implementation plan to address current disconnections and move Australia to a more interoperable environment within a 5 and 10 year timeframe.

01/06/2017
The Australian Digital Health Agency (DHA) has released a Request for Tender (RFT) to develop a Strategic Interoperability Framework for Australia, with the objective of creating a seamless health system which delivers high quality, safe care through better sharing of information. Sharing patient information across the Australian healthcare system would require the alignment of policy, workflow, patient information and business models. 
DHA conducted a consultation with the community recently, with more than 1,000 survey responses and written submissions. Over 65% of respondents said that the Australian healthcare system is difficult to navigate. People want to know the cost, quality, and availability of services, and desire to have a more integrated service experience.
The outcome of the RFT will shape the future design of an interoperable health system where the Australian Government continues to own, operate and deliver the infrastructure, while working with industry to ensure that Australians can access the health information they need where and when they need it.
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No system is infallible: ATO boss on tax fraud

  • The Australian
  • 11:53AM May 30, 2017

Ben Butler

A dozen ATO employees have been sacked for accessing the private information of friends, celebrities or other taxpayers so far this financial year.
The ATO’s internal compliance teams have investigated 30 staff members for privacy breaches, compared to 23 in the previous financial year, a senate committee heard this morning.
Taxation Commissioner Chris Jordan told the Estimates Committee that “stupid people try to look at their friends”.
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29 May 2017

Sonic in, and MyHR suddenly looks more useful

Posted by Jeremy Knibbs
After four years and about $1.4 billion, the Australian Digital Health Agency (ADHA) has negotiated two breakthrough deals that might just see the needle finally move on the utility and awareness of the My Health Record.
The deals will set the scene for tangible progress on a project that has been controversial and widely condemned by medical IT experts and doctors as a waste of time and money.
In a hugely symbolic turnaround, Sonic Healthcare will become the first private-sector provider to upload pathology reports directly to the MyHR. And over the next few weeks, the ADHA will be releasing an industry offer for all private pathology companies in Australia to connect.
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2 June 2017

That’s not a compact: THIS is a compact

Posted by Jeremy Knibbs
The RACGP and AMA compacts with the federal government aren’t seen by most GPs as meaningful, which isn’t surprising. At just 55c extra per consult this coming year, a drawn-out path to a full lift of the freeze over the following two years, and not much else, these contracts were always at risk of being seen as limp. The agreements might in fact be locking in a position of no progress, or worse,  ongoing regression.  After all, we’ve now firmly agreed to snail’s pace changes to MBS rebates, which essentially keep GPs well under any sort of indexed pay rise for the next few years. And that’s the tangible part of this compact.
As much as the RACGP has led with its chin by making such a compact, blaming the College is probably a little simplistic. They are, after all, mainly a training organisation. Plus, they’ve grown into an organisation that is large and struggling to undersand what it is. As  such it is a little unwieldy in terms of governance and leadership in matters like these. Which is a long way of saying, the College at this point really isn’t set up for this sort of stuff.
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Digital health transforming healthcare with benefits for Australians through My Health Record

Meredith Makeham | 30 May 2017
It would be an understatement to say that digital technology has transformed the way we engage with the world around us in so many facets of our lives, such as communications, business and banking, travel and social interactions.  Our healthcare services have generally been much slower in the development of digital tools to support us with understanding and interacting with our health and care needs. There are some good reasons for caution here – our health systems and care providers are focused on the important principle of ‘First, do no harm’, and innovation needs to be balanced with the assurance of safety as a fundamental feature of new design.  
However there is a shift in the way we are now able to experience and understand our health and care needs, and one sign of this is the development and planned expansion of our national My Health Record system, supported by the recent federal budget announcement of $374 million over the next two years, and due for delivery to all Australians by the end of 2018 – unless they choose not to have one.
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Digital tech - the answer to Aussie healthcare's biggest ailments?

Contributor May 31, 2017 8AM
In Australia, it’s expensive to ensure good health, with approximately 10 per cent of GDP or $160 billion a year being spent on healthcare and the Medicare levy set to rise further in the coming years.
Despite the costs of healthcare being high, the medical outcomes in Australia are outstanding. In the OECD, Australia rates 6th for life expectancy and Australian healthcare is considered better than many other developed countries.
However, a Catch-22 becomes apparent – it’s the very leaps in modern medicine that mean our lives are generally longer and more healthy that has led to an aging population, which typically needs more medical services and care provision.
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myGov update fails on promises and potential

Even after a revamp, myGov is failing to live up to its potential
The federal government’s “timely revamp” of the myGov website rolled out over the past weekend was a dramatic improvement from its existing version, but remains far from a highly intuitive and engaging user experience.
The joint project between the Department of Human Services, the Digital Transformation Agency and the Australian Tax Office ultimately failed to live up to its potential as a vital tool facilitating simple and easy to use digital experiences.
Whilst the site has progressed to a functional level post-update, there are long but simple strides to be taken before the site can truly be user-intuitive.
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Private Pathology Reports To Go Live in My Health Record

Created on Wednesday, 31 May 2017
Sonic Healthcare will become the first private sector provider to upload pathology reports direct to the My Health Record as part of a key initiative to ensure clinicians and patients have better access to medical information.
The Australian Digital Health Agency announced today that it will be releasing an industry offer in early June 2017 for all private pathology companies and in Australia to connect to the My Health Record.
This will allow all Australians with a My Health Record and their health care professionals to view test results through the My Health Record.
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Online resource for end-of-life care

The Federal Minister for Aged Care, Ken Wyatt, has launched a new website containing important evidence-based medical and practical information to support the provision of palliative care to older people at the end of life.
Page last updated: 25 May 2017
25 May 2017
The Federal Minister for Aged Care, Ken Wyatt, today launched a new website containing important evidence-based medical and practical information to support the provision of palliative care to older people at the end of life.
Speaking at a function at Parliament House to mark Palliative Care Week, Minister Wyatt said civilisation can be measured by how it treats its older people.
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Opt-out e-health records won't be deleted

By Allie Coyne on Jun 1, 2017 11:54AM

Just made unavailable.

The federal Health department won't remove e-health records for individuals who opt-out of the My Health Record system, but simply make the data unavailable to healthcare providers.
Health department special advisor on strategic health systems and information management Paul Madden revealed the decision at senate estimates earlier this week.
He said an individual's e-health record would not be deleted from the system should they decide they do not want to be included in the scheme, so it could be easily reinstated should the individual change their mind.
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Cloud shift mooted for e-health record system

My Health Record won’t be deleted on request, government reveals
Rohan Pearce (Computerworld) 01 June, 2017 10:13
The government may seek savings in the cost of operating My Health Record by shifting to cloud infrastructure.
Paul Madden, special adviser, Strategic Health Systems and Information Management, at the Department of Health, said that the cost forecasts for operating the system in 2019-20 and 2020-21 are still being finalised.
We have some variables in the cost of the system, which we will work through in the next 12 to 18 months,” he told a Senate Estimates hearing earlier this week after being asked by Senator Lisa Singh why the federal budget showed no funding past June 2019 for My Health Record.
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Queensland Health firewall back online

Kara Vickery, The Courier-Mail
May 30, 2017 1:02pm
Subscriber only
THE firewall blamed for crashing Queensland’s electronic medical record system has now been replaced with a more “up-to-date” program, with all five affected hospitals back online today.
But health authorities warn they cannot rule out a similar problem in future in the face of hundreds of daily cyber-attacks.
The Courier Mail revealed last week problems with the electronic medical record system at five Queensland Hospitals – Princess Alexandra, Lady Cilento Children’s Hospital, Cairns, Townsville and Mackay.
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Qld Health replaces firewall after WannaCry patch bungle

By Allie Coyne on May 30, 2017 2:05PM

Medical records system now fully operational.

Queensland Health has replaced a glitchy firewall that locked users out of its e-health records system following attempts to patch against the damaging global WannaCry ransomware attack.
State Health Minister Cameron Dick today said the technical issues with the Cerner Millenium-based integrated electronic medical record (iEMR) had been resolved, and all five hospitals that had been impacted by the technical problems were again able to access the system.
The log-in issues arose after the agency scrambled to apply patches provided by vendor partners Microsoft, Cerner and Citrix on the weekend of May 13 to protect against the WannaCry ransomware.
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Improving Australia’s health requires better use of patient information

May 30, 2017 1.01pm AEST
Australia’s policies on preventing heart disease are based on outdated research from the US. from shutterstock.com

Authors

  1. Philip Clarke
Professor of Health Economics, University of Melbourne
  1. Josh Knight
Research Fellow in Health Economics, University of Melbourne
  1. Xinyang Hua
Research Assistant, University of Melbourne
Fifty years after we passed a constitutional referendum to count Aboriginal and Torres Strait Islander people in the Australian Census, data limitations mean they are still not counted in many health statistics.
Take a recent report produced by The Heart Foundation, for example. This mapped hot spots for heart disease and stroke (cardiovascular disease) across Australia, but only for non-Indigenous Australians. The explanation in notes to the report indicates that:
… due to the low population and insufficient ABS data, we are unable to provide a true representation of CVD [cardiovascular disease] prevalence in the Northern Territory… The CVD prevalence tables and maps are for persons aged 18+ only and do not include Aboriginal and Torres Strait Islander peoples.
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We GPs need to be careful about who we poke fun at

Justin Coleman
26 May 2017

COMMENT

The safest targets are the closest: self-mockery is a sure-fire bet.
This week’s sorry tale of a rural GP’s public humiliation via Facebook had plenty of us sighing with relief that it wasn’t us.
When Dr Christopher Buck posted a message after returning from a late-night anaesthetics callout in Kalgoorlie, he assumed only his friends would see it. Unfortunately for him, it was shared on a mother’s forum, where all hell broke loose.
The post began: “Dear pregnant women. Please respect your friendly duty anaesthetist and consider getting your epidural inserted prior to 11.30pm…”
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MedAdvisor (MDR:ASX) Digital Revoultion of Pharmacy Scripts

MedAdvisor (MDR: ASX) operates in the healthcare IT space, specifically in improving the interaction between pharmacies, patients, drug manufacturers and doctors. They provide a fully digital end to end experience for processing medical scripts for prescribed medication.
If we quickly look at each player from the above quartet and how the MedAdvisor app or platform helps solve at least 1 major problem for each of them?
Pharmacists/Pharmacies: It allows their customers to refill (where they have a repeat prescription) scripts on the app at any time, thus they can just come collect. This allows the pharmacists to process scripts more efficiently and allows them to provide regular customers with a faster and more streamlined service offering.
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Deep learning to determine when you die

Researchers say technique has potential to take doctor out of the loop for certain medical decisions
George Nott (Computerworld) 02 June, 2017 09:00
Researchers at University of Adelaide have used deep-learning image analysis techniques to determine patient lifespans.
In the proof-of-principle study, published in the Nature journal Scientific Reports today, Dr Luke Oakden-Rayner and his team applied machine learning methods to CT scan imagery to predict patient mortality.
The analysis – based on convolutional neural networks – was able to predict which patients would die within five years, with 69 per cent accuracy, a score comparable to the ‘manual' predictions made by clinicians.
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How technology can assist with patient ‘activation’

How can robotic pharmacy kiosks, remote counselling, smart pills and sensors engage patients? asks Dr Angel Gonzalez

In my last article, I discussed how ‘fully engaged’ or ‘activated’ patients have better health outcomes at lower costs.
Pharmacists around the world supported by e-health tools are allowing more patients to actively participate in maintaining their health and promoting collaborative care with providers.
MedsOnCue from the USA allows the patient to scan a QR code and retrieve medication counseling via online videos on their computer or mobile device. It provides the FDA information on the prescription and the ASHP (American Society of Health-Systems Pharmacist) patient education guidelines in English and Spanish.
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My Health Record in Pharmacy

Wed 28th June @ 6:30 pm

Sydney North Primary Health Network (SNPHN) invites Pharmacists to attend this workshop to learn how to register for the My Health Record system and to utilise the benefits of digital health technologies within the pharmacy setting.
This session will provide practical demonstrations of how to access the My Health Record through the Provider Portal and Fred IT dispensing software. Following a presentation on the features and benefits of the My Health Record, a number of case studies will be explored to demonstrate ways in which the My Health Record can improve communication between healthcare providers and contribute to improved patient care. Assistance with registration for the My Health Record system will be offered to all attendees at the event.
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CSIRO working on software tool for early cancer detection

Scientists at CSIRO's Data61 unit are working on a software tool that could help in faster detection of angiogenesis — the development of new blood vessels — which is known to precede the growth of cancers.
The organisation said the new algorithm could lead to earlier detection and improved success in rates of treatment.
Data61 teamed up with the Shanghai Institute of Applied Physics, Chinese Academy of Sciences, to produce images of mice brains and livers at various stages of cancer growth.
After analysing 26 high-resolution 3D micro-CT images from 26 mice, produced by the Shanghai Synchrotron Radiation Facility, the scientists came up with an algorithm that would create a true picture of the vasculature, preserving information about the length and shape of the blood vessel and its branches.
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Icon recruits IBM Watson in cancer fight

  • The Australian
  • 2:00PM June 1, 2017

Supratim Adhikari

Queensland-based Icon Group has signed up with IBM to implement an ‘augmented intelligence’ platform to put critical information at the fingertips of oncologists across the country.
Icon’s partnership will see the IBM Watson for Oncology platform make its debut in Australia and Icon co-founder and digital adviser Cathie Reid said that the solution will help keep clinicians stay on top of the ever increasing volume of cancer research.
“Traditionally they rely on a series of conferences and journals and have to soak up every bit of the new research but Watson gives them easier access to this information,” she said.
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Indian and Australian experts shift their radar on digital health and its future

31 May 2017 | News
Jill Hennessy MP, Health Minister of the State of Victoria, Australia opined that the key investment in Victoria is the electronic referral (eReferral) program.
In a bid to take the digital health segment to a whole new level in India, the George Institute for Global Health Global Health, in partnership with the Australian High Commission, conducted a Digital Health and Technology roundtable in Delhi. Australian and Indian health experts, policymakers, and business and thought leaders came together to discuss the solutions required in health services delivery, advances in medical health and digital technologies, regulatory challenges and implementation experiences in both countries. The roundtable is one of the first activities to be held under the Health MoU exchanged between Prime Minister Turnbull and Prime Minister Modi in April this year.
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George Institute initiates discussion with Indian and Australian experts on future of digital health

Our Bureau, Bengaluru
Thursday, June 01, 2017, 16:15 Hrs  [IST]
The George Institute for Global Health, in partnership with the Australian High Commission, deliberated on the future of digital health in the country.
At a roundtable Australian and Indian health experts, policymakers and business leaders came together to discuss the solutions required in health services delivery, advances in medical health and digital technologies, regulatory challenges and implementation experiences in both countries. The roundtable is one of the first activities to be held under the Health MoU exchanged between Indian Prime Minister Narendra Modi and Australian Prime Minister Turnbull in April this year.
According to Dr. Vivekanand Jha, Executive Director,  George Institute for Global Health in India, India has recently launched the National Health Policy 2017 which articulates the need for increasing access, improving quality and lowering the cost of healthcare delivery.
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NBN clients burnt as telcos struggle to deliver on speed

  • The Australian
  • 12:00AM May 29, 2017

Anthony Klan

Thousands of National Broadband Network users are being overcharged by some of the ­nation’s biggest providers who are refusing to notify consumers they are being charged for high-speed services that cannot be delivered to their homes.
Optus is the biggest offender, with experts citing several hundred thousand homes paying for net speeds that are physically undeliverable.
Following media exposes of over-selling of NBN products, Telstra earlier this month announced it would refund 7920 customers who had been sold so-called high-speed ­packages.
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Enjoy!
David.

Sunday, June 04, 2017

The ADHA Issues A Tender For Work It Should Be Doing Itself In My View. Also Some Very Odd Terms.

This appeared last week.

Strategic Interoperability Framework RFT

Vision for a connected Australian Health System

Australians and their clinicians want a seamless health system which delivers high quality, safe care through better sharing of information.
The Australian Digital Health Agency today has released a Request for Tender (RFT) to develop a Strategic Interoperability Framework for Australia.
Ms Bettina McMahon Executive General Manager, Government, Industry & Delivery will lead this important work, saying "Sharing patient information across the Australian healthcare system is a complex issue requiring the alignment of policy, workflow, patient information, even business models."
The Australian Digital Health Agency has a requirement for the provision of services to develop an interoperability strategy for the digital health ecosystem in Australia.
"Interoperability requires recognising the known concerns of patients and healthcare providers and working through useful approaches to manage the potential risks."
"Ultimately, an interoperable health system will provide a seamless service experience for a person using health services," said Ms McMahon.
The CEO of the Australian Commission on Safety and Quality in Health Care, Adjunct Professor Debora Picone AM, has welcomed the decision to tender for a national interoperability framework: "We know the key to a high-quality health care system is the secure, timely and accurate sharing of information between health providers and their patients."
"The Commission is looking forward to working with the Agency and Australian jurisdictions to support an interoperable health system," said Adjunct Professor Picone.
The Agency's recent consultation with the community, including more than 1,000 survey responses and written submissions, revealed that over 65% of respondents said the Australian healthcare system is difficult to navigate. People want to know the cost, quality, and availability of services, and experience a more integrated service experience.
The outcome of the RFT will shape the future design of an interoperable health system where the Australian Government continues to own, operate and deliver the infrastructure and work with industry to ensure that Australians can access the health information they need where and when they need it.
Responses to the RFT close at 11am local Sydney time on Monday 26th June 2017, with a procurement phase for the new system expected to commence in the middle of 2017.
Download the following RFT document:

Request for Tender Number 0329 - Strategic Interoperability Framework and Draft Contract

Here is the link:
The core of the Request for Tender (RFT) is the services required:
B.                                Services

B.1.                           Description of Services
There are two key deliverables to be provided by the successful Tenderer as part of the Services.
B.1.1.                     The first key deliverable is:
a.         to undertake a review of current state that documents successful interoperability efforts in other jurisdictions or industries where relevant to the Australian health system and the key success factors, not limited to technological factors (the measures of success should also be spelt out); and documents the current health interoperability directions and strategies that are being pursued in the jurisdictions within Australia. The review of the current state is required to include an international literature review to inform the Agency of what is working in other jurisdictions.  The successful Tenderer will be required to:
i.           provide a written report detailing its findings from its review of the current state;
ii.          present its findings to the Agency in the form of a powerpoint presentation.
The second key deliverable is:
to develop a ‘Strategic Interoperability Framework’ to support the Agency in the development, delivery and ongoing assurance of a digitally interoperable environment within the Australian healthcare sector. This Strategic Interoperability Framework will be required to include an overview of guiding interoperability principles and the component parts of an interoperable health eco-system that would deliver more connected services to people accessing health services in Australia. This Strategic Interoperability Framework will be required to establish a practical approach to deliver a digitally interoperable health system for Australia and deliver the Agency’s vision of interoperability. It will be used as the foundation for an implementation plan to address current disconnections and move Australia to a more interoperable environment within a 5 and 10 year timeframe.
b.        To support this second key deliverable, it is a requirement that the successful Tenderer develop a consultation plan for approval by the Agency.
B.1.2.                     During the provision of the Services and the development of the strategic interoperability framework, the successful Tenderer (if any) will be required to consider the following factors:
B.1.3.                      
i.              provide a written report detailing its findings from its review of the current state;
i.ii.  clearly identify component parts of the current state of the system with respect to interoperability principles which are working effectively, and where there are gaps that require modifications, improvements and further developments in order to address these
ii.iii. present its findings to the Agency in the form of a powerpoint presentation.
B.1.4. 
a.         the broad range of digital health related interoperability standards, guidelines and policy which are required across different technical, professional and safety domains to enable an interoperable health care environment, their variable states (and drivers) of development and adoption, and their interconnections with each other, best practice and current industry and jurisdictional directions, as reviewed in the first deliverable, being the review of the current state;
b.        the ability to connect and empower care providers and to support people to have more control and choice;
c.         the Agency’s core principles including co-design and the engagement of health care consumers, clinicians, industry and research in the creation and ongoing development of all of its products and services;
d.        an evaluation process to determine the success of the development and application of the suggested interoperability strategic framework;
e.        the appropriate balance between cost, outcome, efficiencies and risk in the adoption of the suggested interoperability strategic framework, including funding considerations for the potential adoption and ongoing development and assurance with compliance of interoperability requirements for health services;
f.          the suggested Strategic Interoperability Framework should be developed and operate in harmony with our developing national digital health strategy and the Agency’s ongoing workplan priorities; and
g.         the suggested Strategic Interoperability Framework should support the principles of equity and access for all Australians to safe and high quality health care services.

B.1.5.                     The Strategic Interoperability Framework will be required to include the following audiences:
a.         the community; including healthcare consumers and their carers;
b.        software vendor organisations, including clinical software and secure messaging vendors; innovators new to the health sector; and the system operators (e.g. HI Service operator, NASH operator, My Health Record system operator) via the Australian Digital Health Agency;
c.         Australian Commission for Safety and Quality in Healthcare; and
d.        Standards Australia and its digital health subcommittee/s.
B.1.6.                     Prior to the commencement of this consultation, the successful Tenderer (if any) will provide a consultation plan to the Agency for approval.
B.1.7.                     The successful Tenderer (if any) will be required to provide weekly project status reports to the nominated Program Manager within the Agency. The format of these reports will be specified by the Agency.

----- End Extract.
Strangely there is the following just below the extract above:
Commencement of Services 17th of July 2017
The Services are required to be delivered in full by 30th of August 2017.
So it seems, as best I can tell, the whole of the work is to happen in about six weeks – obviously a really in-depth study. (At another point Sep 30th 2017 is mentioned – but not clear why.)
From my perspective I have simply no idea what can usefully achieved in the time available and why the skills to undertake this work are not in the ADHA. Surely this is very specialist work which general  IT consultants would need considerable time to become familiar with?
Also, the idea of developing a plan for the next 5-10 years in six weeks seems bizarre to say the least!
This is certainly an RFT I would let go through to the keeper.
David.

AusHealthIT Poll Number 373 – Results – 4th June, 2017.

Here are the results of the poll.

Are You Confident The Current National Digital Health Strategy, With The myHR As Its Core, Will Be Successful?

Yes 3% (7)

No 95% (192)

I Have No Idea 2% (4)

Total votes: 203

The numbers speak for themselves, almost no one, that reads here, thinks the strategy as presently known has much merit. Pretty sad I reckon.

A really great turnout of votes!

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

David.