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
Has been a big week with lots of reaction to the new Digital Health Strategy.
Lots of other stuff as well – enjoy!
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The Council of Australian Governments Health Council has given the federal government the green light to automatically sign citizens up to an electronic health record, with a public consultation on draft interoperability standards to come by the end of next year.
My Health Record, the Australian government's e-health record system, has been officially given the green light from the Council of Australian Governments Health Council to automatically sign citizens up to the service, allowing them to opt-out if they choose.
By 2018, all Australians will have a My Health Record and by 2022, all healthcare providers will be able to contribute to and use health information in My Health Record on behalf of their patients. They will also be able to communicate with other healthcare providers on the clinical status of joint patients via the digital platform.
According to the strategy, Safe, seamless, and secure: Evolving health and care to meet the needs of modern Australia, the interoperability of clinical data is essential to high-quality, sustainable healthcare, with My Health Record allowing the collection of citizen's data to share in real-time between providers. However, there is currently no overarching standard in place to govern the sharing of data, with a public consultation on draft interoperability standards to determine an agreed vision and roadmap for implementation of interoperability slated to occur "by the end of 2018".
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If patients are to be 'put at the centre of their healthcare', they need to be put at the centre of their health data.
The thing to remember about strategy documents is that they're merely aspirational. They set out a proposed pathway to achieving a set of defined goals, but they're no guarantee that those goals will even be achieved.
As the old BBC TV series Yes Minister taught us, when it comes to writing government reports, "the tricky bit should be disposed of in the title". This strategy [PDF] does exactly that: Safe, seamless, and secure.
That dealt with, let's look at some of the details that worry me.
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Lynne Minion | 08 Aug 2017
Australia's new digital health strategy has been labelled “incomplete”, with critics claiming it is short on detail about how sensitive medical records will be secured.
Australia’s state and territory health ministers approved the Federal Government’s Safe, seamless, and secure: Evolving health and care to meet the needs of modern Australia at a COAG meeting on Friday, giving the green light to automatically sign up citizens to My Health Record by 2018, with an opt-out function. By 2022, all of the nation’s healthcare providers will be connected to the digital platform.
But some, including managing director of IT consultancy PivotNine, Justin Warren, have raised concerns about a lack of detail.
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8 August 2017
The Australian Digital Health Agency says it will smooth a five-year transition to the digital future for doctors by having technology vendors adopt secure interoperable platforms across the health system.
The agency’s blueprint for change is spelled out in a five-year strategy, approved last week by all state and territories, that will begin in earnest with the creation of opt-out My Health Records for all Australians in 2018.
“By 2022 all healthcare providers will be able to contribute to and use health information in My Health Record on behalf of their patients…” the strategy says.
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Health ministers back national eHealth strategy
The Australian Digital Health Agency (ADHA) has revealed it has established a cyber security centre to help safeguard the My Health Record system.
The new Digital Health Cyber Security Centre will “ensure Australian healthcare is at the cutting edge of international data security,” according to the agency.
“Its primary purpose is to protect the national digital health systems and personal health information of Australians from the cyber threat, and to raise the security posture of the Australian health sector,” states an ADHA developed national eHealth strategy document.
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Asher Wolf
Freelance JournalistThe government is planning to give every Australian a digital health record by the end of 2018. With that goal in mind, the Council of Australian Governments (COAG) Health Council has approved Australia’s National Digital Health Strategy, drafted by the Australian Digital Health Agency (ADHA.) So how much data will a digital health record — known officially as a My Health Record (MHR) — contain?
Lots.
The MHR was previously known as the Personally Controlled E-Health Record (PCEHR.) But after patients and healthcare providers avoided signing up to the PCEHR in droves, ADHA renamed the project and changed patients’ sign-up option from opt-in, to opt-out only. Yes, that’s right: you all get an MHR, whether you like it or not. Want to opt-out? Too bad.
The government won’t delete your e-health record: people who opt-out will still have a shadow-file — a shell account the ADHA will retain, void of healthcare data from the date patients opt-out. And how well do opt-outs work anyway? Well, before the UK scrapped its equivalent digital health data project — known as care.data — it was discovered the National Health Service was disregarding patient requests and still populating patient files with information, even after patients opted-out.
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7 August 2017
The Victorian government’s decision to go it alone with a mandatory real-time prescription monitoring for high-risk medicines has exposed some disarray in the plans for a national scheme.
Victoria’s Health Minister, Jill Hennessy, recently announced a $29.5 million plan to roll out the surveillance program to crack down on the misuse of dangerous prescription drugs within the next year, including $1 million to train doctors and pharmacists.
“In an Australian first, and following worldwide best practice, using the system will be mandatory for doctors and pharmacists before prescribing or supplying a high-risk medicine,” the state minister said in a statement.
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It will soon be illegal for pharmacists in Victoria to dispense controlled medications without checking a prescription monitoring system.
This will follow the introduction of the state’s $29.5 million real-time-monitoring system in 2018.
And the state government is tabling legislation that makes it mandatory for pharmacists to check a patient’s prescription history before they dispense a high-risk medicine.
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By Australian Hospital + Healthcare Bulletin Staff
Thursday, 03 August, 2017
The federal government is investing $16 million to ensure the national rollout of real-time prescription monitoring for medicines to prevent their misuse and needless loss of life.
The Real Time Prescription Monitoring system will give pharmacists and doctors an instant alert if patients have received multiple supplies of prescription-only medicines, providing an up-to-the-minute medication supply history of certain high-risk medicines at the point of consultation. This information will enable doctors and pharmacists to make more informed decisions about the safety of supply of medication to that patient, assisting them to identify patients who are at risk of harm due to dependency, misuse or abuse of controlled medicines, as well as patients who are diverting these medicines for other purposes.
This can happen if a patient has developed a dependency on controlled medicines or is selling these medicines to others, including for the purposes of manufacturing other illegal drugs. Controlled medicines include morphine, oxycodone, dexamphetamine and alprazolam.
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11 August 2017
TECH TALK
The so-called King Review of pharmacy has generated fierce debate among pharmacists, or at least among their representative groups.
Most GPs will be happy to ignore this debate. There is one suggestion, however, that may have a big effect on GPs — the endorsement of paperless prescriptions.
For GPs already linked to electronic script exchanges, it may seem like an obvious step. For those who don’t know what an ‘e-script exchange’ is, it may seem a bit like sci-fi.
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9 August 2017
COMMENT
For now, texting as a free service remains a dream writ only on the pages of surveys.
What patients want and what they get are often very different things.
When offered the choice of how to receive pathology results, patients prefer text messaging.
A survey published this week indicates three-quarters of patients aged under 60 years would prefer texts for normal results, although only 7% would prefer texts to deliver news of an abnormal result. For abnormal results, they far prefer a phone conversation (73%) to having to attend the doctor (14%).
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Tim Kelsey, CEO of the Australian Digital Health Agency, presented at the Health Informatics Conference (HIC) on 9 August 2017 about our work program, My Health Record and COAG's (Council of Australia's Governments) approval of Australia’s National Digital Health strategy.
Australian Digital Health Agency - My Health Record Expansion Program
What is the My Health Record, why is it important, and how can it help? This short (2:36) introductory video answers these questions from a variety of perspectives: the patient, the carer, and Australian Digital Health Agency staff members.
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Contractor given harsher rebuke.
The Australian Red Cross Blood Service and its website contractor have escaped penalties from the country's privacy watchdog over a 2016 data breach that exposed the data of 550,000 donors.
A Precedent employee tasked with enhancing a feature on the Blood Service's Donate Blood site accidently saved a backup of the site's user acceptance testing (UAT) database to a publicly accessible portion of the web server that hosted the UAT environment.
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Report on database dump commends quick response by Australian Red Cross Blood Service
A data breach that involved a backup of a prospetive donor database maintained by the Australian Red Cross Blood Service being placed on a public web server was the result of a “one-off human error,” according to a report from the Office of the Australian Information Commissioner.
Australian Information Commissioner Timothy Pilgrim launched an investigation in October last year after the the privacy breach was revealed. The OAIC today released a pair of reports on the incident: One on the Blood Service and one on Precedent Communications Pty Ltd, which managed the donateblood.com.au website.
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Kate Aubusson
Published: August 9 2017 - 12:15AM
The first Lauren Poole had heard of epithelioid sarcoma was the day she was told her thumb had to be amputated to save her life.
The tiny lump on the tip of her thumb had been innocuous enough. But her instincts told her to have it removed and tested.
She was diagnosed with the rare soft tissue cancer, and 17 hours later a surgeon was severing her thumb at the main knuckle.
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Australia now has a National Digital Health Strategy, which proposes that by 2022, health information will be available whenever and wherever it is needed, and that its exchange will be secure.
The Strategy was endorsed by federal, state and territory health ministers meeting in Brisbane last Friday.
(See other items on their agenda here – including Indigenous health, Andrew Forrest and a global Eliminate Cancer Initiative, a national primary care training package regarding family violence, the Fifth National Mental Health and Suicide Prevention Plan 2017-2022, and plans to provide support for people with severe mental resulting in psychosocial disability who are not eligible for the NDIS).
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Lynne Minion | 11 Aug 2017
Queensland Health has announced internationally recognised transplant specialist and digital hospital evangelist Professor Keith McNeil is decamping from his role with the NHS and returning to Brisbane to help drive the digital transformation of the state’s hospitals.
Due to take up the newly created position of Assistant Deputy Director General and Chief Medical Information Officer in December, McNeil will bring considerable clinical insight and technical competency to Queensland’s eHealth program.
McNeil has resigned as the UK’s first national Chief Clinical Information Officer for Health and Care after 13 months in the job for what he says are personal and family reasons.
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Published: 5:13 pm, Wednesday, 9 August 2017
A new electronic records system being rolled out across South Australia's public hospitals is possibly not fit for purpose, the Australian Medical Association says.
The AMA says it sent a questionnaire to almost 250 staff, including doctors and nurses, asking for their views on the $422 million Enterprise Patient Administration System.
It says almost 40 per cent reported their opinion of EPAS was poor, 30 per cent believed patients were not clinically safer and 20 per cent found it responsible for adverse patient outcomes.
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August 9, 2017
A new electronic records system being rolled out across South Australia’s public hospitals is possibly not fit for purpose, according to the Australian Medical Association (AMA).
The AMA said it sent a questionnaire to almost 250 staff members, including doctors and nurses, asking for their views on the AU$422 million enterprise patient administration system (EPAS).
It says almost 40 percent reported that their opinion of EPAS was poor, 30 percent believed patients are not clinically safer, and 20 percent found it responsible for adverse patient outcomes.
“The AMA has consistently supported the concept of electronic medical records,” president William Tam said on Wednesday.
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Andrew Hough, The Advertiser
August 9, 2017 6:53pm
A FORMER Socceroo’s “horrific” and “macabre” death at a major Adelaide hospital was entirely preventable, the State Coroner has ruled.
An urgent inquest was told his bladder ruptured and his lungs collapsed after oxygen was mistakenly attached to a catheter tube meant to drain urine.
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KATRINA STOKES, HEALTH REPORTER, The Advertiser
August 9, 2017 11:03am
A DAMNING new survey by the state’s peak medical association has revealed the highly controversial Enterprise Patient Administration System is a total dud, it’s “dangerous” and questions whether it should be used at the new Royal Adelaide Hospital.
Results from an Australian Medical Association (SA) questionnaire of 248 staff, including doctors and nurses, reveals the system is “unfit for purpose” and “dangerous”.
AMA (SA) president Dr William Tam has questioned whether it should be rolled out at the nRAH.
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The AMA has said a new electronic records system being rolled out in South Australian hospitals is not fit for purpose.
A new electronic records system being rolled out across South Australia's public hospitals is possibly not fit for purpose, according to the Australian Medical Association (AMA).
The AMA said it sent a questionnaire to almost 250 staff members, including doctors and nurses, asking for their views on the AU$422 million enterprise patient administration system (EPAS).
It says almost 40 percent reported that their opinion of EPAS was poor, 30 percent believed patients are not clinically safer, and 20 percent found it responsible for adverse patient outcomes.
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Daniel Wills, State Political Editor, The Advertiser
August 10, 2017 11:22pm
BUILDERS of the new Royal Adelaide Hospital have claimed that delays with the State Government’s troubled new electronic patient records system made it “impossible” for the project to be completed on time, as they launch a $185 million suit in the Federal Court.
The Advertiser yesterday revealed a new legal battle had broken out over the $2.3 billion project, set to open on September 5, and has now obtained documents detailing the claim.
The case has been brought by two building firms that combined in a joint venture to construct the new RAH — CPB Contractors and Hansen Yuncken — against the private consortium overseeing the project, Health Minister Jack Snelling and the state of SA.
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The group representing nurses well-versed in informatics is appealing for heavy involvement in the delivery of Australia's digital health strategy.
A consortium of organisations representing nurses in Australia is advocating for their role in digitally transforming the country's healthcare, arguing that it makes sense for nurses to lead in decision-making and act as knowledge brokers to transform services and empower patients.
The Nursing Informatics Position statement, developed by the Health Informatics Society of Australia, Nursing Informatics Australia, and the Australian College of Nursing, touts the role of nurses in the widespread implementation and adoption of digital health technologies as pivotal for the primary purpose of improving safety and quality of patient care.
"While the Australian healthcare system is the envy of many countries, in recent years, levels of improvement in health system performance have remained static and it may be argued, have plateaued," the report [PDF] explains.
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10.08.2017
In his first speech, the new DTA chief Gavin Slater talked up the value of digital technologies that cause the biggest privacy fears — digital identity verification, facial recognition and electronic health records — but ignored the p-word entirely.
There was one rather large elephant in the room when Gavin Slater gave his first speech as CEO of the Digital Transformation Agency to an IT industry audience last week: privacy.
Slater did not touch the subject, even when talking up the value of the government digital initiatives that generate the biggest privacy fears: the use of facial recognition, electronic health records, and the DTA’s nascent national digital identity verification system, GovPass.
Slater lauded e-health and the use of facial recognition to speed up immigration processing at airports, along with myGov and myTax, as examples showing the federal government had already created significant value in recent years through digital transformation. “I don’t think we do a good enough job in government of talking about the progress that is actually being made,” he added.
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Six additional community pharmacy software vendors have agreed to connect up to the My Health Record system
The Australian Digital Health Agency has entered into agreements with Dispense Works, Minfos, Mountaintop Dispense, RxOne, ScriptPro Dispense, and Z Dispense, the agency announced on Wednesday.
These are in addition to Fred Dispense and Aquarius Dispense, which already connect to the My Health Record system.
And negotiations are ongoing with a number of other pharmacy dispensing software vendors; the agency says it is confident that agreements will be in place with almost all vendors in the next few months.
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Australian Digital Health Agency enters into agreements with more software vendors
The Australian Digital Health Agency has struck agreements with half a dozen community pharmacy software vendors to connect to the federal My Health Record system.
The ADHA revealed that Dispense Works, Minfos, Mountaintop Dispense, RxOne, ScriptPro Dispense and Z Dispense will integrate support for the eHealth record system.
Fred Dispense and Aquarius Dispense already support My Health Record, and the agency said that it was confident that agreements will be in place with “almost all vendors in the next few months”.
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Transforming Australia’s digital health services will benefit Australians in a number of ways; from reducing hospital admissions, and adverse events, to improving patients’ care and treatment options.
The Council of Australian Governments (COAG) Health Council recently approved Australia’s National Digital Health Strategy.
Currently, 5 million Australians have a My Health record – the strategy aims, amongst other things, to expand this offer to all Australians by 2018 (unless they opt to not have one).
Guest
Tim Kelsey
CEO, Australian Digital Health Agency
Presenter
Dr Norman Swan
Producer
Joel Werner
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Amid ongoing review.
ACT Health has set about introducing a real-time data analytics platform to address its troublesome performance reporting, while a system-wide review of the territory's health data management processes continues.
The review was ordered by Health Minister Meegan Fitzharris earlier this year after ACT Health failed to provide the Productivity Commission with emergency department figures for benchmarking with other jurisdictions, because of concerns with data accuracy.
Once the cause of the health directorate's ongoing data issues are understood, revised governance arrangements for data management and a framework for essential data reports willl be introduced, and the territoy's data warehouse will be rebuilt.
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SHARRI MARKSON, The Daily Telegraph
August 7, 2017 12:00am
A NATIONAL identification card for every Australian is back on the agenda, while cargo from the Middle-East will now undergo exhaustive security checks.
It comes as the Turnbull government examines new ways to strengthen security at airports. Security flaws at regional airports, where passengers and cargo do not undergo any screening, is also being immediately reviewed.
Immigration Minister Peter Dutton, Infrastructure and Transport Minister Darren Chester and Justice Minister Michael Keenan will present a range of measures to the National Security Committee of Cabinet soon — possibly within the week. Requiring passengers to show ID before boarding domestic flights will be considered, with sources suggesting there could be renewed discussion about a national ID card.
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Authored by Nicole MacKee
INCREASED health care data collection and broader expectations of transparency may lead to a legal duty to disclose performance data as part of informed consent, says an expert in the MJA this week.
Dr Rebekah McWhirter, from the Menzies Institute for Medical Research and the University of Tasmania’s Centre for Law and Genetics, wrote in an MJA Perspective that there was currently no general duty to disclose performance data, but “a duty may arise in future as the health care system evolves”.
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7 August 2017
IMPROVING PRACTICE SOFTWARE
THE ISSUE
Each type of information about a patient’s health problems is stored in a different place in the electronic clinical record.
This partly reflects the history of the development of clinical software used in Australian general practice, some of which started as systems only to improve the ease and quality of prescribing, with other functions being added gradually.
The patient’s long-term health conditions appear in one screen or place, while investigations relevant to all of their problems appear together in a separate screen or place, as do correspondence, current medicines, and other treatments.
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11:32 08 Aug 2017
The 5-year contract will see MasterCare PAS hosted on Global Health’s Altitude Cloud Service.
It is the core system for a number of other rehabilitation hospitals across Australia
Global Health (ASX:GLH) has secured a contract to deploy its MasterCare Patient Administration System (PAS) at the Arcadia Pittwater rehabilitation hospital in the Northern Beaches of Sydney.
Launching in early 2018, the 5-year contract will see MasterCare PAS hosted on Global Health’s Altitude Cloud Service.
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New Zealand healthcare provider Orion Health has inked a five-year contract with the Department of Health and Human Services in Victoria to deploy its flagship interoperability solution, Rhapsody Integration Engine, across the DHHS and 15 public health agencies.
Under the contract, Orion will partner with MKM Health, an Australasian IT technology company with extensive knowledge of the Victorian healthcare sector, to supply additional architecture, solution support and professional services capability.
The Victorian DHHS delivers programmes and services that support and enhance the health, well-being and safety of 6.2 million people.
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August 7, 2017 6.12am AEST
Author: Jon Cornwall
Senior Lecturer, Faculty of Health, Victoria University of Wellington
Death is inevitable. The creation of healthcare records about every complaint and ailment we seek treatment for is also a near-certainty.
Data about patients is a vital cog in the provision of efficient health services.
Our study explores what happens to those healthcare records after you die. We focus on New Zealand’s legal situation and practices, but the issue is truly a global one.
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A test of broadband speeds across 189 countries has found that Australia ranks 55th, well behind New Zealand (30th) and miles behind table-topper Singapore.
The table was compiled by British broadband advice site Cable.co.uk from more than 63 million broadband speed tests.
The data collection was done across 12 months ending on 10 May, by M-Lab, a partnership between New America's Open Technology Institute, Google Open Source Research, Princeton University's PlanetLab, and other partners.
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A veteran independent telecommunications commentator claims that government policy, not the NBN Co or retail service providers, is to blame for the fiasco that the national broadband network rollout has become.
Paul Budde said at its core, the problem was one created by politicians, going all the way back to the original NBN policy which was drafted by the Labor Party.
"The only solution for the government is to realise that their government-led rollout is not simply a commercial exercise. If it was based on commercial principles, the rollout would first start in markets where they can charge a premium price," he pointed out. "The government must realise that they can’t burden the NBN Co with an unrealistic return on investment."
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- Updated Aug 7 2017 at 11:00 AM
Is the NBN getting you down?
Are you awaking irritable and still tired each morning, afraid that Malcolm Turnbull's version of the National Broadband Network has condemned you, your children and possibly your children's children to broadband speeds that are marginal at best right now, but that will lag far behind the rest of the world in years to come?
Lord knows the NBN has been getting me down, and I don't even have it yet.
Ever since the NBN appeared in my suburb, my already very sketchy broadband speed has sunk to a 10-year low, especially for uploads. Many of the smart home gadgets in my house, ranging from Google Home to security cameras, now refuse to work, not all of the time, but all too often.
NBN Co insists it's not its fault, and that my ISP must be to blame. My ISP, which sent out a technician who couldn't find anything wrong with my connection, suggested that it may not be a coincidence that the connection went dodgy soon after the NBN took over the local backbone.
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Enjoy!
David.
