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, November 28, 2017

It Rather Looks Like The MyHR Has Broken An Important Rule If Success Is To Be Achieved!

This appeared last week:
21 November 2017

How to succeed with digital innovation in health

Posted by Felicity Nelson
Dr Steve Hodgkinson has a message for digital health innovators: the longer a project takes, the more likely it is to fail.  
Dr Hodgkinson, the CIO at Victoria’s Department of Health and Human Services, has overseen the launch of around 30 new applications in the past 18 months, with products delivered in as little as six weeks, and none taking longer than six months.  
The thinking behind a swift roll-out was that it gave stakeholders a sense of how the application would work and provided an opportunity for feedback early in the process.  
Rather than taking 18 months or two years to develop the perfect” system, the department used existing cloud platforms to get a working model up as soon as possible and then executed the design based on user feedback.  
This transparency promoted organisational learning and made people feel energised and excited about the project, Dr Hodgkinson said. 
“Just getting started is the thing,” he said, speaking at Microsoft’s “Creating a Digital Difference” event in Sydney this month.  
The department launched a thunderstorm asthma early-warning system in October, in partnership with the Bureau of Meteorology, the University of Melbourne, and Deakin University. The computing work was done by Microsoft’s Azure platform.  
The system gave three days’ warning of a likely event and sent notifications to the public through the Vic Emergency app.  
…..
This strategy, which Dr Hodgkinson namedPlatform+Agile”, could be useful for the development of a range of digital health systems, he said. “But electronic health records it is a more complicated conversation,” he said.  
Digital health often feels stuck in the mud, with systems unable to talk to each other and projects such as My Health Record eating into $2 billion without much to show for it.  
Part of the problem was that government was trying to create “a single system to rule them all”, which was neither necessary nor practical in a fragmented sector like health, Dr Hodgkinson said.  
A better solution would be for government to become an “intelligent consumer” of global digital services. 
Lots more here:
As I recall the so called ‘soft launch’ of the PCEHR (as it then was) happened on July 1, 2012 after about 2 years of development.
You can relive the period with this fantastic collection of memorabilia found here:
This means rather than taking six months the shambles has so far taken at least 7 years – hardly ‘agile’ .
And now we know it is going further with opt-out and all these new data feeds in 2018.
On the basis of value for money and duration this is really doomed I reckon – we have all been suffering for far too long!
David.

Monday, November 27, 2017

Weekly Australian Health IT Links – 27th November, 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

The myHR is really in the news for both good and not so good reasons this week. Otherwise some more private sector activity and the NBN still seems to be causing some concern. Happy reading.
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Privacy groups outraged over failure to inform Aussies about a new government health record

Sue Dunlevy, National Health Reporter, News Corp Australia Network
PRIVACY groups have slammed the Federal Government for their silence over a controversial internet health record forced on every Australian as of next year.
More than $1.7 billion of taxpayer’s money has gone into developing a personalised My Health Record for every Australian.
It will detail every subsidised medicine used, every doctor and hospital visit, blood test result, X-ray and scan ever provided to each person.
People who want to opt out of the system to keep private sensitive information like abortions, sexually transmitted disease, mental illness, obesity surgery will have three months to do so.
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GPs and hospitals claim My Health Record is not fit for purpose as alarmingly low usage figures are released

Lynne Minion | 21 Nov 2017
It’s cost an estimated $2 billion and taken five years to develop so far, but concerns are growing that the Federal Government’s My Health Record may be at risk of becoming a white elephant as hospital and GP groups claim it is yet to show clinical benefit.
New figures released by the Australian Digital Health Agency, which is rolling out the national repository for health information, show that while 21 per cent of the population has a My Health Record, only 263 specialists were connected to the system, less than 150 hospital discharge summaries are viewed each month by any healthcare organisation, and about 200 GP-generated shared health summaries were accessed by staff working in public and private hospitals in August.
The alarmingly low use of the system by clinicians has amplified the chorus of concerns from healthcare providers and technology experts who claim the My Health Record isn’t fit for purpose.
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A GP diagnoses My Health Record's ills

21 November 2017

COMMENT

The main problem is that it's a bureaucrat's solution which tries to be all things to all people, an anonymous GP writes.
The MyHealth Record is like my garden. You can stick fancy plants in, ask people the flower they want to see blossom and plant those too. It needs money, too, but then it will look very pretty. Then, no matter what you do, the plants suddenly wilt and die and the garden is left barren.
There is an alternative to health IT horticulture: you spend your time fertilizing the soil, digging it, nurturing the local ecosystem, and then sow tiny inexpensive seeds. Some germinate, grow and flower, some fail. But you learn what works.
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There's a glimmer of hope for My Health Record, but the clock is ticking

22 November 2017

COMMENT

You would worry for the My Health Record this Christmas — simply because it still has the look of a giant, overfed turkey. Respect to the Australian Digital Health Agency — it was open and transparent about what’s been going on.
It could have buried the numbers as politicians have often done beneath the statistical irrelevancies of the millions of patients signed up to the system, that number so quoted in the media sound bites when pretending taxpayers dollars are not being squandered.
The shared health summaries being created by GPs are meant to be the “backbone” of the system, a quick, concise clinical overview that hospitals, private specialists, allied health practitioners can refer to when providing care.
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My Health Record still not worth its $2b investment

A new report shows it has a long way to go
24th November 2017
The future looks grim for the Federal Government’s My Health Record unless its inherent problems are addressed, new figures suggest.
GP groups have been scathing about cost blowouts and its slow implementation - it has taken five years to develop at an estimated cost of $2 billion.
However, take up is painfully slow.
In August, just 200 GP-generated shared health summaries were accessed by hospital staff.
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Data Divide

For many years we have been talking about the ‘digital divide’ in healthcare, but the implementation of any digital solution does not itself improve outcomes, unless there is clear evidence to prove it. To gain this evidence involves the collection of the good data, and then a robust analysis of the data collected.
Unfortunately, most implementations of digital solutions in healthcare, especially electronic medical records (eMRs), have not applied sufficient resources to the governance of data collection, and resources for data analysis. This has led to a big ‘data divide’ between healthcare organisations, states and territories, and countries. Our recent meeting on Health Data Analytics in Brisbane highlighted this perfectly.
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16 new software companies finalise agreements with Australian Digital Health Agency for enhanced diagnostic imaging access

By: Dean Koh
24 Nov 2017
“My Health Record is making strong inroads into developing the support and services. This work will help fulfil the potential of a secure online summary for all Australians and ensure healthcare professionals have access to key patient information.”
More than 95% of Australian diagnostic imaging practices will soon be able to connect to the My Health Record system with 16 new software companies finalising service agreements with the Australian Digital Health Agency.
Over the coming months software companies will build My Health Record connectivity into their systems, according to the media release. By the end of 2018, less than 12 months after offering arrangements, diagnostic imaging centres will be able to access software that connects with My Health Record and to upload reports for their patients.
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Major boost to diagnostic imaging access with 16 software companies signing onto My Health Record

Thursday, 23 November 2017
More than 95 per cent of Australian diagnostic imaging practices will soon be able to connect to the My Health Record system with 16 new software companies finalising service agreements with the Australian Digital Health Agency.
Over the coming months software companies will build My Health Record connectivity into their systems. By the end of 2018, less than twelve months after offering arrangements, diagnostic imaging centres will be able to access software that connects with My Health Record and to upload reports for their patients.
Demand from patients for a secure on-line summary of their health information is gathering momentum. Over 5.3 million Australians have a My Health Record and a new record is created every 38 seconds.
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All software vendors and Chemist Warehouse embrace My Health Record

The network has taken a leap forward with every pharmacy now able to link up
24th November 2017
Every Australian pharmacy will be able to use My Health Record, with the final software provider about to connect to the system.
Corrum, which is used by 1000 pharmacies, will connect to the system next year.
Pharmacy uptake has also been boosted by Chemist Warehouse, which says it plans to roll out My Health Record in all of its pharmacies.
The aim of My Health Record is to improve medication management by allowing pharmacists to upload all medications dispensed to a patient.
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Chemist Warehouse and Corum connecting to My Health Record

Friday, 24 November 2017
Every Australian with a My Health Record will be able to walk into a community pharmacy and have their Pharmacist upload important medicines information into their secure My Health Record to improve their health care.
Chemist Warehouse, representing 30 per cent of the community pharmacy market, and Corum representing 1,000 pharmacies, today announced their upcoming connection to My Health Record system in 2018. Every community pharmacy software vendor has now signed up to the Community Pharmacy Software Industry Partnership to connect to the My Health Record system.
Chemist Warehouse Managing Partner and Director Mark Finocchiaro said the company sees great potential to improve the health of Australians through technologies such as My Health Record.
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21 November 2017

How to succeed with digital innovation in health

Posted by Felicity Nelson
Dr Steve Hodgkinson has a message for digital health innovators: the longer a project takes, the more likely it is to fail.  
Dr Hodgkinson, the CIO at Victoria’s Department of Health and Human Services, has overseen the launch of around 30 new applications in the past 18 months, with products delivered in as little as six weeks, and none taking longer than six months.  
The thinking behind a swift roll-out was that it gave stakeholders a sense of how the application would work and provided an opportunity for feedback early in the process.  
Rather than taking 18 months or two years to develop the perfect” system, the department used existing cloud platforms to get a working model up as soon as possible and then executed the design based on user feedback.  
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“This is what everyone has been waiting for.” Secure messaging breakthrough as tech titans announce two-way interoperability

Lynne Minion | 24 Nov 2017
In what is being signalled as a leap forward in the development of secure messaging, two Australian health tech titans announced this week that they have achieved two-way interoperability for the sharing of clinical information.
Documents including referrals, specialist letters, diagnostic results and discharge summaries are now being securely exchanged by healthcare providers using Global Health’s ReferralNet and Telstra Health’s Argus secure messaging platforms, according to the announcement.
“This is what everyone has been waiting for,” Nikki Thrift, General Manager of Connectivity for Global Health, told Healthcare IT News Australia.
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  • Updated Nov 20 2017 at 11:00 PM

HealthMatch helps patients find clinical trials and is heading to US after TechCrunch win

A Sydney-based start-up that has created an online platform to offer desperately ill patients access to clinical trials of new treatments is heading to the US after winning a pitching contest hosted by big-name US tech site TechCrunch.
HealthMatch, which is  staffed only by   co-founders Manuri Gunawardena and Arran Schlosberg, won the inaugural Australian TechCrunch Startup Battlefield event in Sydney last Thursday, meaning they will now head over to pitch in the high-profile US version of the contest next year, just as they are trying to secure a series A funding round.
HealthMatch is a platform that uses machine learning to sort through the thousands of clinical trials being run by contract research organisations (CROs) in Australia and matches registered patients that are relevant. 
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11:00pm, Nov 21, 2017 Updated: 11:09pm, Nov 21

Revealed: Alan Tudge’s department knew of Medicare breach prior to bombshell report

The Department of Human Services flagged the illegal sale of Medicare details on the dark web almost a fortnight before the illicit trade was exposed in a bombshell media report, The New Daily can exclusively reveal.
Internal emails, obtained under freedom of information laws, reveal that department officials discussed the security issue as early as June 22 – nearly two weeks before revelations that Medicare numbers were being sold online.
On July 4, The Guardian revealed that a dark web vendor was advertising the sale of any Australian’s Medicare number for the bitcoin equivalent of just $22 after exploiting a government system vulnerability.
In the wake of the revelations, Human Services Minister Alan Tudge said that he and his department had only learned of the illicit trade when contacted by a Guardian journalist on July 3.
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FreeStyle Libre device takes pain out of daily glucose checks

  • The Australian
  • 12:00AM November 22, 2017

Sarah-Jane Tasker

An innovative glucose-monitoring device, which removes the need for multiple daily finger pricks, could be rolled out to hundreds of thousands of Australians with diabetes if the federal government agrees to fund it.
The device, FreeStyle Libre, is expensive to use full-time for many people, given it costs $92.50 every 14 days for discs used to monitor glucose levels. That equates to about $2500 annually, including the cost of the reader.
Elizabeth McKinley, 58, a single mother of five, who has had type 2 diabetes for 15 years, has called for the costs to be reimbursed. She has trialled the device and found it significantly helped in managing her diabetes, but the ongoing cost meant she had to stop using it.
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Naked and confused: The day a GP decided to visit Dr Google

22 November 2017

GUEST EDITORIAL

I would say that almost every patient a GP sees these days has performed a Google search of their symptoms before turning up at the doctors.
Being a doctor, I’ve never had to perform a health-related Google search, but in the interests of getting to know my patients better, I decided to give it a go. 
I took the plunge one early Saturday morning while I was getting my breakfast ready — what I wanted to know was, was my preferred plate of eggs and bacon a healthy option? 
According to Healthline, eggs are one of the six healthiest foods on the planet. Feeling a little bit smug, I googled “bacon”. 
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Updated EMM guide: supports safer medication use in hospitals

By Australian Hospital + Healthcare Bulletin Staff
Thursday, 16 November, 2017
The reduction of adverse drug events is the priority of an updated EMM guide, launched this week.
The Australian Commission on Safety and Quality in Health Care launched the third edition of the guide, called ‘Electronic Medication Management Systems: A guide to safe implementation’, which takes account of newer evidence that has come to light since the second edition was published in 2012. It also reflects the experiences of Australian hospitals that have already implemented electronic medication management (EMM) systems.
Medicines are the most common medical intervention in Australian hospitals. As many as one in nine doses of medicine administered in hospitals are associated with a clinical error.
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Global Health is now compatible with Telstra Health

07:36 22 Nov 2017
The company recently completed its fifth year of profitable operations.
At its current share price of $0.28, it offers a compelling dividend yield
Global Health Limited (ASX:GLH) has achieved two-way interoperability between its ReferralNet secure messaging service and Telstra Health’s Argus secure messaging platform.
The two platforms can now securely exchange clinical documents, including referrals, specialist letters and discharge summaries.
The collaboration represents a significant step forward for the Australian healthcare industry as it transitions to becoming fax-free, a structural shift that will result in considerable cost savings.
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Victoria picks Fred IT to build $30m drug tracking system

By Justin Hendry on Nov 24, 2017 11:45AM

System planned for rollout next year.

The Victorian government has selected pharmacy IT solutions provider Fred IT Group to build the state’s $29.5 million real-time prescription monitoring system.
The centralised tracking system known as SafeScript aims to reduce the misuse of prescription drugs and allow for safer clinical decisions by giving health practitioners “up-to-the-minute information on the prescription histories of their patients”. 
Fred IT’s appointment follows the passage of the Drugs, Poisons and Controlled Substances Amendment (Real-time Prescription Monitoring) Bill 2017 through state parliament last month.
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Kracking the latest health hack risk

22 November 2017

TECH TALK

A Krack vulnerability sounds like something that’d send you straight to the ED. But it’s actually a security risk in the most common wi-fi protocol, WPA2, revealed last month by Belgian researchers.
The discovery made news across the world. Here at home, the Australian Digital Health Agency (ADHA) issued a formal security alert about it.
KRACK refers to Key Installation Atta-C-K, an acronym so illogical it could almost have been the title of a clinical trial.
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Avatars may help schizophrenia patients control threatening voices, study finds

Kate Kelland
Published: November 24 2017 - 12:33PM
London: An experimental therapy for people with schizophrenia that brings them face-to-face with a computer avatar representing the tormenting voices in their heads has proved promising in early stage trials.
Scientists who conducted a randomised controlled trial comparing the avatar therapy with a form of supportive counselling found that after 12 weeks, the avatars were more effective at reducing auditory hallucinations, or voices inside the head.
More research is needed to investigate the approach in other healthcare settings, so the therapy is not yet widely available.
But if further trials prove successful, experts said, avatar therapy could "radically change" treatment approaches for millions of psychosis sufferers across the world.
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AMA Submission on the secondary use of My Health Record data

20 Nov 2017
The AMA submission urges the government to adopt a carefully balanced position on the secondary use of My Health Record data.  Our members recognize the positive opportunities the new My Health Record data set will create.  But the extent and management of each disclosure decision must not breach the trust of patients who expect the government to keep their health data safe and protect it against any privacy breach.  Doctors are also mission critical to the success of the My Health Record.  The secondary use of My Health Record data must not  breach their trust either.
Related document (Public): 
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Are doctor-shoppers really at the heart of our opioid crisis?

Tuesday 21 November 2017 5:30PM  (view full episode)
Around 600 Australians die each year from prescription drug overdoses, and the figure rises each year.
When it comes to prescription opioid overdoses, they involve members of the community we might never normally associate with addiction.
To tackle the epidemic, Australia is to introduce Real Time Prescription Monitoring next year, but is it enough?
If this program raises any issues for you or anyone close to you please contact Lifeline, 13 11 14, which has a special addictions support service.
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November 19 2017 - 1:36PM

UTAS Associate Professor and GP Dr Jan Radford talks medical data collection

Carly Dolan

Dr Radford will head to Europe next year on a Churchill Fellowship to further her work with electronic medical data collection and how it can benefit the health of patients.

CARLY DOLAN: What is the current data collection process in Tasmania?
JAN RADFORD: We’re doing a little bit in this area but it’s new, and how do you sustain it and then use it for the greater good? There are some projects we’ve just started to work on but it’s a matter of slowly progressing the whole thing because you’ve got to make sure that patient records are handled with very good care. So the data governance has to be right.
CD: Can you explain what it is you’re looking into?
JR: When I started as a GP 31 years ago, it was all written down and filed away. It’s slowly crept in that electronic records have become more and more used and are now really the norm in Australian general practice. Each country has become electronic in that sense at a different rate.
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NBN users with medical alarms at risk, says Labor

The Labor Party has raised the possibility that NBN users may be at danger during the forthcoming fire season if their phone services are running off the network.
A statement from Shadow Communications Minister Michelle Rowland said the fire chief in Western Australia had, recently, warned that phone services which were running off the NBN could be exposed during an emergency.
Rowland and Shadow Health Minister Catherine King said that the NBN Co itself had pointed out that two of the technologies being used to roll out the network — fibre-to-the-node and HFC — could not be relied upon during a power outage.
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NBN maybe possibly might release speed database, perhaps

CEO confident RSPs will make details available, otherwise he will (possibly)
Rohan Pearce (Computerworld) 24 November, 2017 06:00
NBN chief executive Bill Morrow says the company is prepared to publish details of the theoretical maximum speeds achievable for households — possibly.
During a briefing earlier this month on the company’s Q1 results, Morrow said that the company would consider publishing its speed estimates.
However, in an appearance yesterday at a Senate Estimates hearing the CEO reiterated that he didn’t believe that NBN would have to — and that he wasn’t even sure if, legally, the company would be able to.
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Many top websites tracking users' every move

Many well-known websites are using third-party analytics scripts to track every movement of visitors to their sites, a study claims.
Known as session-replay scripts, these were found on sites like Microsoft, IBM, The London Telegraph, and numerous others.
The scripts record keystrokes, mouse movements, and scrolling behaviour and send the full content of pages viewed to third parties.
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Enjoy!
David.

Sunday, November 26, 2017

It Has Been A Really Mixed Week For The myHR. The ADHA Keeps Spruiking It As More And More Issues Emerge.

Last week we saw these announcements about all the new users that were to be connected to the myHR.
See here:

Chemist Warehouse and Corum connecting to My Health Record

Friday, 24 November 2017
Every Australian with a My Health Record will be able to walk into a community pharmacy and have their Pharmacist upload important medicines information into their secure My Health Record to improve their health care.
Chemist Warehouse, representing 30 per cent of the community pharmacy market, and Corum representing 1,000 pharmacies, today announced their upcoming connection to My Health Record system in 2018. Every community pharmacy software vendor has now signed up to the Community Pharmacy Software Industry Partnership to connect to the My Health Record system.
Chemist Warehouse Managing Partner and Director Mark Finocchiaro said the company sees great potential to improve the health of Australians through technologies such as My Health Record.
More here:
And here:

Major boost to diagnostic imaging access with 16 software companies signing onto My Health Record

Thursday, 23 November 2017
More than 95 per cent of Australian diagnostic imaging practices will soon be able to connect to the My Health Record system with 16 new software companies finalising service agreements with the Australian Digital Health Agency.
Over the coming months software companies will build My Health Record connectivity into their systems. By the end of 2018, less than twelve months after offering arrangements, diagnostic imaging centres will be able to access software that connects with My Health Record and to upload reports for their patients.
Demand from patients for a secure on-line summary of their health information is gathering momentum. Over 5.3 million Australians have a My Health Record and a new record is created every 38 seconds.
More here:
However on the less positive side we found this:

GPs and hospitals claim My Health Record is not fit for purpose as alarmingly low usage figures are released

Lynne Minion | 21 Nov 2017
It’s cost an estimated $2 billion and taken five years to develop so far, but concerns are growing that the Federal Government’s My Health Record may be at risk of becoming a white elephant as hospital and GP groups claim it is yet to show clinical benefit.
New figures released by the Australian Digital Health Agency, which is rolling out the national repository for health information, show that while 21 per cent of the population has a My Health Record, only 263 specialists were connected to the system, less than 150 hospital discharge summaries are viewed each month by any healthcare organisation, and about 200 GP-generated shared health summaries were accessed by staff working in public and private hospitals in August.
The alarmingly low use of the system by clinicians has amplified the chorus of concerns from healthcare providers and technology experts who claim the My Health Record isn’t fit for purpose.
GPs, who are provided with financial incentives to upload shared health summaries to the system through the government’s ePIP program, said they don’t need to access My Health Record for up-to-date and accurate clinical information.
Lots more here:
This seems to show that hardly anyone is using it and this also:

Privacy groups outraged over failure to inform Aussies about a new government health record

Sue Dunlevy, National Health Reporter, News Corp Australia Network
PRIVACY groups have slammed the Federal Government for their silence over a controversial internet health record forced on every Australian as of next year.
More than $1.7 billion of taxpayer’s money has gone into developing a personalised My Health Record for every Australian.
It will detail every subsidised medicine used, every doctor and hospital visit, blood test result, X-ray and scan ever provided to each person.
People who want to opt out of the system to keep private sensitive information like abortions, sexually transmitted disease, mental illness, obesity surgery will have three months to do so.
But privacy groups are gobsmacked by the government’s decision not to use TV, radio or newspaper ads to explain this to the public.
If you fail to opt out within the three-month deadline, the government will automatically create the record for you — and it will be kept for 130 years.
Lots more here:
and even this:

There's a glimmer of hope for My Health Record, but the clock is ticking

22 November 2017

COMMENT

You would worry for the My Health Record this Christmas — simply because it still has the look of a giant, overfed turkey. Respect to the Australian Digital Health Agency — it was open and transparent about what’s been going on.
It could have buried the numbers as politicians have often done beneath the statistical irrelevancies of the millions of patients signed up to the system, that number so quoted in the media sound bites when pretending taxpayers dollars are not being squandered.
The shared health summaries being created by GPs are meant to be the “backbone” of the system, a quick, concise clinical overview that hospitals, private specialists, allied health practitioners can refer to when providing care.
Lots more here:
So in summary were are all going to be enrolled in a system which we may, or may not be informed of, to gather all our health information willy nilly. Information will be added to this record without our knowledge and we can’t delete it – even if we really want to. Basically no on except the Government is likely to be using the information and we are all footing a huge bill to fund it!
You could not make this stuff up! They really have wandered off the reservation!
David.

AusHealthIT Poll Number 398 – Results – 26th November, 2017.

Here are the results of the poll.

Where Do You See A Working E-Health Standards Process Can Best Come From?

The ADHA 1% (1)

HL7 Australia 6% (9)

IT-14 44% (69)

Industry (MSIA etc.) 10% (16)

Somewhere Else 36% (56)

Nowhere 1% (1)

I Have No Idea 3% (4)

Total votes: 156

Any insights welcome as a comment, as usual, especially regarding where we should go from here! It certainly seems there is little confidence in leadership from the ADHA.

A really great turnout of votes!

Again we note three respondents who are clueless!

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

David.