Wednesday, September 02, 2015

Telstra Pushes Into Asia In A Serious Way In E-Health. Sounds A Little Risky To Me.

These release appeared last week.

Telstra Health Expands Presence in Asia with Hospital Contract Wins

Business | August 24, 2015
KUALA LUMPUR, Malaysia, Aug. 24, 2015 /PRNewswire/ — Telstra Health, a division of Australia’s largest telecommunication and technology company, today announced several key contract wins and implementations of hospital electronic medical record systems in Malaysia and Thailand, adding to its existing customer base in Asia and its established offices in Hong Kong, Malaysia and India.
Telstra Health creates solutions for key challenges in the healthcare sector by integrating leading eHealth solutions, such as the CloudMed Arcus Hospital Information System (Arcus), which is an integrated patient care system that provides hospital networks spreading over multiple locations with a single medical record.  
Implementation of Arcus has commenced at Sunway Medical Centre group, Penang Adventist Hospital group and Tung Shin Hospital’s Western Medicine and Traditional Chinese Medicine wings in Malaysia. In addition, through a distributor, Convergence Systems, Arcus is being delivered to Khon Kaen University Hospital in Thailand.
Jim Flynt, Managing Director of Telstra Health’s CloudMed subsidiary and General Manager of Health Applications, said finding more efficient and effective ways to deliver healthcare would be increasingly important across Asia, with healthcare costs in the region expected to increase from US$1.34 trillion in 2013 to US$2.21 trillion by 2018, due to growing populations and chronic illnesses becoming more common.
“Our Arcus product is designed to make it easier for doctors, nurses and pharmacists to treat patients, reducing the amount of time spent on paperwork and freeing up time to spend on what they do best – caring for patients,” said Mr Flynt.
“The system is highly flexible and can support multiple languages including English, Thai and Mandarin across multiple sites while it will also be able to record both western medicine and traditional Chinese medicine data in the future.
“While Australia remains our primary focus, the expansion into Asia marks an important milestone in the continued development of Telstra Health as we become a global health business. Many of the pain points in Australia - such as the need to digitalise and automate complex processes and share information in real time - are the same for healthcare sectors around the world.
“CloudMed, a wholly owned business of Telstra Health, acquired the assets of Indian based health software developer IdeaObject last December. Their Cloud Hospital Information System was already used by more than 250 hospitals across Asia. We’ve been able to build on this with these contract wins and are looking for growth in the region from our offices in Hong Kong, Kuala Lumpur and Chennai,” Mr Flynt said.
Sunway Group Healthcare Services’ Managing Director, Mr. Lau Beng Long said, “Arcus will be the first to introduce the use of tablet PCs to doctors, pharmacists and nurses to enable optimal mobility and flexibility when treating patients in both inpatient and outpatient environments. It will also be an integral tool for the consolidation of medical consultation notes and prescriptions at the end of a patient’s visit.”
Dr Wesley Toh See Wei, CEO and President of Penang Adventist Hospital, said “This system means any future hospitals in our pipeline can easily be brought online and become part of our healthcare ecosystem, be it on premise or in a hybrid setting, allowing us to achieve a holistic view of the care activities across the organization,” said Dr Wesley.
Mr. Chung King Keong, the Administrator of Tung Shin Hospital in Kuala Lumpur said, “We embrace Telstra Health’s vision of creating a connected healthcare system. Capturing, digitising and sharing clinical and administrative information can make healthcare smarter, safer and more efficient,” said Mr Chung. 
Telstra Health previously acquired UK based health analytics firm Dr Foster in March, currently with customers in 10 countries including the UK, the US, Italy and Spain.
About Telstra Health
Telstra Health is a provider of eHealth solutions with the ambition to create a better health system for patients, providers and health insurers. Telstra Health aims to be the partner of choice and is working with medical experts, the health sector, government, funders as well as the world’s best and most innovative eHealth companies to build a future where eHealth solutions are integrated together to create a brilliantly different health care system. Telstra Health is a business division of Telstra Corporation, Australia’s leading telecommunications company. For more information visit www.telstra.com/health
Media contact:
Cath Harris
Phone: +61-477-747-176 
The release is found here:
The release deserves very close reading from an Australian point of view. If this cloud based system can be shown to work / be adjusted to work here I am sure there will be many smaller hospitals who would find a remotely supported managed system a god-send.
It will be vital to keep an eye on what comes next - but this move into the hospital sector is clearly a major risk / benefit step for the Company.
I for one - with an major interest in e-Health and a few Telstra shares in my super fund - will be watching closely what comes next.
David.

Tuesday, September 01, 2015

Some IT Fiascos Seem To Drag On Forever. Witness The Queensland Health Payroll Debacle!

This appeared a few days ago:
  • Updated Aug 24 2015 at 5:04 AM

IBM 'negligent and misleading', Queensland alleges

The Queensland government has accused technology giant IBM of misrepresenting its credentials in delivering a $6 million payroll system that cost $1.2 billion to fix.
It said if IBM hadn't talked up its credentials to design, build and deliver the payroll system for Queensland Health before it signed a contract in 2007, it would have awarded the deal to its archrival Accenture, court documents reveal.
​ The state government is attempting to sue IBM for damages over the botched health payroll debacle, which partly contributed to the demise of the Bligh Labor government in 2012.
IBM has vowed to fight the claim and is blocking an attempt for the Queensland government to sue for damages in a four-day trial starting in the Supreme Court in Brisbane on Monday.
The technology system debacle – which overpaid some workers, underpaid others or paid them not at all – was described by former Supreme Court Richard Chesterman, QC, during his $5 million inquiry as possibly the worst failure in public administration in Australia.
The legal action against IBM was initiated by the Newman government, which blamed Labor for not pursuing the company for the botched payroll system for 80,000 health workers.
Despite speculation the Palaszczuk government would let the legal action lapse, it continued the compensation claim after winning office in January.
IBM is trying to block the action, saying it was cleared from future litigation during a 2010 agreement with the state.
In its submission to the courts, the Queensland government alleged it had suffered significant loss and damage as a result of the contract it signed with IBM in 2007 and the failed implementation of the payroll system for Queensland Health, which went live in 2010.
"The state alleges further that it would never have entered into the IBM contract and incurred the resulting losses had it not been for negligent and misleading representations made by IBM prior to the entry into the IBM contract," the submissions said.
It says the supplemental agreement with IBM in 2010 – where the IT company was paid a final payment of $718,861 to help fix remaining problems in the payroll system – did not terminate the IBM contract.
Lawyers for IBM claim the company was granted a release by the 2010 deal.
Lots more here:
This was followed a little later by this:
  • Updated Aug 26 2015 at 1:10 PM

Qld claims payroll project too complex for IBM


A former senior Queensland bureaucrat said IBM had underestimated the complexity and the resources required to deliver the health payroll system before it went live in 2010.
Mal Grierson, who was director general of the Department of Public Works, told the Supreme Court in Brisbane on Wednesday there was a belief in the government the global technology company had struggled to get on top of the problems with the IT system after it signed up to the contract in 2007.
He said IBM's strategy to transfer the existing payroll system it had developed for the Department of Housing to Queensland Health and its 80,000 workers was flawed.
Mr Grierson, who was negotiating with IBM over ways to fix the IT problems, said he was dealing with complaints about IBM's performance across three portfolios – housing, health and education – where it was delivering separate projects for the then Bligh government.

"There was a belief in government IBM had not understood the complexity of the Queensland Health payroll system. And they had not put enough resources – the numbers and calibre of people – that was required," Mr Grierson told the Supreme Court in Brisbane on Wednesday. 

"Comparing the health payroll system to the housing payroll system was like chalk and cheese. The assignment to take the housing payroll system and build that for Queensland Health was completely wrong."

IBM is attempting to block Queensland government from suing them over the botched implementation of the health payroll system – a $6 million contract which later cost taxpayers $1.2 billion to fix. 

The Queensland government is suing IBM not for breach of the original 2007 contract, but for allegedly misrepresenting their credentials to deliver the health payroll project on-time and on-budget. 

The misrepresentations also involve using the payroll system for the Housing Department as the basis for the Queensland Health project.

Mr Grierson said former premier Anna Bligh and senior ministers, including health minister Paul Lucas and housing minister Robert Schwarten, were perplexed with why IBM was struggling with the task.

"There was a message coming from the premier down saying, 'This is IBM we're talking about – why are they not doing this properly?'," he said.

Mr Grierson admitted one of the reasons IBM was selected for the 2007 contract was because of its international reputation for delivering big projects.

"When IBM was selected it was because of the expertise to replace the Queensland Health payroll system. The government didn't ask IBM about the complexities," he said.

"They just assumed IBM would do the analysis to deliver the project. That was the bottom line."

Much more here:

http://www.afr.com/technology/enterprise-it/ibm-negligent-and-misleading-queensland-alleges-20150820-gj42md

The ABC also provided coverage:
IBM tries to block legal action over Queensland Health payroll disaster

By Allyson Horn 

Tue at 6:27pm - August 25, 2015 

Former ministers have given evidence in a Supreme Court hearing as IBM tries to stop a State Government lawsuit over the Queensland Health payroll debacle.

The technology giant was contracted in 2007 by the Labor government of the time to set up a new payroll system that went live three years later and saw thousands of staff underpaid, overpaid or not paid at all.

The state launched legal action to recoup some of the $1.2 billion it cost to fix the bungle.

On Tuesday, lawyers for IBM appeared in the Supreme Court in Brisbane in a bid to block the case.

Former health minister Paul Lucas and former public works minster Robert Schwarten were questioned why the Government did not pursue legal action straight away.

Both men said their first priority was getting workers paid and that legal action might have jeopardised that.

Mr Lucas said he was "extremely disappointed" with IBM at the time, but he did not want to sack the company and risk workers not getting paid. 

http://www.abc.net.au/news/2015-08-25/ibm-tries-to-block-legal-action-over-qld-health-payroll-disaster/6723598 

I find it amazing this has not been sorted ages ago given the contract was let in 2007 - under an earlier Labor Government - which shows how long this has been rolling along!

I assume a working system is now in place - but I have not heard that is the case. A comment confirming Payroll is working up there now would be good for all our interest!

David.

Monday, August 31, 2015

Weekly Australian Health IT Links – 31st August, 2015.

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

An interesting week with Telstra seemingly wanting to buy up the eHealth farm! Interesting they are into Asia with Hospital Systems. That is a hard market segment to say the least!
Interesting the Qld Health Payroll debacle continues to cause news ages after it has been resolved - or has it?
Reporting season has also seen some e-Health companies announce results - most seem reasonable.
Enjoy the browse.
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Telstra Health contract wins expand Asian profile

Telstra Health has secured four new contracts in the Asian region as the company looks to expand its presence in the region.
The company, which already has established offices in Hong Kong, Malaysia and India, has been awarded contracts which will see its Health CloudMed Arcus Hospital Information System deployed by hospitals in Malaysia and Thailand.  The integrated patient care system that provides an end-to-end single medical record system for hospital networks spread over multiple locations is currently in use in more than 250 hospitals across Asia.
Under the new contracts, implementation of Arcus has commenced at Sunway Medical Centre group, Penang Adventist Hospital group and Tung Shin Hospital’s in Malaysia and Khon Kaen University Hospital in Thailand.
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Telstra bets on e-health to become billion dollar business

Date August 24, 2015 - 12:15AM

David Ramli

Reporter

Exclusive
Telstra has launched its rapidly growing eHealth division into Asia, winning two key contracts worth tens of millions of dollars in Thailand and Malaysia.
The latest deals signal a bold new push for the telco and forms a new plank of its strategy to  extract billions of dollars from Asia's increasingly affluent middle class.
"Health is just such an extraordinary opportunity especially when you consider the rate of digitisation," Telstra group executive retail Gordon Ballantyne told Fairfax Media. "We first have to build it in Australia but we have been overwhelmed by the interest in other Asian countries to come and adopt some of the things we're doing here."
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Telstra Health Expands Presence in Asia with Hospital Contract Wins

Business | August 24, 2015
KUALA LUMPUR, Malaysia, Aug. 24, 2015 /PRNewswire/ — Telstra Health, a division of Australia’s largest telecommunication and technology company, today announced several key contract wins and implementations of hospital electronic medical record systems in Malaysia and Thailand, adding to its existing customer base in Asia and its established offices in Hong Kong, Malaysia and India.
Telstra Health creates solutions for key challenges in the healthcare sector by integrating leading eHealth solutions, such as the CloudMed Arcus Hospital Information System (Arcus), which is an integrated patient care system that provides hospital networks spreading over multiple locations with a single medical record.  
Implementation of Arcus has commenced at Sunway Medical Centre group, Penang Adventist Hospital group and Tung Shin Hospital’s Western Medicine and Traditional Chinese Medicine wings in Malaysia. In addition, through a distributor, Convergence Systems, Arcus is being delivered to Khon Kaen University Hospital in Thailand.
-----

Telstra Health scores hospital contracts in Malaysia, Thailand

Telstra's health division will roll out its Arcus media records system at four hospitals
Telstra Health has won four new contracts with hospitals in Malaysia and Thailand.
Telstra's eHealth business already had a presence in Malaysia, as well as Hong Kong and India.
The new contracts involve Telstra Health’s CloudMed Arcus Hospital Information System (Arcus). Arcus provides a single medical record system for hospitals across multiple locations.
"Our Arcus product is designed to make it easier for doctors, nurses and pharmacists to treat patients, reducing the amount of time spent on paperwork and freeing up time to spend on what they do best — caring for patients," said group executive of Telstra Retail Gordon Ballantyne,
"The system is highly flexible and can support multiple languages including English, Thai and Mandarin across multiple sites while it will also be able to record both western medicine and traditional Chinese medicine data in the future."
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Who’s who of Aussie (global) ICT

August 24, 2015
PRO MEDICUS (ASX:PME) is a leading provider of radiology information systems (RIS) Picture Archiving and Communication Systems (PACS) and advanced visualisation solutions across the globe with over 30 years experience helping clients deliver first-rate patient care by enhancing and streamlining medical practice management. The company’s expertise is in the client visualisation technology and the management of the supporting information. Pro Medicus does this by providing products and services that combine speed, scalability and smarts to help eliminate administrative tasks and workarounds, optimise the efficiency of clinical and administrative staff and maximise profits. The company provides a full range of radiology IT software and services to hospitals, imaging centres and health care groups worldwide. The company has global offices in Melbourne, Berlin and San Diego. www.promed.com.au
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  • Updated Aug 24 2015 at 5:04 AM

IBM 'negligent and misleading', Queensland alleges

The Queensland government has accused IBM of misrepresenting its credentials for the health payroll contract. Bloomberg
The Queensland government has accused technology giant IBM of misrepresenting its credentials in delivering a $6 million payroll system that cost $1.2 billion to fix.
It said if IBM hadn't talked up its credentials to design, build and deliver the payroll system for Queensland Health before it signed a contract in 2007, it would have awarded the deal to its archrival Accenture, court documents reveal.
​ The state government is attempting to sue IBM for damages over the botched health payroll debacle, which partly contributed to the demise of the Bligh Labor government in 2012.
IBM has vowed to fight the claim and is blocking an attempt for the Queensland government to sue for damages in a four-day trial starting in the Supreme Court in Brisbane on Monday.
-----
  • Aug 26 2015 at 12:53 PM

Qld claims payroll project too complex for IBM

IBM struggled to cope with the complexity of the Queensland Health payroll system. Craig Warga
A former senior Queensland bureaucrat said IBM had underestimated the complexity and the resources required to deliver the health payroll system before it went live in 2010.
Mal Grierson, who was director general of the Department of Public Works, told the Supreme Court in Brisbane on Wednesday there was a belief in the government the global technology company had struggled to get on top of the problems with the IT system after it signed up to the contract in 2007.
He said IBM's strategy to transfer the existing payroll system it had developed for the Department of Housing to Queensland Health and its 80,000 workers was flawed.
-----

Ian Maddocks: Record of care

Ian Maddocks
Monday, 24 August, 2015
INTEGRATION of care is a common theme in health, with expectations that information technology will play a major part to bridge gaps in offering patients continuous, seamless care.
 In 2012, the federal government launched the e-health record system, where patients could register for a personally controlled electronic health record (PCEHR). More recently, the government has announced moves to introduce an “opt out” rather than “opt in” system and will rename the PCEHR myHealth Record.
The PCEHR aims to provide continuity of care by providing full details of the patient’s health care, medical contacts and interventions. But is that enough?
Access to my own record finds it is designed to advantage health care providers rather than those receiving care.
-----

App Review: Boost health, one spoonful at a time

26 August 2015
ONE of the challenges in effecting dietary change in the modern world is avoiding the hidden sugars and fats found in processed foods. 
Following That Sugar Film, the That Sugar App aims to educate on the amount of hidden sugar in all of the foods we consume daily.
The app opens to a short video explaining the health benefits of limiting refined sugar. 
Accessing the home page then allows the user to look up a wide range of different foods commonly available in Australia and determine their sugar content in teaspoons per serve or per 100g. 
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Leading doctor takes aim at 'best' specialist site

Tessa Hoffman | 21 August, 2015 |
A senior doctor has rubbished a new website that claims it can put GPs and patients in touch with the country's top specialists.
Launched this month, the Specialist Doctors website says it has a database of some 750 clinicians across 21 specialties.
The site is co-founded by former AMA president Associate Professor Kerryn Phelps (picture above, on the website's home page) and two specialists who oversee hospital departments.
The doctors claim to have used a peer-review process to find and share "their preferred list of specialists at the top of their fields”.
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Medical messaging: What would you change?

27 August 2015
The RACGP says hospitals and specialists lag behind general practices in their healthcare communications. Following an SA coroner's finding in July that "archaic snail mail" contributed to the warfarin-related death of Adelaide woman Marjorie Aston, MO is inviting suggestions on ways to improve communications between doctors, and between hospitals and doctors. Contributions will be passed on to the federal and state health departments. Enter your suggestions in the comment field below.
DR PETER BRADLEY
Springwood, QLD
THERE is no excuse for all medical parties and providers – hospitals included, certainly specialists and allied health providers (most GPs already are) – not being set up on one of the commonly available and affordable encrypted email systems for exchanging patient information… period. 
Just make it happen. Faxes are not really secure, often poor quality and almost illegible. They also take up time and unnecessary memory space because of the need to scan them into electronic records, and, once scanned in, they are not able to be conveniently copied from or attached to subsequent communications. 
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What is the state of CDA R3?

Posted on August 23, 2015 by Grahame Grieve
Question
We have seen references to new extension methodologies being proposed in CDA R3; however I can’t seem to find what the current state of CDA R3 is.  Most searches return old results.  The most recent document related to CDA R3 using FHIR instead of RIM.  What is the current state of CDA R3 and where can I find more information.  HL7 pages seem to be pretty old.
Answer
The Structured Documents work group at HL7 (the community that maintains the CDA standard), is currently focused on publishing a backwards compatible update to CDA R2 called CDA R2.1. CDA R3 work has been deferred to the future, both in order to allow the community to focus on R 2.1, and to allow FHIR time to mature.
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SNOMED CT Foundation E-Learning Course: Call for Applications

Created on Wednesday, 26 August 2015
The International Health Terminology Standards Development Organisation (IHTSDO) is calling for applications for their SNOMED CT Foundation course.
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  • Aug 27 2015 at 4:31 PM

Sleeper stock Compumedics delivers healthy profit

Shares in Compumedics performed strongly on the back of an impressive 2014-15 result which featured profit growth of more than 100 per cent.
Over the last two years, the company has distinguished itself as one of the few small cap healthcare stocks generating a profit while maintaining a healthy balance sheet.
Providing investors with further confidence was the management's guidance, which pointed to net profit in a range between $2.8 million and $3.2 million in 2015-16. The company had minimal debt as at June 30, 2015, and was in a net cash position.
Compumedics develops and manufactures medical devices largely used in diagnosing sleep and brain activity as well as measuring blood flow. The group is highly diversified, owning US-based Neuroscan and DWL Elektronische Gmbh in Germany.
This provides access to markets in the Americas, Europe and the Middle East, complementing an established position in Australia and the Asia-Pacific region.
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NICTA merges with CSIRO to create new entity Data61

David Swan

Australia’s chief IT research facility NICTA is no more, with the government announcing a new organisation, Data61, that will see NICTA merge with CSIRO’s Digital Productivity flagship.
The decision comes after a long period of uncertainty for NICTA, which had been pushing ahead with research and innovation despite the federal government cutting its funding altogether from June next year.
Minister for industry and science Ian Macfarlane said the new entity, to be part of CSIRO’s digital productivity group, would be one of the largest digital innovation teams in the world.
“Both CSIRO and NICTA have an impressive track record in digital innovation and have demonstrated their ability to take homegrown technologies to market,” he said.
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Nanomedicine potential

Charlotte Mitchell
Monday, 24 August, 2015
THE world has just started to see the exciting potential of nanomedicine in the treatment of cancer, according to Australian experts, but several issues need to be addressed before the technology becomes more widely available.
Professor David Goldstein, senior staff specialist in the department of medical oncology at Prince of Wales Hospital, Sydney, told MJA InSight that Australia was actively involved in the global research effort into cancer nanomedicine, which “will ensure that we can get the right drugs into the patient, in the right place, at the right time, and with less side effects”.
As with any new medical treatment, determining which patients should get nanomedicine will be about weighing up the potential risks and benefits.
“This ratio has to be large. However, when patients have a malignancy, there usually is a relatively favourable benefit–risk ratio”, he said. 
-----

The Search For 'Dark Matter' And 'Dark Energy' Just Got Interesting

by The Conversation, The Conversation
-- this post authored by Ryan Wilkinson, Durham University
Only about 5% of the universe consists of ordinary matter such as protons and electrons, with the rest being filled with mysterious substances known as dark matter and dark energy. So far, scientists have failed to detect these elusive materials, despite spending decades searching for them. But now, two new studies may be able to turn things around as they have narrowed down the search significantly.
Dark matter was first proposed more than 70 years ago to explain why the force of gravity in galaxy clusters is so much stronger than expected. If the clusters contained only the stars and gas we observe, their gravity should be much weaker, leading scientists to assume there is some sort of matter hidden there that we can't see. Such dark matter would provide additional mass to these large structures, increasing their gravitational pull. The main contender for the substance is a type of hypothetical particle known as a "weakly interacting massive particle" (WIMP).
To probe the nature of dark matter, physicists look for evidence of its interactions beyond gravity. If the WIMP hypothesis is correct, dark matter particles could be detected through their scattering off atomic nuclei or electrons on Earth. In such "direct" detection experiments, a WIMP collision would cause these charged particles to recoil, producing light that we can observe.
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NBN Co says 9 million homes by 2018: believable?

After previously promising 8 million homes by 2020, NBN Co now says at least a million more homes will be connected two years sooner - do we believe it?
nbn, the company building the NBN network, which has already built itself a new logo, says in a media release today that 9.1 million homes and businesses will be ‘ready for service by 2018.’
The news comes as part of its ‘comprehensive corporate plan’, which iTWire colleague Graeme Philipson also wrote about this morning in terms of nbn, the company, unsurprisingly hitting its ‘revised’ targets
The company explains that ‘the introduction of additional technologies, a projected boost to the size of the construction workforce and newly-signed agreements with the construction industry are anticipated to see the total number of premises that are able to connect double over each of the next three years to 9.1 million.’
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Windows 95 – 20 years old today

Windows 95 released on 24 August 1995, was a big change from Windows 1.x, 2.x and 3.x – it was the end of Windows running over MS-DOS and the beginning of a complete operating system.
I still remember the excitement of this new 32-bit operating system based on NT 4.0 and installing it from 13, 3.5” floppy disks. That was relatively painless – Microsoft Office at that time had something like 20 separate floppies and often fell over during install.
It was the defining moment for Windows and its look and feel – design cues – carried right through to Windows 7 released in July 2009. These included the task bar, Start menu, and general use of multiple Windows for different tasks.
W95 was in another way a defining moment for marketing. Microsoft spent over US$300 million to launch it.
-----
Enjoy!
David.

Sunday, August 30, 2015

A Senior Clinician Tries To Use The PCEHR And Discovers What A Heap Of Crock It Is!

This appeared earlier in the week:

Ian Maddocks: Record of care

Ian Maddocks
Monday, 24 August, 2015
INTEGRATION of care is a common theme in health, with expectations that information technology will play a major part to bridge gaps in offering patients continuous, seamless care.
 In 2012, the federal government launched the e-health record system, where patients could register for a personally controlled electronic health record (PCEHR). More recently, the government has announced moves to introduce an “opt out” rather than “opt in” system and will rename the PCEHR myHealth Record.
The PCEHR aims to provide continuity of care by providing full details of the patient’s health care, medical contacts and interventions. But is that enough?
Access to my own record finds it is designed to advantage health care providers rather than those receiving care.
I enrolled for a PCEHR over 12 months ago, but attempting to access it recently I found considerable difficulty working through its security codes and passwords.
A recent change of address was a difficulty. When challenged by security to insert the name of the primary school I had attended (there were three), I failed to choose the one I had nominated a year ago, so I was a source of some suspicion to the system.
Even with assistance from a patient helpline adviser, I was unable to consistently satisfy the security bars. I am a fading octogenarian, lacking all but the simplest IT skills, but we are the major users of health care these days.
Eventually able to search my file, I could find a Medicare-based listing of some of the doctors and dates I had visited, but no diagnoses or opinions; and dates of pathology tests and x-rays, but no reports. There was also a list of drugs obtained through the Pharmaceutical Benefits Scheme.
As a child, I had access to fully integrated, whole-of-life health care, from a solo GP in a Victorian country town. I had home care for pleurisy (a mustard plaster to the chest), whooping cough and measles (boiled water only for 2 days), and an appendicectomy at the local hospital (open ether anaesthetic by the doctor from the next town).
…..
When I worked in Uganda about 50 years ago, patients carried their health record with them — so the concept of a PCEHR is used in many places.
A mother would present her child in my clinic along with a bundle of small papers retrieved from deep in the front of her bosom. It contained all the child’s former consultation entries and I would add my own, to see the record disappear again into the depths.
I learned the value of a patient-held record that was never lost and always available.
…..
Emeritus Professor Ian Maddocks is an eminent palliative care specialist, recognised internationally for his work in palliative care, tropical and preventive medicine. He was Senior Australian of the Year in 2013.
The full article is here:
This article says so much about the failings of the PCEHR.
It’s hard for older people to use, it’s incomplete and largely empty and it will be years, if ever, that Professor Maddocks, or anyone else, will see any value from the system.
What amazes me is why the geniuses in NEHTA and the Department of Health can’t grasp that they have a genuine lemon on their hands and cut their losses.
Does anyone recall just who determined the PCEHR was a good idea and can we ask them to explain themselves?
David.

AusHealthIT Poll Number 285 – Results – 30th August, 2015.

Here are the results of the poll.

How Important Do You Think It Is That The CEO Of The Proposed Australian Commission for eHealth (ACeH) Be An E-Health Expert?

Critical 36% (31)

Pretty Important 17% (15)

Neutral 15% (13)

Unimportant 31% (27)

I Have No Idea 1% (1)

Total votes: 87

It seems a clear majority (53% to 31% of those who had a view) feel expertise is important. We can now see how much notice is taken of this view. Very little I fear!

Good to see such a great number of responses!

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

David.

Saturday, August 29, 2015

Weekly Overseas Health IT Links -29th August, 2015.

Note: Each link is followed by a title and 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.
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Surveys on Physician EHR Satisfaction Show Conflicting Results

AUG 21, 2015 7:50am ET
Depending on who you talk to these days, physician satisfaction with their electronic health record systems is either dramatically increasing or decreasing. Results of two new surveys released this month point in opposite directions, fueling debate about whether widespread EHR adoption is in fact having a positive impact on doctors’ practices.
On the positive side of the ledger, a survey out this week by market research firm Black Book has identified a “shift upward in physician experience across the large practice and clinic sector, since first measuring EHR satisfaction six years ago.” In particular, the firm finds that large physician practices are more satisfied with electronic health record usability, interoperability and productivity improvements over the past few years than small practices.
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Snooping employees sacked, disciplined after HIPAA breach

Posted on Aug 21, 2015
By Erin McCann, Managing Editor
What happens when a healthcare organization's employees are found to have been inappropriately accessing patient medical records? The actions of one health system might serve as an example.
After 14 of its employees were found to have accessed a high-profile patient's medical records "without a legitimate patient care need," the nine-hospital Carilion Clinic in Roanoke, Va., is sending a clear message that this behavior will not be tolerated.
"Appropriate actions have been taken with each employee, up to and including termination," said Vicki Clevenger, vice president of internal audit & compliance, and chief compliance officer for the health system, in a prepared statement
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John Halamka: 3 areas healthcare should address in 2016

August 21, 2015 | By Katie Dvorak
It's already almost time to plan for a new year, and as 2015 heads toward its final stretch, stakeholders in the healthcare industry already are looking at what areas to focus on in 2016.
In a recent post to his Life as a Healthcare CIO blog, Beth Israel Deaconess Medical Center CIO John Halamka outlines some of the things learned this year that could shape planning at his and other facilities in 2016.
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Google Glass Comes to Doctor’s Office Near You as Upgrade Looms

August 20, 2015 — 10:00 PM AEST
 A few weeks ago, a New Zealand doctor donned Google Glass and beamed video of an aortic surgery to the U.S. offices of medical device maker Endologix Inc.
The test demonstrated the potential power of a technology that famously flopped with consumers but is quickly becoming a go-to gadget for the medical world. Google is expected to roll out a new version of Glass in the coming months, and medical device makers, hospitals and family doctors are eagerly anticipating improvements. These will probably include an adjustable eyepiece, longer-lasting battery and water-resistant properties, according to people familiar with the project.
Medical professionals see Glass -- lightweight eyewear that lets wearers livestream events, take notes, surf the Web and more -- as a way to save money and provide better care. Endologix plans to use Glass to train doctors to implant the stents and arterial grafting technology it sells.
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OpenNotes Strives for Better Physician-Patient Communication, Transparency

AUG 20, 2015 7:22am ET
From humble beginnings in 2010 to more than 5 million patients nationwide currently, the OpenNotes initiative is gaining momentum as patients are being given unprecedented online access to the notes their clinicians write after a doctor visit, increasingly making believers of once skeptical physicians.
As the effort garners support from provider organizations across the country, Beth Israel Deaconess Medical Center (BIDMC) in Boston remains at the epicenter of research activities aimed at demonstrating that the sharing of visit notes with patients can improve overall safety and quality of care by ensuring the accuracy of clinician notes, while reducing medical errors and improving medication adherence.
Providing patients with “full and early access to their data” is a prerequisite, argues Sigall Bell, M.D., assistant professor of Medicine at BIDMC and Harvard Medical School, as well as director of patient safety and quality initiatives at the Institute for Professionalism & Ethical Practice at Boston Children’s Hospital. She believes that ambulatory care, in particular, presents some unique safety challenges and that the sharing of visit notes can go a long way towards fostering good communication between patients and doctors so that follow-up appointments and referrals, diagnostic tests and procedures, and prescribed medications are clearly understood.
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Does it matter if docs don't like EHRs?

Posted on Aug 20, 2015
By Michelle Ronan Noteboom, Contributing writer
Physicians are increasingly dissatisfied with their electronic health records. According to a recent survey conducted by the AMA and AmericanEHR Partners, just 34 percent of physicians said they were satisfied or very satisfied with their EHR in 2014, compared to 62 percent in 2010.
While the statistics make for great headlines, should we be alarmed – or even care?
To summarize the findings: 42 percent of physicians thought their EHR's ability to improve efficiency was difficult to very difficult; 72 percent believed their EHR made it difficult to very difficult to decrease their workload; 54 percent reported that their EHR increased total operating costs; 43 percent claimed they hadn't overcome productivity challenges related to their EHR.
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Wachter on patient safety musts

Posted on Aug 20, 2015
By Bernie Monegain, Editor-at-Large
As much as patients have benefited from a healthcare system that has avoided blaming individual care providers for errors, Robert Wachter MD, proffers that the approach must also include accountability.
He writes in a new blog post in the journal Health Affairs that there are some practices in medicine that are a must-do, not merely a nice-to-do.
Robert Wachter, MD"We believe that the time has come to articulate criteria for 'must do' safety practices: practices that have sufficiently compelling supportive evidence that clinicians should not have the right of individual veto," he writes.
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Vendor changes increasing EHR satisfaction among larger doc practices

August 19, 2015 | By Marla Durben Hirsch
Vendor improvements to their electronic health records are increasing large practices' satisfaction with their systems, according to a new survey from Black Book Rankings.
The survey, of 1,304 large multispecialty practices, found a shift upward. For instance, in 2013, 92 percent of multispecialty groups using EHRs were very dissatisfied with their systems' ability to improve clinical workload, documentation and user functionalities. But in 2015, 71 percent of large practice clinicians said that their expectations were met or exceeded; 82 percent of support and administrative staff also reported better operational and financial performance.
Allscripts, Greenway, McKesson and athenahealth all recorded the largest increases in satisfaction in the past 12 months. Users of these systems stated that uptick was due to vendor investments in updates and releases, practice assessments and clinical workflow enhancement. Other factors included revenue cycle management and analytics value add, population health improvements and solicitation of physician feedback.
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Hospitals face readmissions head on with help from health IT [Special Report]

August 19, 2015
By Katie Dvorak
From the minute a patient is admitted to the hospital and for months after he or she leaves, providers are committed to ensuring a return visit doesn't happen--and health IT is aiding in that effort.
As penalties continue to come down and costs continue to rise, providers are using all the tools at their disposal to combat the problem, with the goal of keeping patients healthy the most important of all.
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Vendor changes increasing EHR satisfaction among larger doc practices

August 19, 2015 | By Marla Durben Hirsch
Vendor improvements to their electronic health records are increasing large practices' satisfaction with their systems, according to a new survey from Black Book Rankings.
The survey, of 1,304 large multispecialty practices, found a shift upward. For instance, in 2013, 92 percent of multispecialty groups using EHRs were very dissatisfied with their systems' ability to improve clinical workload, documentation and user functionalities. But in 2015, 71 percent of large practice clinicians said that their expectations were met or exceeded; 82 percent of support and administrative staff also reported better operational and financial performance.
Allscripts, Greenway, McKesson and athenahealth all recorded the largest increases in satisfaction in the past 12 months. Users of these systems stated that uptick was due to vendor investments in updates and releases, practice assessments and clinical workflow enhancement. Other factors included revenue cycle management and analytics value add, population health improvements and solicitation of physician feedback.
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Top 4 EHR vendors with most improved user satisfaction

Written by Akanksha Jayanthi (Twitter | Google+)  | August 19, 2015
Over the past six years, EHR satisfaction among large physician practices has risen, according to a Black Book Rankings report. From 2013 to the second quarter of 2015, physician experience satisfaction has increased 737.5 percent, from 8 percent to 67 percent.
In 2013, 92 percent of multispecialty groups using EHRs said they were "very dissatisfied" with their EHR systems' ability to improve clinical workload, documentation and user functionalities. However, in 2015, 71 percent said their expectations for vendors to optimize and improve their EHRs had been met or had been exceeded.
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HIMSS Seeks Input on Role of Government in HIT

AUG 19, 2015 7:29am ET
What comes after Meaningful Use? And, what is the appropriate role that government should play in health information technology going forward?
Those are the kinds of questions the Healthcare Information and Management Systems Society is trying to answer by collecting industry feedback through a survey that delves into government intervention.
Given that Stage 3 is likely to be the final stage of the EHR Incentive Program, HIMSS believes that now is the right time to get industry input on the proper role for government in health IT, especially in light of ongoing efforts by the Department of Health and Human Services for healthcare delivery system reform and the Precision Medicine Initiative that will rely heavily on health IT to achieve their objectives. 
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Telehealth program slashes lengths of stay, boosts outcomes

Posted on Aug 19, 2015
By Eric Wicklund, Editor, mHealthNews
A telehealth program that engages patients before and after their hip and knee replacement procedures not only made those patients feel better about the experience and their providers, but reduced length of stay and improved post-discharge responses.
VOX Telehealth, based in Princeton, New Jersey, reported those results from a study conducted at Bon Secours St. Mary's Hospital in Richmond, Virginia, where the program was compared to the hospital's traditional process and national averages.
According to VOX officials, 92 percent of patients enrolled in the telehealth platform -- which starts 30 days before surgery and continues until 60-90 days after surgery -- were discharged directly to home, compared to a national average of only 30 percent. Officials attribute that improvement to the fact that patients are more prepared for the process, so there are fewer complications or concerns that would merit a longer stay of transfer to another facility (length of stay, in fact, dropped to 1.6 days, compared to the hospital's average of two days and the national average of 3.7 days).
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Virtual reality for medical training: How it benefits hospitals

August 19, 2015 | By Katie Dvorak
While virtual reality use to train medical employees is still fairly new, some health organizations already are seeing benefits from the technology.
At Nicklaus Children's Hospital, for example, part of the Miami Children's Health System, virtual reality is being used to train employees on procedures that include cardiopulmonary resuscitation (CPR), nasal gastric tube insertion, starting an IV, wound care and more, according to a Fortune article.
In addition, virtual reality use at Miami Children's is improving retention rates, CEO Narendra Kini says in the article. The provider has seen retention hit close to 80 percent after a virtual training session, compared to 20 percent after traditional training.
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FDA's infusion pump warning sends 'powerful message' on risk management

August 19, 2015 | By Susan D. Hall
The U.S. Food and Drug Administration's warning to healthcare organizations to stop using a line of infusion pumps because of cybersecurity flaws is only one of the regulatory developments affecting medical device makers and pharmaceutical firms, attorney Anna Spencer says in an interview with HealthcareInfoSecurity.
Still, the agency sent "a very powerful message to the industry" to be more focused on risk management, says Spencer, a partner and team leader for health information policy in Sidley Austin LLP's healthcare and privacy, data security and information law practices.
At the same time, companies also must grapple with how to apply older laws to the use of new technology, she adds.
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Healthcare IT market will grow at rapid rate

By AuntMinnie.com staff writers
August 18, 2015 -- Driven by an increase in healthcare costs, the healthcare information systems market is expected to reach $53.2 billion in revenues by 2019, according to a new report by Transparency Market Research.
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Hospitals Use Paper, Electronic Methods for Summary of Care Records Exchange

AUG 18, 2015 7:49am ET
Electronically exchanging health information with outside providers is critical to ensuring access to patient records at the point of care in hospital settings. However, less than 10 percent of hospitals use only electronic means of exchanging summary of care records with outside sources.
That’s the finding of a newly released Office of the National Coordinator for Health IT analysis of 2014 data from a nationwide survey of non-federal acute care hospitals conducted by the American Hospital Association.
ONC’s data brief reveals that last year a majority of hospitals used a combination of electronic and non-electronic means to send (77 percent) and receive (67 percent) summary of care records to/from outside sources. And, a quarter (26 percent) of hospitals received summary of care records in non-electronic format only (e.g., mail, fax or eFax).
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Stage 3 meaningful use: What's next?

Posted on Aug 18, 2015
By John Andrews, Contributing Writer
Stage 3 of meaningful use is shaping up to be the most challenging and detailed level yet for healthcare providers. Among the elements that warrant attention are quality reporting, clinical decision support and security risk analysis.
But first things first: Stage 3 may not be as near final as some would hope, and there are likely to be modifications before a final rule is issued, says Pamela Chapman, implementation specialist with Austin, Texas-based e-MDs.
"We have a long way to go until Stage 3 is finalized and it is my understanding that CMS is not even looking at the public comments yet, so we don't know what we'll be looking at," she said this past month.
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How the healthcare system discourages creating low-cost solutions

August 18, 2015 | By Susan D. Hall
The U.S. leads the world in creating new drugs and healthcare tech, but the system discourages inventors from creating cost-lowering technologies in favor of ones with a healthy return on investment, according to an article at the Journal of the American Medical Association.
"In the United States, the surest way to generate a healthy return on investment is to increase health care spending, not reduce it," says the authors, from the Uniformed Services University of the Health Sciences and Yale School of Medicine.
They use as an example a low-cost, once-a-day pill to treat cardiovascular disease, with the estimated potential to reduce the incidence of myocardial infarction and stroke by more than 80 percent.
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Cerner Wins DoD Award, Changing the Interop Landscape

Scott Mace, for HealthLeaders Media , August 18, 2015

Twin shocks have upset conventional wisdom: Epic failed to nab a coveted Department of Defense contract to supply electronic health records system technology, and along with other contenders, failed to appeal the federal government's decision.

EHR vendors' big ambitions include wanting to be every provider's health information exchange intermediaries, and replacing basic state-run and private HIE functions, that is: requesting patient records, and transmitting updated records after episodes of care.
Until now, these ambitions looked lopsided depending on the market share of the EHR vendor. Epic has claimed to have more than half the U.S. population under its EHR management. Kaiser and Geisinger led the Epic wave years ago. More recently, large academic medical centers in particular have skewed toward Epic.
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Community Hospitals Look to Replace EHR Vendors

AUG 17, 2015 7:43am ET
More than half of community hospitals across the country are unhappy with the usability of their EHR systems, and nearly 20 percent of those hospitals are actively looking to replace their EHR vendors, according to a recent survey.
That’s the finding of a new survey of 277 community hospital providers from healthcare research firm peer60. At a time when community hospitals—particularly rural hospitals—are struggling with financial challenges, these healthcare organizations are also finding the implementation of EHRs to be an unsatisfying experience: 54 percent of respondents indicated that they were unhappy with the usability of their system and 53 percent said their system lacked functionality. 
According to peer60, the introduction of federal Meaningful Use guidelines “has not been particularly good for community hospitals.” While 53 percent of providers in their survey have attested for Stage 2 Meaningful Use, a sizable portion of hospitals (36 percent) said they are still in the middle of attesting and 11 percent said they have not even started.
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OpenNotes showing benefits at BIDMC

Posted on Aug 17, 2015
By Mike Miliard, Editor
Five years after being chosen as one of three pilot locations for the OpenNotes project, Beth Israel Deaconess Medical Center is seeing encouraging returns from allowing patients access to their clinical notes.
A study this month in the Joint Commission Journal on Quality and Patient Safety makes the case that such no-holds-barred patient engagement can drive real improvements in quality and safety.
"What we heard from patients and doctors fell into recognizable categories – for example, catching medication errors, better remembering next steps and improved plan adherence, enhanced error reporting, improved coordination of care for informal caregivers of vulnerable patients with many providers and appointments and reduced diagnostic delay," according the report's lead author, Sigall Bell, MD, of the division of general medicine and primary care and assistant professor of medicine at Harvard Medical School.
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DirectTrust's David Kibbe: Healthcare waking up from years of security neglect

August 17, 2015 | By Susan D. Hall
Long-term neglect has put healthcare behind the curve in terms of security, according to David Kibbe, M.D., president and CEO of DirectTrust.
"I think we're getting the message, but we could do a lot better," he says in an interview with HealthcareInfoSecurity.
The healthcare industry is feeling the pressures of two competing concepts, he says: that information needs to flow more freely to better coordinate care, and that the more "liquid" flow of data is more vulnerable to hacking.
"Healthcare as an industry has not taken seriously security in the past, to the extent that other kinds of industries have taken security and privacy, and has not bothered to put those security components into place that would protect the privacy of that information," Kibbe says. "They are trying to play catch-up now, very desperately."
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Ready or Not: Oct. 1 ICD-10 Transition Deadline Appears Here To Stay

by Joe Infantino, iHealthBeat Senior Staff Writer Monday, August 17, 2015
All signs point to ICD-10 going live in October, observers say, regardless of whether all players are ready.
After years of delays, U.S. health care organizations are set to transition from ICD-9 to ICD-10 code sets by Oct. 1. With about a month-and-a-half left before the transition deadline, several lawmakers are pushing for more flexibility for those who aren't ready, while CMS has issued a set of measures aimed at easing lingering concerns.

A Long Time Coming

In 2009, HHS published regulations setting the ICD-10 transition for 2011.
But in the following two years, reports showed:
  • A general lack of readiness;
  • Providers were concerned about costs; and
  • The transition to the 5010 operating system in preparation for ICD-10 was not progressing smoothly.
By August 2012, HHS had delayed the transition date to Oct. 1, 2014. It was delayed again in the summer of 2014, when CMS announced a final rule establishing Oct. 1, 2015, as the new deadline.
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Enjoy!
David.