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."

Sunday, November 30, 2008

Useful and Interesting Health IT Links from the Last Week – 30/11/2008

Again, in the last week, I have come across a few reports and news items which are worth passing on.

These include first:

Medicare worker 'used dead people to claim baby bonus for 58 fake kids'

AAP

November 27, 2008 07:39am

A MEDICARE employee has been charged with using the identities of dead people to claim more than $300,000 in false baby bonus and immunisation payments for 58 fictitious children.

Australian Federal Police allege the man used his position as a Medicare Australia employee to access the Centrelink records of dead people to obtain encrypted tax file numbers (TFNs).

An AFP statement said the Perth man allegedly used the TFNs to create 23 false claims for baby bonus and immunisation payments for 58 fictitious children, which were then paid into his bank account.

He allegedly claimed more than $300,000 in false baby bonus payments.

More here:

http://www.news.com.au/story/0,27574,24714164-29277,00.html

While this person is probably a crook if the reports are true, the larger issue is how the systems (Medicare and Centrelink) could not notice such systematic and expensive abuse for such a long period. We would hope e-Health systems were a bit more proactive in detecting fraud earlier. Additionally these are two major systems with linkages that permitted abuse and these need to be carefully reviewed and secured.

Looks like Medical Identity Fraud is a real issue in OZ - as discussed a week or so ago.

Second we have:

Revealed: how hospitals lied about records

Natasha Wallace and Louise Hall

November 27, 2008

SECRET internal health documents have confirmed two hospitals manipulated emergency data, making the times that more than 100 patients were seen appear "more favourable" to meet benchmarks.

The confidential internal investigations into Ryde and Gosford hospitals' emergency data were obtained by the Herald under freedom-of-information laws yesterday.

Both investigations recommended staff, some of who admitted to entering false data, be disciplined and the reports be sent to ICAC. Both reports said senior management had ignored staff complaints about the issue.

The December 2006 report on Ryde Hospital concluded that in late 2005 staff changed figures and sent false data to the Health Department - in effect, doubling the percentage of patients transferred to a bed within eight hours.

"This investigation identified that during the months of November and December 2005 a significant number of changes were made to the [emergency] data which consequently presented a more favourable access block statistic for Ryde Hospital for these months … this practice started in September 2005 and there is evidence to support that the practice continued up to and throughout February 2006," the report said.

It said "it appears that there was an executive decision made to make changes to [emergency department] data".

Staff told investigators management was under pressure from the area health service to improve the hospital's triage performance and that staff had formally complained of being "coerced" to change the data.

"Initially we probably weren't too happy with it but decided that given our effective manager at the time was being beaten by the area for access block [patients waiting more than eight hours]," one staff member said.

Despite several staff complaints between October 2005 and March 2006, "the practice continued unhindered until it was raised to an area level".

The report said the issue "could be occurring across the state and is one which the Department of Health should give consideration to reviewing".

In November and December 2005, 99 patients had their waiting times reduced to meet benchmarks. The waiting times were reduced by between 23 minutes and four hours and 25 minutes so the hospital could improve its "access block" rate - the percentage of patients waiting more than eight hours for a bed.

The manipulated data meant Ryde Hospital reported figures significantly below previously reported data - access block figures were reported as 19.8 per cent for the October-December 2005 quarter compared with rates as high as 43.9 per cent previously. For December 2005 it was reported as 13 per cent when it should have been 28.3 per cent.

More here:

http://www.smh.com.au/news/national/revealed-how-hospitals-lied-about-records/2008/11/26/1227491636518.html

This is really a bad story and makes one worry about the reliability of all figures produced by NSW Health. The culture in NSW Health that forces people to behave like this in fabricating data is clearly appalling.

Third we have:

Medical searches on Web can trigger anxiety: study

November 26, 2008 - 3:57AM

Playing doctor on the Web often leads people to mistakenly believe that they are suffering from rare illnesses, according to a study by researchers at Microsoft.

"Web search engines have the potential to escalate medical concerns," or "cyberchondria," Ryen White and Eric Horvitz wrote in the study published by the Redmond, Washington-based software company on Monday.

They described cyberchondria as "unfounded increases in health anxiety based on the review of Web content."

White, an expert in text mining, Web search and navigation, and Horvitz, another Microsoft researcher who is president of the Association for the Advancement of Artificial Intelligence, noted that the Internet provides an "abundant source" of medical information.

"However, the Web has the potential to increase the anxieties of people who have little or no medical training, especially when Web search is employed as a diagnostic procedure," they said.

"Common, likely innocuous symptoms can escalate into the review of content on serious, rare conditions that are linked to the common symptoms," they said.

Much more here:

http://news.smh.com.au/technology/medical-searches-on-web-can-trigger-anxiety-study-20081126-6hm1.html

Another new word to add to the vocabulary. I am sure it is just another manifestation of the old saying “a little knowledge is a dangerous thing” and also potentially worrying.

Fourth we have:

Commonwealth Bank fixes computer glitch

November 26, 2008 - 7:10AM

The Commonwealth Bank has fixed up the problem that short-changed around 200,000 people due to a computer glitch.

Process duplication meant that all withdrawals on Tuesday had been done twice, leaving people with less money in their accounts.

But the bank said on Wednesday that the problem had now been fixed and all its customers' accounts were back in order.

More here:

http://news.smh.com.au/national/commonwealth-bank-fixes-computer-glitch-20081126-6hnj.html

This reminds me of the old saying that to ‘err is human but if you really want to mess up use a computer’. This one actually got me and for a while I thought I had more money that I actually had!

Fifth we have:

Internet's bandwidth health still in trouble, report says

Demand for Internet bandwidth will exceed supply by 2012, Nemertes says

Brad Reed (Network World) 24/11/2008 07:08:00

Nemertes Research continued to throw cold water on the future of the Internet this week, releasing a study projecting that demand for bandwidth on the Web would exceed its capacity by 2012.

The study, which is a follow-up to similar research Nemertes conducted last year, projects that the current global economic recession will only delay rather than eliminate the increased demand for bandwidth the firm predicted last year. Then, Nemertes projected that traffic growth would eclipse supply by 2010, but the firm now says it has adjusted its projections to reflect deteriorating global economic conditions.

Nemertes emphasized it is not projecting that the Internet will crash or shut down altogether. Rather, the typical user probably will experience Internet "brownouts," where such high-bandwidth applications as high-definition video-streaming and peer-to-peer file-sharing will stop performing up to users' expectations, the firm says.

During a presentation at an Internet Innovation Alliance symposium last week, Nemertes analyst Mike Jude said that one consequence of declining Web performance would be that users would look less to the Internet to deliver their desired applications. "More and more applications are coming online that will drive expectations for service quality even higher," he said. "I'm not saying that the Internet is going to crash in 2011, but that people's expectations are going to be throttled. People will stop going to the Internet for those services."

More here:

http://www.computerworld.com.au/article/268462/internet_bandwidth_health_still_trouble_report_says?eid=-255

It is a bit of a worry we only have Internet bandwidth globally to support the next couple of years. I hope someone does some investment soon to keep us ahead of the curve.

Last we have the slightly more technical article for the week:

Conroy defends Telstra's NBN bid

Panel to fight hard-nosed commercial negotiators.

Darren Pauli 28/11/2008 13:40:00

The federal government has defended its acceptance of Telstra's "non-compliant" National Broadband (NBN) proposal and said its expert panel will thrash out the details with the telco.

Telstra outraged many within the telecommunications industry this week after submitting a watery 12 page bid to address the government's strict 18-point criteria for the design and operation of Australia's largest telecommunications network.

Telstra would deploy fibre to the node to 90 percent of Australia, 8 percent short of the government's coverage requirements which it had staunchly enforced.

Communications Minister Stephen Conroy said the compliance of Telstra's bid will be assessed during the initial expert panel negotiations over the next eight weeks.

“Telstra have indicated that they believe that it's a proposal that can be considered... and the expert panel will now test it against the 18 objectives,” Conroy said.

“[Telstra is] absolutely not [calling the shots], let's be clear. Telstra have been demanding concessions, as have others... we're not going to be pushed around on this, we're not going to deviate from what we've set down,” he said.

“Is it any surprise that any of the bidders might say, give us more government money, and we might be able to reach your objectives? These are hard-nosed, commercial negotiators, and this will be a tough, hard-nosed negotiation between the expert panel, and there's some very tough, hard-nosed commercial people on the expert panel.”

The government received six NBN bids, including national proposals from Telstra, Terria-Optus, Acacia and Axia NetMedia, and state bids from TransACT, and the Tasmanian government. Canadian-based company Axia NetMedia has an equal stake in Singapore's national fibre network which is owned by Optus parent company SingTel.

The members on the expert panel are John Wylie, Lazard Carnegie Wylie CEO; Tony Mitchell, Allphones Chairman; Laureate Professor Rod Tucker, University of Melbourne; Professor Emeritus of Communications, Reg Coutts, University of Adelaide; Tony Shaw, former Australian Communications Authority Chairman and Dr Ken Henry, Treasury Secretary.

More here:

http://www.computerworld.com.au/article/269125/conroy_defends_telstra_nbn_bid?fp=&fpid=&pf=1

What can one say about the mess Minister Conroy has created here. The way you procure goods or services, as a Government, is to decide exactly what it is you want to buy, specify it, and then go to the market to procure what it is you want. None of this has been done properly and the broadband e-Health needs is now even further off. Hopeless!

More next week.

David.

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