Monday, April 09, 2012

Weekly Australian Health IT Links – 10th April, 2012.

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

It is now clear that the NEHRS (PCEHR of old) is going to be rejected by a good majority of doctors for reasons of lack of specific rebates to cover costs and a set of medico-legal concerns around use and liability for information content within the NEHRS.
The attempt to shift the responsibility for intra-practice identification of NEHRS users from Government (which would need to fund new and better systems and security) to practitioners is also being rejected wholesale by clinicians.
These areas require a major rethink if any victory is going to be snatched from what will have to be a delayed start-up of any actual NEHRS.
We also have a bit of a blast from the past with iSoft disappearing from the planet and Google having another go at changing the world while ‘just wanting to be trusted’.
We are getting down to the ‘pointy end’ of all this and there is not much time to sort things out.
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No shaking e-health record controversy

  • by: Karen Dearne
  • From: Australian IT
  • April 04, 2012 12:00AM
CONTROVERSY still rages around the Gillard government's personally controlled e-health record system as the Senate debate on legislation is on hold until May.
Since the PCEHR Bills were passed in the lower house in late February, consumer advocates have turned to a joint parliamentary inquiry into Cyber-Safety for Seniors as a venue for unresolved concerns over the program.
Last week, Health's chief information officer, Paul Madden, conceded the PCEHR system will be vulnerable to attack from fraudsters at the user's end.
Coalition senators have called for a year's delay in launching the national patient record-sharing system, due to start on July 1.
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E-health liability to fall to GPs: govt plan

5th Apr 2012
THE health department’s draft conditions of registration for the personally controlled e-health records (PCEHR) system would “deter every medical practice in Australia from participating”, according to AMA secretary general Francis Sullivan.
The draft conditions, obtained by Medical Observer, would require organisations to assume all legal liability and grant department officials unrestricted access to their premises and records.
In a letter to the department, also obtained by MO, Mr Sullivan warned the association would “advise its members not to register” if the conditions remained in their current form.
The proposed conditions would require practices to agree the department had “no liability to [the practice] in respect of any loss, damage, cost, expense, claim [or] proceeding… you might suffer”, while being “responsible for any loss that [the system operator]… may incur”.
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Medicolegal fears over e-records

5 April, 2012 Paul Smith
More than 60% of doctors are concerned about the medicolegal risks of using the electronic health record system being rolled out from July.
The survey of 200 AMA members – including GPs and other specialists – also uncovered worries over the administrative impact on practice staff and the financial implications of both preparing for and using personally controlled e-health records (PCEHRs).
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GPs wonder who'll pay for e-Health records

DOCTORS claim a government promise to pay them to create patient health records for the new e-Health system from July is not funded.
They also fear they could fall foul of the Health Insurance Act if they claim a Medicare rebate.
Australian Medical Association president Steve Hambleton argues Health Minister Tanya Plibersek's funding pledge amounts to nothing more than "allowing doctors to do this for free".
The contested pledge came last week when Plibersek told the Health-e-Nation conference on the Gold Coast that doctors would be paid a Medicare rebate of up to $101 to set up an e-health record when the government's $500 million Personally Controlled Electronic Health Record scheme starts on July 1.
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E-health funds don’t add up

2 April, 2012 Paul Smith  
So is there extra cash for the workload faced by GPs as a result of the impending e-health revolution? The answer is yes, no, maybe and it depends.
They way it was pitched last week, it sounded as though the descriptors for the MBS attendance items would be tweaked to allow doctors to claim them for time spent setting up a shared health summary. Now it appears there is no tweak, no anything.
In her speech, Health Minister Tanya Plibersek said GPs would be able to claim the current items “when creating or adding to a shared health summary on an e-health record which involves taking a patient’s medical history as part of a consultation”.
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GPs demand e-health clarity

5th Apr 2012
TWO weeks after Health Minister Tanya Plibersek announced MBS items would be available for doctors working with e-health records, there appears to be still no clear message from the minister or health department about how the new system will work.
The AMA and RACGP have sought urgent clarification on a number of key questions but have each received different answers, some of which contradicted advice provided to MO by the health department last week.

AMA president Dr Steve Hambleton said the government had made it clear it had not budgeted any new money to compensate GPs for the time spent working on the new records, but every other answer was “the same double-talk”.
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GPs to ‘absorb’ e-health costs

2 April, 2012 Paul Smith  

There will be no dedicated funding, new Medicare items or revamped item descriptors for GPs creating shared e-health summaries, sparking fears general practice will be left to absorb the costs of making the system work.

The summaries form a key part of the personally controlled electronic health record system being rolled out from July. They will contain patients’ diagnoses, medications, adverse reactions and allergies, and are meant to be used by hospitals, after-hours services and other health professionals.

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Doctors worried about PCEHR admin: AMA survey

An Australia-wide survey of specialist and general practice clinicians has found significant concerns about the administrative requirements of the PCEHR. It also uncovered worries about the financial impact the PCEHR will have on clinicians who guide their patients through the PCEHR process.
The survey, conducted online by the AMA, garnered 197 responses. The majority of respondents were GPs, although a total of 18 specialties were represented overall. Responses were also heavily skewed towards clinicians in private practice.
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The full results of the AMA PCEHR survey can be found here
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PCEHR explained in AMA draft guide

4th Apr 2012
THE extent of the change to general practice to be brought by the government’s e-health records system has been outlined, with the release of a 26-page draft guide on use of the new system.
The guide was released today for public comment by the AMA, which compiled it at the request of the National E-Health Transition Authority. It explains how practitioners might use the PCEHR in their day-to-day practice.
AMA president Dr Steve Hambleton said while the system would “put the patient in the driver’s seat for managing their health” it would also have “practical clinical limitations for medical practitioners… in respect of the content, accuracy, and accessibility of the information”.
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The Draft AMA Guide to Using the PCEHR is available online (http://ama.com.au/node/7648) for comment until 27 Friday.
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GPs have financial concerns over PCEHR

4 April, 2012 Gemma Collins
GPs are more concerned than other health professionals about implementing the PCEHR system and are less likely to advise patients to sign-up for their own e-health record, a survey has found.
A survey of more than 200 doctors including GPs, physicians, surgeons and psychiatrists found that almost 80% of participants were concerned about the administrative requirements of the PCEHR system, and nearly three quarters said they were worried about the financial implications.
And it was GPs who came out as the biggest worriers with 90% having financial and administrative concerns about the new system going live on July 1.
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NEHTA's new baby holds key to doctors' access to e-health records system

  • by: Karen Dearne
  • From: Australian IT
  • April 04, 2012 5:03PM
TWO senior National E-Health Transition Authority executives have created a $0 company to act as the registration authority for the National Authentication Service for Health, as part of the Gillard government’s e-health record system.
NEHTA chief executive Peter Fleming and chief financial officer Christopher Hale registered NASH GA Pty Ltd last October, with Mr Hale as director and company secretary, and Mr Fleming as director.
The entity is a wholly owned subsidiary of NEHTA, established with one nil-value ordinary class share; it had a name change in February to E-Health Authentication Services Pty Ltd.
A NEHTA spokesman said the company was established as "a special purpose vehicle to act as the Certification Authority for the NASH", in accordance with Gatekeeper Accreditation (GA) requirements set for public key infrastructure (PKI) systems by the Australian Government Information Management Office.
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Rural patients to be charged for PCEHR

5 April, 2012 Gemma Collins
The Rural Doctors Association of Australia is recommending that rural doctors charge their patients to cover the cost of implementing their shared e-health records. 
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Govt shells out $21m for final leg of e-health record system

The funding will cover the final scope of the project before it goes live on 1 July
The Department of Health and Ageing (DoHA) has allocated $21 million to the National E-Health Transition Authority’s (NEHTA) for the final scope of the national e-health record system.
The final round of funding for the government’s $466.7 million Personally Controlled Electronic Health Record (PCEHR) project has come some four months after it was scheduled for allocation last November.
A spokesperson for the department confirmed the figure and the completion of negotiations but would not comment on why the funding had been delayed.
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Upgraded eHealth PIP under consideration: DoHA

Written by Kate McDonald on 29 March 2012.
The Department of Health and Ageing (DoHA) is currently consulting with stakeholders to consider an upgrade to the Practice Incentives Program (PIP) eHealth payments.
While there is no detail as yet and a decision has not been made, a DoHA spokeswoman said “consultation is currently under way to upgrade the current Practice Incentive Program payments to encourage the adoption of upgraded software that will contain PCEHR capability”.
According to Health Minister Tanya Plibersek, the government invested around $85 million in the PIP eHealth incentive in 2010-11, with around 4200 general practices receiving up to $50,000 each.
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Nehta to identify e-health clinical gaps

  • by: Karen Dearne
  • From: Australian IT
  • April 04, 2012 10:01AM
THE National E-Health Transition Authority is preparing a healthcare provider functionality "clinical safety case report" for release of the first version of the e-health records infrastructure, which was due for delivery by Accenture last month.
"A clinical safety case report for release 1a is currently being prepared," Nehta says in just-provided answers to Questions on Notice during a February Senate estimates hearing.
"This report does not focus on the live clinical environment; rather it primarily focuses on potential clinical hazards introduced through the delivery of the PCEHR national infrastructure.
"Testing by the software developers is still underway at this stage.
"Ongoing identification and analysis of clinical hazards will continue until it informs the go-live decision for PCEHR release 1b and, importantly, post deployment into the live clinical environment."
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Health helpline 'failing dismally'

THE government's $200 million After-Hours GP Helpline is "dismally failing" to reduce pressure on hospital emergency departments and may, in fact, be increasing attendances, a study shows.
The research, published today in the journal, Emergency Medicine Australasia, says many people who don't need to go to hospital are being sent to an emergency department anyway because the nurses and doctors providing advice through the after-hours helpline have to be conservative in their health assessments, says one of the authors, Fremantle emergency doctor Professor Yusuf Nagree.
"When you're on the phone you can't see the patient so you have to err on the side of conservatism," Professor Nagree said.
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Phone triage is expensive and ineffective

5 April, 2012 Michael Woodhead
Emergency specialists say the government must stop misrepresenting the impact of its $200 million telephone triage lines, as the services have no effect on ED burden and may in fact be making things worse.
A complete review of the healthdirect and After Hours GP Helpline services is needed, according to Professor Yusuf Nagree, professor of emergency medicine at the University of Western Australia, because they are dismally failing in their reported aim of “helping to ease demand on emergency wards and general practice,” he writes in the Internal Medicine Journal.
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Hold the line, say emergency staff

Julia Medew
April 5, 2012
A group of emergency doctors says that the phone line, if anything, may be increasing the strain on emergency departments.
A $226 MILLION nurse and GP hotline has not reduced emergency department demand as the federal government hoped and should be reviewed, emergency doctors say.
They also accuse the federal government of ignoring specialist advice in 2005 that the phone line was unlikely to reduce demand for hospitals and of misrepresenting the situation in publicity about the phone line in recent months.
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Hotline not easing pressure on EDs

5 April, 2012 Sophie Cousins 
The Federal Government's $226 million after-hours nurse and GP hotline is not reducing pressure on emergency departments, and may be having the opposite effect, emergency doctors claim.
In 2006, the government pledged more than $170 million over five years on a national health call centre, Healthdirect Australia, to be run by nurses who would give free triage advice.
Last year the service was extended to include GP support through the after-hours GP helpline, at a cost of $50 million over three years.
Health Minister Tanya Plibersek last December proclaimed the GP helpline had reduced pressure on EDs by 27%, with 20,000 people avoiding the ED as a result of the service since last July.
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Telehealth for aged care homes and pharmacies

4 April, 2012 Michael Woodhead  
Telehealth pilot projects are being offered for aged care homes using the National Broadband Network, and retail pharmacies are also seeking to host telehealth services.
The Federal government is inviting applications for almost $21 million in funding for its NBN-Enabled Telehealth Pilots Program, which aims to connect health providers with people in their homes or in aged care and palliative care facilities.
The pilots are available for areas where both homes and health providers are connected to the National Broadband Network , which is being rolled out in selected areas of Australia over the next three years.
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Seamless transfer of information is a revolution

27th Mar 2012
The process of connecting individual GPs to a large public hospital and eventually its private hospital, plus a large clinic full of specialists, has been an extraordinary project. This is the first rollout of the PCEHR, and is funded by the federal government.
Many of my patients have embraced the idea of having their records available to the teaching hospital 1km away from my practice where most of them end up if they require hospitalisation.
There is, however, a registration process involving the patient agreeing to share medical information with the hospital. Once this is in place, I can send an electronic referral in a split second.
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ISOFT dies but new CSC approach is born

4 April 2012   Linda Davidson
The iSOFT brand was formally retired last week and the company, now part of CSC’s healthcare group, took the opportunity to unveil a more flexible, agile approach to the use of its products.
Speaking at the opening of a new demonstration suite at the company’s Banbury headquarters, solutions director for NEMEA, Nick Harte, said the products would offer “bridges to a future electronic patient record” or help customers to sweat their existing assets by supplementing them with smart solutions.
This strategic approach was outlined to eHealth Insider by UK managing director Adrian Stevens in November 2010, when he announced that a 75-strong development team had been engaged to work on interoperability, business intelligence, medications management and hosted Synergy [a primary care system].
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Computer Sciences Corporation - Special Call

April 4, 2012  |  about: CSC
Operator
Good day, everyone, and welcome to CSC's update call on the NHS. Just a reminder, today's call is being recorded. At this time, I would like to turn the conference over to Mr. Bryan Brady, Vice President of Investor Relations. Please go ahead, sir.
Bryan Brady
Thank you, operator. Good evening, ladies and gentlemen, and welcome to CSC's update on the progress regarding our contractual relationship with the U.K. NHS.
We issued a press release and an 8-K yesterday containing the company's most recent update. And so I hope you've had an opportunity to read those.
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Bionic eye to let blind see as Australian team prepares to test brain implant

A TEAM of Australian researchers developing a bionic eye implant for the clinically blind will begin testing its first full system prototype this month.
Monash Vision Group, which leads a team of about 50 researchers on the $15 million project, is on track to have a direct-to-brain bionic eye implant ready for human trials next year.
MVG general manager Jeanette Pritchard said the team had completed successful bench testing on the microchips to be used in the device.
"The really exciting part is that we are taking those chips and putting them into the package that will actually represent something like what will go into the patient," she said.
The microchips would be implanted directly on the surface of a patient's visual cortex, located in the lower portion of the brain.
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NBN labelled a waste to set Labor back years

Peter Martin
April 5, 2012
"Kevin's style was to lock himself in a cave ... then emerge as Moses from the mountain" ... president of the Australian Institute of Public Administration Percy Allan. Photo: AP
IT MAY be popular now, but Labor's $36 billion national broadband network is shaping up to be a financial disaster that will set Labor's image back decades, rebranding it the party of waste and extravagance.
That's the view of Percy Allan, president of the Australian Institute of Public Administration and a former head of the NSW Treasury under premiers Wran, Greiner and Fahey.
Releasing a report card on "public policy drift", he told the Herald that Kevin Rudd came to office in 2007 promising "evidence-based" decision-making, but never spelled out what the term meant.
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Abbott needs more than an NBN lite

Paul Budde
Published 9:36 AM, 5 Apr 2012 Last update 10:37 AM, 5 Apr 2012
There is still a lot of chest beating going on, but in reality the Coalition’s views have been moving closer to the NBN as it is currently being rolled out.
Over the last few years we have seen that there is more or less bipartisan support for the structural separation of Telstra and for the fixed wireless broadband and satellite networks – in the case of the latter, at least support for the need for such a service. There is also acceptance of the fact that NBN Co is here to stay, albeit perhaps subject to change.
A key remaining difference is that the current NBN is based on the superior and future-proofed FttH infrastructure, while to save costs the Coalition favours an FttN solution, which eventually would also need to be upgraded to FttH but which would be cheaper as an interim solution.
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Google unveils 'wearable augmented reality glasses'

  • From: AP
  • April 06, 2012 1:12PM
IF you think texting while walking is dangerous, just wait until everyone starts wearing Google's futuristic, internet-connected glasses.
While wearing a pair, you can see directions to your destination appear literally before your eyes. You can talk to friends over video chat, take a photo or even buy a few things online as you walk around.
These glasses can do anything you now need a smartphone or tablet computer to do, and then some.
Google gave a glimpse of “Project Glass” in a video and blog post this week. Still in an early prototype stage, the glasses open up endless possibilities - as well as challenges to safety, privacy and fashion sensibility.
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Enjoy!
David.

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