Monday, April 16, 2012

Weekly Australian Health IT Links – 16th 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

A really big week with lots of debate on e-Health regulations and mechanisms for payment of those who will be doing the work.
Secondly we also see some controversy around Orion in NZ - a major supplier to the PCEHR Program.
Next we see that Government is spending more on shredders rather than responding to Freedom of Information Requests and we also have some material on the cloud and some of its implications.
Last it was good to see the NEHTA Malaysian Junket seems to have been called off. Sensible in such tough economic times! 

This week looks like being caught up in the Safety Debate with discussion of just how much effort is being put in by NEHTA and DoHA to ensure what is being done first does not do any harm and secondly actually works as intended to reduce clinical errors and maximise patient safety. Of course with the way the NEHRS has been architected they already have removed a lot of the potential for benefit in such areas as interactive clinical decision support (CDS).

Blogs posted this morning will get you started and there is more to come during the week.
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E-health lead rollout sites lacking patients

THE three lead sites for the personally controlled e-health record rollout are yet to recruit patients for trials scheduled to end on June 30.
The Gillard government's PCEHR system is supposed to be operational from July 1.
But the National E-Health Transition Authority has revealed "activity in the e-health sites to date has focused on recruitment of (GP) practices and connection to the (Medicare-operated) Healthcare Identifiers service".
Three former GP divisions (now rebadged as Medicare Locals) -- in Brisbane North, Hunter Valley, NSW and in Melbourne East -- each received $5 million in mid-2010 to implement software supporting the PCEHR system and to trial the use of records by doctors and patients. "Those (lead) sites that are operating local repositories will commence operations over the coming weeks," NEHTA said in answers to questions put by senator Sue Boyce and released last Thursday. "NEHTA specifications are being used in the point-to-point exchange of clinical documents in the e-health sites. However, it is impossible to count how many of these documents are being exchanged."
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Ehealth records: too important to muck up

, by Melissa Sweet
In 2009 the National Health and Hospitals Reform Commission recommended that by 2012 every Australian should be able to have a personal electronic health record that they would own and control.
The PCEHR (personally controlled electronic health records) system is due to launch on July 1.  The plan is for everyone to have the option of registering for an eHealth record and choosing who will be able to access it, and to what level.
But we have been warned not to expect any whizz bang launches or ambitious targets. As DOHA secretary Jane Halton has made clear, the last thing the Government wants is a rush of registrations.
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AMA secretary-general Francis Sullivan demands regulations be changed

  • by: Sue Dunlevy, Patricia Karvelas
  • From: The Australian
  • April 11, 2012 12:00AM
HEALTHY patients who go to their doctor simply to get their e-health record set up will not receive a Medicare rebate.
The decision has outraged doctors and comes as the body in charge of the personally controlled e-health records has pulled out of a taxpayer-funded roadshow to Malaysia next month to show the system to Australian surgeons at a conference in Kuala Lumpur because of the "tight fiscal environment".
The National e-Health Transition Authority, which has a multi-million-dollar travel and entertainment budget, had announced on its website it was planning to send four doctors to the Royal Australasian College of Surgeons conference in the Malaysian capital to promote the scheme.
NEHTA has a Model Healthcare Community, a mock up of how the e-health computer system is meant to work, that it planned to take to the surgeons' conference in Malaysia.
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Health department reversal on PCEHR liability

12th Apr 2012
The health department will rewrite the “unfair” conditions of registration for the personally controlled e-health records (PCEHR) system which required practices to assume all liability and grant unrestricted access to premises and records.
The draft conditions were panned by health insurers and industry experts after MO last week broke the news that the AMA had warned the health department that the “unfair” requirements would “deter every medical practice in Australia from participating”.
MDA National president Associate Professor Julian Rait said any lawyer would say the condition requiring access to a practice’s premises, IT systems, records and staff was “a dealbreaker”.
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Doctors will not be liable for PCEHR breaches: DoHA

Written by Kate McDonald on 13 April 2012.
The terms and conditions for healthcare provider participation in the PCEHR will not require them to assume all legal liability for breaches of the system, according to the Department of Health and Ageing (DoHA).
The Australian Medical Association (AMA) had rejected an early draft of the PCEHR participation agreement, saying it appeared healthcare providers would be liable for failures and breaches of the PCEHR and that health department officials would demand access to medical practices and records.
The AMA said the proposed registration conditions “place extraordinary obligations on healthcare provider organisations for matters that are largely out of their control”.
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GPs face 'extreme obligations' with e-health

12 April, 2012 Sarah Colyer
GPs would be forced to open up their practices and hand over records to health department investigators under draft powers to police the national electronic health records system.
The conditions, circulated for comment this month, would be mandatory for any practice wanting to take part in the personally controlled electronic health records (PCEHR) scheme due to commence on July 1.
The success of the system is dependent on GPs agreeing to create and manage patient health summaries on the records.
But the AMA has warned that the conditions create such "extraordinary obligations" that they would deter every medical practice in Australia from taking part.
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E-health: not just a flick of a switch for overworked doctors

13 Apr, 2012 04:00 AM
THE Rural Doctors Association of Australia (RDAA) has cautioned the Federal Government that the Personally Controlled E-Health Record (PCEHR) system will fail unless doctors and practices are fairly compensated for the time and risk involved in establishing and maintaining e-health records for their patients.
RDAA has joined a range of other medical organisations in calling for better support for doctors and practices in implementing the new system.
“RDAA strongly supports the PCEHR system—it will bring enormous benefits to patients and the health system, and we want to see it work” RDAA president, Dr Paul Mara, said.
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E-health set to roll despite software hiccup

Updated April 13, 2012 08:34:27
First patients being recruited for E-health system
The Hunter GP organisation delivering a new electronic health system for the region says the program is on track despite problems with the national software rollout.
Newcastle, Melbourne and Brisbane are the lead sites for the E-health system that the Federal Government intends to eventually roll-out across the country.
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GPs want cash for e-health input

THE doctors who underpin the Medicare Locals system say the government will have to provide incentive payments to GPs if they want them to write the records for the $467 million e-health system.
The Australian General Practice Network says the Gillard government's approach of paying for the records to be set up when patients visit a GP is "piecemeal" and won't facilitate solid as well as rapid enrolments.
AGPN chairman Emil Djakic says the government should provide service and practice incentive payments to establish the records for the Personally Controlled e-Health Record system.
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AMA sets its own items for managing a shared health summary for the Personally Controlled Electronic Health Record (PCEHR)

The AMA has introduced its own items for preparing and managing a shared health summary for the Personally Controlled Electronic Health Record (PCEHR).
AMA President, Dr Steve Hambleton, said today that the Government had not created new items for doctors’ time and work with patients on the PCEHR and had not allocated any new funding in the Medicare Benefits Schedule (MBS) to cover this new clinical service to be provided by doctors.
“The public announcements from the Government suggest that patients will only get a Medicare rebate if the shared health summary is prepared as part of an existing MBS consultation,” Dr Hambleton said.
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AMA proposes PCEHR consult items and fees

10th Apr 2012
GPs have been advised to charge each patient up to $210 when preparing a shared health summary for the government’s personally controlled e-health record (PCEHR) system, which will be rolled out from 1 July.
AMA president Dr Steve Hambleton said government had not created any new MBS items, and had not set aside any new funding, to remunerate GPs for the work they would put into creating shared health summaries.
“The public announcements from the government suggest that patients will only get a Medicare rebate if the shared health summary is prepared as part of an existing MBS consultation,” Dr Hambleton said.
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AMA prices e-health record creation

By Suzanne Tindal, ZDNet.com.au on April 10th, 2012
The Australian Medical Association (AMA) has laid out a payment scheme for how it thinks doctors should be compensated for creating a patient's health-record summary.
A health-record summary is a quick fact sheet of a patient's health that their GP will create and keep up to date. The health summary is a key element of the government's personally controlled electronic health record (PCEHR) scheme, which the government is starting from 1 July.
GPs have been concerned about the amount of time it will take to manage the shared e-health summary, and are looking for compensation for the time that they will spend on updating them. At the end of last month, Health Minister Tanya Plibersek said that the government will accede to this wish by providing funds to GPs for managing the records.
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Australia leads the way in health products management

3 April 2012. National E-Health Transition Authority (NEHTA) CEO, Mr Peter Fleming has recognised Australia’s National Product Catalogue, for being the most comprehensive of its type in the world, during a speech at the 21st Global GS1 Healthcare Conference held in Sydney from 20-22 March.
Mr Fleming said Australia’s world-leading National Product Catalogue (NPC), is one of the first in the world to focus exclusively on the needs of the healthcare industry, while meeting the needs of healthcare purchasers by allowing for provision of data about products from other sectors, and is endorsed by all state, territory and federal health departments.
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NEHTA and GS1 to host NPC webinars

Written by Kate McDonald on 10 April 2012.
GS1 Australia and the National E-Health Transition Authority (NEHTA) are holding webinars each day next week to help suppliers understand how to use the National Product Catalogue (NPC).
The 'Realise the Efficiency of the NPC' webinar will show how to use the NPC to bring new business efficiencies to their organisation and provide essential information on how to get involved, the organisers said.
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Electronic alert to end abuse

THE suicide of James - from an overdose of prescription morphine and diazepam he obtained during daily runs to various GPs and pharmacies - proved one tragic death too many for Victorian coroner John Olle.
Unusually, Olle has used his powers to recommend the state introduce a real-time prescription monitoring and alert system within 12 months to reduce the deaths and harm caused by such doctor-hopping or prescription-shopping by vulnerable patients.
At present, state and territory governments rely on monthly submissions of paper-based records of controlled (Schedule 8) drugs prescribed by doctors and dispensed by pharmacists. A move from manual to electronic recording, and then real-time reporting, will give providers the information needed to make clinically appropriate prescribing decisions.
But some critics fear a national alert system being developed by the Gillard government may not deliver the desired outcomes.
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Concerns over breast screening software

By Elspeth McLean on Thu, 12 Apr 2012
In January, the Otago Daily Times revealed systems failures in the national breast-screening service BreastScreen Aotearoa, discovered in 2009, resulted in delayed routine two-yearly screening mammograms for 241 women, five of whom were found to have cancer. Documents released under the Official Information Act reveal more about the issues, as Elspeth McLean reports.
The report on the 2009 discovery some women were waiting too long for breast screening invitations brings to light concerns about the performance of software provider Orion Health at that time.
The 2010 report, released under the Official Information Act, shows BreastScreen Healthcare (BSHC) was dissatisfied with Orion's performance and sought legal advice on its contract. It was advised it had "limited options" to address performance.
BSHC, which covers Otago and Southland, expressed concern at Orion's "lack of responsiveness. Testing has shown many gaps/risks".
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DCA and Communicare forge alliance to accelerate community eHealth initiatives

Tuesday, 10 April 2012 18:05
Two of Australia’s leading healthcare solutions organisations, DCA and Communicare, are joining forces to support health and community services organisations to improve the quality of service to healthcare consumers.
“The acquisition is a strong strategic fit for DCA,” said Declan Ryan, DCA’s Chief Executive Officer. “Communicare provides further expansion into the community services sector and a strong presence in Western Australia. It’s also an excellent fit with DCA’s existing health and community services business division and enables both companies to increase their service delivery capability”
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Video spares patients as it assists students

Amy Corderoy
April 9, 2012
ASHLEY ALLUM has seen a lot of doctors. But if there's one thing more unnerving than hospital tests it is having them watched by a roomful of students.
Ms Allum has cerebral palsy and recently also developed a gastrointestinal disorder which has meant a drastic change in diet and numerous medical appointments.
But the 24-year-old was totally relaxed during her most recent trip to Blacktown Hospital's clinical school - partly because instead of having students in the room, the consultation was beamed live to their class, a couple of doors away.
"It meant I was able to forget about that, really," she said. "I was able to feel comfortable".
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Australian data breach costs rise to $2.16 million per incident in 2011

April 10, 2012
The average cost of a data breach reported by Australian organisations has risen steadily for the third consecutive year, reaching $2.16 million in 2011, according to research released  by Symantec Corp. (NASDAQ: SYMC) and Ponemon Institute. The study also found that malicious or criminal attacks were the most common cause of data breaches and the most expensive type of breach overall for Australian businesses. The 2011 Cost of Data Breach Study: Australia report is based on the actual data breach experiences of 22 Australian companies from ten different industry sectors.
“The large volume of data breach incidents occurring over the last year has put data breaches high on the agenda for Australian executives,” said Craig Scroggie, vice president and managing director, Pacific region, Symantec. “As local organisations embrace new technologies, businesses need to focus on processes, policies and technologies that improve their ability to prevent and detect data breaches. Taking steps to keep customers loyal and repair any damage to reputation and brand after a data breach has occurred, can help to significantly reduce the cost of a data breach”.
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Reform on FOI bogs down

Philip Dorling
April 9, 2012
FEDERAL freedom of information reforms have stalled, with government spending on high-performance shredding machines easily outstripping funding for public servants to handle requests for information.
A review of published government contracts by The Age has revealed that government agencies spent close to $10 million on new shredding machines over the past three years.
By comparison, annual freedom of information reports show that the government spent only $764,000 in the same period training public servants to process freedom of information applications from the public. The understaffed FOI watchdog, the Office of the Australian Information Commissioner, is facing budget cuts.
There is also a growing backlog of FOI decision reviews, a state of affairs that is being exploited by agencies seeking to delay the release of sensitive information.
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Matrix magic makes veterinary surgery less intimidating

Deborah Smith
April 10, 2012
THE ''patient'' has no head and no limbs, but her belly is creepily realistic to the touch, thanks to the special effects company that also created the gooey pod scene in The Matrix.
Sophie Moffat, a final-year veterinary student at the University of Sydney, carefully makes an incision in the pink, three-layered ''skin'' of this life-like model of a dog's abdomen.
She begins to search inside for the uterus and ovaries. ''They're not easy to find,'' she explains, probing around near the bladder.
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Risks of putting digital life in cloud

April 13, 2012 - 7:04AM
Don't let a cloud burst leave your data all washed up, writes David Braue.
Later this month Google will close the shutters on Picnik.com, a popular online photo-editing site that Google bought in 2010 and is now being absorbed into the web giant's Google+ social-networking venture.
Picnik's users, many of whom have built up significant portfolios of work created with Picnik's Flash-based image editing tools, have been exhorted to download their images using Picnik Takeout – a feature that compresses all of a user's images into a compressed, downloadable .ZIP file. It's a one-time offer: once the site goes dark on April 19 (US time), every picture stored in the service will be gone.
Picnik isn't the first cloud service to close its doors, but it's a textbook example of the risks inherent in entrusting too much of your digital life to cloud-computing services. Web-based services like Apple's iCloud; file-sharing site DropBox; Adobe's Photoshop Express; Microsoft's new Office 365 apps and Windows Live services; photo-sharing sites like Facebook, Yahoo's Flickr and Smugmug; and Google Docs and related apps – these, and hundreds of other online services, are built around the idea that the software providers will look after your data for you, forever.
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Migration to the cloud ecosystem: Ushering in a new generation of platform competition

Chaim Fershtman   Neil Gandal
13 April 2012
Cloud computing – services that are accessed directly over the Internet – is the new ‘game-changer’ in the information technology world. Yet cloud computing is still in its infancy. This column explores what it might mean for competition among service providers.
Cloud computing – services that are accessed directly over the Internet – is the new buzzword in the information technology world. The ‘cloud’ label comes from the fact that the computing infrastructure is not in your hands; it is located far away ‘in the clouds’, as it were. The device in your hands (personal computer, tablet computers, mobile devices, etc) is akin to an old-fashioned computer ‘terminal’ linked to a mainframe. (Readers who finished university after the 1980s will need to look this up on Wikipedia.)
Cloud computing is often called a 'game-changer', something that will dramatically change the industry, yet there is virtually no research on the economics of it. The literature that exists has primarily focused on the technical aspects of cloud computing (Ambrust et al 2009).1 Another branch of the literature focuses on the macroeconomics effects: creation of jobs, changes in output, etc (Etro 2009).
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US cloud firms should get off the soap box

By Suzanne Tindal, ZDNet.com.au on April 13th, 2012
A recent US report on trade barriers has revealed a hissy fit by US companies about the Australian government's caution on cloud.
The report (PDF), released last month by the Office of the United States Trade Representative, says that US companies have voiced concerns that various Australian government departments are "sending negative messages about cloud computing services to potential Australian customers in both the public and private sectors, implying that hosting data overseas, including in the United States, by definition entails greater risk and unduly exposes consumers to their data being scrutinised by foreign governments".
Departments that the report singled out as being the bad eggs included the Department of Defence, the National Archives of Australia, the Department of Finance and Deregulation, the Australian Government Information Management Office (AGIMO) and the Office of the Victoria Privacy Commissioner.
The report goes on to say that many of these concerns, when directed at US firms, "appear based on a misinterpretation of applicable US law, including the US Patriot Act and regulatory requirements".
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Enjoy!
David.

1 comment:

Paul Fitzgerald said...

re cloud firms getting off their soapbox - to the best of my knowledge and research, there are no laws specifying data must be on-shore (except data feeding the NEHRS - for some reason. Data has to be stored in a country that has privacy legislation and recourse for breaches. You can't have the Government on one hand promoting cloud computing, and on the other hand saying you can store data off-shore - defeats the purpose.