Again, in the last week, I have come across a few reports and news items which are worth passing on. Interestingly an all Australian set of reports this week!
These include first:
Investigation into medical files
Posted Fri Sep 12, 2008 7:11pm AEST
A federal government office will investigate the management of disused medical files in South Australia after concerns were raised about a large number of private medical records at a rented home in Adelaide.
The former doctor who lives at the house is mentally ill and is about to move out of the house.
The landlord is unsure what to do with the files that are likely to be left behind.
It is the second case of its kind in recent years and the issue has been referred to the federal privacy commissioner.
More here:
http://www.abc.net.au/news/stories/2008/09/12/2363397.htm
Yet again those paper records cause a problem. It seems clear that these paper records need to be secured and each patient be informed as to the fact a record exists so if they select a new GP the record can be forwarded to them for their GPs use.
Second we have:
Rush to build personal e-health records risky
Karen Dearne | September 16, 2008
LOCAL software developers clamouring to build personal e-health records risk creating new silos of unconnected patient information, warns Neil Jordan, Microsoft's managing director of worldwide health.
While progress on a national e-health record system has stalled, Jordan says he is slightly concerned "that everyone I've spoken to here wants to build a personal health record (PHR)".
"That's okay, but don't build them all separately or you will end up with the same problem you currently have with e-health records - they're in a whole load of silos," he says.
"There's never going to be one personal health record in a country the size of Australia, because a diabetic is going to need something quite different from someone who is obsessed with fitness and does lots of monitoring while working out."
With most personal health records now held in GPs' computers, Jordan says the person "who is ultimately funding GPs is going to benefit by putting such a platform in place".
More here:
http://www.australianit.news.com.au/story/0,24897,24348898-24169,00.html
I could not agree more with the headline – while being a little alarmed at the lack of understanding of the Australian Health IT world made apparent by the fly-in Microsoft expert in his remarks. Fortunately it is only a few weeks until the National e-Health Strategy being developed by Deloittes will be handed to Government and hopefully such silos will be one of the first issues addressed!
Third we have:
HealthSmart boss resigns
17 September 2008 08:52 PM
The public servant in charge of Victoria's mammoth HealthSmart electronic health initiative has resigned for what the state's health department today said were personal reasons.
Fiona Wilson had led the troubled project since mid-2003 in her capacity as the director of the Office of Health Information Systems within the Victorian Department of Human Services. However a spokesperson for the department told ZDNet.com.au tonight that Wilson had grown weary of the regular commute from Auckland where her partner resided.
More here:
http://www.zdnet.com.au/news/software/soa/HealthSmart-boss-resigns/0,130061733,339292039,00.htm
It is a pity to see yet another senior e-Health player decide to leave the field. While I have, and have expressed, strong reservations about the strategy adopted by HealthSmart, there is no doubt this was an effort of serious intent with the right objectives in upgrading the Health IT in Victorian public hospitals. Maybe a mid-course review and possible correction at the time of this leadership change could smooth the path to ultimate success.
Fourth we have:
Prescriptions to go digital in the coming year
Thursday, 11 September 2008
DESPITE financial disagreements between project partners and a government delay in announcing research findings, e-scripting will be available to GPs as early as next June, says the project’s main promoter.
Australian software company Fred Health’s e-script plan, which will allow general practitioners to send prescriptions to pharmacists over the internet, stalled when their joint development partners put the project on hold.
Amid ongoing uncertainty over the government’s interest in the technology and without any clear financial security plan, GP software vendor Health Communications Network and pharmacy software vendor Corum withdrew from the original JV project, dubbed ScriptX.
However Fred Health chief executive Paul Naismith is optimistic the new JV, eRx Script Exchange, with New Zealand-based software company Simpl and the Health and Human Services division of Microsoft, will be available as early as June next year.
“The original ScriptX proposal had different partners who felt the proposal at this stage was too large a risk for them. We felt differently so we reformed it and set out to deliver electronic scripts with eRx the way ScriptX had intended,” he said.
“It’s our current project plan to be delivering e-scripts by mid next year, certainly within the next 9-10 months.”
More here:
http://www.consultmagazine.net/StoryView.asp?StoryID=269477
Additional coverage is here:
Private e-scrips to launch
Karen Dearne | September 16, 2008
PHARMACIST Paul Naismith is taking a punt on launching a privately-owned electronic prescribing project, ahead of the release of a KPMG review on options being considered by the federal Government.
Mr Naismith, chief executive of pharmacy IT supplier Fred Health, said improving "basic safety" by reducing medication errors was too important to delay.
Fred Health and the newly established eRX Script Exchange are wholly owned subsidiaries of PCA Nu Systems, in turn controlled by parties associated with the Pharmacy Guild.
A Health Department spokeswoman said a range of approaches to e-prescribing were being explored, and the private proposal supported by the Pharmacy Guild "had been looked at". "The KPMG report is being considered as part of broader activities in progressing e-prescribing within Australia," she said.
Full, in depth, article here:
http://www.australianit.news.com.au/story/0,24897,24351225-15306,00.html
Bluntly there is no way this project should be allowed to proceed. It is my view the central infrastructure for e-prescribing should be Government controlled and regulated (I have no problem with the service delivery being outsourced). The service should be run for the benefit of consumers, doctors and pharmacists, not as a profit making project for commercial interests and such vested interests as the Pharmacy Guild.
Fifth we have:
Cloud computing may draw government action
U.S. government policy makers will soon focus on the privacy, security and other implications of cloud computing, some experts say.
Grant Gross (IDG News Service) 15/09/2008 09:17:00
Cloud computing will soon become an area of hot debate in Washington, D.C., with policy makers debating issues such as the privacy and security of data in the cloud, a panel of tech experts said Friday.
There are "huge challenges" facing policy makers in the next year or two as cloud computing becomes increasingly popular, said Mike Nelson, visiting professor for the Center for Communication, Culture and Technology at Georgetown University and a former tech policy advisor for U.S. President Bill Clinton.
Among the major policy issues to be worked out: Who owns the data that consumers store on the network? Should law enforcement agencies have easier access to personal information in the cloud than data on a personal computer? Do government procurement regulations need to change to allow agencies to embrace cloud computing?
Cloud computing is "as important as the Web was 15 years ago," said Nelson, speaking at a Google forum on the policy implications of hosted applications and services. "We don't have any idea of how important it is, and we don't really have any clue as to how it's going to be used."
Despite the growing number of people using cloud services such as hosted e-mail and online photo storage, many consumers don't understand the privacy and security implications, said Ari Schwartz, vice president and chief operating officer of the Center for Democracy and Technology, an advocacy group focused on online privacy and civil rights. So far, U.S. courts have generally ruled that private data stored in the cloud doesn't enjoy the same level of protection from law enforcement searches that data stored on a personal computer does, he said.
More here:
http://www.computerworld.com.au/index.php?id=833256149&eid=-255
This issue is a real sleeper. I believe when people realise just how much of their personal information is out there ‘in the cloud’ there may indeed be some pressure for regulation. This is, of course, even more so once private health information is involved as with MS Vault and the Google PHR.
Last we have the slightly more technical article for the week:
SOA deployments: What actually works
After several years of hype, the results of SOA efforts have been a mixed bag. SOA expert explains how to get SOA right
Dave Linthicum (InfoWorld) 17/09/2008 08:46:00
SOA may have seemed the savior of bad software architecture and poor development project planning, but the reality is that it's a complex and difficult venture. Thus, the number of failed SOA projects is about equal to the successful ones. In other words, you have a 50 percent chance of failing, and the odds of failure are even greater if you work within a larger Global 2000 organization or within the government.
But key patterns are emerging from the successful SOA efforts, patterns that can help you determine whether your SOA is a failure or a success.
The most important lesson from these patterns is that SOA is as much about old-school IT disciplines as it is about new, inventive technology. Moreover, it's about changing an organization from the people down to the technology, driving a systemic and valuable change. The patterns of success likewise follow that change from the people on down to the technology.
Much more here:
http://www.computerworld.com.au/index.php?id=1246639526&eid=-255
This is a useful review showing that for Service Orientated Architecture initiatives to succeed you need to get the basics right. The failure rate in large projects is worrying – especially with the commitment we seem to have from NEHTA to use this approach pretty much exclusively in what are looking like very big projects.
Last a brief happy birthday for the Integrated Circuit (IC)
Integrated circuit turns 50
September 14, 2008
The computer chip industry on Friday celebrated the 50th birthday of the integrated circuit, a breakthrough that set the stage for the internet and the digital age.
A half-century ago a young engineer named Jack Kilby first demonstrated an integrated circuit he designed while working through the summer at his Texas Instruments job because he didn't have enough vacation time for a holiday.
More here:
http://www.smh.com.au/news/technology/integrated-circuit-turns-50/2008/09/14/1221330704451.html
More next week.
David.
4 comments:
Disused medical files -
Let’s get real about this. After a medical practitioner retires or closes the practice the medical practitioner is legally responsible for the files which must be kept ‘filed’ ‘stored’ for up to at least 7 years and in some cases 21 years, say where the doctor delivered the child. If the practice transfers ownership the files can legally go with the practice to the new owner(s).
The practitioner is not required to contact each and every patient, many of whom would have disappeared, to ask them if they want their files and if so to come and collect them. Nor should such an imposition be thrust upon the practitioner to do so for it would be a fruitless, time consuming, costly activity.
In the case cited, the fact that the medical doctor is mentally ill is unfortunate. Even so, he appears to have been responsible and done the right thing and stored the medical records in a reasonably safe location.
This is an interesting case and one which probably should be used to test the law as it stands today. Not much good leaving the records in the care of a mentally ill doctor. The landlord seems to be a reasonable person who wants to know what should be done with the records. They are not his responsibility. The authorities aren’t going to want to have to take responsibility - for that could open a pandora’s box and where the authorities could become the ‘dumping’ ground for unwanted records.
Probably the best solution is to burn and be done with them. Giving 60 days notice of intent to do by an advertisement in the newspaper is probably best avoided. Of course, one day it is just remotely possible the problem might be solved when records are electronically stored and in the hands of the consumer - but that is at least a decade away - conservatively speaking.
The Pharmacy Guild will not rest until it can dominate the e-prescribing space come hell or high water.
This recent eRX Script Exchange 'punt' by Fred Health's Paul Naismith is just another example where the Guild is doing everything in its power to exert its influence through "the software vendors which are controlled by parties associated with the Pharmacy Guild."
How well the Government and bureaucrats understand the Guild’s modus operandi is anyone’s guess; probably not nearly as well as they think they do and not nearly as well as they should.
The Guild would have all and sundry believe that they represent and speak for all community pharmacists and all owners of community pharmacies. This is the message they continually promote and nothing could be further from the truth. It is time the bureaucracy and government cut through the Guild’s smoke and mirrors.
Yep - as you say "Cloud computing is a real sleeper". So was Y2K. We need the hype to drive the market forward. Let's not worry too much about privacy and security implications.
Think of it this way. Look at the finance world today - vast borrowings on never ending credit, sub-prime mortgages, contracts for difference, uncontrolled short selling, on selling risk around the world without any understanding of where the underlying assets lie, and lots of hyped up takeover bids by equity funds (remember Qantas & Enron) driven by greed and intent of making a quick killing. Without the hype so many of these things would not have gained traction - then - where would we be today? Where would we be I ask you? Here in America we wouldn't be handing over $800 billion to buy the debt which resulted from all the hype. And as taxpayers we would be $800 billion better off until another $300 billion is splashed around on whatever disaster comes next.
But I digress. We need the hype to give Cloud computing traction, and a life of its own. Imagine where it might take us once all our personal information is out there ‘in the cloud’ !!!!
As a point of order, the ZDNet story about the departure of Ms Wilson from HealthSmart is a direct rip-off of my story, which appeared on The Australian IT some hours earlier. See:
http://www.australianit.news.com.au/story/0,,24361164-15306,00.html
This story was the result of original reporting.
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