That Old Paper Transfer Of Private Information Lets Us Down Again! Private Information Leaks Are Usually Caused By Human Error – Not Technology!

This appeared last week:

Patient privacy breach: over 1600 medical letters found dumped in Sydney bin

Kate Aubusson
Published: April 21, 2017 - 4:52PM

More than 700 public patients have had their privacy breached and potential delays in their follow up care after more than 1600 medical letters were found dumped in a Sydney bin.

NSW Health is investigating the incident involving a sub-contractor for a company tasked with transcribing medical letters sent from specialists to general practitioners.

On Tuesday, April 11, a man found piles of follow-up letters containing patient details stuffed into a garbage bin at an apartment block in Ashfield. It is understood there were more than 1600 documents in total. Some of the letters were duplicates. 

The man called in his neighbour, a female health worker, who recognised the documents were out-patient letters and contacted Ashfield police. 

A sub-contractor for Global Transcription Services (GTS) was supposed to take the letters home to post but instead stuffed them into the bin. The young woman had been dealing with personal upheaval and health issues, Health Minister Brad Hazzard said on Thursday, adding it was inappropriate to comment further.

The letters related to 768 public hospital patients from Royal North Shore, Gosford Hospital outpatients and Cancer Centre and Dubbo Hospital Cancer Centre.

There were also 700 letters relating to patients from six private providers: Chris O'Brien Lifehouse, providing services to Dubbo Cancer Clinic, Northern Cancer Institute (Frenchs Forest and St Leonards), Sharp Neurology, Southside Cancer Care Centre, Strathfield Retina Clinic and the Woolcock Institute.

It is not known how many private patients were affected. It is understood that less than one per cent of affected patients were treated by Lifehouse. 

The bulk of the letters were treatment progress reports from specialist consultations in December.

More here:

http://www.smh.com.au/national/health/patient-privacy-breached-as-over-1400-medical-letters-found-dumped-in-sydney-bin-20170420-gvp8be.html

Other than wondering quite why so much detail about the breach was provided the cause of the problem is pretty clear. A worker simply failed to carry out their responsibilities appropriately for personal reasons.

Such issues can happen with both paper and electronic records albeit often in different ways.

Nonetheless, despite some comment and articles to the contrary, we are all entitled to have our private information kept private unless we choose to disclose it. No ifs or buts as far as I am concerned and I really struggle with the decency and sensitivity of those who think any different.

If you have a use case that validates the unauthorized disclosure of personal identified private information I would love to see it – unless it involves emergency care or the like. I am not expecting many takers!

David.

The ADHA Puts A Case For Digital Health. Pity The Evidence Is So Old And Inconclusive.

This blog from the ADHA appeared a few days ago.

Health in an age of information

Thursday, 20 April 2017

"Cause we are living in a material world
And I am a material girl
You know that we are living in a material world
And I am a material girl"^[1]

You know these lyrics. Madonna's single "Material Girl" and its accompanying video were huge hits in 1985, and went on to define much of her career. But was she right? Is she really a material girl? And are we living in a material world? More than 30 years after she sang this song, we find that the world we live in is becoming less and less about material things, and more and more about information.

From the perspective of the national and global economy, information technology is a vast and growing sector that is displacing manufacturing in value and influence. A similar trend is apparent in the economy of our daily lives: financial transactions are routinely conducted electronically, and reliance on the physical tokens of notes and coins starts to seem quaint.

The rising influence of information even shows in our understanding of reality itself. We’ve known for some time that the apparently solid objects of our experience are composed of atoms that consist mostly of space. And as physicists probe ever more deeply, even subatomic particles seem less and less substantial. Some theorists go so far as to propose that this gossamer-thin materiality rests on a bedrock of – you guessed it – information. As the science writer James Gleick puts it:

"The bit is a fundamental particle of a different sort: not just tiny but abstract – a binary digit, a flip-flop, a yes-or-no. It is insubstantial, yet as scientists finally come to understand information, they wonder whether it may be primary: more fundamental than matter itself. They suggest that the bit is the irreducible kernel and that information forms the very core of existence."^[2]

Healthcare is no exception to these trends. As treatment methods become more sophisticated, we find that the quality of healthcare is increasingly dependent upon the quality of the information available to practitioners and patients.

It may seem like a truism to say that better health information leads to better healthcare, but in some respects the healthcare profession has been remarkably slow in embracing information technologies. Facsimile machines, for instance, are still in regular use to convey messages between medical practitioners, despite having been phased out in most other sectors. And handwritten notes are still commonplace in both large and small clinical practices.

There are good reasons for this conservatism, starting with the Hippocratic injunction to first, do no harm. Obvious as it is that reliance on facsimile messages and handwritten notes is somewhat old-fashioned, it is not so obvious that they are actively harmful. Newer systems for storing and communicating information may be more efficient and promise greater safety, but that promise ultimately needs to be tested in the crucible of daily practice. In such circumstances, a "devil you know" approach has clear attractions.

Network effects are another inhibiting factor. A single telephone is of no use whatsoever – it becomes useful when there is another telephone that it can call. And it becomes more useful still when there are hundreds or thousands of other telephones. Similar issues arise for other communications and storage technologies: they only become useful when both sender and receiver have similar equipment and apply compatible protocols.

The complexity of healthcare information is yet another factor. The financial sector has readily adopted modern information technologies in part because the key data in that sector is numeric information, which is easily represented and thoroughly standardised. In contrast, the underlying information in healthcare is exceedingly complex: it is often difficult to represent and only loosely standardised.

Despite all this, it has been estimated that adopting modern information technologies to Australia’s healthcare sector will save hundreds of lives and millions of dollars each year^[3]. Let’s repeat that: hundreds of lives and millions of dollars could be saved each year by adopting modern information technologies to healthcare.

This represents the challenge, the mission, and the promise of the Australian Digital Health Agency’s work. Improving healthcare information may sound abstract, but this is work with very real, practical outcomes in the material world we live in.

Dr Andrew Westcombe is a technical editor at the Australian Digital Health Agency, with a PhD in Philosophy. 

^[1] Songwriters: Rans, Robert; Brown, Peter. Material Girl lyrics © Sony/ATV Music Publishing LLC.
^[2] Gleick, James, The Information: A History, A Theory, a Flood. Pantheon Books, NY, 2011, pp. 9-10.
^[3] See http://www.strategyand.pwc.com/au/home/press/press-releases/displays/48757598

Here is the link:

https://www.digitalhealth.gov.au/about-the-agency/digital-health-space/item/15-health-in-an-age-of-information

I have provided the whole blog so as not to mis-state any of the arguments.

First it is really good to see some sensible points being made on the issues and complexity surrounding digital health.

Second it is really sad to see that the best that can be said on the benefits front is so old.

Booz and Company report identifies possible $7.6 billion in annual savings from Government investment in e-health

Sydney, 6 May 2010 — A report released today by leading global management consultancy, Booz and Company, has revealed Government investment in a comprehensive e-health system may generate more than $7.6 billion in annual healthcare savings by 2020.

The Booz and Company report, Optimising E-Health Value, outlines a comprehensive case for national investment in e-health to better connect GPs, hospitals and other points of care, so as to improve sharing of patient information.

The report points to reduced errors in medication as offering the greatest potential for savings ($2.6 billion), followed by improved care programs and prevention measures ($2.3 billion). Adverse drug events from errors in medication are estimated to affect 10.4% of patients currently treated by GPs in Australia each year, of which half are classified as moderate to severe, 138,000 require hospitalisation, and as many as 18,000 may result in death according
to some sources.

Booz and Company says a comprehensive commitment to e-health could help Australia avoid an estimated 5,000 deaths, two million primary care and outpatient visits, 500,000 emergency department visits and 310,000 hospital admissions each year.

Report co-author and Sydney-based Booz and Company Principal, Klaus Boehncke, said the analysis demonstrated clearly the benefits from significant investment in e-health, and the need to build such investment in the health reform agenda.

“E-health is the crucial missing piece of the health reform jigsaw presently, and it must not be allowed to slip from view,” Mr Boehncke said.

“Indeed, the success of some of the Government’s reforms, particularly the local hospital networks and primary care networks, and reduced Emergency Department waiting times, depends largely on the connectivity that a robust e-health system provides,” he said.

The report was based on Booz and Company’s global experience advising Governments and health authorities in countries overseas including the United States, Canada, Germany, Italy, Singapore, Hong Kong and the UAE. The e-health model outlined in the report draws on Australian health data and has been adjusted to reflect the characteristics of Australia’s health system.

The report says existing e-health investment in Australia has been patchwork, limited and often focused on acute care. It calls for a shift in e-health focus from hospitals to networking primary care settings – GP clinics - where the volume of patient interaction is high and the potential for flow-on benefits are greatest.

“GPs are increasingly at the sharp end of providing integrated and chronic care, and their role becomes more important under the Government’s reforms, with their initial focus on diabetes. There is a real opportunity to reap powerful gains by putting them at the centre of the e-health push,” Mr Boehncke said.

“Australia’s GPs – 95% of whom use computers - are among the most highly computerised in the world. However, they are not well connected with each other, or with other points of care such as hospitals, so the valuable patient information they hold is not shared with other care providers or indeed among their own community,” he said.

“With a national e-health infrastructure in place, we estimate an investment in information networking of $3,000 per annum per GP clinic could deliver up to $668,000 in annual savings per clinic, mainly through prevention and avoidable hospitalisation. Up to $5 billion of the total savings from e-health investment in our model would come from improving connectivity and dissemination of information to and from GPs.”

Booz and Company’s analysis argues the case for Federal and State Governments to fund the information networking of GPs, as they would be the beneficiaries of the resulting savings. The firm estimates Governments would share in 68% ($5.2 billion) of annual savings accruing from a national e-health investment.

Other e-health benefits identified within the Booz & Company report include:

• Better use of healthcare infrastructure
• Less duplication of diagnostics such as lab tests and X-rays
• Savings from optimised use of pharmaceuticals
• Enhanced productivity among healthcare workers
• Early warning from disease outbreaks

Based on current trends, the estimated total annual savings of $7.6 billion from e-health may represent 3% of total health expenditure. This figure does not include flow-on economic benefits to Australia, such as improved workforce productivity, which are estimated to be considerable.

Mr Boehncke said the health community was watching closely for signs from the Federal Government that it would commit to a significant investment in e-health.

“It did seem obvious that e-health would figure prominently in the reform agenda but there are now concerns it may have slipped off the table. That would be disappointing – there are good reasons why comparable countries overseas are investing heavily in this area, and the arguments for doing so here are irresistible,” he said.

Here is the link:

https://www.strategyand.pwc.com/au/home/press/press-releases/displays/48757598

Even if these benefits were real, and I don’t believe the quantum cited for a moment, with the strides in hospital computing, GP computing and secure messaging in the last 6-7 years surely most of them have been captured. Of course the myHR was not even a twinkle in anyone’s eye in 2010, so who knows what impact it may, or may not, have. Of course its costs of the myHR are also not included.

Before more is spent we need current estimates of costs and benefits. I wonder when they might be produced or is the May Budget just to have more evidence free expenditure, or worse, expenditure based on evidence like this. Really if this is the best evidence the ADHA can put forward frankly we are all doomed!

I hope not!

David.

Weekly Australian Health IT Links – 25th April, 2017.

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

Rather a quiet week as we count down to the Budget on the Digital Health front. There seem to be a good range of topics this week.

I wonder when SA Health can get their act together – seems like a huge mess at present!

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http://medicalrepublic.com.au/sonic-primary-sitting-digital-health-progress/8562

Are Sonic and Primary sitting on digital health progress?

The wonders of modern digital connectivity are there for the taking, but there are elephants in the e-waiting room

By Jeremy Knibbs

21 April 2017

This is one of those stories that as a GP you won’t, on spec, be interested in. But only because you’ve never been told “what lies beneath” the story: the unnecessary, and potentially significant, retardation of better communication between the various important hubs of health information in this country, and therefore the slowing of delivery of much more efficient healthcare, via GPs, to their patients.

Ask most GPs what they think of the big private pathology providers and your response will be usually be somewhere between indifferent to unusually positive. One GP we asked is literally thrilled with the new mobile results service that Sonic Healthcare now provides through its path labs. To GPs, path results arrive through their patient management system with relative ease. What is there to be bothered about?

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https://www.doctorportal.com.au/mjainsight/2017/14/why-are-we-communicating-so-badly/

Why are we communicating so badly?

Authored by James Dando

Issue 14 / 18 April 2017

I AM too young to be familiar with fax machines. My parents had one, and I can vaguely remember them making fun of my grandfather’s skepticism of this “new” technology. I didn’t have to use one. That was until I started working in a hospital.

Now I use a fax machine almost daily, as well as other arcane technologies, such as the pager that has to be carried around at all times.

These rather quaint examples make for fun anecdotes to regale non-medical friends with, but they speak to something more profound: the generally abject quality of the communication tools employed by health care practitioners.

This is especially clear in our handling of medical records. It’s ironic, given that our profession takes so much pride in the ability to tell the story in a succinct and a systematic way, that we are so tolerant of platforms that obscure rather than illuminate the important points in a patient’s history.

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http://www.optometry.org.au/blog-news/2016/12/29/optometry-updated-on-digital-health/

Optometry updated on digital health

Thursday, December 29, 2016

By Ashleigh McMillan
Journalist

A roundtable on the future of digital health in Australia has shed light on the implementation of My Health Record for allied health in 2017.

The event held on 7 December was hosted by Allied Health Professionals Australia (AHPA), of which Optometry Australia is a member, with support from the Australian Digital Health Agency (ADHA).

In 2017, pathology and diagnostic imaging will be added to the My Health Record, with Pharmaceutical Benefits Scheme data being used to ensure current medications are included in patient profiles.

ADHA chief executive officer Tim Kelsey announced at the event that his main goal was to assist secure messaging platforms in the health-care sector to communicate with each other.

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http://www.physiotherapy.asn.au/APAWCM/The_APA/news/2017/April/New_telerehab_study_shows_benefits_to_cardiac_patients.aspx

New telerehab study shows benefits to cardiac patients

18 April 2017

New Australian research released by the Journal of Physiotherapy again shows that governments and private health insurers should facilitate tele rehabilitation as part of the health system. This is another example of the growing benefit of digital health consultations to patients.

The study, conducted at Brisbane’s Princess Alexandra Hospital and The Prince Charles Hospital, showed that tele rehabilitation is as effective for improving exercise capacity, strength and quality of life in patients suffering chronic heart failure as traditional hospital outpatient rehab. Importantly, it also found that patients were much more likely to attend their rehab sessions when they were delivered by video as opposed to having to come into an outpatient clinic.

Exercise-based rehab increases physical function, improves quality of life and lowers hospital admission rates for people with chronic heart failure. However, cost and the availability of convenient rehab programs often prevents people from undertaking proper rehab.

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http://www.theaustralian.com.au/business/technology/opinion/agencies-failing-to-meet-cybersecurity-norms/news-story/98d1e16c3eaa2df54aa1914dde8cdc8f

Agencies failing to meet cybersecurity norms

• Anthony Wong
• The Australian

Cybersecurity issues continue to grab headlines as industry and government focus on developing strategies to build capability and competitiveness.

Reports last week of security flaws in the wireless chips used in a wide range of Apple and ­Android mobile devices came hard on the heels of news that network-enabled toys are being used by hackers to access ­personal data.

At the same time, Gemalto’s latest Breach Level Index ­revealed 1.4 billion data records were compromised last year in 1792 major data breaches, which represented an 86 per cent ­increase in attacks over 2015.

In light of such revelations, it’s concerning to see that two of ­Australia’s three largest government agencies recently failed an audit of their cyber resilience capabilities.

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http://www.medicalobserver.com.au/professional-news/how-we-can-fix-poor-quality-data-in-gp-software

How we can fix poor quality data in GP software

Dr Oliver Frank

18 April 2017

IMPROVING PRACTICE SOFTWARE

Less time would be spent on data scrubbing if software flagged problems.

THE ISSUE

Safety, quality and efficiency of care depend on high-quality clinical data.

General practice records are plagued by inferior data that decreases the quality and efficiency of care, and increases risk to patients and GPs.

Poor quality data causes frustration and embarrassment during care planning, clinical audit and research projects, and can lead to loss of incentive payments.

Incomplete or inaccurate data is usually uncorrected in the process of providing care.

Following discovery of poor-quality data during audits, practices spend some of their profit, as well as the time and energy of their GPs, practice nurses and practice staff, to undertake data cleansing.

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http://indaily.com.au/news/2017/04/18/doctors-lost-control-ed-planned-epas-shutdown-union/

Doctors "lost control of ED" after planned EPAS shutdown: union

Doctors lost control of an Adelaide emergency department after the hospital's electronic patient health records system was switched off at the start of the hospital’s busiest day, a union inspection report says.

Bension Siebert @Bension1

Adelaide Tuesday April 18, 2017

A report penned by a doctors’ union inspector, obtained by InDaily, says medical staff at the Queen Elizabeth Hospital “effectively lost control of the patients and the service” during a 24 hour period late last month.

The crisis was caused by a severely overcrowded emergency department, a lack of available staff and hospital beds, and a planned shutdown of e-health system EPAS, which occurred during “the busiest day for ED’s and hospitals generally” says the report, by South Australian Salaried Medical Officers’ Association senior industrial officer Bernadette Mulholland.

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http://www.abc.net.au/news/2017-04-19/epas-failings-harm-investigation-into-former-socceroo-death/8454750

EPAS failings highlighted by death of former Socceroo Stephen Herczeg, inquest told

By court reporter Rebecca Opie

April 19, 2017

Questions surrounding the traumatic death of a patient whose oxygen tube was connected to his catheter may never be answered because of failings with South Australia's new electronic patient record system, a coronial inquest has heard.

Former Socceroo Stephen Herczeg, 72, died in the Queen Elizabeth Hospital (QEH) last September.

The chronic lung disease patient was admitted to hospital after a fall to treat a suspected urinary tract infection.

South Australian coroner Mark Johns started an inquest 35 days after Mr Herczeg's death amid concerns for patient safety.

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http://www.abc.net.au/news/2017-04-20/ama-wants-answers-following-sa-health-leadership-turmoil/8455826

SA Health leadership turmoil due to recruiting wrong people

ABC Radio Adelaide

20 April, 2017

SA Health has admitted it recruited the "wrong people" to leadership positions after the Australian Medical Association (AMA) questions the "revolving door" of staff during a time of "immense change" within the public healthcare system.

On Tuesday it was revealed Central Adelaide Local Health Network interim chief executive Len Richards had quit after only two months in the job.

Mr Richards was appointed to replace previous CEO Julia Squire, who was sacked in January following an industrial dispute with the nursing union.

At the time, SA Health said Mr Richards would continue until after the opening of the new Royal Adelaide Hospital (NRAH), which is now only weeks away.

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http://indaily.com.au/news/2017/04/20/sa-health-executive-roles-impossible-ama/

SA Health executive roles "impossible"

The SA head of the Australian Medical Association has suggested SA Health's senior roles should be carved up after the under-fire department's boss admitted the high turnover rate of executives was damaging morale and leading to staff ignoring executive directions.

Bension Siebert @Bension1

Adelaide Thursday April 20, 2017

Interim Central Adelaide Local Health Network CEO Len Richards resigned yesterday after just two months in the role – the latest in a long series of resignations from top positions in Health in recent years. He replaced Julia Squire, who was sacked in January.

Speaking on ABC Radio Adelaide this morning, SA Health boss Vicki Kaminski said that the high turnover rate among executives at the department was affecting staff morale, and part of the problem was that the department was recruiting “the wrong people”.

She said some lower-level staff had stopped following executive directions because they did not expect the same individuals to be in their roles for long enough to make a difference.

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https://www.pharmacynews.com.au/news/latest-news/patients-to-get-live-access-to-health-summaries

Patients to get live access to health summaries

21 April, 2017 Heather Saxena  

Patients at 180 GP practices will soon have access to their medical history via a $5.99 app.

The Australian-developed Meditracker app, which is being rolled out at IPN practices, gives live access to health summaries and medications.

Patients can also show their medication list to pharmacists to help avoid drug interactions or adverse events.

The app has been trialed at several IPN medical centres since January. It also links to various fitness trackers.

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https://chf.org.au/media-releases/online-psychology-bush-much-needed-advance

Online psychology for bush a much-needed advance

MEDIA RELEASE THURSDAY, 20 APRIL

The introduction of Medicare cover for online consultations with psychologists for people in rural Australia is a welcome development, the Consumers Health Forum says.

“The expansion of telehealth services for country people is timely and appropriate particularly for psychological services when so many rural Australians currently miss out on this often critically-needed therapy,” the CEO of the Consumers Health Forum, Leanne Wells, said.

“The announcement by the Health Minister Greg Hunt and the Minister for Regional Development, Fiona Nash, provides a valuable signpost to making the most of telehealth in semi remote and remote Australia where a full array of multidisciplinary health services are often inadequate and rates of untreated illness are significantly above those in urban areas.

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http://www.queenslandcountrylife.com.au/story/4610505/telehealth-boost-for-rural-psychological-services-hailed/?cs=4704

Telehealth boost for rural psychological services hailed

Colin Bettles @ColinJBettles

21 Apr 2017, 10:30 a.m.

FARMERS and medical professionals have praised moves to enhance the delivery of virtual mental health support services into regional and remote areas of Australia, where standards are lower and suicides rates higher.

Regional Development Minister Fiona Nash unveiled the telehealth boost for rural psychological services that will cost $9 million over four years from 2017/18 to 2020/21.

Senator Nash said it was the first outcome from the Coalition’s Regional Australia Ministerial Taskforce that met for the first time last month of which Health Minister Greg Hunt is also a member and also backed the improved access to psychologists in rural areas through the introduction of a new Medicare rebate.

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https://www.australiandoctor.com.au/news/latest-news/medicare-to-cover-teleconsults-with-psychologists

New telehealth rebate for rural psychology consults

Antony Scholefield | 20 April, 2017 |  

Rural patients on GP-written mental health plans will soon receive Medicare rebates for teleconsults with psychologists.

From November, patients in select rural areas will be able to claim subsidies for seven video consults per year.

That's three fewer than the 10 face-to-face consults that presently attract subsidies under mental health plans.

Rebates will be available to patients in regions four to seven of the Modified Monash rural classification scheme.

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http://www.medicalobserver.com.au/professional-news/when-patients-slam-you-online-heres-what-to-do

When patients slam you online, here's what to do

Ruanne Brell

19 April 2017

These days, it is very common and quite easy for people to comment online about any experience they have, be it a meal at a restaurant or a holiday destination. This concept is being extended to patients rating doctors and medical practices through a growing number of websites and social media platforms — including through numerous online forums such as RateMDs, Truelocal and Whitecoat, on Google or Facebook.

It is never pleasant to read negative comments about yourself, particularly if you think they are unfounded. Sometimes, a negative online review is the first you know about a patient’s dissatisfaction with you during a consultation, with the staff at your practice or some other aspect of the care you provided. It doesn’t help that comments are often posted anonymously or under a pseudonym so you may not be able to identify the person to know if they were even a patient of yours.

Generally speaking, people are free to publish what they like, but subject always to the laws relating to privacy, defamation and, for example, sexual discrimination and racial vilification. Most websites and social media platforms will have privacy policies and terms of use that outline acceptable content and how to contact them if you want something removed.

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http://www.smh.com.au/national/public-service/ato-commits-to-stop-datasharing-on-its-public-servants-20170411-gvj6da.html

Tax Office commits to stop sharing personal data of its public servants

Noel Towell
Published: April 18, 2017 - 12:15AM

The Tax office has assured its 19,000 public servants that their sensitive employment data will no longer be shared with external private sector polling companies.

The pledge comes as further progress is made towards ending three years of industrial stalemate at the revenue agency.

Fairfax revealed last month that Tax Office secretly handed sensitive employment details on its own workforce to a private firm in an attempt to voter-profile an all-staff industrial ballot.

The ATO covertly supplied its contractor with the names, email addresses, locations of work and pay grades of each of its 19000 employees without their knowledge or consent.

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https://www.itnews.com.au/news/dhs-challenges-agencies-to-cyber-wargames-458672

DHS challenges agencies to cyber wargames

By Paris Cowan on Apr 19, 2017 11:50AM

September battle heats up.

The Department of Human Services has laid down the challenge to Canberra’s biggest IT shops to go head-to-head in simulated cyber wargames this September.

The department’s CISO Narelle Devine says this is likely the biggest and first-of-its-kind security training exercise the government has staged.

The Australian Taxation Office, Department of Defence, and Department of Immigration and Border Protection have agreed to field teams of between five-to-ten of their best security professionals to battle it out over two days. A handful of other agencies are still waiting to opt in.

“If you learn how to attack you can defend well. If you can think like the cyber adversary then you’re going to be in a good place,” says Devine, a former Navy commander who joined the department in October last year.

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http://www.hospitalhealth.com.au/content/technology/article/virtual-care-at-the-cutting-edge-of-digital-health-639577108

Virtual care at the cutting edge of digital health

By Australian Hospital + Healthcare Bulletin Staff
Friday, 14 April, 2017

Our Industry Comment guests for Autumn are HISA CEO Dr Louise Schaper and Nurse practitioner Matiu Bush, presenting at the Australian Telehealth Conference 2017 where they will be exploring trends and innovations in digital health technology.

Nurse practitioner Matiu Bush takes his passion for creative innovation to the next level — as a patient experience consultant co-designing with patients.

Matiu was the former nurse manager at Peter MacCallum Cancer Centre where he transformed the patient experience from waiting room through to consultation and rehab.

As the new Design Integration Lead at RSL Care, he is now revitalising service delivery for aged care patients across the country.

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http://www.smh.com.au/national/health/patient-privacy-breached-as-over-1400-medical-letters-found-dumped-in-sydney-bin-20170420-gvp8be.html

Patient privacy breach: over 1600 medical letters found dumped in Sydney bin

Kate Aubusson
Published: April 21, 2017 - 4:52PM

More than 700 public patients have had their privacy breached and potential delays in their follow up care after more than 1600 medical letters were found dumped in a Sydney bin.

NSW Health is investigating the incident involving a sub-contractor for a company tasked with transcribing medical letters sent from specialists to general practitioners.

On Tuesday, April 11, a man found piles of follow-up letters containing patient details stuffed into a garbage bin at an apartment block in Ashfield. It is understood there were more than 1600 documents in total. Some of the letters were duplicates. 

The man called in his neighbour, a female health worker, who recognised the documents were out-patient letters and contacted Ashfield police. 

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http://www.healthintersections.com.au/?p=2622

#FHIR Testing is Coming

Posted on April 20, 2017 by Grahame Grieve

The FHIR Team has been working with the HL7 Education Work Group to introduce FHIR certification testing so that members of the FHIR community can demonstrate their knowledge of the specification. There’s going to be 2 levels of certification test.

FHIR Proficiency Test

This test ascertains whether a candidate has basic knowledge of the FHIR specification – what areas it covers, what resources, data types, and profiles are, some basic overview of the way RESTful interfaces work. This test is open to anyone, and it works very much like the existing V2 and CDA tests – though it’s a little easier than them.

Anyone can sit – and pass – this closed book test.

FHIR Professional Credentials 

This is a much harder test – it explores the functionality of the FHIR specification deeply, and to pass it requires considerable experience working with the specification. The idea of this test is that if you pass it, you’ve met our expectations for being an expert and providing advice to other implementers about how to implement the specification properly.

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http://www.koreabiomed.com/news/articleView.html?idxno=475

Australian CEO stresses significant role of digital healthcare

• By Constance Williams
• Approval 2017.04.17 11:57

Modern, efficient data management not only benefits doctors and patients in overseeing individual cases but also promises a wealth of data that can be anonymized and aggregated for analysis and diagnosis.

Which is why healthcare experts such as David Hansen, CEO of the Australian e-Health Research Center, stresses the importance of the role of information and communication technologies in digital healthcare.

“A lot of people consider digital health to be from electronic medical records, but it’s much bigger than that; it’s about digital disruption of the healthcare system,” he said in an interview with Korea Biomedical Review on Wednesday.

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http://www.computerworld.com.au/article/618036/national-blood-authority/?fp=16&fpid=1

National Blood Authority recruits new CIO

Simon Spencer leaves Australian Public Sector Commission for NBA

Rohan Pearce (Computerworld) 21 April, 2017 12:30

The National Blood Authority has recruited Simon Spencer to take charge of IT at the government agency.

Spencer comes to the authority from the Australian Public Service Commission. He had been deputy CIO at the APSC since June 2015.

“He is an experienced ICT leader with nearly 20 years of experience across public sector organisations, including as a consultant and contractor,” NBA CEO John Cahill said in staff notice.

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https://www.digitalhealth.gov.au/about-the-agency/digital-health-space/item/15-health-in-an-age-of-information

Health in an age of information

Thursday, 20 April 2017

"Cause we are living in a material world
And I am a material girl
You know that we are living in a material world
And I am a material girl"^[1]

You know these lyrics. Madonna's single "Material Girl" and its accompanying video were huge hits in 1985, and went on to define much of her career. But was she right? Is she really a material girl? And are we living in a material world? More than 30 years after she sang this song, we find that the world we live in is becoming less and less about material things, and more and more about information.

From the perspective of the national and global economy, information technology is a vast and growing sector that is displacing manufacturing in value and influence. A similar trend is apparent in the economy of our daily lives: financial transactions are routinely conducted electronically, and reliance on the physical tokens of notes and coins starts to seem quaint.

The rising influence of information even shows in our understanding of reality itself. We’ve known for some time that the apparently solid objects of our experience are composed of atoms that consist mostly of space. And as physicists probe ever more deeply, even subatomic particles seem less and less substantial. Some theorists go so far as to propose that this gossamer-thin materiality rests on a bedrock of – you guessed it – information.

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Enjoy!

David.

Anzac Day Holiday - Taking A Commerative Day Off!

Australian Health IT News tomorrow just for this week.

Have a good ANZAC day and honour all those who served!

David.

This Is A Really Sad Example Of A Failure Of Knowledge On How The Health System Works And Can Work.

A young doctor saying they are an intern posted this last week.

Why are we communicating so badly?

Authored by James Dando

Issue 14 / 18 April 2017

I AM too young to be familiar with fax machines. My parents had one, and I can vaguely remember them making fun of my grandfather’s skepticism of this “new” technology. I didn’t have to use one. That was until I started working in a hospital.
Now I use a fax machine almost daily, as well as other arcane technologies, such as the pager that has to be carried around at all times.
These rather quaint examples make for fun anecdotes to regale non-medical friends with, but they speak to something more profound: the generally abject quality of the communication tools employed by health care practitioners.
This is especially clear in our handling of medical records. It’s ironic, given that our profession takes so much pride in the ability to tell the story in a succinct and a systematic way, that we are so tolerant of platforms that obscure rather than illuminate the important points in a patient’s history.
Even within a single hospital network, the archive can be dense, chaotic and generally migraine-inducing. It’s not uncommon to find a crucial operation report hidden among a dozen computer-generated data logs or lost at the end of a digital cul-de-sac.
But the real problems start when records are scattered between public and private or across the territorial boundaries of local or state health networks. In this case, chasing the records feels like a fishing expedition, and there are days when the fish just aren’t biting.
Here’s a typical example. A patient who is cognitively-impaired is admitted with a vague history of a previous admission to another hospital following a fall, and it’s thought, reasonably, that retrieving those records may be useful to the current admission.
But on contacting that hospital, which is less than 100 km away, I find that I can’t even be told if those records exist, much less their content. The only way to find out is to start blindly faxing request forms out into the wilderness of medical records. That represents a dismal yield on an investment of considerable amounts of time.
These frequent trips down the rabbit hole in the search for records that may not even exist are really morale depleting. I was prepared by medical school for the stress of dealing with people who are sick. I wasn’t prepared for the task of cold-calling pathology labs around south-western Sydney on the off-chance of turning up an old blood test.

There is a good deal more here:

https://www.doctorportal.com.au/mjainsight/2017/14/why-are-we-communicating-so-badly/

The way you handle this as an intern is really simple. Just ring the hospital and ask for the medical records department (or the records clerk after hours) and if not helpful – they should be by the way - get them to ring your hospital switchboard and have them page you. This proves to the remote caller who you are. From then they are really obliged to help you with old records for your patient. Same goes for path labs etc. Note of course denying help with a patient who is impaired is deeply unethical anyway. No way, if you are the responsible doctor, can requesting information to assist the patient be a privacy breach or even near it!

Even better is simply to ring the patient’s GP. They are usually more than happy to help and usually the patient or their relative knows who the GP is!!

This all assumes that the patient does not have the relevant details on a sheet of paper (USB stick is a bit optimistic) which should be carried in the wallet of all cognitively impaired patients.

Clearly some 15 years from now, when the myHR is properly populated with information, if ever, then this will be another useful way to go – but of course means you need to be able to establish the patient identity to obtain an IHI and be authorised to access the record. Of course by then most of us might have a digital identity that allows access to local health information held by our GP on line (the UK is moving to this as I type). That would be more reliable than the myHR (which will always be a secondary and often incomplete system).

All in all this article is rather a cry for more responsible information management in the community and care with the travelling patient rather than for a billion dollar + myHR!

David.