The Australian E-Health Press provided a good serve this week. It included these:
First we have:
GPs send clear message on reforms
Andrew Bracey - Friday, 28 August 2009
PROPOSALS to drastically overhaul primary healthcare services will not translate to better patient health outcomes, Australian GPs have warned.
A new MO poll has revealed just how dim a view GPs take of the specific reforms proposed by the National Health and Hospitals Reform Commission (NHHRC).
And expanded MBS and PBS rights for nurse practitioners and midwives are causing the most frustration.
Nearly all the 152 GPs surveyed said they believed the measure would not result in better patient health, and of a list of six controversial NHHRC reforms, more than half said it was the one move they most wanted scrapped.
Eighty per cent of GPs doubt the value of comprehensive primary healthcare centres, which have been touted as the vehicle to promote collaborative care. Seventy per cent rejected the idea of voluntary patient enrolment.
.....
Reforms GPs do not believe will improve patient health
Expanded prescribing and referral rights for nurse practitioners and allied health: 93%
Comprehensive Primary Health Care Centres: 80%
National Access Targets: 75%
Voluntary patient enrolment: 70%
Pay for performance systems: 70%
Person-controlled e-health records: 60%
For more details, visit medicalobserver.com.au/nhhrc
More here:
http://www.medicalobserver.com.au/News/0,1734,5156,28200908.aspx
Important stuff. Note the scepticism on the Personal EHRs.
Second we have:
Speed up e-health, Government urged
24 August 2009 | by Simone Roberts
Pharmacists have repeated calls for an accelerated timetable for the implementation of a national e-health system following comments by the Minister for Health and Ageing, Nicola Roxon, last week.
Ms Roxon told the Health-e-Nation conference in Canberra that the Federal Government was determined to build a connected, secure and efficient health system.
"We are building an e-health system now, because a future without it is unthinkable," she said.
"It is frustrating that in a sector where technology and research drive continual innovation in patient care, paper is still king. After a decade of doing our banking – and almost everything else – online, we're still carrying our x-rays under our arm, a script to the pharmacy, and the hospital can't send a discharge summary to the family GP."
The Pharmaceutical Society of Australia welcomed Ms Roxon's comments but said the Government needed to move quicker.
"The National E-Health Strategy has pointed to a 10-year implementation phase for the introduction of e-health in Australia which the PSA believes is just far too long and has the potential to endanger patient care," PSA president Warwick Plunkett said.
"We have to speed the process up so that reforms such as electronic prescriptions and electronic health records are available as soon as possible for the wellbeing of Australian consumers.
"There is little doubt that e-health initiatives will make our health-care system safer and more efficient and there is demonstrable proof that the technology is efficient and secure."
More here:
http://www.pharmacynews.com.au/article/speed-up-e-health-government-urged/495443.aspx
We also had this appear last week
Push to fast-track online medical records
Tuesday, 25 August 2009 | The Australian Financial Review | Julian Bajkowski and Paul Smith
Federal and state health departments want the system for electronic health records to begin by the end of the year.
More here (AFR Electronic Subscription Required – Newspaper subscription does not help!):
http://www.afr.com/home/login.aspx?EDP://20090825000031485143§ion=news
This second article is simply a puff marketing piece for an AFR conference that was to be conducted the next day. However both this and the previous article put me in the situation of agreeing with NEHTA. To actually get anywhere is going to have blood, sweat and tears and TIME. We have wasted almost a decade so far and now we do have some buzz around the topic – what we don’t have is leadership, real plans and funding so nothing is really going to happen until these gaps are addressed.
Third we have:
iSoft trims workforce
Karen Dearne | August 28, 2009
GLOBAL restructuring by iSoft will lead to job cuts in service delivery in some regions, including Australia and New Zealand, despite the company posting a 137 per cent rise in net profit to $34.7 million last week.
iSoft executive chairman Gary Cohen says a possible 70-100 IT positions may be lost in Britain - or around 10 per cent of the British workforce - but the overall impact would be offset by plans to add up to 50 new sales and marketing people to drive business growth.
According to Britain's E-Health-Insider, iSoft plans to reduce its frontline staff headcount from 193 to 131 through redundancies, and merge the support and technical teams into a single unit.
But Mr Cohen told The Australian that the restructure was "not about cost-cutting".
"This is about tailoring our operations to changed market dynamics, particularly in the UK where the old business was very focused on servicing the National Health Service's IT reform program," he said.
"While we're still working alongside CSC on those contracts, we're moving into a growth mode at the same time and for that the organisation requires a different set of skills.
"So this is about growing our businesses. We're currently a company with revenues of $600 million, and we want to more than double our size in the next three to four years."
Mr Cohen said a process of "bottom-up consultation" on corporate culture change and upskilling has just begun in the Australian and New Zealand operations, as well as in its Malaysian, Middle Eastern and Indian offices.
More here:
http://www.australianit.news.com.au/story/0,24897,25992823-15306,00.html
iSoft seems to have hit the media this week in all sorts of ways. This particular news item is a bit of a worry as one would be a little concerning if marketing is focussed on in place of product development and support. For success and growth I would suggest you need both – so care with morale and balance of workforce is certainly important.
We also have some press releases which discuss the business future and iSoft’s role in those controversial super clinics.
See here:
iSOFT Group Limited (ASX:ISF) Interview With CEO Mr Gary Cohen On Sustainable Growth
And here:
Balance! Healthcare Entrusts iSOFT Group Limited (ASX:ISF) With GP Super Clinic Solution
After the good results I think it is important the knuckle down and continue the consolidation that has thus far gone pretty well. It would be good, for instance, to see a director or senior executive appointed with an established reputation in the field of health informatics as well as a little more frontline healthcare expertise at the executive level. (Usual disclaimer about having a few iSoft shares)
Fourth we have:
Nursing home wires up
Jennifer Foreshew | August 25, 2009
AGED-CARE provider PresCare investigated a range of electronic aids for residents at its newest Queensland site.
After trialling the use of wireless radio-frequency identification chips at several of its complexes, PresCare built a $30 million flagship facility at Carina, in Brisbane, offering state-of-the-art technology services.
Known as Vela, the Carina site, which will soon have its official opening, began taking residents in March and now has 54 occupants. It is expected to be fully occupied by Christmas.
Vela offers video-on-demand, Foxtel, free-to-air TV and internet protocol phones and radio in residents' rooms. The site has 154 beds, with $5.5m invested in technology alone.
PresCare technology director and chief financial officer Greg Skelton said the focus of the facility was improving safety and the in-room experience for residents.
"We were finding that a lot of our residents were having falls and they could not get to a fixed point, so they were often stranded calling out for help," Mr Skelton said.
"We put this RFID solution together so that we can actually find the residents within a 3m proximity of wherever they are."
The technology, designed and installed by Queensland communications company SureCom, integrates enterprise location tracking from AeroScout, nurse call, camera surveillance, building automation, voice over internet protocol phones and internet protocol camera security, plus people and asset tracking.
Residents and key staff wear easy-to-use wristbands or necklaces, which are monitored through a series of sensor points throughout the complex. Residents push a personal alert button for help. Staff can locate someone quickly, as in the case of a resident with dementia leaving defined boundaries.
More here:
http://www.australianit.news.com.au/story/0,24897,25974717-24169,00.html
Interesting to see such a focus on using technology to make life in nursing homes more interesting and safer.
Fifth we have:
Taxpayers may need to subsidise Tassie broadband
Matthew Denholm | August 26, 2009
THE objectives of the new Tasmanian National Broadband Network Company include delivering "affordable" broadband services and setting prices, prompting claims services may be subsidised.
Coalition government scrutiny spokesman Guy Barnett said yesterday the objectives, contained in the company's constitution, conflicted with the Rudd government's promise that services would be "commercially viable".
Senator Barnett said the company's constitution left wide open the prospect of taxpayers subsidising the provision of broadband services in Tasmania.
"Clearly, there is a concern because this directly conflicts with the government's commitment to commercial viability," Senator Barnett said. "There will be other services competing -- there are already services in Tasmania offering broadband services for as low as $30 a month."
Tasmanians have comparatively low rates of household income, raising concern about the take-up of top-end broadband services, he said. "Take-up rate projections of 20 per cent suggest it is going to require subsidies from the government to make it commercially viable," Senator Barnett said.
Full article here:
http://www.australianit.news.com.au/story/0,24897,25983558-15306,00.html
Oh dear! I guess this sort of commentary will continue until such time until some decent economic and business cases are developed and made public.
Sixth we have:
Livewire Launches Siblings Community To Support Brothers & Sisters Of Young People Living With a Serious Illness, Chronic Health Condition or Disability
Livewire, a wholly owned subsidiary of the Starlight Children’s Foundation, today launched Livewire Siblings, a new online community, where young people aged over 10 and under 21, who have a brother or sister living with a serious illness, chronic health condition or disability can support and connect with one another.
Livewire Siblings (http://siblings.livewire.org.au) is a free, safe and supportive community where young people can meet and chat online with other siblings who understand what they are going through. The site allows them to share experiences as well as gain skills and knowledge to help them feel more in control of their situation.
Currently, there are approximately 585,000¹ siblings, aged over 10 and under 21, of people living with a serious illness, chronic health condition or disability in Australia. These young people often face unique teenage challenges, and suffer a heavy emotional burden – experiencing feelings of isolation from the rest of their family and their peers; as well as guilt, confusion, anger, jealousy.
Many siblings are as emotionally vulnerable as their brother or sister as they deal with feelings of loss, anger and sadness, and come to terms with the consequences of their family’s situation. What’s more, they often receive less parental attention than their ill siblings and take on increased household responsibilities as they help their parents cope with looking after their sick brother or sister.
Prominent child and adolescent psychologist, Dr Michael Carr-Gregg, says “The sibling relationship is the single most important relationship that a chronically ill young person will have - in terms of its duration and intensity – and the psychological impact on the sibling can be as significant, if not more, than the psychological impact on the patient.
“Up until very recently, siblings needs have been overlooked and ignored, and I commend Livewire for recognising the importance of this formerly invisible group,” he concluded.
As part of Livewire Siblings, young people can chat online with other siblings, create blogs, read content and information created just for them, check out the latest music and games, post in forums and have their say!
“The launch of Livewire Siblings, signifies the next exciting step in Livewire’s goal to connect and support young Australians, aged over 10 and under 21, living with a serious illness, chronic health condition, and their families. Too often, the needs of siblings are forgotten in the wake of their brother or sister’s illness, yet there is an overwhelming need to connect and befriend others with similar experiences who understand their situation and can empathise,” says Omar Khalifa, Managing Director, Livewire.
“Livewire aims to fulfill their need to connect with others, providing a forum for self expression, and enabling them to work through the healing process by discussing issues, concerns, troubles and experiences,” he added.
Unlike other social networks, Livewire Siblings is a secure, moderated community tailored to the needs of its members. Livewire Siblings chat hosts and moderators are trained in adolescent health, and are online seven days a week to ensure that Livewire remains a supportive and fun place to be. Livewire works closely with the Australian Federal Police to help ensure all members of Livewire remain safe while engaging with the community.
This project is supported by funding from the Australian Government under the Clever Networks program, Starlight and major partners. This funding has enabled Livewire to develop a long lasting, sustainable program that will connect, support and empower its members.
Livewire aims to connect 20,000 young people, siblings and parents by the end of 2009, and has engaged with over 80 other Not-for-Profit organisations to create a truly sector-wide capability. Livewire has already begun to work with Ability First, Diabetes Australia and Cystic Fibrosis to provide access to Livewire to its eligible members.
Any young Australian aged over 10 and under 21, who has a sibling currently living with a serious illness, chronic health condition or disability who wishes to join Livewire Siblings, or find out more information should visit www.livewire.org.au or contact member.services@livewire.org.au.
Contact link above:
Certainly this seems to be something to be aware of for those this service can help.
Seventh we have:
Guidelines fall short in real-world medicine
Kathryn Eccles - Friday, 28 August 2009
MANY clinical guidelines are not useful in daily medical practice, and are often difficult to apply in a general practice setting, a Dutch study has confirmed.
Researchers held a series of focus groups with 30 GPs, who analysed 56 key recommendations from 12 Dutch national guidelines.
Guidelines the Dutch GPs found particularly problematic included those covering asthma among children, rhinosinusitis, transient ischaemic attack, thyroid disorders and sexually transmitted diseases.
They considered that 57% of the recommendations were not applicable, particularly to patients such as those with comorbidities.
“Evidence-based guidelines focus on patients with single diseases and often exclude complex patients, which limits the applicability in practice,” the authors said.
“GPs often disagreed with recommendations because they argued the underlying evidence provided was lacking or felt that it was not clear why they should apply them,” they said.
“In addition, they perceived some recommendations not being applicable due to heterogeneity of populations.”
In Australia, the NHMRC is developing a new Internet clinical guidelines portal in an effort to address similar concerns identified in the Dutch study.
The new site is due to launch before the end of 2009, and will rationalise guideline access, according to an NHMRC spokeswoman.
.....
Common barriers
- Didn’t agree with recommendation due to lack of applicability or evidence
- Environmental factors, e.g. organisational constraints
- Lack of knowledge regarding guideline recommendations
- Unclear or ambiguous guideline recommendations.
Implementation Science 2009;4:54
More here (registration required):
http://www.medicalobserver.com.au/News/0,1734,5166,28200908.aspx
This is important material that needs to be considered as we implement decision support portals.
Lastly the slightly more technical article for the week:
Five slick search engines you should know about
Google, Yahoo and Bing get the press but Exalead, Scour, Hunch , Scirus and Indeed fill a void
John Fontana (Network World) 02 July, 2009 12:03
Tags: search engines, scour, scirus, indeed, hunch, exalead
With Microsoft's recent addition of Bing to the search landscape, the spotlight is again shining on who has the best engine for finding anything and everything on the Internet. The debate over who has the best search likely will go on into eternity with a focus on the big three: Google,Yahoo and Microsoft. But there are countless other search engines out there focused on zeroing users in on the data they want or need. Here is a look at five that are offering some slick service.
Exalead
The University of California Berkeley Library recommends a second opinion when searching the Internet, and Exalead is one of its top recommendations.
The search engine features a number of advanced options including phonetic search for those who are sometimes spelling challenged. Spell a word like it sounds and results will include words that sound like what was typed into the search field.There is also a proximity search feature with a "Near" operator that finds documents where the query terms are within 16 words of each other, and a "Next" operator where search terms are next to each other. Other options include searching in a specific language only, after or before a certain date, and a prefix search that looks for the beginning letters of a word.In the results, users see thumbnail pictures of Web pages, which can be pulled up and previewed without leaving the site.In addition, Exalead has enterprise search products available (desktop, network). Its Cloudview platform support 300 formats, including structured data (RDBMS, ERP, Lotus Notes, directories) and unstructured content (e-mail messages, PDFs, Office documents, Web pages).
More here:
http://www.computerworld.com.au/article/309503/five_slick_search_engines_should_know_about
Four others are listed in the article – one particularly focussed on matters scientific. Worth a few book marks of these are areas of interest.
More next week.
David.
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