The Australian E-Health Press provided a good serve this week. It included these:
First we have:
GPs urge caution over college data plan
Elizabeth McIntosh - Friday, 14 August 2009
THE RACGP is looking to radically widen the scope of its standard-setting activities, with a plan to drive improvements in patient care.
But the plan – hailed by the college as a means to drive improved patient outcomes – has concerned frontline GPs, who fear any clinical standards set could later be used by the Federal Government to determine incentive payments.
The plan is based on a Web resource called Oxygen, which will collate and store de-identified patient data – from information on age and sex to clinical outcomes. In turn, this will allow participating GPs to compare their patient outcomes against national and local averages.
According to Associate Professor Ron Tomlins, chair of the college’s national standing committee on quality care, such comparisons would ultimately drive up the quality of patient care.
The resource could also be used to set new clinical practice standards, devised and agreed to by the wider profession, he said. This would broaden the college’s current focus on practice accreditation by moving it into the clinical domain.
“The college is focused on [the resource] being about clinical outcomes and what is best for the viability and sustainability of general practice,” Professor Tomlins said.
“If we do this, we will move beyond the way we look at accreditation processes.”
He added the data collected using Oxygen would boost GPs’ position when negotiating with government for additional resources and funding.
Professor Tomlins said Oxygen would be funded and managed by the college but was unable to detail costs. He said de-identified patient data would be drawn from practices using the Pen Computer Systems Clinical Audit Tool – whose annual license costs $195 per GP.
More here (subscription required):
http://www.medicalobserver.com.au/News/0,1734,5081,14200908.aspx
This is actually very important in my view. The fears of ‘frontline GPs’ are warranted if clinicians do not retain genuine control of clinical standards and are able ensure there are no ‘unintended consequences’ of incentives – as have been the experience in the UK. As long as clinicians retain control it is equally important that we have clinical care being shaped to provide optimal outcomes – and you can only have that if you are measuring just what is being done – and the Pen CAT is a very good way of doing that. A well designed and managed approach can help I believe.
Second we have:
MD backs Guild e-script system
by Michael Woodhead
GP software vendor HCN has chosen the Pharmacy Guild’s eRx Script Exchange system as the preferred electronic prescribing tool to integrate into its Medical Director program.
It says the move will give 90% of GPs the ability to send electronic prescriptions by the end of the year. But the company says it will not rule out working with the rival RACGP-backed Medisecure system at some point in the future.
The CEO of HCN, Dr John Frost, told 6minutes that the company had chosen the eRx system because it believed it to be the most robust and functional form of e-prescribing currently available in Australia.
More here:
http://www.6minutes.com.au/articles/z1/view.asp?id=493949
This is a major move in the e-prescribing wars given Medical Director does have significant market penetration among GPs.
At least one correspondent thinks the market share is a little exaggerated (from 6minutes the next day):
“While no one disputes MD’s market domination, to date there has been no independent support of the vendor’s estimation of market share. In 2006, two different studies reported 73% and 63% respectively for GP use of MD. The average for nearly 5000 BEACH participants over the past five years is 62% and as Medisecure is ‘being used by 290 practices with Medical Director’, a more realistic figure for GPs accessing eRx is probably less
than 60%.
Dr Joan Henderson”
It is important to note I still believe we need a different approach to that planned by both the proponents. It should be one designed to balance the interests of all stakeholders, be fully open and be operated on a cost recovery basis or even federally funded.
Third we have:
AIIA proposes 'opt-out' plan for eHealth card
by James Riley
Wednesday, 29 July 2009
Government may need to include an opt-out mechanism with its plans to assign an individual healthcare number to all Australians as the best way to address legitimate privacy security concerns, Australian Information Industries Association chief executive Ian Birks said.
“Essentially it is a good thing that electronic health records has been identified as a key to healthcare reform in Australia,” Mr Birks told iTWire.
Better information, better use of data and better awareness of the available health information would lead to better health outcomes for individuals and reduced costs for Government and providers.
But Birks said the only way to successfully address the privacy concerns of some would be to give individuals control over their personal data, including the ability to opt-out entirely.
“Obviously there will be concerns from some sections of the community about security and privacy,” Birks said. “And probably the best way to (make people confortable) would be through some kind of opt-out mechanism.”
“That’s what has happened in other jurisdictions and it has been shown to be successful.
More here:
http://www.itwire.com/content/view/26577/53/
I could not agree more about the need for genuine ‘opt-out’ with the IHI. I wonder what we keep seeing comments around e-Health cards which are really on no-one’s agenda.
Fourth we have:
iSoft pays $18m for BridgeForward
Karen Dearne | August 12, 2009
ASX-LISTED health IT supplier iSoft has driven a stake into the US market with an $18 million purchase of hospital data integration specialist BridgeForward.
iSoft executive chairman Gary Cohen said BridgeForward's new integration engine, Viaduct, was a good fit with iSoft's next-generation Lorenzo platform.
"This acquisition means we're channelling the R&D dollars we would have invested in building out integration capabilities in Lorenzo into a world-leading product that's already built," he said.
"We see significant potential for Viaduct to be embedded with Lorenzo, as they are both built on a service-oriented architecture.
"There's also great potential for Viaduct as a standalone product. An integration engine is a critical component in electronically connecting healthcare systems, and this provides the interoperability that allows disparate legacy systems to share information."
More here:
http://www.australianit.news.com.au/story/0,24897,25918991-15306,00.html
Good to see iSoft is continuing to develop its international exposure. Hopefully this will assist ISoft’s Australian sites over time as well. (Usual shareholder disclaimer applies)
Fifth we have:
Take a good look - this picture might soon be banned
Joel Gibson Legal Affairs Reporter
August 15, 2009
SHOWING a sex tape to a third party or fishing someone's financial or medical records out of a bin could get you sued under privacy laws proposed yesterday. They would be among the toughest in the world.
The NSW Law Reform Commission released draft laws to give victims of stalkers, hidden cameras, harassment and some publications the right to sue for damages.
But the proposals also raised the prospect of lawsuits over a newspaper picture of a person in a public place or an artist's painting of someone in a street scene.
An invasion of privacy would exist where a person has ''a reasonable expectation of privacy'' that is not outweighed by a relevant public interest. Mere annoyance or anxiety would be enough to justify their claim.
Medical records would be off-limits, including details of a celebrity's treatment for drug addiction, such as supermodel Naomi Campbell's case against a British newspaper. Only if the information had to be published in the public interest, for example to warn of someone's infectious condition, would it be allowed.
Information about someone's sex life, even if cheating on a partner or paying a prostitute, also would be private, except where the sexual practices undermine a public figure's ability to do his or her job, for example, or belie previous statements.
Full article here:
This is all starting to get confusing with both the Australian Law Reform Commission and the NSW Law Reform Commission coming up with privacy related approaches. We need to watch closely for e-Health implications.
There is all sorts of information here:
http://www.lawlink.nsw.gov.au/lawlink/lrc/ll_lrc.nsf/pages/LRC_cref124
Sixth we have:
One giant leap for robokind: cyber limbs
Amanda O'Brien | August 15, 2009
Article from: The Australian
A BIONIC knee that powers an amputee up stairs, a Star Wars-inspired arm that lets a double amputee feed himself grapes, artificial limbs connected to nerve ends to trigger movement, metal hands that give elements of sensory feel...
The latest advances in prosthetics are making RoboCop look ordinary as science fiction turns to reality amid a surge of investment overseas.
``They're starting to look at whether an amputee could run faster than an able-bodied person,'' Perth-based clinical prosthetist Mark Hills says.
``They're playing with nanotechnology and with skin-type products. Where it ends up it's very, very hard to know.
``They're looking to graft metal directly on to bone, and when they can do that, you are practically into a bionic cyborg. It's fantastic.''
But amid the celebrations, experts admit that Australian amputees are missing out. They say government funding is too low to pay for cutting-edge prosthetics and many amputees are still using decades-old technologies.
Perth grandmother Elizabeth Grant brought a tiny taste of the new frontier to Australia last month when she was fitted with the nation's first X-finger: a fully functioning artificial finger that curls and grips like a normal digit and will eventually be covered by a lifelike cosmetic cover.
More here:
http://www.theaustralian.news.com.au/story/0,25197,25928728-23289,00.html
Very interesting stuff indeed. It seems to be a pity that Ms Roxon does not provide a few direct dollars to assist development and implementation of workable technologies.
Seventh we have:
GPs slugged with admin costs for Easyclaim
Elizabeth McIntosh - Friday, 14 August 2009
THE Federal Government is paying GPs less than a fifth of what it costs practices to install and operate the Medicare Easyclaim system and frustrated doctors say it’s time to redress the disparity.
While practices are being paid just 18 cents for each Medicare claim processed via the Easyclaim system, the Australian Association of Practice Managers (AAPM) estimates the true cost of the task is at least five times higher.
“Two minutes is the minimum amount of time it would take [to process a claim],” said AAPM president Marina Fulcher.
“If you are paying staff around $25 an hour, it is $1 in staff time alone. Eighteen cents doesn’t compensate for anything.”
Pushing the Easyclaim system on to general practice translates into big savings for the Government. Official 1997 estimates put the cost of processing a claim at a traditional Medicare office at $1.60. Up-to-date estimates are not available.
In late May, the Government launched a multipronged campaign to encourage patients to claim Medicare rebates electronically, via the Easyclaim system or Medicare Online, rather than attending traditional offices. The Easyclaim system allows practices to refund rebates directly to patient bank accounts via an EFTPOS machine.
More here (subscription required):
http://www.medicalobserver.com.au/News/0,1734,5064,14200908.aspx
Oh dear, Oh dear! These are the same people who now want to do all sorts of other e-Health activities. They are going to need way better ways of relating with clinicians if this is even partly true!
An Operating System for the Cloud
Google is developing a new computing platform equal to the Internet era. Should Microsoft be worried?
By G. Pascal Zachary
From early in their company's history, Google's founders, Larry Page and Sergey Brin, wanted to develop a computer operating system and browser.
They believed it would help make personal computing less expensive, because Google would give away the software free of charge. They wanted to shrug off 20 years of accumulated software history (what the information technology industry calls the "legacy") by building an OS and browser from scratch. Finally, they hoped the combined technology would be an alternative to Microsoft Windows and Internet Explorer, providing a new platform for developers to write Web applications and unleashing the creativity of programmers for the benefit of the masses.
But despite the sublimity of their aspirations, Eric Schmidt, Google's chief executive, said no for six years. Google's main source of revenue, which reached $5.5 billion in its most recent quarter, is advertising. How would the project they envisioned support the company's advertising business? The question wasn't whether Google could afford it. The company is wonderfully profitable and is on track to net more than $5 billion in its current fiscal year. But Schmidt, a 20-year veteran of the IT industry, wasn't keen on shouldering the considerable costs of creating and maintaining an OS and browser for no obvious return.
Much more here:
http://www.technologyreview.com/web/23140/?nlid=2255
This is a really important article on what Google is up to.
This is also interesting.
Google gives search a 'Caffeine' boost
Search giant seeks feedback on new search architecture from power users, Web developers
Sharon Gaudin 12 August, 2009 08:10
Tags: Google
Google Inc. is set to let users try out an upgraded search technology, code-named Caffeine, that its engineers have been developing for the past several months.
Google today announced that it is opening the so-called "next-generation architecture" to Web developers and power users to test out. Users can access the as-yet unfinished Caffeine in a Google sandbox, a testing environment that isolates new code from production systems.
The announcement that Google is honing a faster, more accurate and comprehensive search engine comes about two weeks after rivals Microsoft Corp. and Yahoo Inc. announced that they are partnering up to challenge the search giant. The deal calls for Microsoft's Bing search engine to power various Yahoo sites, while Yahoo sells premium search advertising services for both companies.
More here:
http://www.computerworld.com.au/article/314555/google_gives_search_caffeine_boost?eid=-255
If Google is on the move it is move it is important to keep an eye on what is happening! The various searches I tried do not seem to provide many different results so far.
Lastly the slightly more technical article for the week:
Crikey August 13, 2009
15 . Bug-free computer software: Australia paves the way
Stilgherrian writes:
A computer crash and reboot are frustrating enough, but even more so when it’s an embedded system running a surgical robot, a weapons system or a self-driving car. Waste time rebooting and you could be dead.
Breakthrough Australian research could dramatically reduce the odds of that happening. Researchers at NICTA, Australia’s ICT Research Centre of Excellence, have just announced ... well, how can I explain this?
Computer programs are complex machines made of mathematics -- vastly more complicated than physical machines like nuclear reactors or spacecraft. Software is written by humans, and humans make mistakes. Typically, you can expect about 10 errors per thousand lines of computer code, and software like Microsoft’s Vista or OS X, or even applications like Microsoft Office or Adobe CS3, contain tens of millions of lines.
Given this complexity, programmers simply can’t test for every potential error. All software has bugs, and the bugs are only fixed when someone finds them. That’s why we all download and install software patches every month. Unless the hackers get there first. Which they do.
More here (subscription required):
http://www.crikey.com.au/2009/08/13/bug-free-computer-software-australia-paves-the-way/
This seems to be pretty important stuff – especially in critical areas like health. Sadly a correspondent to Crikey says the claim – while good – is not quite as represented.
See here:
http://www.crikey.com.au/2009/08/14/comments-corrections-clarifications-and-cckups-60/
Bug-free computer software:
Angus Sharpe writes: Re. “Bug-free computer software: Australia paves the way” (yesterday, item 15). Deep breath. Now I’m all for any system or methodology that can reduce bugs in software, but Stilgherrian says that “Programmers can build software on top of [this new software] and be certain that it’ll function correctly.” Wrong. Making the title of the story “Bug-free computer software” wrong. And fortunately, that’s not what the authors of the software actually claim. They claim that the software “is free of a large class of errors” (presumably buffer overflows etc.).
Why is this important? It’s the difference between saying that you cannot pick a door lock with tool XYZ, or saying that a door lock is perfect, and un-pickable, ever (Even with tools that haven’t been invented yet. Even when attached to glass doors.)
The first is possible, the second never true.”
Still – sounds like progress!
The full release is found here:
This quote positions things – I suspect.
“This is a remarkable achievement,” said Yale University’s Professor of Computer Science Zhong Shao, “It makes a significant advance toward building fully verified system software with meaningful dependability guarantees.”
More next week.
David.
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