Weekly Australian Health IT Links – 24th October, 2011.

Here are a few I have come across this week.
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

Quite a busy week with Senate Estimates unearthing a little more information on what is going on behind the scenes.
Other than that we have had some changes in the attitude of the RACGP to the PCEHR and some results from the Wave 1 and 2 sites, and some more discussion on e-Health Standards and NEHTA’s treatment of its staff.
Lastly the father of Unix has died. His contribution was pretty awesome and his work led to operating systems (Linux, iOS etc) which are serving all of us and will for a very long time into the future.
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Personally controlled e-health records up and ready for testing

17th Oct 2011 Danny Rose
MO test-drives the government’s personally controlled e-health record
UPDATING a personally controlled electronic health record (PCEHR) will be a “single button” process integrated with existing clinical software and “won’t be onerous”, National E-Health Transition Authority (NEHTA) clinical lead Dr Rob Hosking has assured GPs.
Dr Hosking last week gave MO a tour of an operational early build of the technology that, from July 2012, will enable patients to have a secure online medical file.
The process is initiated by the patient, who must activate their own record online before seeking the cooperation of a ‘nominated provider’ – typically their GP – to help populate it with their relevant medical information.
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GPs demand PCEHR payment

The Royal Australian College of GPs has stepped up its demands for GPs to receive incentives to use, and contribute data to, the Personally Controlled Electronic Health Records that are to be introduced from next July.
In August the RACGP issued its qualified support for the PCEHR but noted at the time that there was a need for more than one off investment in information technology, instead calling for ongoing, and properly funded, investment in data management to ensure that the information stored in PCEHRs is accurate.
But it has today warned that unless GPs are properly compensated for their efforts in using and maintaining the PCEHR it may prove to be as much of a white elephant as the UK’s National Programme for IT system which is now being dismantled by the British Government.
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GPs should be compensated for e-health, says Royal Australian College of General Practitioners

  • by: Karen Dearne
  • From: Australian IT
  • October 20, 2011 5:00AM
THE Royal Australian College of General Practitioners wants GPs to be reimbursed for the work of creating and maintaining personal e-health records.
RACGP chair Claire Jackson has called for new payments under the Medical Benefits Schedule in recognition of the extra workload GPs "will undertake in consultations (including updating) the patient’s shared health summary" and other elements of the Gillard government’s $500 million personally controlled e-health record system.
"We are concerned that the current plan does not offer any incentives for general practice to create and maintain documents for indexing in the PCEHR, such as shared health summaries," Professor Jackson said in a statement on Wednesday.
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No e-health rebates for GPs

  • by: Karen Dearne
  • From: Australian IT
  • October 20, 2011 3:13PM
THE Health department has rebuffed calls to reimburse GPs for creating and managing e-health records for patients, saying doctors will spend less time chasing paper.
The Royal Australian College of General Practitioners yesterday called for new Medicare rebates in recognition of the extra workload GPs will undertake in consultations to initiate and update patients' shared health summaries and other elements of the Gillard government’s $500 million personally controlled e-health record system.
"The RACGP is concerned that the current plan does not offer any incentives for general practice to create and maintain documents for indexing in the PCEHR, such as shared health summaries," RACGP president Claire Jackson said in a statement on Wednesday.
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E-health security may cost government $10m

17th Oct 2011 Mark O’Brien
THE government may be forced to subsidise medical software vendors with contributions of up to $10 million a year in order to provide security for electronic patient records.
According to industry experts, there is still no clear value for GPs in the personally controlled e-health records (PCEHR) system.
MediSecure CEO Phillip Shepherd said if GPs didn’t see value in the system, they would be reluctant to pay enough for clinical software to allow vendors to provide ongoing security upgrades and protect patient information.
“You have to create an environment where stakeholders other than the government see the PCEHR as a value proposition,” Mr Shepherd said.
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NEHTA faces high staff turnover

  • by: Karen Dearne
  • From: Australian IT
  • October 21, 2011 12:00AM
STAFF turnover at the National e-Health Transition Authority is "high" at 30 per cent per annum, its chief executive Peter Fleming has conceded, prompting "research" into the reasons.
Mr Fleming said employees were talented and working long and hard towards establishing the nation's e-health record infrastucture for the benefit of all Australians, but it was difficult for him to have an opinion on morale.
"Turnover is reasonably high, yes. We've actually commissioned researchers to talk to our staff and understand the drivers behind that," he told a late night sitting of Senate estimates this week.
"The research is in relation to the type of organisation - a transitional authority - and how it compares to other consulting groups, and in those terms it's actually on par with what we see in the consulting industry.
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NEHTA investigated for workplace bullying

By Josh Taylor, ZDNet.com.au on October 20th, 2011
The National E-Health Transition Authority (NEHTA) has been investigated by WorkCover over bullying within the organisation, while reporting an annual staff turnover rate of 30 per cent, a senate estimates hearing has heard.
The company is charged with managing and supporting the delivery of personally controlled e-health records (PCEHR) as part of the Federal Government's $466.7 million investment in e-health. Speaking at an estimates hearing last night, NEHTA CEO Peter Fleming confirmed that WorkCover had been brought into the NEHTA offices in Sydney to investigate a staff complaint over bullying.
"There was, just recently, a very brief investigation. I believe a WorkCover officer came and had a talk to our head of personnel, and I believe that issue was dealt with to their satisfaction," he told the committee.
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VisiInc PLC (VZJ) Research Shows Australian Support of E-Health Personal Records

By Justin Kuepper · Wednesday, October 19th, 2011
VisiInc PLC (ETR: VZJ), a provider of revolutionary collaboration tools for online conferences that enable real-time sharing of complex data in its native format, similar to companies like Cisco Systems Inc.’s (NASDAQ: CSCO) WebEx and j2 Global Communications Inc. (NASDAQ: JCOM), recently released a national Australian survey highlighting support for E-Health technologies.
VisiInc PLC (VZJ) (http://www.deutsche-boerse.com) have released a National Australian survey showing public confidence in security will boost E-health uptake, just days after VisiInc announced their acquisition of VIA3.
The USD$16 million scrip deal to acquire USA company VIA3 will deliver a powerful combined technology of 3D real time collaboration, voice and video conferencing, an ultra-secure platform and marks a major push into Australian E-health market. The acquisition is timely with a national Australian opinion survey revealing that the uptake of E-health could be considerably higher if security issues are addressed.
In June 2011 VisiInc PLC entered into an agreement to launch MMRGlobal’s patented consumer and professional health IT products and services, including MMRPro for healthcare professionals (http://www.mmrprovideos.com) and the MyMedicalRecords Personal Health Record (PHR) (http://www.mmrvideos.com), on the Visi™ platform utilizing the Vistime product.
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How do they do IT? eHealth’s bleeding edge part 1

The NBN has being touted as a cure-all for eHealth across the nation but hospitals, medical schools and medical professionals show eHealth is fighting fit
Ever since the Federal Government announced its plan to construct a National Broadband Network (NBN) much time and talk has been dedicated to the endless possibilities of the fibre network. In few sectors has this been more the case than healthcare.
Indeed, the potential for ultra-fast broadband to transform the health sector and make the electronic health, or e-health, a reality has often been touted as the raison d'ĂȘtre for the network.
However this excitement — spurred on by the promise of specialist consultations via video conferencing and GPs being able to access digital health records — has cast a shadow over the many layers and limitations of day-to-day technology already embedded in healthcare, whether it be hospitals, specialist clinics, nursing or medical schools.
The fact is, despite the government’s hype about the NBN, hospitals, medical schools, nurses and doctors are already achieving advances in health through the use of information technology.
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How do they do IT? eHealth’s bleeding edge part 2

The NBN has being touted as a cure-all for eHealth across the nation but hospitals, medical schools and medical professionals show eHealth is fighting fit

Telehealth

With an ageing population and a shortage of nurses placing a strain on the healthcare system, RDNS' Ironside points to video conferencing technology as an area of increasing activity.
The not-for-profit healthcare provider has embedded video conferencing across its business in an effort to help nursing staff treat as many people as possible.
“The primary focus for us in IT here at RDNS is around delivering a better quality of care to our clients through using technology and we do this by driving innovation and using the technology available,” Ironside says.
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Orion Health snaps up Microsoft e-health unit

CLAIRE ROGERS
Last updated 08:32 17/10/2011
New Zealand's largest software exporter Auckland-based Orion Health has purchased Microsoft's hospital information software assets in Asia Pacific for an undisclosed sum.
The two companies will also work together to provide solutions for the global electronic health market.
Orion Health chief executive Ian McCrae has said the acquisition would see it take on 50 staff.
Orion, which employs more than 400 staff, turned over almost $100 million last year.
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Orion Health Teams with Microsoft for Expansion

HDM Breaking News, October 17, 2011
Health information exchange software vendor Orion Health has acquired Microsoft Corp.'s hospital information system and RIS/PACS that are marketed in Southeast Asia.
The vendors also will jointly market Orion Health's HIE product and Microsoft's Amalga data aggregation, analysis and reporting software to public and private HIEs, as well as accountable care organizations.
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E-health record failure blamed on top-down approach

The failure of the UK’s e-health program has been blamed on rushed implementation, failure to engage clinicians and a top-down government-driven partnership with private contractors. 

A review of the UK’s program, similar to the $500 million PCEHR planned in Australia, concluded that it was “time consuming and challenging, with as yet limited discernible benefits for clinicians and no clear advantages for patients.”
Researchers who reviewed five areas where the IT system was implemented through partners such as Cerner and iSoft, blamed the program’s ‘top down’ approach which led to an “unrealistic, politically driven timeline from the outset”, with “multiple tensions” between the creators and NHS staff.
In their review (link) the authors suggest there needs to be a clear vision and realistic timescale from the start with more “user involvement” of local clinicians and health staff in decision making.
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Health CIO Paul Madden clears air on PCEHR standards debate

  • by: Karen Dearne
  • From: Australian IT
  • October 20, 2011 1:48PM
Health department chief information officer Paul Madden says draft specifications will be "guaranteed not to change" - except in the case of system errors - during the first two years of operation of the $500 million personally controlled e-health record system.
The technical specs are urgently needed as Health Minister Nicola Roxon has committed to a July 1, 2012 starting date for the nationwide patient information-sharing program.
Rollout is proceeding, despite concerns primarily from the software industry that a lack of standards risks massive future costs in fixing non-compliant systems. 
Mr Madden rejected the IT industry's criticism over a "tiger team" approach intended to fast-track technical specifications, saying the department and the National e-Health Transition Authority were not departing from the normal standards-setting process. 
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Bionic eye team looks to catch up despite burning through the cash

THE consortium behind Australia's bid to be a force in bionic eyes has burned through more than half its $42 million war chest, with clinical trials still at least 18 months away.
University of NSW Biomedical Engineering Professor and Bionic Vision Australia acting director Nigel Lovell said the consortium had enough remaining funds to meet its milestones and start clinical trials of a bionic eye by mid-2013.
"This is very much milestone-driven with a whole lot of performance indicators along the way. It will get done," Professor Lovell said.
"We're not halfway through yet. We're progressing towards our human trials in 2013 and things are looking very solid."
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Pharmacists paid by drug company for patient details

Kate Hagan
October 19, 2011
ONE of the world's biggest drug companies has been accused of paying Australian pharmacists to promote some of its best-selling drugs, in a controversial deal that has divided the profession.
Pfizer pays pharmacies a $7 ''administration fee'' for each patient signed up to so-called support programs that involve the drug company providing information directly to patients about nine of its drugs.
Pharmacists say the deal, which Pfizer struck with the Pharmacy Guild of Australia in July, is similar to the one dumped this month for them to market dietary supplements with prescription medicines.
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Health groups challenge ethics of Pfizer deal

Kate Hagan
October 20, 2011
A COALITION of 60 health groups has described a deal for pharmacists to promote Pfizer branded drugs as ''highly questionable'', saying it could cost patients more.
The Consumer Health Forum's chief executive, Carol Bennett, said the deal - under which Pfizer pays pharmacies $7 for every patient they sign up to ''support programs'' for nine of its drugs - was another example of the Pharmacy Guild of Australia trying to maximise profits at the expense of consumers.
The support programs involve Pfizer sending regular emails and text messages to patients about their medication and condition, in what some people say is thinly disguised marketing.
Pfizer Australia's managing director, John Latham, yesterday told Pharmacy News that more than 11,000 patients had signed up, but it was unclear if they were all referred by pharmacists.
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20 October 2011, 5.39pm AEST

One wrong foot after another: the ethics of the Pharmacy Guild’s deals

Dr Ken Harvey
First it was the Pharmacy Guild’s deal with Blackmores that raised ethical concerns. Now it’s the Guild and Pfizer.
Both deals involve undisclosed payments from drug companies to Guild subsidiaries to ensure that dispensing software identifies certain prescriptions on which pharmacists are prompted to take action.
In the Blackmores case, to on-sell Blackmores “companion” complementary medicines with prescription drugs; in the Pfizer case to sign up patients prescribed nine Pfizer brand name drugs to the company’s “support” programs.
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Super sloppy: First State customers kept in the dark

Asher Moses
October 19, 2011 - 5:34PM
Update 5:30pm: First State Super has just updated its website with a statement on the issue - the first time it is notifying its broader customer base since the breach.
Update 4pm: The Federal Privacy Commissioner, Timothy Pilgrim, announced today he was opening an "own motion investigation" into First State Super.
First State Super customers have been left in the dark over a serious security breach at the company, saying they only learned through media reports that hundreds of thousands of accounts may have been exposed.
Acting NSW Privacy Commissioner John McAteer says the apparent decision to notify just a small portion of its customers rather than the entire database was not acceptable.
Yesterday it was revealed that First State Super, which has over $30 billion in funds under management, called the police on private security consultant Patrick Webster after he informed them of a flaw that opened up access to the company's database of sensitive customer details. All identity thieves would need to do to gain access was change numbers in the URL bar.
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Security of member information update

There has recently been some media coverage about unauthorised access to our members’ online benefit statements. The statements were in PDF format and were viewed by the person responsible but he did not gain direct access to other account details nor did he conduct any transactions.
Only 568 member statements were viewed out of a total membership of some 770,000. The members whose statements were viewed have been notified.   
The fault in our security was also rectified immediately, and a comprehensive IT security review is now underway.
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Defence checks fake ID data

Dan Oakes
October 20, 2011
TENS of thousands of security clearances are being urgently investigated after fake information was entered to speed up the process, Defence officials revealed yesterday.
The opposition has also claimed that four government MPs were told of the security issues months before they were investigated, but did not act on them.
Under questioning at a Senate committee hearing, a senior Defence Department official also admitted that 5000 of those clearances were classified as ''top secret''. It is the first indication of exactly how widespread the problems are.
Claims that Defence employees were forced to enter fake data at the initial stages of the clearances were aired earlier this year. Whistleblowers said the fake information was designed to fill gaps in personal histories, speeding up the processing of clearances, which were passed on to ASIO for further evaluation.
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Dennis Ritchie, Father of Unix and C programming language, dead at 70

  • Bob Brown (Network World)
  • 14 October, 2011 02:45
Dennis Ritchie, the software developer who brought the world the C programming language and Unix operating system, has died at the age of 70. 
Ritchie (known by the username "dmr") was part of a dynamic software development duo with Ken Thompson at Bell Labs, which they joined in 1967 and 1966, respectively. Ritchie created the C programming language, which replaced the B programming language Thompson invented. 
The two later went on to create Unix, initially for minicomputers and written in assembly language, in 1969, and written in C in 1973. Unix went on to become key software for critical computing infrastructure around the world, though wasn't for everyone. 
Ritchie once said: "UNIX is very simple, it just needs a genius to understand its simplicity." Unix , of course, became the inspiration for newer operating systems including Linux and Apple's iOS
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Kurzweil Responds: Don't Underestimate the Singularity

Last week, Paul Allen and a colleague challenged the prediction that computers will soon exceed human intelligence. Now Ray Kurzweil, the leading proponent of the "Singularity," offers a rebuttal.
Although Paul Allen paraphrases my 2005 book, The Singularity Is Near, in the title of his essay (cowritten with his colleague Mark Greaves), it appears that he has not actually read the book. His only citation is to an essay I wrote in 2001 ("The Law of Accelerating Returns") and his article does not acknowledge or respond to arguments I actually make in the book.
When my 1999 book, The Age of Spiritual Machines, was published, and augmented a couple of years later by the 2001 essay, it generated several lines of criticism, such as Moore's law will come to an end, hardware capability may be expanding exponentially but software is stuck in the mud, the brain is too complicated, there are capabilities in the brain that inherently cannot be replicated in software, and several others. I specifically wrote The Singularity Is Near to respond to those critiques.
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Enjoy!
David.

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