Interesting To See How Electronic Medication Ordering Can Reduce Errors. Seems It Really Works.

This appeared a little while ago.

Researchers: CPOE averted 17.4 million medication errors in one year

February 22, 2013 | By Gienna Shaw
Electronic prescribing through computerized physician order entry averted 17.4 million medication errors in the U.S. in a single year, according to researchers publishing in the Journal American Medical Informatics Association.
The authors analyzed data from 2006 to 2008, including the American Hospital Association's 2008 electronic health record adoption database to estimate the reduction in medication errors that they said could be attributed to CPOE.
"Processing a prescription drug order through a CPOE system decreases the likelihood of error on that order by 48 percent," the authors wrote. "Given this effect size, and the degree of CPOE adoption and use in hospitals in 2008, we estimate a 12.5% reduction in medication errors, or 17.4 million medication errors averted."
Putting a hard number on the results of any health information technology on quality improvement is a challenge--and research on the effects of HIT are often ripe  for debate.  
For example, data transfer between health IT systems can threaten patient safety perspective, according to an analysis of health IT-related safety events by the ECRI Institute Patient Safety Organization, FierceHealthIT reported earlier this month.
A breakdown of the events found that 53 percent were associated with medication management systems. Of the systems identified in such events, computerized physician order entry systems were mentioned the most (25 percent of the time).
More with links here:
A useful one for the evidence files.

Anyone Hearing About Senior Staff Changes At NEHTA? Just Wondered.

Am hearing some interesting rumours.


This Seems To Be A Trend That Is Only Growing In Importance. It Will Be Fun To Watch.

The momentum with IBM’s Watson is really growing.
We have this report here:

Computer-aided medicine

Doctor Watson

Feb 14th 2013, 16:10 by T.C. | LONDON AND NEW YORK
TWO years ago IBM attracted a lot of admiring publicity when its “Watson” program beat two human champions at "Jeopardy!", an American general-knowledge quiz. It was a remarkable performance. Computers have long excelled at games like chess: in 1997 Deep Blue, another of the computer giant's creations, famously beat the reigning world champion Garry Kasparov. But "Jeopardy!" relies on the ability to correlate a vast store of general knowledge with often-punny, indirect clues. Making things hardest still, the clues themselves are, famously, phrased as answers, to which contestants must supply an appropriate question.
Yet IBM has always had bigger plans for its artificial know-it-all than beating humans at quiz shows. On February 8th it announced the first of them. Together with the Memorial Sloan-Kettering Cancer Centre, an American charity, and Wellpoint, a health company, it plans to adapt the system for oncologists, with trials due to begin in two clinics. The idea is to use the machine as a sort of prosthetic brain for doctors, by delegating to it the task of keeping up with medical literature.
What is really impressive about Watson is not so much that it thrashes humans, but how it does so. The machine extracts “meaning” from vast quantities of what computer scientists call unstructured data, which essentially means anything designed to be consumed by humans rather than computers. To prepare for its "Jeopardy!" appearances, the program was fed (among other things) dictionaries, archives of newspaper articles, lexical databases of English and the whole of Wikipedia. From these it was able to extract relationships between concepts and become deft enough with metaphors, similes or puns that it could cope with the show’s elliptical clues.
It is this ability to process human-oriented information that IBM hopes will be useful for doctors. The volume of medical research is huge and growing. According to one estimate, to keep up with the state of the art, a doctor would have to devote 160 hours a week to perusing papers, leaving eight hours for sleep, work and, well, everything else in life. Fortunately, Watson doesn't need any sleep.
More here:
Here is another report on the same topic.

IBM's Watson Supercomputer Bears Arms to Battle Cancer

By Darryl K. Taft  |  Posted 2013-02-08
IBM's Watson supercomputer celebrated the second anniversary of its trouncing human competitors on "Jeopardy" with the announcement of two new medical applications aimed at helping battle cancer.
In the past year, IBM has partnered separately with the Memorial Sloan-Kettering Cancer Center (MSK) and WellPoint to develop Watson health care products starting in the areas of oncology and utilization management. Now IBM, MSK and WellPoint have announced the latest advancements based on their collaboration, including unveiling the first commercially developed Watson-based cognitive computing breakthroughs. These innovations stand to help transform the quality and speed of care delivered to patients through individualized, evidence-based medicine.
"Today, I join IBM, our partner WellPoint and many other health care leaders in New York City to mark a milestone on the path to bringing the power of Watson to oncology care," Dr. Mark Kris, chief of Thoracic Oncology Service at Memorial Sloan-Kettering Cancer Center, wrote in a blog post. "In collaboration with IBM and WellPoint, we will unveil the first commercially developed Watson-based cognitive computing system that is being taught by Memorial Sloan-Kettering experts. We believe these innovations will help transform the quality and speed of care for patients and enhance research to lead to more cures."
"IBM's work with WellPoint and Memorial Sloan-Kettering Cancer Center represents a landmark collaboration in how technology and evidence-based medicine can transform the way in which health care is practiced," Manoj Saxena, IBM's general manager for Watson solutions, said in a statement. "These breakthrough capabilities bring forward the first in a series of Watson-based technologies, which exemplifies the value of applying big data and analytics and cognitive computing to tackle the industry's most pressing challenges."
Lots more here:
and we have a different AI approach here:

AI found better than doctors at diagnosing, treating patients

AI can think like a doctor, but faster and with more information, Indiana U. researchers find

February 12, 2013 05:32 PM ET
Computerworld - Applying the same technologies used for voice recognition and credit card fraud detection to medical treatments could cut healthcare costs and improve patient outcomes by almost 50%, according to new research.
The research by Indiana University found that using patient data with machine-learning algorithms can drastically improve both the cost and quality of healthcare through simulation modeling.
The computer models simulated numerous alternative treatment paths out into the future and continually planned and replanned treatment as new information became available. In other words, it can "think like a doctor," according to the university.
This is not the first time artificial intelligence has been brought to bear on healthcare.
Last year, IBM announced that its Watson supercomputer would be used in evaluating evidence-based cancer treatment options for physicians, driving the decision-making process down to a matter of seconds. The Watson supercomputer was first offered to Cedars-Sinai's Samuel Oschin Comprehensive Cancer Institute in Los Angeles. Later that year, Watson was brought in to help Memorial Sloan-Kettering Cancer Center physicians diagnose and treat cancer patients.
The new research at Indiana University was non-disease-specific -- it could work for any diagnosis or disorder, simply by plugging in the relevant information. The research is aimed at addressing three issues related to healthcare in the United States: Rising costs expected to reach 30% of the gross domestic product by 2050; quality of care where patients receive the correct diagnosis and treatment less than half the time on a first visit; and a lag time of 13 to 17 years between research and practice in clinical care, the university said.
Lots more here:
It is clearly going to be interesting to keep an eye on what comes out of all these efforts - especially in terms of clinical outcomes - which is, of course, the name of the game.

Can This Be Seen As Acceptable In Any Way? Can’t See How.

Checked this link today.

Standards Catalogue

The National E-Health Standards Catalogue (Standards Catalogue) consists of a collection of standards and specifications that are essential guidance for those who develop, sell, support, buy and implement e-health software in Australia. The catalogue provides a list of the standards recommended by, and specifications sourced or developed by, NEHTA, and is updated regularly.
What does the Standards Catalogue provide?
  • advice on when and where the use of a standard is appropriate.
  • can be navigated via  content classifications
  • links to both de facto and de jure standards from national and international standards bodies including proprietary, business, and more openly developed standards.
Open Standards
We support the adoption of open standards where appropriate. These standards should require no royalty payments, be openly published, allow extension, promote reusability, and reduce the risk of technical lock-in and high switching costs. However, where open standards are not appropriate due to significant market or technical issues, we will adopt the standards deemed most fit-for-purpose, relevant and useful to the community.
Importance of Standards
Standards are relevant to all areas of our work, and provide rigour as well as a means of validation with external expert groups. The lack of clear standards makes it difficult for vendors to develop software applications that can support a broad range of communication within the health community. Vendors face developing their own solutions and accepting the risk of industry adopting a different approach. Where widely supported standards are available to vendors, the lack of agreement at a national level about their use can preclude their adoption.
Standards also benefit those who purchase and implement health software applications. Knowing which software products conform to agreed standards can greatly simplify the purchasing process, and increase purchaser confidence that the selected product will be fit-for-purpose. Standards also offer the potential to avoid vendor 'lock-in'.
The PCEHR Standards Catalogue currently being updated and will be available soon.
For any inquiries regarding Standards, please contact us at
----- End Extract.
How can this be?
“The PCEHR Standards Catalogue currently being updated and will be available soon.”
Why was this not available 9+ months ago? Who is responsible for this total delivery failure and why are we all paying their salaries?
This page has been saying the same over at least a year. Just why would that be?
Just nonsense.
Co-incidentally this week we also have seen this.

Lack of e-health standards “unacceptable”

THE absence of compulsory basic standards for electronic health records in general practice is an “unacceptable” situation and its resolution is very much overdue, according to two experts involved in collecting GP data.
In an editorial in this week’s MJA, two senior members of the Bettering the Evaluation and Care of Health (BEACH) program, which collects information about clinical activities in general practice, have called for the urgent development of “nationally agreed standards for the electronic health record (EHR)”. (1)
“We now have a variety of EHR systems with inconsistent structures, data elements and terminologies”, Associate Professor Helena Britt and Associate Professor Graeme Miller, director and medical director of the Family Medicine Research Centre, wrote.
They listed three negative effects caused by the absence of compulsory basic standards.
“First, it makes it extremely difficult to transfer patient data to other general practices and health providers”, they wrote.
“Second, it makes it hard for practices to change to a different EHR system because transfer of patient data to a new system, with different data structures and coding systems, is unreliable.
“Last, it makes it impossible to obtain reliable national information about the care provided to individuals and the population through passive data collection from GPs’ computers.”
Professor Britt and Professor Miller said this was “unacceptable when in 2011–2012 there were 125 million GP services provided at a cost to government of about $5 billion”.
However, some GPs involved in health informatics say that change is happening.
Dr Chris Mitchell, a GP in northern NSW, told MJA InSight that significant steps had been taken to use EHRs to improve patient care.
Lots more here:
It is getting hard to believe, with all this, that the Health IT Standards setting processes in Australia are presently being properly managed and delivered.

This Really Might Be An Interesting Ride. Will Be Interesting To See What Happens Next.

This appeared a day or so ago.

HIStalk Interviews Robert Lorsch, CEO, MMRGlobal

February 25, 2013 Interviews  
Robert H. “Bob” Lorsch is president, CEO, and chairman of MMRGlobal of  Los Angeles, CA.

Tell me about yourself and the company.
I sold my business in 1998 for several hundred million dollars to AT&T. After the company was sold, I have spent many years focused on philanthropic activities – California Science Center, Cedars-Sinai Medical Center, St. John’s Hospital, and a variety of other organizations.
In 2000, I myself was diagnosed with a rare form of thyroid cancer. Despite the fact that I was extremely connected to doctors, hospitals — both as someone who’s been in the Los Angeles community for many, many years and as somebody who had supported these organizations — I was personally subjected to the task of selecting the guy that was going to be the surgeon who was going to go into my neck and deal with my cancer.
Lots more here:
Here are a few selected quotes regarding Australia from the interview:
“Have you ever taken someone to court for infringement?
We currently have four matters that are of interest. Approximately two or three weeks ago, we filed a lawsuit against Walgreens. Last week, we filed a lawsuit against WebMD. We currently have identified in Australia that the Australian government actually built a $1.1 billion personal health record system that blatantly, we believe – and I would appreciate it if you would always qualify it with “we believe” – infringes on our patents almost totally. The irony of the whole thing is that the government actually appears – and I want to say “appears” – to have used our attorneys who got us the patents in Australia to review and give them an opinion on the intellectual property.
We have found the same thing in Singapore, where the health department in Singapore and other companies — including a very, very large company out of China — are infringing on our patents there. 
We have begun the process of pursuing Australia. We would hope to settle it very, very quickly, because they have a billion-dollar system that is basically given away to everybody who lives in Australia, which completely, completely destroys the ability for us to sell our product.  We would hope that they will be objective in entering to some type of licensing agreement with us. Our patents go far back before they ever actually looked at the system that they built subsequent to the issuance of the patents, which we believe they were aware of.”
And here:
“In our case, we don’t care if somebody licenses or somebody buys. They win and we win either way. The objective here is to not do something that makes it impossible to make a deal, but also do something that is fair to our shareholders in the sense that we’re not denied access to the marketplace just because somebody said, “The heck with them. We don’t care about their patents,” which is what is happening in Australia. I mean the Australian government in a macro example — macro being huge, but one country — they basically said, “We’re going to make a personal health record. We’re going to give it away to 20 million people free and we’re going to infringe on IP and we don’t care.”
Reading the article it seems clear this company is expecting a real payout. The seems rather annoyed that all those people are being given a free Government PHR in competition with what they provide.
It will be interesting to see just how the meeting at HIMSS goes with NEHTA if it actually happens.
The full - very long - interview is well worth a read.

AusHealthIT Poll Number 156 – Results – 26th February, 2013.

The question was:

Do You Believe Those Who Testified At The Recent Senate Estimates Told The Truth, The Whole Truth And Nothing But The Truth in Their E-Health Testimony?

For Sure 6% (3)
Probably 0% (0)
Possibly 2% (1)
Nope 73% (35)
No Idea - The Spin Confuses Me! 17% (8)
I Have Just No Idea 2% (1)
Total votes: 48
Very interesting. It seems readers here do not actually trust the bureaucrats!
Again, many thanks to those that voted!

Weekly Australian Health IT Links – 25th February, 2013.

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

Quite an interesting week. Cyber security seems to be managing to lift its awareness which can only be a good thing.
The second article reporting on the lack of Government transparency will seem rather apt and relevant to the e-health space I suspect.
For the rest we have the MJA covering information use in the health sector and, we are still seeing reporting on the patent issue - with some interesting reporting on who is doing what with whom.
Until next week.

Hackers threaten pharmacy IT

18 February, 2013 Nick O'Donoghue  
Pharmacy owners are being urged to increase their IT security in the face of a new threat from foreign computer hackers.
Speaking to Pharmacy News, Paul Naismith, CEO of Fred IT, expressed concern about the potential for hackers to hold pharmacies ransom, following reports that a number of Australian health professionals’ IT infrastructure had been attacked recently.
Mr Naismith said the problem would be the number one IT security trend to watch out for in 2013.
“It’s an ongoing thing that pharmacists need to be reminded of,” he said.

Openness policy stymied from the top

Date February 23, 2013

Marc Moncrief

A THREE-YEAR-OLD policy to revolutionise transparency in government is struggling from a lack of leadership at the highest levels, the federal information commissioner has warned.
A review by the Office of the Australian Information Commissioner calls for political leaders to force cultural change in the public service or risk being left behind by peer countries with more open governments.
It says the government should require, rather than just suggest, that so-called ''high value'' information be published openly on the central website created for the purpose more than two years ago,

Frustration mounts on e-health

18th Feb 2013
THE national clinical lead advising on the e-health program has revealed frustration at not being able to access the system that he helped introduce.
The admission comes as two senior academics take aim at what they call a “lack of compulsory basic standards for e-health records in general practice”.
National E-Health Transition Authority (NEHTA) national clinical lead and GP, Dr Mukesh Haikerwal, who is also the chair of the World Medical Association (WMA) Council, told Fairfax newspapers at the weekend that he was one of the few doctors linked into the complete e-health service and went live with it at his Melbourne practice in mid-December to test the system.

E-health tour goes on the road

19th Feb 2013
AUSTRALIA'S chief clinical adviser on e-health has been touring the country to discuss the beleaguered electronic medical records program with GPs, with a message for those who have had problems using the system.
National E-Health Transition Authority (NEHTA) national clinical lead and GP Dr Mukesh Haikerwal, who is also the chair of the World Medical Association (WMA) Council, told MO he had already been to Adelaide, Brisbane, Melbourne and Perth and would be in Sydney tomorrow as part of the tour in collaboration with various AMA state entities.
“I have been talking about the e-health system and how people can participate in e-health,” he said.

E-health patents tangle NEHTA in global patent litigator web

Australia’s National e-Health Transition Authority (NEHTA) is the latest health authority to be approached by medical patent holder MMRGlobal, which claims that the government’s PCEHR system has breached its Australian patent.
In a press release issued last week, MMRGlobal announced it would investigate the potential breach, and also stated it had begun legal action against US online pharmacy Walgreens for patent violation. 
NEHTA CEO Peter Fleming told the Senate Estimates committee last week that the company had not contacted NEHTA.
However the former CEO of MMRGlobal’s Australian subsidiary, Probir Dutt, claims to have had a number of meetings with NEHTA staff before Mr Fleming joined the organisation.

NEHTA contacts US firm over patent breach allegations

THE National E-Health Transition Authority has reached out to the US e-health software firm investigating it over patent infringement allegations.
According to MMRGlobal chief executive Robert Lorsch, lawyers from NEHTA had contacted the firm to discuss the matter.
"The company has spoken with an attorney for NEHTA," Mr Lorsch told The Australian.
"MMR suggested entering into an agreement to exchange documents to facilitate an informal resolution to this matter for the benefit of all parties. 

Twist in e-health patent claim

MELBOURNE law firm Davies Collison Cave has dropped MMRGlobal as a client just days after the latter said it was investigating alleged patent infringements by the National E-Health Transition Authority.
Robert Lorsch, the Los Angeles-based MMRGlobal chief executive, claims Davies Collison Cave told him that his company would have to be dropped from the client roster due to a "conflict".
"We used Davies Collison Cove (for patents) and one of the reasons that they're not involved right now is they have a conflict because they're also representing the government," Mr Lorsch told The Australian.

Robotic prostate surgery cuts readmissions

20 February, 2013 Antonio Bradley
Controversy looks set to continue over funding for high-tech robotic prostatectomies, despite a study claiming they drastically reduce readmission rates and reduce costs in the long-term.
The research, comparing 100 robotic prostatectomies performed at the Royal Brisbane and Women's Hospital against 100 conventional open procedures, found robotic surgery slashed total readmission costs by 90% — from $70,000 to just $7000.
Patients also had much shorter hospital stays, averaging only 1.2 days, compared with 4.4 days with conventional surgery, researchers wrote in the ANZ Journal of Surgery (online).

Toys for the boys?

16 June, 2011 Paul Smith
I’M standing in the corner of a room that has all the trappings of a state-of-the-art operating theatre.
There’s a huge, flat-screen TV high on the wall, halogen lighting systems, and an operating table stuffed with numerous hydraulic gadgets. And a couple of metres away, its four large arms raised like a spider about to envelop its prey, is a robot.
In front of me, next to a bank of computers and machines that go ‘ping’, is a grey console — the control system for the robot.

RACGP urged to update privacy rules

18 February, 2013 Paul Smith
The RACGP is facing calls to review its privacy standards after a 14-year-old said she was cyber-stalked by a man who overheard her name being called out in a GP waiting room.
The My Family Doctors practice in Townsville said a 31-year-old man befriended the teenager on the social networking site late last year.
The girl's mother alerted the surgery and was told to report the incident to the police.
The man, when contacted by the practice, said he had mistaken the girl's age and assumed she was over 16.
In the wake of the incident, the practice introduced a ticketing system to alert patients when to see their GP.

Obstacles on the information highway

Ruth Armstrong and Ann Gregory
Med J Aust 2013; 198 (3): 123.
doi: 10.5694/mja13.c0218
The concept of monitoring and reporting on safety and quality in health care is not new. As Diane Watson, CEO of Australia’s National Health Performance Authority reminds us in this issue of the Journal (doi: 10.5694/mja13.10097), as early as 1860, Florence Nightingale called for the uniform collection of hospital statistics, so that outcomes could be compared “by hospital, region, and country” (Evid Based Nurs 2001; 4: 68-69).
In 2013, we are more able than ever to collect, interpret, share and act on such information, yet significant obstacles, some of which are explored by contributors to this issue of the Journal, remain.

Ruth Armstrong & Ann Gregory: E-health obstacles

THE concept of monitoring and reporting on safety and quality in health care is not new.
As Diane Watson, CEO of Australia’s National Health Performance Authority reminds us in the latest issue of the MJA ADD LINK, as early as 1860, Florence Nightingale called for the uniform collection of hospital statistics, so that outcomes could be compared “by hospital, region, and country”.
In 2013, we are more able than ever to collect, interpret, share and act on such information, yet significant obstacles, some of which are explored by contributors to this issue of the MJA, remain.
Clinical registries of patient treatment and outcomes provide vital information to improve care, but they will only be credible if they are as complete as possible.

Lack of e-health standards “unacceptable”

THE absence of compulsory basic standards for electronic health records in general practice is an “unacceptable” situation and its resolution is very much overdue, according to two experts involved in collecting GP data.
In an editorial in this week’s MJA, two senior members of the Bettering the Evaluation and Care of Health (BEACH) program, which collects information about clinical activities in general practice, have called for the urgent development of “nationally agreed standards for the electronic health record (EHR)”. (1)
“We now have a variety of EHR systems with inconsistent structures, data elements and terminologies”, Associate Professor Helena Britt and Associate Professor Graeme Miller, director and medical director of the Family Medicine Research Centre, wrote.

Numbers for eHealth lagging

Date February 17, 2013

Tim Barlass

THE federal government's controversial eHealth system to get the nation's medical records available online has had a dismal uptake from the public and the medical profession.
The scheme has been compared to the government's bungled roof insulation system by the Coalition's eHealth spokesman, Andrew Southcott, who called it ''Pink Batts on steroids''.
The eHealth scheme was launched with fanfare in July, with an advertising truck touring Australia to encourage 500,000 people to register in the first year. The Health Minister, Tanya Plibersek, declared: ''We estimate eHealth will save the federal government around $11 billion over 15 years. That's pretty good bang for your buck.''

Financial, health data dumped in Sydney rubbish bins

Survey of bins in the CBD found 11 per cent contained bank account details and legal documents.
Documents showing a customer's cardholder account details and address were found in a rubbish bin used by a bank branch in Sydney.
Some Sydney bank branches, lawyers' and doctors' offices have been found guilty of not properly disposing of personal information in rubbish bins which could be used by criminals for the purposes of fraud or identity theft following a private investigation.

Push for funding to be doubled

19th Feb 2013
THE Australian Medicare Local Alliance has asked for an almost doubling in Commonwealth funding for Medicare Locals, calling for an extra $610 million to fund two ambitious new programs — targeting chronic disease and early childhood.
The first federal budget submission from the AML Alliance — since its establishment last year — asks for $130 million per year over four years for a chronic disease prevention and management program plus another $92 million over three years for an early childhood development program.
The proposed additional $160 million per year, described by alliance chair Dr Arn Sprogis as “tiny” compared to the overall health budget, would be on top of the $171 million originally allocated to the 61 primary healthcare organisations when they were created from general practice divisions.

Bionic hand that gives back patients their sense of touch

Date February 18, 2013 - 11:47AM

Nick Collins

The bionic hand that will let those who can't sense touch 'feel' again.
A bionic hand that allows patients to feel sensations as well as control its movements with their mind is to be fitted to an amputee's arm for the first time.
The prosthetic uses electrodes to relay messages to and from the brain via nerves in the arm, meaning the patient can direct it with their thoughts.
It transmits sensory feedback from all five fingers as well as the palm and the wrist, meaning it feels lifelike and allows the patient to grasp objects accurately.

Scientists sense breakthroughs in dark-matter mystery

Date February 19, 2013

Jean-Louis Santini

For decades, the strange substance called dark matter has teased physicists, challenging conventional notions of the cosmos.
Dark matter holds together our galaxy and the rest of the universe. 
Michael Turner, University of Chicago
Today, though, scientists believe that with the help of multi-billion-dollar tools, they are closer than ever to piercing the mystery – and the first clues may be unveiled just weeks from now.

US 'explorers' to don Google internet glasses

Date February 21, 2013
Google on Wednesday invited "explorers" with creative vision and $US1500 to spare to be part of a select group of people who get to experiment with glasses synced to the internet.
A video intended to capture what it feels like to use Google Glass was posted online along with information about what the eyewear does and how to be among those putting them to the test.
"We're looking for bold, creative individuals who want to join us and be a part of shaping the future of Glass," said a message at the website.

The Calling Of An Election In September May Really Impact Developments In E-Health.

As readers will no doubt be aware the Prime Minister astonished the National Press Club audience by announcing an Federal Election for September 14, 2013 a good six months ahead of the time when such an announcement was required to be made. Despite the PM’s suggestion that this step would result in clear air for six months before the election campaign begins what has happened, not surprisingly, is that we are now in the midst of an eight month election campaign.
As we move closer to election day we can expect an increasing focus on just how the Labor Health and e-Health reforms have worked out. There are others well qualified to speak on overall Health Reform but in the e-Health domain we have already seen some considerable movement.
Dr Andrew Southcott (Member for Boothby in South Australia) is the Opposition spokesman on Primary Health and E-Health and it is interesting to see how his concern with present directions and execution is hardening.
Just over a year ago (21 February 2012) he told The Australian the following.
“Opposition e-health spokesman Andrew Southcott said the Coalition supported the concept of shared e-health records, but had concerns about the way the system was being implemented.
"Labor's implementation of the PCEHR since taking government in 2007 has received enormous criticism from industry for the poor management of the program's development and progress," he told the house last week.” [1]
Later in 2012 he told The Australian.
“Opposition e-health spokesman Andrew Southcott said that given "almost $1 billion of taxpayers' money has been spent or allocated for this in the past two years, it would be prudent for the Australian National Audit Office to examine the PCEHR program".
IT projects were "notorious for costing a lot more than expected and delivering a lot less than expected, and this seems to be in that category".
"I think we've had very poor ministerial oversight of this project," Dr Southcott said. "The infrastructure is not ready, the National Authentication Service for Health, which provides user verification and system security, is not ready, consumers could not register online and the GPs' software is not ready -- I'm told one of the largest GP providers won't have software ready until next February.” [2]
By mid-February this view had modified” to become the following.
THE federal government's controversial eHealth system to get the nation's medical records available online has had a dismal uptake from the public and the medical profession.
The scheme has been compared to the government's bungled roof insulation system by the Coalition's eHealth spokesman, Andrew Southcott, who called it ''Pink Batts on steroids''.”[3]
In the interim we have also had indicate the need for a careful review before further investment in undertaken.
One has to conclude, from these statements, that an Opposition victory in September will result in major change if not outright cancellation of the Personally Controlled Electronic Health Record (PCEHR) Program. It also seems highly likely the Program will become a point of Opposition attack - a fact that I am told is ruffling some bureaucratic feathers in Canberra.
As far as the Government has been concerned the level of public discussion has gone remarkably quiet over the last few months with virtually no public commentary or announcements in the last six months.
Two late breaking pieces of news have been the admissions at Senate Estimates in mid-February that only about 52,000 citizens had registered for a record - below the 500,000 who were expected by June 30, 2013 and some really rather left field news that a tiny US Company (MMRGlobal) is claiming it has patents over key aspects of the PCEHR. NEHTA and DoHA are said to be investigating the claims at the time of writing.
Overall, it seems to me that yet again what we are seeing are comprehensive failures of leadership and governance in the e-Health Domain. In my view most stakeholders have not been effectively engaged and persuaded regarding the Government’s plans
This short quote from a very recent paper by Professor Michael Georgeff and Dr Stan Goldstein for the ACHR tells the sad story of the derailing of the National E-Health Strategy which was meant to guide what happened but has sadly been sidelined. [4]

The National eHealth strategy and PCEHR

The National eHealth Strategy developed by Deloitte in 2008 [The National eHealth Strategy. Deloitte Touche Tohmatsu, September, 2008] laid out an approach to the implementation of a more digitally-enabled healthcare system. Three steams of activity were key to that strategy:
·         Build the basic infrastructure: connectivity, Individual Healthcare Identifiers, provider directories—the digital roadways and railways
·         Focus on high priority solutions: complete solutions that support chronic disease management, telehealth, and medications management
·         Invest in change management: assist stakeholders to manage the transformation to the digital world
However, somewhere along that path, the shared health record took centre stage under the name of a Personally Controlled Electronic Health Record (PCEHR).
A shared information repository is a key part of the basic infrastructure that governments need to provide. But a data repository—such as the PCEHR—is just infrastructure. As we have tried to emphasise in this report, it is the “apps” that count, not the data! It is the business processes and solutions that sit on top of the PCEHR and the rest of the national infrastructure that will make the difference to health care.”
What we have been left with is a lot of money being spent on a Program which lacked evidence for its approach and more importantly lacked the bi-partisan support which is so important for large scale multi-year IT Programs.
It is really hard to see how this can work out well between now and the election in just seven months time.
Collaboration and Connectivity: Integrating Care in the Primary Health Care Setting.  January 2013 ACHR - To be released 2013.