Weekly Australian Health IT Links – 18th March, 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

Other that the revelations from the Qld Health Payroll enquiry it has again been a reasonably quiet week on the surface - other than the Judith Sloan attack on DoHA! (see blog yesterday)
Following Eric Browne’s and other comments last week it seems that there is something going on with the NPDR (National Prescribing and Dispensing Repository) which may have all sorts of implications for the NEHRS as well as for standards setting. One gets the feeling the unified and rational architecture - such as it was with the NEHRS - is unravelling.
This will be an area to keep a close eye on.
My weekly visit to my NEHRS record was relatively fuss free - but the system is, as always, awfully slow.

Guild supports decision to cancel e-dispensing alerts

The Pharmacy Guild of Australia has backed a decision to switch off computer alerts telling doctors when patients have had prescriptions dispensed, if it encourages GPs to embrace e-health.
The alerts, which were a feature of both eRx Script Exchange and MediSecure, have been stopped after concerns were raised that the alerts would impose a duty on GPs to chase up patients who had not had the prescriptions dispensed, by indemnity insurers and the Royal Australian College of General Practice (RACGP). 
Dr Nathan Pinskier, an RACGP spokesperson, said the College feared the existence of the notifications extended doctors' duty of care to ensure patients were following their advice. 

Plug pulled on e-dispensing alerts

12 March, 2013 Paul Smith
Computer alerts telling doctors when patients' medication has been dispensed have been switched off amid fears they impose a duty on GPs to chase up patients they believe are at risk.
The concerns — raised by indemnity insurers and the RACGP — centre on the two electronic prescribing systems, MediSecure and eRx, which are currently used by thousands of doctors.
When pharmacies signed up to the systems dispense a script, a notification is issued and sent electronically to the prescribing GP.

Queensland Health payroll inquiry begins

Witnesses have begun giving evidence to the Queensland Health Payroll System Commission of Inquiry
  • AAP (CIO)
  • 11 March, 2013 14:14
An inquiry into Queensland Health's $1.2 billion payroll fiasco will examine whether there was a need to "cut corners" in the initial tendering process.
Witnesses began giving evidence to the Queensland Health Payroll System Commission of Inquiry in Brisbane on Monday.
Thousands of public servants were underpaid, overpaid or unpaid after a flawed IBM computer system was introduced in March 2010 by the former government.

Queensland Health payroll inquiry begins

Date  March 11, 2013

Nathan Paull

An inquiry into Queensland Health's $1.2 billion payroll fiasco will look into whether IBM had an unfair advantage in bidding to supply a computer system that caused havoc in the state's healthcare system.
Former Accenture partner Marcos Salouk, whose company was initially the preferred vendor but lost out to IBM, told the inquiry he was "devastated" when his company lost the bid.
He said he was surprised to hear IBM had won with a bid rumoured to be about $100 million below Accenture's and within the government's tight budget.

Queensland Health payroll system 'high risk'

More than 50,000 staff are believed to have been overpaid more than $90 million in the Queensland Health payroll bungle
  • AAP (CIO)
  • 12 March, 2013 14:14
Queensland Health's failed $1.2 billion payroll system was so disastrous because of the complexity of what was required in such a short amount of time, an inquiry has heard.
Former Logica general manager Michael Duke told an inquiry in Brisbane the company only submitted a partial bid during the tendering process in 2007 and was unsuccessful.
Duke said Logica, which had already been operating financial systems for the government, only put in a partial bid because it saw the payroll system as a "large chunk of work" that was complex and "high risk".
He said the company wouldn't have been able to deliver government's plan to roll financial systems into its shared services program along with rostering and payroll, which were all to be implemented and maintained by one prime contractor.

IBM not first choice: payroll inquiry

Date March 12, 2013 - 5:35PM

Nathan Paull

A private contractor led the process that gave global technology giant IBM the job of replacing Queensland Health’s payroll system, an inquiry has heard.
Darrin Bond, a former project director in the government’s IT arm CorpTech, says he was against using a prime contractor for the payroll system and eventually changed departments because of it.
Mr Bond told the Queensland Health Payroll System Commission of Inquiry in Brisbane on Tuesday that it was a private contractor, Terry Burns, employed by CorpTech, who advocated giving a prime contractor control over the system’s finance, HR and payroll components.

Contract signed before payroll system proven to work

Date March 14, 2013 - 7:56AM

Nathan Paull

Senior bureaucrats didn't check whether a proposed system would actually work before signing off on a contract to replace Queensland Health's payroll system, an inquiry has heard.
Darrin Bond, a former project director in the government's IT arm CorpTech, says a push for technology giant IBM to sign the contract meant the Queensland government didn't have time to properly assess the proposal.
IBM's tender bid to run Queensland Health's complicated payroll system was about $100 million cheaper than its nearest rival.

Queensland Health inquiry: Hood admits outside contractor a bad idea

Private contractor and former IBM boss Terry Burns' hand in IBM being selected to implement and maintain the system has been repeatedly called into question during an inquiry to determine what went wrong
  • AAP (AAP)
  • 14 March, 2013 10:09
A senior public servant in charge of Queensland Health's failed payroll system has conceded an outside contractor shouldn't have led the tendering process.
Private contractor and former IBM boss Terry Burns' hand in IBM being selected to implement and maintain the system has been repeatedly called into question during an inquiry to determine what went wrong.
Thousands of public servants were underpaid, overpaid or unpaid after IBM's flawed computer system was introduced in March 2010 by the former Labor government in a fiasco estimated to have cost taxpayers about $1.2 billion.

Scientists used iPhone to diagnose intestinal worms

  • From: AFP
  • March 13, 2013 6:58AM
SCIENTISTS used an iPhone and a camera lens to diagnose intestinal worms in rural Tanzania, a breakthrough that could help doctors treat patients infected with the parasites, a study said on Tuesday.
Research published by the American Journal of Tropical Medicine and Hygiene showed that it is possible to fashion a low-cost field microscope using an iPhone, double-sided tape, a flashlight, ordinary laboratory slides and an $8 cameral lens.
The researchers used their cobbled-together microscope to successfully determine the presence of eggs from hookworm and other parasites in the stool of infected children.

Government IT projects 'not well understood'

Date March 12, 2013

Trevor Clarke

Australia's new CIO Glenn Archer is proud of quiet achievers in IT departments.
The Australian government's new chief information officer says government IT projects are ''not well understood'' by the wider community and their implementers deserve recognition.
Notwithstanding several documented IT stuff-ups in various government agencies over the past decade, including Victoria's CenITex and Queensland's payroll debacle, Australia's recently installed CIO, Glenn Archer, said ''IT departments or sections within departments'' were the quiet achievers in delivering services in a sector that spends over $6 billion a year in technology.
''There is a great deal of interest in those IT projects that don't go quite according to plan but those that quietly function and deliver major business benefit often never get much mention,'' Mr Archer said, while acknowledging there were problem projects.

Delving into the Quantified Self

Health informatics expert Professor Fernando Martin-Sanchez says that the future of health care will involve shared decision-making between patents and clinicians and will often rely on a range of personal health data patients will collect about themselves.
Martin-Sanchez is Professor and Chair of Health Informatics at the University of Melbourne Medical School and Head of Health and Biomedical Informatics Research Laboratory of IBES (Institute for a Broadband-Enabled Society) and will be speaking about his research at next week’s Health-e-nation conference in Melbourne.

Protecting Patient Privacy and Data Security

Julie K. Taitsman, M.D., J.D., Christi Macrina Grimm, M.P.A., and Shantanu Agrawal, M.D.
N Engl J Med 2013; 368:977-979
DOI: 10.1056/NEJMp1215258
On December 4, 2012, two Australian radio DJs called London's King Edward VII's Hospital, identified themselves, in fake British accents, as Queen Elizabeth and Prince Charles, and asked about a celebrity patient who had been admitted for pregnancy complications. A nurse, filling in at the reception desk in the early morning hours, answered the phone and, without attempting to verify the callers' identities, transferred them to the duty nurse caring for the Duchess of Cambridge. The duty nurse then provided them with confidential patient information.1 The Australian DJs broadcast the phone call, considering it a humorous prank, but as the world knows, it had disastrous consequences.

AMA rejects physicians’ plea for PIP payments

11th Mar 2013
A CALL by physicians to have the same access to e-health PIP payments and incentives as GPs has been rejected by the AMA.
Royal Australian College of Physicians (RACP) president Associate Professor Leslie Bolitho said last week e-health could not be successful unless all medical practitioners in Australia, including both GPs and specialist physicians, adopted e-health technologies.
This would result in better patient outcomes, particularly for complex chronic patients who saw a multitude of healthcare providers, she said.

Specialists want cut of e-health cash

12 March, 2013 Paul Smith
Specialist physicians are warning key clinical information will be missing from the government's e-health records system unless they get a cut of the Practice Incentive Program funds.
There have been long-running concerns over whether private specialists will use the personally controlled e-health record system, given the low levels of computerisation in their practices.
Although GPs and practice managers have battled to meet the latest ePIP requirements, the Royal Australasian College of Physicians said it wanted the system extended.

Question: FHIR and un-semantic interoperability

Posted on March 12, 2013 by Grahame Grieve
 I did not understand the blog post about un-semantic interoperability.  Can you elaborate?  Will FHIR provide any of this un-semantic interoperability?
Well, the original post on unsemantic interoperability is just pointing out that many people mis-understand the nature of what semantic interoperability is trying to achieve:
We’ve had semantic interoperability in healthcare since we started having healthcare. Since the beginning of healthcare (by whatever definition you can use), healthcare practitioners have exchanged data using spoken and written words, and the semantic meaning has been clear (well, as clear as it can be given that human knowledge is limited).
So whatever it is that we are doing, it’s not introducing semantic interoperability. In fact, what we are doing is introducing a new player into the mix: computers. And not, in actual fact, computers, but the notion that there is something to be gained by processing healthcare information by persons or devices who don’t properly understand it. So, in fact, what we are actually doing is seeking for unsemantic interoperability.

A few seconds can save patients' lives

Date March 11, 2013

Benjamin Preiss

Researchers at Victoria University are working on a new computer program they hope will save patients' lives by predicting their vital signs during surgery.
The researchers say the software could be installed in hospital operating theatres and intensive care units.
The PhysAnalyser program will give a 20-second prediction on patients' physiological signs such as heart and respiratory rates and blood pressure.
Professor Yanchun Zhang said the program conducted ''deep analysis'' on patient data. This would be used to predict risks for patients and ''visualise the future anomalies''.

Guy Sebastian caught out by stalled patent probe

SINGER Guy Sebastian has weighed in on allegations of patent infringement by the Gillard government's National E-Health Transition Authority.
MMRGlobal, the US firm investigating NEHTA for alleged patent infringements, was in talks with Sebastian's management team to fund his planned charitable foundation.
However, discussions have hit a roadblock pending the outcome of the probe, which has been delayed by NEHTA's silence.

Decision Support may be the new e-Medication Management Frontier

Electronic medication management has been adopted at health sites around Australia, but there’s still low clinician adoption of one of the system’s great advantages - decision support protocols.
“It can be hard to change the mindset of prescribers who are used to the old, linear way of writing scripts,” says Professor Ric Day, head of clinical pharmacology at the University of NSW and a key player in the adoption of electronic medication management at St Vincent’s Hospital in Sydney.
Some systems have excellent shortcuts, such as ‘therapy bundles’ where a commonly-grouped medication list can be prescribed in one mouse-click.

Royal Adelaide Hospital puts X-rays in focus

THE Royal Adelaide Hospital has taken steps to quickly identify radiation levels in an X-ray environment - an issue not easily tackled in the past - thanks to new technical smarts.
With the hi-tech equipment, the X-ray radiation dose required for interventional X-ray procedures can be reduced by more than 70 per cent.
Philips' AlluraClarity intervention suite was the hospital's choice when it had to upgrade from its old system, according to intervention neuro-radiologist Dr Rebecca Scroop and campus clinical head of radiology Dr Mary Moss.

Healthy diagnosis for Terry White Chemists

RETAIL pharmacy franchise Terry White Chemists was halfway through a long-term enterprise resource planning (ERP) implementation project when it diagnosed a problem.
To support the launch of its new website, the company required a quick and easy stock master data management solution.
Terry White Chemists, which was established in 1959, is one of Australia's top 20 retailers and claims a 9 per cent share of the pharmacy market, with more than 160 franchises nationwide.

AMA calls for review of Medicare Locals

12th Mar 2013
THE AMA has given its strongest endorsement of Medicare Locals (MLs), calling on both political parties to commit to a pre-election review to ensure the new primary healthcare bodies have “substance, purpose, meaning and direction”.
With the Coalition seen as a strong chance to win the 14 September federal election, MLs are anxious about their future, following shadow health minister Peter Dutton’s labelling of the 61 bodies as wasteful bureaucracies.
In an opinion piece in MO this week, AMA president Dr Steve Hambleton wrote while his organisation had initially opposed MLs, “trying to undo all the contracts and leases and management structures would be quite complex and expensive to accomplish in the first year of a Coalition government”.

Coalition 'will abolish' all Medicare Locals

A COALITION government would run the ruler over primary healthcare, abolishing Medicare Locals in favour of new links between GPs and public hospitals as part of efforts to redirect hundreds of millions of dollars each year.
Federal Health Minister Tanya Plibersek warned the opposition not to try to replicate the slash-and-burn approach of conservative state governments, saying the Medical Local structure, introduced by Labor less than 12 months ago, was starting to show positive results for patients.
Opposition health spokesman Peter Dutton said yesterday Medicare Locals had created about 3000 extra taxpayer-funded positions across Australia and "the guiding principle of the Coalition will be to take money away from bureaucratic wages and put it into frontline services".

The hackers have come, the hackers have come

Alan Kohler 11/03/2013
This morning’s revelations in the Financial Review that the Reserve Bank of Australia has been repeatedly hacked means we can almost certainly now add Australia to the list of 141 countries that have been hacked by China’s Unit 61398.
The AFR has reported that multiple computers within the RBA’s network have been compromised and that it had been infiltrated by a Chinese-developed malicious software, or ‘malware’ spy program, that was seeking intelligence on sensitive G20 negotiations.
Officials from the Reserve Bank’s risk management unit are quoted as saying in a previously unreported Freedom of Information document: “Bank assets could have been potentially compromised, leading to . . . information loss and reputation [damage].”

Fake fingers fool the boss in hospital scam

Date March 14, 2013
Five doctors at a Brazilian hospital have been suspended for allegedly covering for absentee colleagues by using fake silicone fingers to fool biometric machines.
Thaune Nunes Ferreira was arrested on Sunday for signing in six co-workers to the biometric employee attendance device at a hospital in Ferraz de Vasconcelos, Sao Paulo.

Rover shows Mars could have supported life

Date March 13, 2013 - 10:36AM

Alicia Chang

NASA's Curiosity rover has answered a key question about Mars: the red planet previously had some of the right ingredients needed to support primitive life.
The evidence comes from a chemical analysis by Curiosity, which last month flexed its robotic arm to drill into a fine-grained rock and then test the powder.
If this water was around and you had been on the planet, you would have been able to drink it. 
John Grotzinger, California Institute of Technology
Curiosity is the first spacecraft sent to Mars that could collect a sample from deep inside a rock, and scientist said they hit pay dirt with that first rock.
"We have found a habitable environment that is so benign and supportive of life that probably if this water was around and you had been on the planet, you would have been able to drink it," said chief scientist John Grotzinger of the California Institute of Technology.

'God particle' found: physicists say they have discovered a Higgs boson

Date March 15, 2013 - 5:44AM

John Heilprin

The search is all but over for the so-called God particle that is a crucial building block of the universe.
Physicists said on Thursday they believe they have discovered the sub-atomic particle predicted nearly half a century ago, which will go a long way toward explaining what gives electrons and all matter in the universe size and shape.
The elusive particle, called a Higgs boson, was predicted in 1964 to help fill in our understanding of the creation of the universe, which many theorise occurred in a massive explosion known as the Big Bang.
The particle was named for Peter Higgs, one of the physicists who proposed its existence, but it later became popularly known as the God particle.

I Would Not Want To Be A Senior Officer In DoHA If Mr Abbott Wins The Election! Dead Ducks.

This article simply could not wait for the usual cycle of daily blogs.

Nothing healthy about department of stuff-ups

HEALTH is an area the Labor Party thinks it owns. According to the polls, Labor has generally been judged the better manager of health (and education) than the Coalition.
One of the worrying recent trends for Labor is that this ascendancy has been significantly whittled away. Labor now holds only a slim lead - down to four points -- as the better manager of health. (The gap for education is five points.) One of the more interesting aspects of government involvement in, and funding of, health is that monumental stuff-ups often go under the radar. There are programs that cost hundreds of millions, even billions, but which never generate the anticipated benefits. In some cases, they never generate any benefits. And then there are the forecasting errors of the Department of Health and Ageing that have led to extreme shortages of doctors followed by extreme surpluses.
More generally, we have a federal department - the largest "policy" department with 5500 workers - the head of which seems unable to really explain what her staff do or account for the results of their busyness.
Take the example of electronic health, one of the centrepieces of the health and hospital reforms, as a classic example of a stuff-up. Through the years, hundreds of millions have been poured into various e-health initiatives, with virtually nothing to show for the spending. The most recent program is the Personally Controlled e-Health Records system, which went live in July last year. At this stage, nearly nine months on, only 56,000 individuals have registered to obtain a record. And fewer than 1 per cent of doctors have signed up. The whole scheme, with a budget of more than $1 billion, looks like being a complete operational and financial fiasco.
We should not be entirely surprised. Having spent billions trying to digitise the National Health System records in Britain, the government essentially gave up several years ago. While relatively simple features of patient records - X-ray and pathology results, medications - can be recorded relatively easily electronically, there are other aspects of patient case notes that are not so amenable. Moreover, issues of confidentiality and access are critical in terms of ensuring patient safety and engendering confidence. Were an unauthorised person given access to records, changes could be made that could prove detrimental, if not fatal, to patients. In other words, the goal of achieving universal and comprehensive electronic medical records is unrealistic at this stage. But this has not prevented the federal government wasting billions of dollars finding this out.
….. (Workforce stuff ups omitted)
While e-health and medical workforce planning are examples of specific stuff-ups, at a broader level the whole Department of Health and Ageing is really a massive catastrophe, engaged in multiple, pointless and unaccountable activities while not running one hospital or other health service.
Take this explanation from the department secretary: "We have a budget structure and this includes the definition of subprogram. Then we have another level under this - several other levels. These groupings of things which kind of make logical sense, but are not reconcilable with the budget documents. So there are particular initiatives, some of which do line up, but mostly they do not." Are you following?
She continued: "So this is the workings and this is down to in some cases projects and in some cases thematic elements but is not consistent with universally, and in fact very often, the budget structure which is what we have in IT systems which enable us to produce information." As Manuel from Fawlty Towers would have said: Que?
On the face of it, it would appear that even the head of the department finds it hard to explain what activities are undertaken in her department, why they are undertaken and how they line up with each other. But, never fear, if only they had a better computer system.
"Let me tell you, the Department of Finance said recently that they wanted us to account down to these levels of detail, and our chief financial officer had a great deal of fun explaining to them that, actually, if they wanted that they were going to have to build us a new computer system - which we would quite like, can I say."
Fun? When you are dealing with taxpayer monies that run into the billions? I can think of other nouns, such as disgrace and waste.
Much much more here:
This really is an astonishing blast at DoHA. I wonder what part the shadow Ministers played?
Clearly it is going to be on for one and all as we get closer to the election.