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Weekly Australian Health IT Links – 30th April, 2012.

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

An interesting and rather varied week.
The way I read it we are seeing increasing clarity in the views of the various interest groups as the start-up date approaches, and a recognition that this might be coming ‘ready or not’ and that there are still a considerable number of rough edges that need to be smoothed.
The blog posted on Friday and found here has excited one reader:
The point I was trying to make is that patients need to be in control and  consent to what happens to them. They should also be able to - as they do now - be able to know what information is held about them. As for controlling what their carer records to assist in delivering their care - and for a host of other reasons - I see this as a professional responsibility and not something the patient should be controlling. Of course the carer has a responsibility to protect the information - keep it safe and only disclose it to anyone other than the patient when given permission and consent. As I say in the comments we have a preferred model of care delivery - based on a primary care driven model - and our Health IT should optimally support that. The PCEHR does not do that in my view.
It is also interesting the Allscripts seem to have hit a bit of a speedbump in the US. Given they support and are implementing in WA and SA there is some concern about how things will play out.
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Security concerns over Australia’s e-health records

Medicos blame NEHTA’s "unreliable performance". But enough with lost data! Let’s criminalise negligent data breaches.
  • Stilgherrian (CSO Online (Australia))
  • — 23 April, 2012 11:34
As Australia grinds ever-closer to putting our health records online from (allegedly) 1 July, disturbing news is emerging. US hospitals are seeing more data breaches, and Australian medical experts warn that patient safety could be put at risk.
“It is not yet possible to make any definitive statement about whether the personally controlled electronic health record is safe or not," wrote three experts in the latest subscriber-only Medical Journal of Australia.
According to News-Medical.Net, the new e-health system has been subject to growing criticism based on privacy and security concerns, and that's down to the unreliable performance of the National E-Health Transition Authority (NEHTA).
There are "accusations of ineffective oversight and failure of administrators to acknowledge design flaws" and "warnings that the system will not succeed because its implementation has been ill-considered and rushed," according to the report — although NEHTA has pulled back the pace.
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Are online medical records safe?

  • Leanne Hudson
  • National Features
  • April 28, 2012 7:00PM
THE Government wants to put your health records in cyberspace and you’ve already been given an ID. Leanne Hudson asks if it’s entirely safe.
Imagine if any medical practitioner could access your healthcare records at the click of a mouse. The emergency department could treat you more quickly, specialists could compare test results instantly and you wouldn’t have to remember the last time you had a tetanus shot.
Welcome to the world of eHealth, a program the  Government has invested $466 million in. Its aim is to create PCEHRs (Personally Controlled Electronic Health Records) that centralise a patient’s healthcare information and, with their permission, present it to registered healthcare providers.
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Exposed: E-health log-on security risk

26th Apr 2012
GPs and other practitioners have been using their unique e-health identifying number as a log-on for the AHPRA website since 2010 without being given any advice on security provisions or even warned the two numbers are the same.
Practitioners will use their Healthcare Provider Identifier (HPI-I) number to access patient information under the personally controlled e-health records system (PCEHR) and the number will be used to track each practitioner’s use and access of that information.
An AHPRA spokesperson confirmed their website log-on was comprised of the last 10 digits of a practitioner’s HPI-I. The first six digits of the HPI-I are common to every AHPRA registered practitioner.
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Test cases for e-health pay revealed

24 April, 2012 Paul Smith
Details of what MBS items doctors can claim for creating and curating shared e-health summaries were released by the RACGP on Tuesday.
Under the $467 million Personally Controlled Electronic Health Record (PCEHR) system, doctors will be expected to create shared health summaries listing patient’s diagnoses, medications, allergies and adverse reactions and immunisations.
The system is being rolled out from July. But there has been a protracted debate over the circumstances in which level B, C and D attendance items can be claimed by doctors for creating the summaries — summaries which will be shared with hospitals, doctors and other health providers who sign up to the initiative.
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Working with e-health on the front line

17 April, 2012 Paul Smith
Dr David Guest is one of the doctors trialling key aspects of the personally controlled
e-health records system through the Improvement Foundation eCollaborative. He has prepared shared health summaries for about 100 of his patients.
At his practice near Lismore he creates a draft version of the health summary drawn from his patient records, asking the patient to read through the information in the waiting room before correcting the summary in the consultation.
“Going through the patient information and tidying it up before it gets uploaded onto to the PCEHR does involve some work,” he says. “For new patients with a long list of problems, it could take 30 minutes ... It’s about determining what is relevant to the patient’s ongoing care. My practice consists of a lot of elderly patients with chronic disease, [such as] diabetes and heart disease patients. So they can be fairly complex."
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Doctors worry about patient data control

DOCTORS have raised concern over joining the Territory's original e-health revolution with a new national database.
The Personally Controlled e-Health Record "opt in" scheme will allow people to enter and control their own medical data from July 1.
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When will ehealth record legislation be passed?

On 25 November 2011, on the recommendation of the Selection of Bills Committee, the Senate referred the provisions of the Personally Controlled Electronic Health Records Bill 2011 and the provisions of the Personally Controlled Electronic Health Records (Consequential Amendments) Bill 2011 to the Community Affairs Legislation Committee for inquiry and report by 29 February 2012. On 28 February the Senate extended the reporting date to 13 March 2012. The reporting date was again extended to 15 March and then 19 March 2012.
The report was tabled on 19 March 2012. With recommendations to review after two years of operation, the Community Affairs Legislation Committee has recommended that the Bills be passed – click here for the report.
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Glancing forward: Prof David Glance

Professor David Glance, the director for software practice at the University of Western Australia, had some reservations. He was on the phone, straddling time zones, telling eHealthspace.org he is doubtful the summary care record in the PCEHR will make any real difference to Australian health consumers.
“Globally, there’s no evidence [a summary care record] will improve health outcomes,” he said.
Professor Glance has an extensive background in ehealth, heading the development of MMEx, a clinical software package. He’s also researched text analysis of clinical data, and the implementation of software in clinical settings.
The problems with a summary care record, said Prof. Glance, are myriad. If someone comes into an emergency department, there are a whole set of preconditions associated with getting a health care record to work properly.
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Delayed choice for prescription alert platform

HEALTH Minister Tanya Plibersek's $5 million plan to crack-down on prescription painkiller abuse, which was announced in February, was originally funded under the fifth community pharmacy agreement with the Pharmacy Guild in 2010.
However, a decision on the platform was reached only late last year.
Ms Plibersek was responding to calls from a Victorian coroner for action on real-time prescribing and dispensing monitoring systems for controlled (Schedule 8) drugs, including the ability to alert doctors before new scripts are issued.
In February, coroner John Olle found James, a 24-year-old Melbourne man, had committed suicide by overdosing on morphine and diazepam; in the three years before his death, James had obtained S8 scripts from 19 doctors and medications from 32 pharmacies.
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Bionic eye patient tests planned for 2013

UNSW launching new bionic vision labs
Bionic vision researchers intend to test a functional bionic eye on patients next year.
“Our primary aim is to complete the first prototypes of the bionic eye so they can be tested in human recipients in 2013,” said Gregg Suaning, a professor from the University of New South Graduate School of Biomedical Engineering, in a statement.
Suaning is also the leader of Bionic Vision Australia’s wide-view device, the first of two prototypes designed to restore vision in people with degenerative retinal conditions.
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Soldiers need e-health records, review finds

24th Apr 2012
ELECTRONIC health records are needed to stop Australian soldiers wounded in war zones from falling through the cracks of bureaucracy during their rehabilitation, a review says.
A review by KPMG found the Defence system failed when it came to rehabilitation, transition to normal life, and compensation for soldiers wounded in Iraq, Afghanistan and other warzones.
But it was good at providing immediate medical care to wounded troops, the 280-page review released on Monday afternoon revealed.
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Consider broad telehealth benefits

A NEW US study which showed “underwhelming” clinical outcomes from telemonitoring still adds to the knowledge base about telehealth and should not dissuade doctors from its benefits, according to Australian experts.
Professor Len Gray, director of the Centre for Online Health at the University of Queensland, said the study, published in Archives of Internal Medicine, was well designed but examined only clinical outcomes, when there were many other potential benefits of telehealth. (1)
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Geeks use computer power to cure cancer

Anthony Agius
April 26, 2012 - 8:07AM
Technology enthusiasts are using the power of their computers to join the fight to cure diseases such as cancer, Alzheimer's and Parkinson's.
The human race agrees cancer is awful. Nobody wants it and nobody likes it. Cancer's impact also spreads to the minds of families and friends of those with the disease, who watch their loved ones try to cope with their own bodies trying to kill them.
The same applies for diseases like Alzheimers and Parkinsons. As people are touched by the effects of these diseases, they want to help. Some become scientists, doctors or nurses, actively working in the front lines to cure, treat and assist. The majority of us contribute to charities, either directly, by volunteering, or indirectly, by giving money, or raising awareness.
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Privacy Act reforms — the implications for the digital environment

The Privacy Act reforms to create greater protection for online users
As Privacy Awareness Week kicks off this week, the Federal Government’s reforms to the Privacy Act, which began in 2006, seem to have fallen off the radar.
Roger Clarke, principal at Xamax Consultancy, attributes the slow government response to “complete apathy” and says the reason the inquiry began in 2006 was to “quieten down the backbenchers” around problems which had been identified in parliament surrounding privacy issues.
“They progressed extraordinarily slowly and they still haven’t really reached any point of resolution, and one has been brought forward from the second tranche, opportunistically and quite recently, but that one also seems to have stalled in the last few months as well,” Clarke says.
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Woman in divorce row loses job fight

Natasha Rudra
April 26, 2012
A WOMAN who used Australian Federal Police databases to dig up dirt on her former husband during a bitter divorce has lost a claim for unfair dismissal.
Fair Work Australia heard the woman, who worked as a financial analyst for the AFP, also tried to rope colleagues into her battle against her former husband but was sacked in April last year after he hired a private investigator and complained to police.
She was found to have breached the AFP code of conduct after getting a co-worker to send her records on her former husband's businesses, which she described as ''gold'' and forwarded on to her mother.
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Technology in the driving seat as Bosch's growth accelerates

THE $1 billion Australian business of Robert Bosch, the world's biggest automotive parts supplier, is evaluating several strategic acquisitions and launching a range of hi-tech growth initiatives to help it achieve its ambition to double in size in the next decade.
Bosch is renowned for its automotive components, power tools and household appliances, but Australian president Gavin Smith says the recent launch of new softwear and business outsourcing operations in Australia, as well as initiatives in solar energy and e-health, will underpin the extensive growth ambitions of the local operation.
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Swiss scientists show off mind-controlled robot

  • From: AP
  • April 25, 2012 8:08AM
SWISS scientists have demonstrated how a partially paralyzed person can control a robot by thought alone.
It is a step they hope will one day allow immobile people to interact with their surroundings through so-called avatars.
Similar experiments have taken place in the United States and Germany, but they involved either able-bodied patients or invasive brain implants.
On Tuesday, a team at Switzerland's Federal Institute of Technology in Lausanne used only a simple head cap to record the brain signals of Mark-Andre Duc, who was at a hospital in the southern Swiss town of Sion 100 kilometers away.
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Interview: Denis Tebbutt, Vendor Engagement, National E-Health Transition Authority (NEHTA)

Denis Tebutt is an adviser to the National E-Health Transition Authority (NEHTA). Denis has spent the last 40 years in high technology businesses with over 30 in the growing information technology sector working across the globe in manufacturing, finance and for the past 10 years in healthcare.
He is a dynamic leader with strong strategic and business development skills founded on a deep understanding of the technology and its role in supporting the development of a more agile and innovative business model for the industries that he has served. The challenge faced by the healthcare sector brings together the experiences and lessons of earlier industries.
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Financial Decline, Departures Roil Allscripts

APR 27, 2012 11:44am ET
The stock price of physician/hospital software vendor Allscripts dropped 40.6 percent at the open of trading on April 27 after the company announced poor first quarter financial results, lowered expectations for the rest of 2012, and announced the departure of its chief financial officer and four board members including Chairman Phil Pead.
Pead was terminated and three board members opposing the decision resigned. CFO Bill Davis will leave in May to join another company outside the industry. Allscripts has named Dave Morgan, senior vice president of finance, as interim CFO.
Nearly 45 million shares traded hands during the first hour of trading on April 27, compared with a daily average of about 3 million shares. The stock had lost up to 45 percent of its value during extended trading after the market closed on April 26.
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Allscripts in skid mode as shares plunge, chairman ousted

By Bernie Monegain, Editor
Created 04/27/2012
CHICAGO – It was no ordinary quarterly meeting Thursday for Allscripts. Its chairman Phil Pead was, by many accounts, forced out. Three board members apparently resigned in protest. And this morning, the EHR vendor's shares have plunged almost 43 percent to $9.15.
The company also reported that CFO Bill Davis would be exiting May 18 for another position outside the healthcare sector, leaving analysts downgrading the firm's stock from “buy” to “neutral.”
Sean Wieland, senior analyst from Piper Jaffrey was among those downgrading.
“Any one of these items would be a concern, but all three happening simultaneously leads us to question what else is there that we don't know,” he wrote in an analyst brief today. He added that a rule of thumb is to downgrade on any CFO turnover.
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Who's accountable for IT failure?

By Michael Krigsman | April 16, 2012, 4:45am PDT
Summary: IT failures are a management crisis of serious proportions that have been largely ignored. Here’s what senior executives need to know - and do - right now.
This two-part series presents a structure for understanding why IT projects fail, in a way that goes far beyond project management alone. Part one elaborates the problem while part two discusses the need for greater accountability on the part of senior management.
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Enjoy!
David.