Health Care

Thursday, September 5, 2013

Study Explains Errors Caused by EHR Default Values - With Only Four Reports of "Temporary" (By the Grace of God) Patient Harm

From Health Data Management and the Pennsylvania Patient Safety Authority:

Study Explains Errors Caused by EHR Default Value
Joseph Goedert
Sept. 5, 2013

A new study analyzes errors related to “default values” which are standardized medication order sets in electronic health records and computerized physician order entry systems.

The Pennsylvania Patient Safety Authority, an independent state agency, conducted the study. “Default values are often used to add standardization and efficiency to hospital information systems,” says Erin Sparnon, an analyst with the authority and study author. “For example, a healthy patient using a pain medication after surgery would receive a certain medication, dose and delivery of the medication already preset by the health care facility within the EHR system for that type of surgery.”

These presets are the default value, but safety issues can arise if the defaults are not appropriately used. Sparnon studied 324 verified safety reports, noting that 314, or 97 percent, resulted in no harm. Six others were reported as unsafe conditions that caused no harm and four reports caused temporary harm involving some level of intervention.

One might ask: how many unreported or yet-to-be-reported EHR/CPOE cases involved, or will involve, permanent harm?

Sept. 9, 2012 Addendum: We learn this from Healthcare IT News (http://www.healthcareitnews.com/news/ehr-adverse-events-data-cause-alarm): "Sparnon said two of the reports involved temporary harm that required initial or prolonged hospitalization." I note that hospitalization, especially prolonged hospitalization, exposes the patient to still more risk.

Regarding the "temporary harms", one which includes "default times" as opposed to doses:

The four cases requiring intervention involved accepting a default dose of a muscle relaxant that was higher than the intended dose, giving an extra dose of morphine [keep playing with 'extra doses' of drugs like morphine enough, and you're going to kill someone - ed.] because of an accepted default administration time that was too soon after the last dose, having a patient’s temperature spike after a default stop time automatically cancelled an antibiotic [do this enough, and you're going to get sepsis and septic shock to deal with - ed.] and rising sodium levels in a patient because confused wording made nurses believe that respiratory therapy was administering an ordered antidiuretic. [Apparently the 'default'- ed.]

Wednesday, September 4, 2013

This Is A Very Important Factor In The Uptake of E-Health. We Have A Good Distance To Travel Yet.

This appeared a few days ago.

The digital divide is genuine but it is closing slowly

by: Bernard Salt, Social Editor
From: The Australian
August 29, 2013 12:00AM

THERE is a digital divide in this nation and it has nothing to do with the National Broadband Network and its rollout, or lack thereof.

It has to do with who has and who does not have home access to the internet. This question has been asked at the past two censuses so it's possible to see where the digital divide lies. And as far as I can see access to the internet in the home is seeping out from the knowledge workers of the inner city to embrace the ordinary and the aspirational of middle Australia on the very edges of the city.

Between the 2006 and 2011 censuses, there was a 16 percentage point lift in the proportion of households with access to the internet. The type of access - broadband, dial-up, wireless - is not relevant to the existence and the course of the digital divide. Rather, the question is whether some parts of metropolitan Australia are being left behind in the digital revolution. At the 2011 census, 79 per cent of households had internet access; based on recent growth rates this proportion now is probably closer to 85 per cent, although there are some parts of the nation where the rate of household internet access exceeds 90 per cent.

The digital cognoscenti live in an odd collection of places such as the curiously named Pleasure Point near Voyager Park in Sydney's southwest; 92 per cent of Pleasure Point's population have internet access. Pleasure Point is a new infill, and clearly aspirational, housing development; internet access is part of the suite of services regarded as de rigueur in selling new homes.

Other areas where internet access today is likely to exceed 95 per cent of households includes Melbourne's Docklands, Brisbane's Burbank and Perth's Burns Beach. The common denominator for these digital hot spots is that they appeal to large families where both partners work and where there are teenagers and/or young adults still living at home, or they are the preferred location for professional singles and couples who would most likely work in the knowledge industry.

But this is not to say that there aren't places within metropolitan Australia where internet access in the home is limited. In suburbs dominated by public housing, internet access hovers about the 66 per cent mark. For example, in the Sydney postcode 2559 that centres on Claymore in the city's southwest, just 62 per cent of households have internet access. Similarly low levels of internet access dominate Ardeer in Melbourne, Athol Park in Adelaide, Dinmore in Brisbane and Balga in Perth.

The digital divide is real; it can mean the difference between one-third of households having or not having internet access. In Sydney, the digital divide separates Pleasure Point from Claymore; in Melbourne it separates Docklands from Ardeer; in Brisbane it separates Burbank from Dinmore.

But there is evidence from the censuses that the digital divide is shrinking. Those suburbs where home internet access was poorest in 2006 are generally those places that recorded most percentage-point growth. For example, in the Adelaide suburb of Athol Park internet access lifted 31 percentage points from 34 per cent to 65 per cent across the five years to 2011.

Lots more here:

http://www.theaustralian.com.au/business/opinion/the-digital-divide-is-genuine-but-it-is-closing-slowly/story-e6frg9jx-1226706049286

Considering this information in the light of our e-Health needs what we see is that we are moving ever closer to full access to e-Health applications on the internet. However we need to remember that many of the target groups for things such a patient portals and the PCEHR are sadly those who either do not have access or who are not all this skilled in its use (the target groups being the aged and those with chronic illness and disability.)

The source document on which this is based is found here:

http://www.abs.gov.au/ausstats/abs@.nsf/Latestproducts/D11394A54F8B9ED1CA25796600152C62?opendocument

The effects of age, household income and location are all very important.

With less than 50% of those under having internet access and with only 60% of the lowest wealth quartile having internet access we really do have a way to go.

David.

What Can “Chronic Resilience” Teach Public Health Practitioners? An Interview With Author Danea Horn

Last month I had the pleasure of receiving an advanced review copy of "Chronic Resilience: 10 Sanity-Saving Strategies for Women Coping with the Stress of Illness". As I read through the book, I made note of many issues that are relevant to public health practitioners. Therefore, it is a pleasure to have Danea Horn expand her comments on these topics for Pop Health readers.

If you would like to connect with Danea, you can visit her website or twitter.

Leah: In public health, we talk a lot about how our society’s “culture” can promote or harm health. In several places in your book, you talk about the connection between our societal values and our health. For example:

Page 33: “Part of the reason we try to be all things to all people is our culture. Have you ever sat through a business meeting while someone is sniffling and sneezing and exposing everyone else to their cold? In that moment they are valuing achievement, money, or appearances above their health and the health of everyone else in the room.”

How can we expand your strategies beyond the individual level? How can we identify and live our health values at the neighborhood, community, and organization levels?

Danea: It only takes one person to start a conversation that can become the catalyst for big changes. Start talking to people at your work and in your community to get a feel for what is valued currently. The policies (written and unwritten) in our offices and items at our potlucks will say a lot about what we collectively value. If you find inconsistency or confusion in your conversations, open up a dialogue with the leaders in your organization or community to discuss what you would like to collectively choose to value. From here you can brainstorm together ways to influence change. They can be small changes like creating a healthy living block party where people share nourishing dishes and swap good-for-you recipes or larger changes like paid sick leave (which is not mandatory in every state…yet). Never be afraid to speak up. A big theme in Chronic Resilience is controlling what you can control and talking is in your control.

Leah: In Chapter #6, you write “It is up to you to decide how public to make your health.” You and several of the women you interviewed for your book have blogs that document your health journey in a very public way. Public health researchers Ressler et al (2012) have identified many benefits of patient blogging (e.g., patients report a decrease in feelings of isolation).

What benefits have you experienced as a result of writing about your health? What challenges have you encountered during the process of sharing your story publicly?

Danea: Writing helps me process what is going on from a different perspective. I am all about learning from our challenges, so each post I write is a search for a lesson or message that my diagnosis is pointing me toward. I can feel frustrated about the progression of my disease and start out writing a rant, but I find that I naturally end up with a message about letting go of my ideals or acceptance. Reframing my health in this way has been very empowering.

I haven’t encountered many challenges by being public with my health journey. Commenters have been very supportive. That said, I am discerning about what I choose to share and do keep some things private. Challenges I know other people have faced, and someone who blogs publicly about their health should be prepared for, are people sharing remedies, treatment recommendations, cure-all solutions and pleas to have faith in a deity they may or may not believe in. While these all come from a caring place they may feel intrusive. Also, you may want to give a heads-up to your close family and friends before you post anything particularly revealing, emotionally or otherwise, that you haven’t shared with them in private first.

There are a number of ways to benefit from writing about your health. Doing it publicly on a blog can create a sense of support and community, but if that feels too invasive, you can join support forums anonymously, create a private blog or journal pen and paper old school style.

Leah: In Chapter #7 (“Empower Yourself With Research”), I was thrilled to see your emphasis on helping patients evaluate the validity and safety of medical information found on the Internet. This is a huge challenge in public health! Our evidence-based messages and guidelines often compete online with anecdotal evidence and unscientific studies.

Why did you decide to dedicate a portion of your book to this discussion? Why is it so important for patients to discuss what they find online with their medical team?

Danea: Before I became discerning about what I read online about my diagnosis, I was completely stressed. I read way too much from too many random sources to properly sort out what I should believe. I also noticed that I was searching for how I was going to become sicker (the side effects, complications, and progression of my illness) instead of searching for how I could support my heath. Fortunately, I realized most of my stress was coming from worry created by endless Internet searching, and I decided to take a different approach.

I found a few sources from trusted physicians and nutritionists to study and implement. I decided to stay focused on my personal symptoms, medications and prognosis instead of what other people I didn't even personally know had experienced. I also started a more open dialogue with my doctors about the diet I wanted to try and some of the studies I had read. When we research and experiment with our health without informing our doctors, we may have conflicting approaches which can create drug interactions or other harmful complications. Doctors are there to support us. If you are uncomfortable talking with yours, it’s time to find one that you trust enough to be completely open and honest with. We should all have a doctor who will work with us to find treatment solutions we feel comfortable with.

Leah: A big thank-you to Danea for making the time for Pop Health! "Chronic Resilience" is a great read for those with a personal and/or professional connection to chronic illness. For public health clinicians, practitioners, and researchers who work in the chronic illness arena: I think you will get a unique first-hand view into (1) the mental, physical, and emotional challenges that affect this population, (2) the incredible resilience that those with chronic illness show on a day-to-day basis (what can we learn from them??), and (3) specific strategies that can be employed to support patients with chronic illness. As Danea and I discuss above, these strategies have the potential to be expanded from the individual level to offer support to entire communities.

Tuesday, September 3, 2013

Don’t Ever Underestimate The Power Of The Pharmacy Guild. They Are A Force Of Nature.

This appeared a few days ago.

Electronic script scanning incentive announced

30 August, 2013 Nick O'Donoghue

Pharmacists will be able to claim up to $2000 per pharmacy if they use electronic prescription scanning systems, as part of a new incentive announced today.

The decision to incentivise the use of Electronic Transfer of Prescriptions (ETP), comes after months of negotiations between the Pharmacy Guild of Australia and the Department of Health and Ageing, and will be applicable for the 2013/14 financial year.

The new incentive, which uses existing Fifth Community Pharmacy Agreement funds, is aimed at driving ETP use in pharmacies to improve quality use of medicines and reducing the number of adverse medication events.

Kos Sclavos, Guild national president, welcomed the new incentive, saying it would encourage more pharmacies to adjust their workflow to facilitate the scanning of barcodes on all electronic prescriptions.

“This is a significant and cost effective step towards boosting the use of electronic prescription technology, reaping tangible benefits in terms of accuracy, efficiency, and patient medication management,” he said.

More here:

http://www.pharmacynews.com.au/news/latest-news/electronic-script-scanning-incentive-announced

So to stop spending time re-typing prescriptions into their dispensing systems and making the whole process safer and quicker for them and the patients, the pharmacists are being give a donation of $2000.

It is amazing this can happen in the Government caretaker period but I am assured it's part of portfolio management utilising an already established agreement.

Talk about being money for nothing!

David.

Rumour Central: It Looks Like The NEHTA Clinical Leads Progam Has Pretty Much Died.

I am hearing well sourced rumours that virtually all the NEHTA Clinical Leads have left and are now 'out the door'.

If this is true it would confirm just what a debacle the PCEHR has become and what a pickle DoHA and NEHTA now find themselves in.

Any insider prepared to say how many Clinical Leads are left? I am hearing only very few.

That there a major problems is confirmed by the following from another correspondent:

"My 1:1 conversation with xxx clearly outlined his deserting of the sinking PCEHR / NEHTA ship.

His personal comments indicate a 'fatal cancer' in the NEHTA / DoHA organisation on the PCEHR."

Is sounds like things inside the NEHTA Clinical Unit have become pretty grim.

David.

Monday, September 2, 2013

Now Here Is A Call I Would Really Like To See Actioned After The Election No Matter Who Wins.

This appeared a little while ago.

Can the PCEHR be salvaged – a consumer view.

Aug 27 2013

The Consumers e-Health Alliance is calling on the major parties to revisit the $1 billion national electronic medical information-sharing system and actually deliver the promised benefits.

CeHA convenor Peter Brown says the launch of the $1 billion Personally Controlled Electronic Health Record (PCEHR) “needs to be seen positively for the opportunities it presents.”

But with emerging difficulties identified by medicos, consumers, the local health IT industry and the full range of State and Federal government agencies charged with implementation, CeHA believes it is now important to bring all parties together to tackle the issues.

There is no way an effective e-health system can be established without standardised infrastructure providing quality interchange and secure storage capabilities for people’s confidential medical information.

We need to build on the basic PCEHR infrastructure by incorporating the many practical systems operating across the currently siloed health sector, but this has to be done in a co-ordinated, connected way. Such an approach is increasingly being undertaken elsewhere around the globe.

The original National e-Health Strategy, agreed by all Commonwealth, State and Territory Health Ministers in December 2008, addressed the need for a national governing body with an independent chair and broad stakeholder representation to set priorities, direction and funding.

Crucially, the National e-Health Governing Board would be publicly accountable for ensuring the desired outcomes, with the support of a new National e-Health Entity tasked with managing the work program, overseeing standards development, a privacy and security framework, and systems compliance. it will also co-ordinate the implementation.

It is unfortunate that these governance arrangements were not established from the outset. Obviously the co-ordination and management of such an inherently complex system would be a critical factor in its successful implementation and ongoing operation. That would achieve good quality co-ordination and collaboration of all stakeholders. This accords with the recommendations of the Health Ministers Conference, December 2008.

Instead, responsibility for operating the network has been handed to the federal Department of Health and Ageing.

Clearly, this was not initially envisaged, and the Department is not designed for such a task and has no prior experience in an operation of this size and type. Department secretary Jane Halton correctly pointed out recently that the national e-Health program was larger than the Snowy Mountains scheme. This is true, but the responsibility for that construction job was not given to a Government department.

The PCEHR system is far, far bigger than can be managed in that way. Healthcare not only involves millions of individual citizens and their personal medical records, but many thousands of organisations – public, private, sole practitioners, and some 800,000 employees.

It involves a new communications paradigm on a grand scale that will be strange to nearly every participating consumer and clinician alike; based on an appropriate electronic networking infrastructure.

It needs to be accepted that such an e-health network can only be made workable by having the four key stakeholder groups – clinicians, consumers, the medical software industry and government agencies – present at the same table at all stages of its development and implementation. The operation needs to be melded into a suitable type of network. This complex situation cannot be validly compared with the banks, since a health service is quite different.

CeHA believes consumer organisations can play an important role in articulating and clarifying privacy and confidentiality concerns, advocating for higher quality patient outcomes and more efficient use of scarce health resources through new technologies, and the use of patient data for medical research endeavours. And importantly, greater engagement with the patients themselves.

Good governance can help to de-politicise one’s electronic health record, by focusing on long-term infrastructure that can evolve to meet the needs and aspirations of clinicians and consumers.

Lots more here:

http://ceha.org.au/?page_id=19

All I can say is that I agree - and that I have been saying the same for the last few years. The unaccountability of DoHA and NEHTA in the e-Health domain is just a travesty.

David.

Sunday, September 1, 2013

Weekly Australian Health IT Links – 2nd September, 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

Before we get to the serious stuff the rumour mill grinding away and is asking - just who is the senior executive in the e-Health domain who loves flying business class and who, as times look to be changing in Canberra, has sold out, jumped ship and migrated far, far north, somewhat leaving his colleagues in the lurch, to take a well-paid international job as e-Health unravels in OZ! The very same executive apparently seems to have left a lot of e-Health Standards processes in a mess and made some long term Standards Australia volunteers just give up. Comments and insights welcome.

The serious stuff is, of course, the election we are all participating in on Saturday, to decide, among other things, who will be the Health Minister and who will be directing e-health in OZ for the next few years.

On the basis of the reports it seems neither of the major parties is seen as having a great deal to offer for clinicians and that neither are all that popular or offering much that will make a difference. As many others are saying all I can do is with you luck in making a choice - it is just way too hard for me!

I will see you all next week and we can discuss what it all means.

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http://www.medicalobserver.com.au/news/dutton-aims-to-deliver-for-gps

Dutton aims to deliver for GPs

27th Aug 2013

Andrew Bracey

THE man in line to possibly become Australia’s next health minister has accused Tanya Plibersek of having “barely contained contempt for doctors” and pledged to rebuild the eroded standing of general practice.

In an interview with Medical Observer, shadow health minister Peter Dutton said Labor and the health minister had treated the nation’s doctors with “suspicion” rather than respect.

He also argued that the super clinic program, along with moves to cap tax-deductible self-education expenses, had undermined general practice and created further disincentives for graduates to choose the specialty.

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http://www.medicalobserver.com.au/news/few-sparks-in-health-debate

Few sparks in health debate

28th Aug 2013

AAP

TANYA Plibersek and Peter Dutton have shown why health is not a major election issue.

The health minister and her opposition counterpart went head to head in a National Press Club debate yesterday and found they agreed on more than they disagreed.

There was, as a journalist said in a preamble to a question, an "outbreak of bipartisanship".

A smiling Ms Plibersek opened proceedings by saying she'd held the portfolio for 622 days and "loved every minute of it".

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http://ehealthspace.org/news/national-press-club-health-debate-leaves-gaps

National Press Club Health debate leaves gaps

Posted Tue, 27/08/2013 - 18:15 by Fran Molloy

At the National Press Club today, Health Minister Tanya Plibersek and Opposition Health Spokesman Peter Dutton laid out key health policy priorities for each party in the lead-up to the Federal Government.

Aside from Peter Dutton’s introductory address, eHealth did not feature prominently in the debate, nor was it highlighted in journalists’ questions.

Minister Plibersek focused on Labor’s track record as well as personal highlights during her almost two years in office including the introduction of the $4.1 billion Grow Up Smiling program for children’s dental care, the flexibility of funding through Medicare locals to fill gaps , and the introduction of $6 billion worth of new medicines since 2007.

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http://www.australiandoctor.com.au/news/latest-news/doctors-unimpressed-with-plibersek-dutton

Plibersek, Dutton get thumbs down

27 August, 2013 Paul Smith

The next federal health minister will have to radically lift their game in the eyes of a medical profession that appears unimpressed with the achievements of either Tanya Plibersek or Peter Dutton.

In an Australian Doctor online survey, more than 75% of doctors rated the performance of the current health minister over the past 18 months as “very poor or mediocre”.

However, one-fifth said her performance had been “excellent or good”.

Ms Plibersek’s rival for the job of spending a $546 billion slice of the nation’s health budget, Mr Dutton, fared better.

But more than half of respondents still thought his performance has been “very poor or mediocre”.

Twenty-eight per cent described his performance as “excellent or good”.

As the election campaign heads towards its final week, the results of the survey of 275 doctors suggest one-third believe Mr Dutton would make a more competent health minister than Ms Plibersek.

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http://www.medicalobserver.com.au/news/coalition-is-triplebackflipping-on-mls-labor

Coalition is triple-backflipping on MLs: Labor

30th Aug 2013

AAP

TONY Abbott's backflip on coalition plans to close Medicare Locals is not "credible", Federal Health Minister Tanya Plibersek says, accusing the opposition of having four different positions on Labor's health network.

Mr Abbott declared "we are not shutting any Medicare Locals" during a leaders debate on Wednesday, despite previously pledging a detailed review of the primary health care providers, and despite refusing to rule out closures earlier in the campaign.

"They first said they were going to get rid of them, then they said they were going to review them, then they said they couldn't rule out closing, and last night they said they could rule out closing," Ms Plibersek told ABC TV on Thursday.

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http://www.theaustralian.com.au/australian-it/tony-abbott-eager-to-overhaul-e-health-system/story-e6frgakx-1226704552564

Tony Abbott eager to overhaul e-health system

by: Fran Foo
From: The Australian
August 27, 2013 12:00AM

TONY Abbott has vowed to work with health professionals to review the troubled $700 million personally controlled e-health record system should the Coalition win on September 7.

One GP called for the PCEHR to be governed by an independent council comprising medical experts. The proposed review does not come as a surprise as the opposition called for a "pause" to the system's rollout more than two years ago.

Both Queensland Liberal senator Sue Boyce and opposition e-health spokesman Andrew Southcott have repeatedly criticised the PCEHR implementation over the years.

While the future of the National E-health Transition Authority - Mr Abbott's baby while he was health minister during the Howard years - under a Coalition government is uncertain, doctors say an e-health overhaul is timely. The opposition's health policy, released last week, says "if elected, the Coalition will undertake a comprehensive assessment of the true status of the PCEHR implementation".

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http://ceha.org.au/?page_id=19

Can the PCEHR be salvaged – a consumer view.

Aug 27 2013

The Consumers e-Health Alliance is calling on the major parties to revisit the $1 billion national electronic medical information-sharing system and actually deliver the promised benefits.

CeHA convenor Peter Brown says the launch of the $1 billion Personally Controlled Electronic Health Record (PCEHR) “needs to be seen positively for the opportunities it presents.”

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http://www.medicalobserver.com.au/news/whos-responsible-for-ehealth

Who’s responsible for e-health?

26th Aug 2013

Andrew Bracey

CONCERN over the departure of a number of NEHTA’s clinical experts, including national clinical lead Dr Mukesh Haikerwal, has prompted calls for an independent council to be given responsibility for the e-health records initiative.

A week after the resignations, NEHTA would not reveal details of how many clinical leads it would retain or seek to recruit following the mass departure.

It said it recognised the importance of clinical input into e-health and the PCEHR and that along with the Department of Health and Ageing, it had “a range of governance arrangements in place to obtain clinical input”.

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http://www.transformingthenation.com.au/2013/08/net-based-supports-helpful-study/

Internet supports helpful: study

28 Aug

by admin in E-Health & Technology, Research

As global rates of diabetes escalate, a new study suggests that internet technologies may be helping to overcoming the impact on the Australian healthcare system.

The Monash University study, published in the Medical Journal of Australia, monitored 577 diabetes patients over 14 months. It showed significant improvements in quality of care and clinical outcomes for patients whose care was supported by internet-based care management service, cdmNet.

The study was led by Professor Grant Russell, Head of the School of Primary Healthcare, and director of the Southern Academic Primary Care Research Unit (SAPCRU) at Monash as well as Professor Peter Schattner of the Department of General Practice.

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http://www.pharmacynews.com.au/news/latest-news/electronic-script-scanning-incentive-announced

Electronic script scanning incentive announced

30 August, 2013 Nick O'Donoghue

Pharmacists will be able to claim up to $2000 per pharmacy if they use electronic prescription scanning systems, as part of a new incentive announced today.

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http://www.transformingthenation.com.au/2013/08/sa-rolls-out-electronic-record/

SA rolls out electronic record

29 Aug

by admin in E-Health & Technology

The first statewide integrated electronic health record in Australia is being rolled out this week.

The launch of SA Health’s Enterprise Patient Administration System (EPAS) at Noarlunga Hospital will mean its doctors and nurses can electronically access patient information at the bedside and throughout the hospital.

State Health Minister Jack Snelling said EPAS would support staff in providing safe, efficient care to patients.

For the first time, clinicians will be able to access medical records electronically and order tests, medication and review results from computers at their patient’s bedside and other points of care around the hospital, Snelling said.

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http://www.abc.net.au/news/2013-08-27/e-health-system-switched-on-at-noarlunga-hospital/4915742

Electronic record system switched on at Noarlunga Hospital

Updated Wed 28 Aug 2013, 8:46am AEST

An electronic patient records system has been rolled out at the Noarlunga Hospital after delays, glitches and a blowout in the project's cost.

The Enterprise Patient Administration System allows clinicians to access treatment information and order tests and medication by a patients' bedsides.

The Noarlunga Hospital is the first to receive the software which will be introduced across metropolitan hospitals and clinics over the next ten years.

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http://www.healthintersections.com.au/?p=1673

Clinical Safety and sharing data

Posted on August 27, 2013 by Grahame Grieve

An institution has a health record eco-system that is distributed and poorly connected. Due to technical, procedural and policy issues, the data is divided into a series of different silos, and there’s not a lot of inter-connection between them. Though – presumably – the systems have connection points through the patient clinical process, because of differences in perspective and purpose, different information is collected, and because of various system design approaches and various lapses in system continuity (the fog of war), the data is a little out of sync.

This is hardly unusual in healthcare.

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http://www.arnnet.com.au/article/524930/telstra_expands_health_capability_through_new_acquisition/

Telstra expands health capability through new acquisition

Buys the health division of DCA

Julia Talevski (ARN)
28 August, 2013 12:34

Telstra is expanding its capabilities in the ehealth arena after purchasing the health division of Database Consultants Australia (DCA), for an undisclosed sum.

DCA provides community care software, eHealth secure messaging software for general practitioners, health directory database development and support services.

Telstra head of health, Shane Solomon, said the acquisition aligned with its strategy of developing new growth businesses and building its health portfolio.

“DCA Health will be an important asset as we continue to build capability in this area,” Solomon said in a statement.

“Connectivity will play a crucial role in the future delivery and management of health services.

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http://www.computerworld.com.au/article/524919/telstra_expands_health_portfolio_another_acquisition/

Telstra expands health portfolio with another acquisition

Solomon said the acquisition of DCA Health will allow Telstra to provide services to consumers who receive health care at home

Stephanie McDonald (Computerworld)
28 August, 2013 11:16

Telstra has acquired e-health software company Database Consultants Australia in the telco’s first standalone health acquisition.

The acquisition follows several other e-health investments from Telstra, which is looking to build up its health portfolio as part of a strategy to develop new growth businesses.

“Connectivity will play a crucial role in the future delivery and management of health services. The future of health care will see more patients cared for at home and technology will play a critical role,” Shane Solomon, Telstra’s head of health, said in a statement.

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http://www.building4business.com.au/papers/Ensuring_clinical_utility.pdf

Ensuring Clinical Utility and Function in a Large Scale National Project in Australia byEmbedding Clinical Informatics into Design

Christopher Pearce, Cecily Macdougall, Michael Bainbridge, Jane Davidson

Abstract

Across the globe, healthcare delivery is being transformed by electronic sharing of health information. Such large scale health projects with a national focus are a challenge to design and implement. Delivering clinical outcomes in the context of policy, technical, and design environments represents a particular challenge. On July 1, 2012, Australia delivered the first stage of a personally controlled electronic health record -- a national program for sharing a variety of health information between health professionals and between health professionals and consumers. As build of the system commenced, deficiencies of the traditional stakeholder consultation model were identified and replaced by a more structured approach, called clinical functional assurance. Utilising clinical scenarios linked to detailed design requirements, a team of clinicians certified clinical utility at implementation and release points.

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http://www.computerworld.com.au/article/524649/oaic_seeks_feedback_australian_privacy_principles_/

OAIC seeks feedback on Australian Privacy Principles

Consultation closes on 20 September

Hamish Barwick (Computerworld)
26 August, 2013 09:54

The draft Australian Privacy Principle (APP) guidelines have been released for public feedback by the Office of the Australian Information Commissioner (OAIC).

Australian Information Commissioner Professor John McMillan said the guidelines outline how the OAIC will interpret and apply the APPs which come into law on 12 March 2014.

The draft guidelines will be released in stages during September. The first stage includes new requirements for agencies and enterprises about how they manage personal information, including the requirement to have a clearly expressed and up-to-date privacy policy.

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http://www.smh.com.au/technology/sci-tech/scientists-zero-in-on-better-radiation-20130827-2soez.html

Scientists zero in on better radiation

Date August 28, 2013

Nicky Phillips

Science Reporter

Collateral damage: A patient is treated with conventional radiotherapy. Scientists are working on a more focused treatment. Photo: Justin McManus

For five minutes most days a small part of Sophie's* brain is zapped with a beam of high-energy X-rays.

So far she has experienced few side effects from the radiation therapy she receives at a Melbourne hospital, after surgery to remove an aggressive brain tumour three weeks ago.

But each time Sophie receives radiation, her face covered with a special mask, she hopes the beam is hitting its target.

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http://www.theaustralian.com.au/business/opinion/the-digital-divide-is-genuine-but-it-is-closing-slowly/story-e6frg9jx-1226706049286

The digital divide is genuine but it is closing slowly

by: Bernard Salt, Social Editor
From: The Australian
August 29, 2013 12:00AM

THERE is a digital divide in this nation and it has nothing to do with the National Broadband Network and its rollout, or lack thereof.

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https://www.mja.com.au/insight/2013/32/time-open-health-data

Time to open up health data

Nicole MacKee

Monday, 26 August, 2013

A “HUGE amount of public benefit” has been lost in the past 30 years because of restricted access to health data fuelled by privacy concerns, says a leading Australian researcher.

Professor John Mathews, retiring executive director of the Menzies Foundation and professorial fellow at the University of Melbourne, said anxiety generated by HIV and AIDS in the 1980s coincided with the digital revolution, resulting in heightened concerns about privacy and a decline in access to health data for research purposes.

However, he said, the thinking had now “matured” and many members of the public were surprised that data collected at public expense was not being routinely used for public benefit.

Professor Mathews was commenting on US research, published in JAMA Internal Medicine, which found patients cared most about the purpose for using their health data, and less about the user of the information and the sensitivity of the information. (1)

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http://www.racgp.org.au/yourracgp/news/media-releases/e-health-technologies/

New online learning activity assists GPs to use e-health technologies for the benefit of the patients

23 August 2013

The Royal Australian College of General Practitioners (RACGP) and the Australian College of Rural and Remote Medicine (ACRRM) have collaborated to develop a new online education activity that provides information and resources on the integration of a range of e-health technologies within general practice.

The Making e-health work for your general practice online learning module is created for general practitioners (GPs) and general practice registrars to assist the understanding of the key role e-health plays in healthcare delivery.

The learning activity is available from today and aims to assist GPs in adopting appropriate e-health systems to their practice setting, build e-health awareness, help GPs understand the principles and benefits of a national eHealth record system (also referred to as the Personally Controlled eHealth Record System) and simplify the implementation of e-health tools in general practice.

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http://www.smh.com.au/digital-life/smartphone-apps/top-dieting-apps-20130822-2scak.html

Top dieting apps

Date August 25, 2013

Jenneth Orantia reviews the best apps for starting - and sticking to - a healthy diet.

Carlorie Counter & Diet Tracker by MyFitnessPal
iPhone, iPad, Android, BlackBerry, Windows Phone
Free

The beauty of MyFitnessPal is its extensive food database, which includes a surprisingly wide selection of Aussie brands. This takes much of the guesswork out of calorie counting (or kilojoules, if you prefer), so it really just comes down to how conscientious you are about logging food and keeping to your daily calorie limit. You can also use MyFitnessPal with dozens of apps and devices such as Runkeeper, Fitbit, and Withings Wi-Fi scales.

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http://www.computerworld.com.au/article/525040/queensland_health_debacle_state_government_post_it_projects_new_site/

Queensland Health debacle: State government to post IT projects on new site

Government responds to an inquiry into the $1.2 billion Queensland Health payroll bungle

AAP (Computerworld)
29 August, 2013 12:10

All major Queensland government technology projects will be listed on a public website.

IT Minister Ian Walker says the site will contain the projects' timeframes, investment objectives and costs.

It's part of the government's response to an inquiry into the $1.2 billion Queensland Health payroll bungle.

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http://www.smh.com.au/technology/sci-tech/boffins-design-glass-implant-that-grows-new-bone-20130826-2sll1.html

Boffins design glass implant that grows new bone

Date August 26, 2013 - 4:28PM

Michele Munz

Missouri S&T researchers are using small, porous glass scaffolds like these to regenerate bone.

Sometimes medical advances don't come from the medical field at all.

Engineers at the Missouri University of Science and Technology have designed a super-strong glass implant with a scaffolding-like structure that is able to grow new bone.

"We have good material and engineering skills," said lead researcher Len Rahaman, "and when you put those two together, it's allowed us to use our skills to produce a bioactive glass that is strong enough to repair large structural bone defects."

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http://www.smh.com.au/it-pro/government-it/what-if-the-nbn-had-stayed-on-track-20130825-hv1hq.html

What if the NBN had stayed on track?

Date Sun Aug 25 23:13:40 UTC 2013

Tony Brown

It would take a crazy politician to tear down a hugely popular project that was on time and budget, says Tony Brown.

Last week in The Sydney Morning Herald, Opposition communications spokesman Malcolm Turnbull called for voters to elect a Coalition government in the looming election - no surprise there - but in reading the piece I had one of those 'what if' moments.

“In December 2010…Labor released the NBN Co corporate plan. It stated that by June 2013, more than 1.7 million households and businesses would be able to connect to the NBN – and its fibre optic network would have 511,000 users,” Turnbull wrote.

As we know the critical fiber-to-the-premises (FTTP) portion of the NBN has in fact only passed around 200,000 homes – with about 25 per cent of these not actually able to connect to services – and has only 33,000 subscribers.

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Enjoy!

David.

Pages

Thursday, September 5, 2013

Wednesday, September 4, 2013

Tuesday, September 3, 2013

Monday, September 2, 2013

Sunday, September 1, 2013

General Comment

Ensuring Clinical Utility and Function in a Large Scale National Project in Australia byEmbedding Clinical Informatics into Design

Science Reporter

Michele Munz

Tony Brown