There is no other word for it other than depressing.
The world of pharmacy is falling on its own sword with pharmacist organisations at loggerheads with pharmacy organisations, principally the PGA.
Essentially it is wrong for a minority pharmacy organisation to dominate all others and leave in its wake some very unhappy people.
It is not a pretty sight seeing the juggernaut that is the PGA begin the process of decimation, wasting resources in a negative fashion that ought to have been distributed more equitably.
It is neither smart or strategic to be entering into warfare when leadership would offer the more decent alternative.
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Regular weekly updates that supplement the regular monthly homepage edition of i2P.
Access and click on the title links that are illustrated.
A range of global and local news snippets and links that may be of interest to readers.
Pipeline Extra simply broadens the range of topics that can be concentrated in one delivery of i2P to your desktop.
Over the past year I have written about the need to recognize and remunerate pharmacists appropriately in order that pharmacy can take a necessary step forward in the new Millenium. Following are some points that are worthy of note.
1. In New Zealand, we now have approximately four hundred owners of pharmacies. Within this group, incomes range between $200,000 and $600,000.00. The average income for an employed pharmacist working in community pharmacy is around $65,000.00, and the salaries for young graduates in Auckland, (and Melbourne too I believe) is $24.00 per hour - around $48,000.00 per year. Not much of a reward for 5 years of study and very indicative of the value and respect placed on the employed professional by the employer!!!
A failing in the push for a Senate Inquiry into the 5th Community Pharmacy Agreement is recognition that the Pharmacy Guild is named in the National Health Act as the party the Government must liaise with before making decisions on fees paid to pharmacists for supply and services.
It is not the Society of Hospital Pharmacists, the Pharmaceutical Society, the National Australian Pharmacy Students Association or APESMA - but the Pharmacy Guild.
It is therefore no wonder that the Guild is the party at the negotiating table.
An amendment to the National Health Act would be needed to change this and while there is a Clause that says another organisation can be included if it represents a majority of pharmacists this has never been tested.
Last month I likened the community pharmacy industry to a “Heath Robinson”.
According to Wikipedia, “William Heath Robinson (signed as W. Heath Robinson, 31 May 1872 – 13 September 1944) was an English cartoonist and illustrator, best known for drawings of eccentric machines....
In the UK, the term "Heath Robinson" has entered the language as a description of any unnecessarily complex and implausible contraption...”
This month I’m worried about who’s driving it.
For most business leaders and owners the next decade will provide scope for two strategic options - "hard" or "bad".
A touch of reality is needed.
It will be a daunting prospect for some. For others, who do not recognise or appreciate the unfolding marketplace there will be blissful ignorance and a shortened business life.
Among those who are "hanging on until things turn up for the better", there will be disappointment.
This is not the time to hang in our hang out.
Let me emphasise, the circumstances being confronted at present are neither cyclical nor seasonal. They are structural and accordingly, changes are essential in philosophies, operations and outputs.
The next three years will inevitably be "bad" for those who adopt a "victim mentality" and do little or nothing. Those well-reported "headwinds" will remain and will eventually push the inert (becalmed) "boats" backwards and out of the race.
Rationalisations and consolidations will be in evidence across a wide sweep of industry sectors. Established companies, brands, products and services will disappear from the corporate landscape, replaced by high-energy, and focused new applications, innovations and belief-driven entrepreneurs.
Thus from "bad" will come "good".
Here I am.
Back from another lengthy and self enforced break and reporting in i2P on things and matters with ICT in pharmacy-land and health generally.
It is not that I am lazy.
It is that there hasn’t been much ‘news’ happening worth getting our knickers in a knot.
It is all the same old; same old in e-health playing field and that is rather uninspiring to say the least. So I have taken the view that if there is nothing positive to say it’s best to stay stum.
But now as 2011 is coming to a rattling death perhaps there are some things worth saying, usefully or otherwise.
What is a snapshot of some of the year’s achievements in the e-health community?
Hard to say that the world is on fire with overwhelming success, but a summary of the activities that might interest the i2P reader, in some order of oomph are:
Last month when the controversy surrounding the PGA/Blackmore’s proposed alliance brought out a large number of critics, the PGA found itself in an extremely vulnerable position.
Some criticism was well-deserved - other criticism arose from misperception surrounding the proposed alliance, while other criticism evolved surrounding the “evidence” relied on by the alliance to underpin their clinical promotion - was blown out of all proportion, or negatively criticised.
More positively, academic Dr Ken Harvey called for the TGA to manage an evidence database for complementary medicines that have had a full evaluation.
He spoke softly as he lifted my arm while telling me it would stay afloat. It didn't.
In fact, several times during the session, it fell back to my side no matter he said.
While I felt reasonably relaxed after my first visit to a hypnotherapist, I left disappointed.
So does hypnotherapy work and why do some of my skeptical friends support it and, more interestingly, why do they say it is part of acupuncture?
In Australia the Pharmacists’ Support Service (PSS) provides a listening ear and support over the telephone to pharmacists in Victoria, Tasmania, South Australia and the Northern Territory and has plans for expansion to all states of Australia. The medical profession in Australia has a range of state based Doctors’ Health Advisory Services including the AMA Victoria Peer Support Service which provides peer support over the telephone. Victorian is the only state to have a state based health program for doctors; the Victorian Doctors Health Program (VDHP)
Funding from the Cyril Tonkin Fellowship enabled me to undertake a study tour of services which support pharmacists and doctors in the United Kingdom (UK) in March 2011.
The aim of the visit was to find out how these services support the health and well being of pharmacists and doctors, including the services provided and how they are funded.
The support services visited were Pharmacist Support, including participation in a Listening Friends training weekend; the Royal Pharmaceutical Society; the Practitioner Health Programme; the Royal Medical Benevolent Fund; the British Medical Association Doctors for Doctors program and the National Clinical Assessment Service. In addition to obtain background material on the environment for health professionals in the United Kingdom visits were also made to the General Pharmaceutical Council; Manchester University School of Pharmacy and Pharmaceutical Sciences and the Pharmacy Department of the Central Manchester University Hospitals NHS Foundation Trust.
This article is the second in a series reporting on my visit and will detail the services available to doctors and dentists living in London through the Practitioner Health Programme.
The future supply of pharmacists to work in Aboriginal health is healthy if the outcome of a National Australian Pharmacy Students’ Association survey is anything to go by.
While 83% of respondents felt it is important to be taught about Aboriginal and Torres Strait Islander health issues as part of their pharmacy course curriculum, only 60% have access to such education. Furthermore, only half of those respondents feel they are taught enough about this topic.
I’ve been thinking about magnetic resonance imaging, sleeping bags, allergies, and great hospitals.
Well, I went in for an MRI, and the diagnosis was not good: Claustrophobia. But I’m getting ahead myself.
While studying x-rays of my shoulder, my doc ordered an MRI. I told him we were nearing eight on the pain scale and pressed for the earliest appointment.
Seven o’clock the next morning, after being scanned for metal, a rad tech strapped me to the transport board and pushed a button.
Moving into the magnetic abyss, I felt like dead man walking. Except, I couldn’t walk. But I could talk. It took about two seconds to find my authoritative voice:
“I NEED OUT NOW.”
She got the hint, and I was pardoned.
Whether you're managing a team of employees or you're on your own, remember that although what you do and how you do it are important, it's the "why" that provides real motivation to succeed.
An experiment conducted by the University of Pennsylvania's Wharton School of Business demonstrates the power of "why."
At a university call center where employees phone alumni to solicit contributions to scholarship funds, the staff was randomly divided into three groups: The first group read stories written by former call center employees about the benefits of the job (such as improved communication and sales skills). The second group shared accounts from former students about how their scholarships helped them with their education, careers and lives.
The third, a control group, read nothing, just explained the purpose of the call and asked for a contribution.
Straw Man “An argument deliberately put up so that it can be knocked down, usually as a distraction from other arguments which cannot be so easily countered,” - The Macquarie Dictionary.Comments: 2
It appears that pharmacists, in general, are tired of the leadership style imposed by Kos Sclavos, the incumbent president of the Pharmacy Guild of Australia (PGA).
While criticism of PGA leadership style and policy has been building for some time, opposition solidified recently with formation of the Pharmacy Coalition for Health Reform – a body that boasts over 20,000 pharmacists among its membership.
Recently, i2P was sent a media release from APESMA, the pharmacist trade union.
It was embargoed until Saturday December 10, which was a point at the beginning of the i2P update cycle.
The release contained a link to an email that is alleged to have emanated from NAPSA – the National Australian Pharmacy Students' Association.
Because it was politically sensitive to that organisation and because it also contained a number of normally private contact details for their members, i2P decided to withhold the information unless it became public knowledge through other media sources - and that has happened..
The email provided the basis for published claims that the PGA was engaged in a bullying process with NAPSA to force their disengagement with the newly-formed PCHR- the Pharmacist Coalition for Health Reform, and it is hard to avoid this view when an examination of the pressures exerted by the PGA are examined in broad daylight.
Because it is near the end of the year, I thought it appropriate to highlight one of our earlier articles published in July 2010, because it gave a foretaste of things to come -
“The New Competitors- Wholesalers, Manufacturers, Pharmacists and Nurses”
The gist of the article was that because global pharma companies would be unable to sustain the “blockbuster” business model and that there would be only modest growth in future drug developments, an unstoppable chain reaction would begin to occur where global pharma would create a new disruptive business model that would remove wholesaler discounts and begin a process of different segments of the health services “scavenging” from each other.
Once upon a time pharmacy was a small, typically one-person show that focussed on patients (as distinct from customers).
It was considered very bad form if a patient presented with a problem and ;
(i) they were not immediately attended to by a qualified pharmacist and;
(ii) they left the pharmacy holding a product in their hands that had not been personally compounded by the pharmacist.
Most patients asked for “their pharmacist” by name and entered into an obvious and valued pharmacist/patient relationship. The care was obvious and not substituted with branded medicines or had the patient interviews delegated to pharmacy assistants or technicians.
In other words the human relationships were respectful and this respect extended between pharmacists as a collegiate relationship.
I started the New Year by researching retail environments that could be adapted to pharmacy and deliver pharmacy 2012 marketing requirements, with emphasis on "professional".
When I got to the Apple retail environment, it simply jumped off the page.
This could be the most important article you read this year.
Few would realise that the title to this article is actually the slogan for Apple Retail Stores, and is in fact the base philosophy behind one of the most successful forms of retail enterprise experienced in the 21st century.
The story of the Apple retail experience has a direct translation across to the malaise that is currently being felt by most Australian pharmacists, so a brief history of the Apple company may help to illuminate a realigned direction for community pharmacy that would capitalise on its strengths and help get off the discount treadmill.
Recently I noticed an article published in "The Conversation" authored by John Dwyer Emeritus Professor at University of New South Wales. The article opens with:
"It’s difficult enough to counter the massive amount of misleading information provided to consumers through the media and online. But the task becomes much harder when tertiary institutes give an undeserved imprimatur to pseudo disciplines by offering them as courses. Central Queensland University (CQU) is the latest to do so, announcing it will offer a Bachelor of Science degree (Chiropractic) from 2012. I’m one of thirty-four doctors, scientists and clinical academics who, in an attempt to protect health-care consumers from the dangers associated with unscientific clinical practices, have today written to the science deans at CQU urging them, as fellow academics, to reconsider this decision.
We want the deans to acknowledge the importance of our universities remaining champions of rigorous academic standards and remind them of the primacy of the evidence base for scientific conclusions and health-care practices." Read more at this link
Coming up to speed after the festive break, I have been astounded at the number of community pharmacy prescription out-of-stocks, both short-term and long-term, that are mounting by the day.
This has a number of financial impacts on a community pharmacy and one assumes that the PGA has a strategy to lessen these impacts - but where is it?
No business can stay in business without customers.
How customers are treated and sadly, mistreated, determines how long the doors stay open. Poor quality service has probably doomed as many businesses as poor quality products.
Enter the "guru of customer service," John Tschohl.
He earned that moniker from USA Today, Time and Entrepreneur magazines. After 31 years focused solely on customer service, he is president of Service Quality Institute, which has representatives in 40 countries.
He's authored hundreds of articles and six best-selling books. And he is willing to share his wisdom with my readers. I don't often devote so much of my column to one resource, but John is the best of the best.
I was thumbing through my January copy of the AJP when I noticed a small column covering a conversation with Nicola Roxon, the ex-Minister for Health and Ageing.
She, along with other commentators on the same page, was basically encouraging pharmacists to “jump in” to reform health.
The encouraged pathway was through fee for service arrangements, some of which are covered under the 5CPA.
“Staff in almost one fifth of pharmacies could be wasting more than five hours per week, the equivalent of one month's working time a year, trying to source out-of-stock medicines.”
So claims a report published in the UK newsletter Chemist & Druggist this month.
The report goes on to claim:
With all the change and distress that is apparent in all ranks of pharmacy at the moment, do you have the urge to lash out at someone or some organisation or just something?
All pharmacists want to evolve their version of an ethical practice, balancing some commercialism with professional core business – whether they own a pharmacy or not.
Multiple groupings of pharmacists have formed up around each special interest and this has created a range of competitive groups, some more aggressive than others, to compete for absolute dominance of pharmacy – and endeavour to create a single voice.
When something does not make sense I always find there is a political objective involved.
And underlying the politics always is the motivation of greed.
Make no mistake about it, Australian pharmacy is about to enter a period of manipulation never before experienced, and it involves supply chain manipulation by government and by Big Pharma.
It is globally orchestrated and tactics vary slightly country to country and the victims of this strategy are very ill patients and the pharmacies behind them desperately trying to bridge supply to keep them alive.
APESMA today proposed a new Terms of Reference for a Senate Inquiry into pharmacy which focuses on new potential benefits to the pharmacy profession including providing a role for pharmacists in medicare locals and GP clinics and new measures to reform the health care system.
Mr Walton said despite incorrect and mischievous claims by the Pharmacy Guild there was nothing in the Senate Inquiry before the Senate that would cause the current Community Pharmacy Agreement to cease.
More than 850 delegates will be in Hobart this week for Medicines Management 2011, the 37th SHPA National Conference.
At Medicines Management 2011, the 37th SHPA National Conference, SHPA will celebrate 50 years as a national organisation and 70 years since its inception.
In 1941, 25 pioneer pharmacists from public hospitals in Victoria first conceived SHPA, and in 1961 SHPA moved formally to become a national organisation and held its first national conference in Adelaide.
Medicines Management 2011, the 37th SHPA National Conference opened today in Hobart. With over 800 delegates, 80 presented papers and 200 posters, this year’s conference is yet another example of the enthusiasm and dedication of pharmacists in hospitals and other parts of the healthcare system to share their work and learn from their peers.
During Medicines Management 2011, the 37th SHPA National Conference, held in Hobart last weekend, the SHPA Australian Clinical Pharmacy Award for 2011 was awarded to Mr Greg Roberts, Clinical Research Pharmacist at the Repatriation General Hospital in Adelaide.
SHPA believes that consumer interests should be at the centre of health delivery and the health reform agenda. SHPA members have a strong ethos of working collaboratively within interdisciplinary healthcare teams and across the continuum of care.
Editor's Note: Nano-particles have been adopted by various manufacturers of consumer products because they improve absorption of their active ingredients and the cosmetic appearance of the product.
Early researchers in this field warned that conditions similar to mesothelioma may result through exposure to nano-particles and that more research is required before endangering the general public.
Very few manufacturers identify that their products contain nano-particles, but recent studies have confirmed the potential for an association with cancer.
Certainly, the least that needs to occur is a warning label, particularly as some sunscreen preparations contain zinc oxide.
It is ironical that the Australian Cancer Council promote the message of "slip, slop and slap" yet allows for another form of potential cancer exposure through the "back door" involving nano-particles in sunscreen products, including the zinc oxide identified in the following study.
Guild Clinical is pleased to announce the course dates for Apply First Aid 2012.
REVIVA First Aid Training provides industry specific, highly interactive training perfect for pharmacists, graduates and pharmacy assistants.
No more forgetting to take your medicine! NPS has introduced a range of new features to its award-winning Medicines List iPhone app that allow people to schedule in reminders to prompt them to take their medicine.
As part of the upgrade, people can also record whether they took their medicine on time — and if not, why not, which is useful information to share when they next see their doctor.
The Australian Self-Medication Industry (ASMI) today welcomed the announcement of a series of significant reforms to the Therapeutic Goods Administration (TGA) and the regulation of non-prescription products.
The measures will impact areas including product advertising and promotion, regulation of complementary medicines, and the transparency of TGA decision-making.
A Queensland University of Technology (QUT) PhD student has developed a potential breakthrough test for predicting the likelihood of the spread or return of breast cancer.
"While in recent years there have been fantastic advances in the treatment of breast cancer there has been no way of predicting its progress," said Helen McCosker, a PhD student at the Institute of Health and Biomedical Innovation (IHBI).
In our July edition of i2P, Kay Dunkley wrote an excellent article relating to social media and its use by health professionals. In that article Kay noted:
The Medical Journal of Australia recently published an excellent article on the topic of social media and the medical profession. It was this article that prompted me to write this opinion piece and I recommend that it should be read by all health professionals who are users of social media. I believe that many of the issues raised for medical practitioners are equally applicable to pharmacists and other health professionals. That article can be found at http://www.mja.com.au/publicissues/194_12_200611/man10874_fm.html
Now the PSA have weighed in with an official version for pharmacists.
Dynamic warm-ups included range of motion activities like high-knee raises, leg swings and run-throughs or change of direction tasks.
Mr Zois said the study proved that, from a power point of view, static stretching was worse than no warm up at all.
i2P news and articles will continue to be published weekly over the Christmas/New Year period, but not quite so "in-depth".
You are invited to explore the recent archives of i2P when you begin to plan for the coming year.
We also encourage you to post comments at the foot of each published item.
i2P knows that the coming year will be more challenging than in previous years.
It will be a year of sorting out priorities - those within the industry wishing to needlessly fight to prop up inappropriate structures will be seen to waste time and resources.
They will be judged harshly by participants at the "coalface"- the silent majority.
i2P hopes that all of its subscribers have a peaceful and safe festive season.
The following news item from Orthomolecular.org adds one more dimension to the debate on nutritional supplements. It seems that safety is definitely not an issue where nutritional supplements are used.Comments: 3
Editor's Note: In Australia, criteria for generating a medication review includes a patient currently taking five or more regular medicines or taking more than 12 doses of medicine per day.
Patient falls are a major reason for patients being admitted to a hospital and quite commonly, patients are further damaged through falls while they are already in a hospital.
The system currently requires a referral by a GP to an accredited pharmacist, which is a slow and cumbersome (sometimes very unrewarding) process.
Editor"s Note: Global Pharma has an unusual and pervasive influence on politicians, regulators and statutory bodies around the globe.
I’ve always had a philosophy of recognising that when things do not go as they are supposed to, first look at the surrounding politics and then follow the money trail.
In the US the main regulator for drug registration and marketing is the Food and Drug Administration (FDA) which has come under greater scrutiny by industry commentators because of seemingly corrupt and improper decisions increasingly made in favour of drug manufacturers.
This month we have selected a media story that appeared in Pharmacy News on the 3 November 2011, and it is story of the continuing saga of direct distribution by Pfizer.
The bigger story underneath is - what is the Pharmacy Guild of Australia doing to represent its members in this ongoing dispute?
i2P has covered the direct distribution saga since its inception here in Australia.
The problem seems to be worsening rather than improving, so we have asked Mark Coleman to comment.
His comments appear below the media item that follows.
Dr David More
From a Medical IT Perspective: I am vitally interested in making a difference to the quality and safety of Health Care in Australia through the use of information technology. There is no choice.. it has to be made to work! That is why I keep typing. Disclaimer - Please note all the commentary are personal views based on the best evidence available to me - If I have it wrong let me know!
This blog has only three major objectives.
This interesting report appeared a little while ago.
November 22, 2011 | Mike Miliard, Managing Editor ROCKVILLE, MD – A new study by the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality finds that physician practices and pharmacies are both keen on e-prescribing's ability to improve safety and save time – but that both groups face barriers to realizing its full benefit. The study, published online in the Journal of the American Medical Informatics Association, focuses on the electronic exchange of prescription data between physician practices and pharmacies, which can save time and money by streamlining the way in which new prescriptions and renewals are processed. It finds that e-prescribing helps reduce the risk of medication errors caused by illegible or incomplete handwritten prescriptions. Physician practices and pharmacies generally were positive about the electronic transmission of new prescriptions, the study found. But prescription renewals, connectivity between physician offices and mail-order pharmacies, and manual entry of certain prescription information by pharmacists – particularly drug name, dosage form, quantity, and patient instructions – continue to pose problems. "Physicians and pharmacies have come a long way in their use of e-prescribing, and that's a very positive trend for safer patient care and improved efficiency," said AHRQ Director Carolyn M. Clancy, MD. "This study identifies issues that need attention to improve e-prescribing for physicians, pharmacies, and patients." Researchers at the Center for Studying Health System Change in Washington, D.C., conducted 114 interviews with representatives of 24 physician practices, 48 community pharmacies and three mail-order pharmacies using e-prescribing. Community pharmacies were divided between local and national companies. Physician practices and pharmacies used e-prescribing features for electronic renewals much less often than for new prescriptions. More than 25 percent of the community pharmacies reported they did not send electronic renewal requests to physicians. Similarly, one-third of physician practices had e-prescribing systems that were not set up to receive electronic renewals or only received them infrequently. Physician practices reported that some pharmacies that sent renewal requests electronically also sent requests via fax or phone, even after the physician had responded electronically. At the same time, pharmacies reported that physicians often approved electronic requests by phone or fax or mistakenly denied the request and sent a new prescription. ..... The study, "Transmitting and processing electronic prescriptions: Experiences of physician practices and pharmacies," is available at jamia.bmj.com. Lots more here: http://www.healthcareitnews.com/news/erx-worthwhile-still-problematic-docs-pharmacies Here is the abstract: J Am Med Inform Assoc doi:10.1136/amiajnl-2011-000515
Objective A core feature of e-prescribing is the electronic exchange of prescription data between physician practices and pharmacies, which can potentially improve the efficiency of the prescribing process and reduce medication errors. Barriers to implementing this feature exist, but they are not well understood. This study's objectives were to explore recent physician practice and pharmacy experiences with electronic transmission of new prescriptions and renewals, and identify facilitators of and barriers to effective electronic transmission and pharmacy e-prescription processing. Design Qualitative analysis of 114 telephone interviews conducted with representatives from 97 organizations between February and September 2010, including 24 physician practices, 48 community pharmacies, and three mail-order pharmacies actively transmitting or receiving e-prescriptions via Surescripts. Results Practices and pharmacies generally were satisfied with electronic transmission of new prescriptions but reported that the electronic renewal process was used inconsistently, resulting in inefficient workarounds for both parties. Practice communications with mail-order pharmacies were less likely to be electronic than with community pharmacies because of underlying transmission network and computer system limitations. While e-prescribing reduced manual prescription entry, pharmacy staff frequently had to complete or edit certain fields, particularly drug name and patient instructions. Conclusions Electronic transmission of new prescriptions has matured. Changes in technical standards and system design and more targeted physician and pharmacy training may be needed to address barriers to e-renewals, mail-order pharmacy connectivity, and pharmacy processing of e-prescriptions. The full paper is here (free). http://jamia.bmj.com/content/early/2011/11/17/amiajnl-2011-000515.full It is interesting to note that as of a few weeks ago over 50% of use physicians were using electronic prescribing and prescription transmission. See here: http://www.surescripts.com/news-and-events/press-releases/2011/november/0911_saferx.aspx It really seems the US has their act together in this area - while we still seem to be trying to sort out Standards and have a couple of presently non-interoperable prescription transmission providers. This is an area where the leadership from DoHA has been just woeful to say the least. This from DoHA in June 2008 says it all!
The Department of Health and Ageing considers electronic prescribing (ePrescribing) to be an important element of the national eHealth strategy and one that has the support of a large range of stakeholders. The development of technical and business process standards for ePrescribing and dispensing of medications will serve as building blocks for broader opportunities arising from developments in medication management systems and individual electronic health records. A number of amendments to State and Federal legislation have already been enacted across jurisdictions to enable ePrescribing systems to be implemented. It is in this context that the Department of Health and Ageing in December 2007 contracted KPMG to undertake a research and consultation process to develop a national ePrescribing framework. The KPMG report titled “Consultancy in Electronic Prescribing and Dispensing of Medicines (ePrescribing)”, finalised in June 2008, identifies strategic, technical and operational perspectives for developing ePrescribing across the various prescribing settings, namely: general community, private and public hospitals and the aged care sector. The report provides an overview of the emerging issues in Australia, considers past experiences, international developments and broad stakeholder views in formulating a guide to the development of standards and guidelines for nationally consistent ePrescribing systems. The process undertaken by KPMG was robust and importantly included substantial stakeholder consultation and investigation of the key issues. The report identifies a number of implementation steps to support a nationally consistent ePrescribing systems environment. The four key recommendations made in the report (page 6) are accepted by the Department of Health and Ageing and will be progressed in conjunction with broader eHealth initiatives. A full copy of the KPMG report can be found at www.health.gov.au ----- End Release Almost 3.5 years later just where are we? We have the Pharmacy Guild and Medisecure / RACGP competing for the market and the Commonwealth incentive funds. The Australian Standards are still in draft and contentious and progress is less than optimal! This really could have been done just so much better! David. Posted by Dr David More MB PhD FACHI at Thursday, December 01, 2011 0 comments
The following appeared a few days ago.
The portal will build upon a pilot portal, built by HP on the Microsoft SharePoint platform
The Department of Human Services (DHS) is on the hunt for a provider to develop and host a Web portal with the aim of better managing and preventing chronic disease among indigenous Australians. The Indigenous Web Based Primary Health Care Resource (IWBPHCR) will be a Web portal which integrates with clinical systems and enables healthcare staff to access materials relating to the prevention and management of chronic illness among indigenous Australians. “The IWBPHCR collates and presents in a single resource existing tools, guides and other online information that promotes best practice in the prevention, identification and management of chronic disease in indigenous Australians,” the documents reads. “It covers the key chronic diseases contributing to the burden of disease including cardiovascular disease, diabetes mellitus type 2, chronic respiratory disease, chronic kidney disease and cancer.” Under the 24-month contract, the successful tenderer will develop a detailed project plan and conduct a clinical review of content to select, review and remove information, which will also include “intensive” development in the initial phase to expand content. It will also provide high availability IT hosting and software development to ensure the relevance of content and conduct ongoing marketing of the project to ensure uptake by healthcare professionals. Following this, the provider will monitor and evaluate the efficiency of the service and how well it benefits users. According to DHS documents, this request for tender (RFT) builds upon an initial RFT for a pilot Web portal in 2010, which HP won and built on the Microsoft SharePoint platform. The pilot Web portal was to enable easy access and identification of materials relevant to managing chronic disease among indigenous Australians. It was issued after the department pinpointed a need for healthcare professionals to access materials including patient education, management tools, guidelines and references to effectively manage chronic disease. Following this, it embarked on a review and consultation process with stakeholders which found extensive clinical resources were already available online. More here: http://www.computerworld.com.au/article/408192/dhs_seeks_web_portal_combat_chronic_disease_among_indigenous_australians/ It seems to me this is archetypical ‘reverse discrimination’. If there is a business case to create a provider portal for 2.2% of the population (the Indigenous Population according to Wikipedia) then the case for a National Portal for all professional healthcare providers must be utterly overwhelming. Pure and simple siloed and ignorant policy development and implementation in my view. The same sort of dreadful policy development quality that cuts the incentives for students to study science and maths in the Budget Update. Both are utterly appalling and prejudice our future. David. Posted by Dr David More MB PhD FACHI at Wednesday, November 30, 2011 3 comments
The following appeared overnight.
November 22, 2011 | Tom Sullivan, Editor Knowing which tactics make for smooth, investment-worthy IT efforts can be as tricky as the projects themselves. Looking to shed some light on the matter, the Government Accountability Office (GAO) compiled a list of best practices based on interviews with CIOs and other acquisitions and procurement officials. Using as a basis seven government IT projects – one of those being the VA’s Occupation Health Record-keeping System – the GAO boiled that list down to the “common factors that were critical to the success of three or more of the seven investments.” Those are:
In the report, titled "Critical Factors underlying successful major acquisitions," the GAO also listed its top seven projects – so judged because they “best achieved their respective cost, schedule, scope and performance goals.” More here: http://www.govhealthit.com/news/gaos-9-common-critical-success-factors-federal-it-projects With a ridiculous testing time table, low levels of stakeholder engagement, specifications dreamt up in a vacuum I leave it as to reader exercise to score NEHTA / DoHA out of 9! Won’t be high I suspect. David. Posted by Dr David More MB PhD FACHI at Wednesday, November 30, 2011 2 comments
The following report appeared in the Australian today.
THE performance of the National E-Health Transition Authority will be scrutinised in a Senate inquiry into the Gillard government's e-health record legislation. The Community Affairs committee has been instructed to examine the design and capability of the $500 million personally controlled electronic health record system, including its expected functionality on the July 1 launch date next year. Health Minister Nicola Roxon tabled her PCEHR bill and companion regulations in the lower house last Wednesday. She needs to shepherd the legislation through parliament quickly to meet her political deadline. Victorian Liberal senator Mitch Fifield has immediately referred it for a broad-ranging public inquiry. Its scope includes "any other issues the committee considers appropriate". The committee will consider the security arrangements, risks to patient privacy, the likelihood of data breaches and the proposed penalties. It has also been instructed to examine NEHTA's use of consultants, contractors and the tendering process during the development of the PCEHR. In particular, it will look at the products that NEHTA has designed, made, tested and certified for use in the system. The Medical Software Industry Association has repeatedly warned that unresolved technical and clinical issues could put patients' safety at risk. It said the Healthcare Identifiers service -- designed by NEHTA with little industry input -- was flawed and could result in duplicate individual identifiers, while there was no means of correcting operator or system errors in users' downstream systems. Meanwhile, privacy and consumer advocates have complained about NEHTA's lack of consultation over key concerns. Lots more here: http://www.theaustralian.com.au/australian-it/performance-of-nehta-to-go-under-senate-spotlight/story-e6frgakx-1226208562245 You can read the terms of reference for the enquiry. http://www.aph.gov.au/senate/committee/selectionbills_ctte/reports/2011/rep1711.pdf The details are found in Appendix Six. While it is very good that the topics cited above are being reviewed my major concern relates to the need to have the appropriate leadership for the whole e-Health program and to have the sort of governance frameworks in place that will ensure there is a sensible balance of all stakeholder’s interests as we move forward. It goes without saying that for me this involves a fundamental review of the evidence for and business case supporting the PCEHR and a root and branch review and audit of just what NEHTA has been doing over the last 5+ years. I will be preparing a submission on my own account to try and push the Senate Committee to ask the really hard questions and to not be fobbed off as they can be in a short Senate Estimates hearing. These two paragraphs found later in the article make it utterly clear that big change is needed. “Mr Fleming said last month that he was "committed to resolving the matter to the satisfaction of both organisations". But in a second letter to Dr Clarke last week, he said NEHTA could not "accept a situation" where Dr Clarke continued to use "firm and direct communications" as he saw fit.” You can read the full letter here: http://www.privacy.org.au/Papers/NEHTA-Fleming-Reply-111123.pdf Mr Fleming, it seems, is not at all comfortable with a little assertiveness on the part of a pretty well respected privacy advocate (Chair of the Australian Privacy Foundation at present) whose job it is to be just that! He apparently does not agree with the views expressed and he (or his staff) seem to be trying to suppress these views by denying attendance at forums. It is just this sort of issue that properly a designed governance framework and sensibly respectful leadership would swiftly address and save us all from a great deal of toing and froing. Indeed in the letter Mr Fleming makes it clear he needs and wants respectful communication and co-operation. This is clearly vital on both sides - especially when matters are seriously contested in the public space. Again a proper governance framework can assist greatly in getting the right outcome. The bottom line to me is that both sides in a disagreement like this actually need to really listen to each other and understand what is being communicated in terms of concerns and issues. You can read all the correspondence here: http://privacy.org.au/Papers/NEHTA-Fleming-111111.pdf For this and a whole host of other reasons leadership and governance are top of my list for the enquiry. Bureaucrats need to remember they are ‘public servants’ and we are all the public! Another point I also intend to make is around the frequently stated fiction from DoHA and NEHTA that implementing the PCEHR is implementing the National E-Health Strategy of 2008. This is just plainly and simply NOT true! Lastly, on the governance issue, we have this claim from Minister Roxon on the legislation.
29th Nov 2011 Mark O’Brien THE Senate will investigate new legislation intended to create Australia’s personally controlled e-health record (PCEHR) system after the two relevant bills were referred to the Senate Standing Committees on Community Affairs last week. The legislation, which includes provision for the merging of MBS and PBS information for the first time, was tabled in the lower house by Health Minister Nicola Roxon last week before being referred to the committee in the Senate on Friday. ..... Ms Roxon told parliament on Wednesday the legislation was developed through two rounds of public consultation and a draft version of the bill. “The central theme of our system and this bill is that any Australian will be able to register for an e-health record, and they will be able to choose the settings for who can access their record and the extent of that access,” Ms Roxon said. ..... Full article here: http://www.medicalobserver.com.au/news/erecords-legislation-to-be-investigated With decent governance we would have a digest that shows how the Government responded to the submissions mentioned above and what changes were made. Of course we don’t have a clue and no one knows if their time was utterly wasted in responding! The details of how to make a submission to the Senate Enquiry are found in this post. http://www.aushealthit.blogspot.com/2011/11/senate-enquiry-into-pcehr-alert.html The closing date is January 12, 2012 - so get thinking and writing if we are to see some better e-Health in the years to come! Feel free to indicate in comments areas you think need to be addressed by the enquiry. David. Posted by Dr David More MB PhD FACHI at Tuesday, November 29, 2011 5 comments
Here are a few I have come across this week. Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
It has really been a busy week. We have had PCEHR legislation introduced into Parliament - a day before it shuts down for the year - we have had a continuation of NEHTA into a rather murky future and we have had a whole set of untested specifications released by NEHTA to the Wave Sites for them to implement! My feeling is that we are now seeing a move towards some trinary outcome. Either it will all go swimmingly and the PCEHR will be a great success, or it will limp along slowly into some quiet oblivion a few expensive years down the track or the whole project will implode on itself. Which do you think is the most likely? ----- http://www.pulseitmagazine.com.au/index.php?option=com_content&view=article&id=779:msia-things-i-should-have-said&catid=16:oz-hit&Itemid=226
Written by Dr Geoffrey Sayer | 21 November 2011 I wish I had kept a diary for the past two years during my time as the Medical Software Industry Association President (MSIA). The things I have seen, heard and read have generated all sorts of emotional responses: surprise; laughter; disappointment; frustration; sadness; anger; and humility. Health at the best of times is a hot topic. Throw an “e” at the start of Health and all sorts of “emotional” responses are brought forward. Throughout this roller-coaster ride of ups and downs, where often you only have a narrow window to get a point across, there are a number of things that, with the benefit of hindsight, I wish I had said. The current politicians’ need both better advisors and to make public servants actually responsible for their actions if they want to progress change. The political process is a short-term cycle and the objective seems to be simply to stay in power. We should accept this as a fact of how politics works. It is not as complicated as they would want us to believe. More time (and money it seems), is spent on spin doctoring rather than calling to account the people or organisations that money is provided to. ----- http://www.theaustralian.com.au/australian-it/government/e-health-authority-to-live-on/story-fn4htb9o-1226203136895
THE National e-Health Transition Authority will live on post-June 2012, with the federal and state governments agreeing to continue their joint funding arrangements for the time being. NeHTA’s immediate future was decided at a meeting of the Standing Council on Health in Brisbane this month, although there is no commitment to a long-term role for the organisation. No public announcement has been made and the level of funding is yet to be agreed. Federal Health Minister Nicola Roxon has been slow to commit to further funding for the e-health program beyond the launch of her personally controlled e-health record (PCEHR) system on July 1. Forward budget allocations for e-health programs drop from $433 million in the current financial year to $35m annually in each of the next three years. ----- http://www.computerworld.com.au/article/408192/dhs_seeks_web_portal_combat_chronic_disease_among_indigenous_australians/
The portal will build upon a pilot portal, built by HP on the Microsoft SharePoint platform
The Department of Human Services (DHS) is on the hunt for a provider to develop and host a Web portal with the aim of better managing and preventing chronic disease among indigenous Australians. The Indigenous Web Based Primary Health Care Resource (IWBPHCR) will be a Web portal which integrates with clinical systems and enables healthcare staff to access materials relating to the prevention and management of chronic illness among indigenous Australians. “The IWBPHCR collates and presents in a single resource existing tools, guides and other online information that promotes best practice in the prevention, identification and management of chronic disease in indigenous Australians,” the documents reads. “It covers the key chronic diseases contributing to the burden of disease including cardiovascular disease, diabetes mellitus type 2, chronic respiratory disease, chronic kidney disease and cancer.” ----- http://www.pulseitmagazine.com.au/index.php?option=com_content&view=article&id=771:video-consulting-from-hospitals-to-the-home-and-everywhere-in-between&catid=16:australian-ehealth&Itemid=268
Written by Chris Ryan | 15 November 2011 Video consulting is a big subject, within a big subject (Telehealth), within a big subject (eHealth). Articulating what is involved can be like articulating the health system itself — not an easy task. This is because video consulting is just normal consulting with another travel option. The trouble is that most people’s horizons only extend to considering the ‘transport’ components (video conferencing), rather than all the end‑to‑end management and logistics that we take for granted under normal circumstances, and more besides. For people who want do more than just hold a Skype video conference twice a year, comprehending the opportunities and issues involved is like watching stars come out — you see the one or two that most closely relate to your perspective, then a few more, and then you realise the sky is full of them. ----- http://ehealthspace.org/news/health-informatics-ehealth-spotlight-sallyanne-wissmann
Posted Wed, 23/11/2011 - 11:14 by Josh Gliddon Massive growth in health information systems, coupled with the forthcoming personally controlled electronic healthcare record (PCEHR) has created significant opportunities for health information managers. But according to Sallyanne Wissmann, there are only two tertiary courses teaching health informatics, creating the possibility of skills shortages in the future. “The demand for people with these skills is growing by the day,” said Ms Wissmann, who is also director of health information services at Mater Health, in Brisbane. ----- http://www.theage.com.au/victoria/bungling-in-state-public-sector-blamed-for-it-blowouts-20111123-1nv3g.html
November 24, 2011 INCOMPETENCE and poor practices in the Victorian public sector have been partly blamed for huge cost blowouts in information technology projects that have left taxpayers hundreds of millions of dollars poorer. State Ombudsman George Brouwer, in a report tabled yesterday, has delivered a scathing assessment of 10 public sector information technology projects, including the notorious myki transport ticketing system and the Victoria Police database. The report found that the estimated cost of delivering the 10 projects that he examined was a combined $1.44 billion more than originally budgeted. ----- http://www.cio.com.au/article/408348/q_i-med_network_cio_bart_dekker/
Dekker talks about service delivery improvements through automation and e-health projects
I-MED Network chief information officer, Bart Dekker. Bart Dekker has been chief information officer of Sydney-based private medical diagnostic imaging group, I-MED Network, for seven years. During that time he has been responsible for a number of e-health services including the creation of an x-ray application for the iPad which allows its doctors to view x-ray images and patient documents on their devices. What does an average work day involve for you at I-MED? I-MED has 200 diagnostic imaging clinics and is an organisation whose workflow is very dependent upon IT. Out of necessity and design, we also use IT to differentiate ourselves from our competition so a large part of my day is spent discussing how we can improve IT service delivery. ----- http://www.theaustralian.com.au/australian-it/government/pcehr-event-document-specs-released/story-fn4htb9o-1226205947810
SPECIFICATIONS for a key part of the $500 million personally controlled e-health record have been released and a vendor portal launched to support software developers working on products for the system. Doctors and other medical professionals will create summaries of relevant health "events" and upload them to their patients' record in the PCEHR system, where the information will be accessible by other healthcare providers treating that patient. ----- http://www.theaustralian.com.au/australian-it/government/personally-controlled-electronic-health-record-system-coming/story-fn4htb9o-1226203867730
HEALTH Minister Nicola Roxon has today introduced legislation for the $500 million personally controlled e-health record system into Parliament, and announced that the Information Commissioner will have a key regulatory role. "The legislation will strike the right balance between security and access," Ms Roxon said in a statement. "Two rounds of consultation were held on this legislation prior to its introduction." But the government is yet to respond to a large number of concerns raised by medical, consumer and privacy groups in submissions to the draft exposure bill, and it appears few changes have been made. ----- http://www.cio.com.au/article/408352/federal_govt_introduces_e-health_legislation_/
Minister Roxon introduced the Personally Controlled Electronic Health Records Bill 2011 into Parliament
The Federal Department of Health has introduced e-health legislation into Parliament pertaining to its $467 million Personally Controlled Electronic Health Record (PCEHR) project, scheduled for completion by 1 July 2012. The Personally Controlled Electronic Health Records Bill 2011 was introduced by the minister for health and ageing, Nicola Roxon, and includes requirements for privacy breaches, the ability for patients to nominate authorised individuals to have rights in regards to their e-health records and the establishment of an Independent Advisory Panel to advise on policy and operations. It also has provisions around audit logs for consumers, and stipulates the Australian Information Commissioner will become the system’s key regulator. ----- http://www.medicalobserver.com.au/news/ehealth-records-one-step-closer
24th Nov 2011 Andrew Bracey and AAP THE federal government has taken another step towards setting up its patient-controlled electronic health records (PCEHRs) system, with Health Minister Nicola Roxon introducing the legislation to Parliament yesterday. Ms Roxon said the proposed national system – which has attracted criticism from doctors for the lack of remuneration offered to GPs who would be responsible for helping to set up and maintain the records – would drag the management of health records into the 21st century. She said individuals' health information was fragmented rather than attached to the patient, resulting in unnecessary retesting, delays and medical errors. ----- http://www.theaustralian.com.au/australian-it/pcehr-users-must-secure-data/story-e6frgakx-1226204250244
FRAUDSTERS and snoops after personal medical information will target privately owned computer systems rather than attempting to crack government-controlled systems, a legal expert warns. Thomsons Lawyers special counsel Kathie Sadler says people using the government's personally controlled e-health record (PCEHR) system will have to address their own storage and security requirements to ensure ongoing protection of medical data. "Each of the doctors, hospitals, aged care facilities and allied health professionals legitimately accessing the PCEHR system will themselves be subject to privacy and confidentiality obligations to the patient," she said. ----- http://www.theaustralian.com.au/australian-it/microsoft-slams-local-data-centre-edict/story-e6frgakx-1226205393994
MICROSOFT Australia has come out swinging against the Gillard government's insistence on local data centres for the personally controlled e-health record system. "Healthcare information stored in a PCEHR will not necessarily be better secured and protected simply by virtue of data being held within Australia's territorial boundaries, as compared to (offshore) storage repositories and portals operated under world's best practice security and privacy systems," it says in a just revealed submission on the draft bill. "By regulating the geography where the data is held rather than the level of security under which it is held implicitly establishes criteria for data protection that are not related to principles of technology security. ----- http://www.computerworld.com.au/article/408313/telstra_launches_bundled_telehealth_rural_regional_patients
Healthcare providers will be offered a $6000 rebate for investing in the device under a $620m Federal Government initiative
The new Telstra bundled telehealth platform Telstra has launched two new bundled telehealth offerings aimed at rural and regional healthcare providers under a $620 million Federal Government initiative. Under the initiative, ‘Connecting Health Service with the Future’, the government will provide up-front payments and rebates of about $6000 for doctors who deploy the standalone Telehealth Professional unit, a combination of hardware and software by Polycom. The Professional offering includes a Polycom HDX4000 desktop videoconferencing unit, broadband access with one megabit per second (Mbps) dedicated video access, installation and set-up of the device and the Telstra virtual meeting room service. ----- http://www.medicalobserver.com.au/news/next-top-model
21st Nov 2011 Pamela Wilson A new modelling tool could help you identify and prevent adverse events in at-risk patients, writes Pamela Wilson. GPs generally wait for patients to realise they are sick and come knocking on the door. But imagine if you knew when a patient was likely to experience an adverse event – even before they did – and you could contact them to discuss early or preventive treatment. This is not a futuristic plot from a sci-fi movie – it’s a scenario that is entirely possible through the use of Predictive Risk Modelling (PRM). -----http://www.pulseitmagazine.com.au/index.php?option=com_content&view=article&id=780:nehta-and-vendors-plan-for-wider-use-of-amt&catid=16:australian-ehealth&Itemid=268
Written by Bettina McMahon | 23 November 2011 The National E-Health Transition Authority (NEHTA) has released a plan to accelerate uptake of the Australian Medicines Terminology (AMT). Developed with the software industry, the plan helps vendors to make a decision about if and when they want to include AMT in their software. Ultimately, NEHTA’s long term goal is semantic interoperability. The plan works towards this goal while acknowledging the different approaches vendors can adopt, and being realistic about what steps vendors are willing to take at this stage in our progress. ----- http://www.nehta.gov.au/media-centre/nehta-news/937-specifications-plan-for-ehealth-software
17 November 2011. The specifications and standards plan for software vendors working on the personally controlled electronic health records (eHealth records) system has been released. The plan, produced by the National E-Health Transition Authority (NEHTA), outlines the timeframes and process for the release of standards for the personally controlled eHealth records system, set to launch nationally on 1 July 2012. The plan is designed to provide software developers and implementers with an agreed set of logical and technical specifications to guide enhancement of their systems to connect to the eHealth records network. For a program of this scope to succeed, a suite of nationally defined specifications and standards is essential. ----- http://www.computerworld.com.au/article/408188/ios_developers_take_10k_prize_ios_vs_android_hacktahon_event
Health based app provides medical advice, uses SAPI
A team of Australian iOS developers have won $10,000 for their health focused app ‘Medic’, which provides non-urgent medical advice to users not needing to call 000. Team Bonobo+1, made up of Michael Del Borrello, Nathan Hamey, Ben Hamey and Daryl Teo, were awarded the prize at Melbourne’s iOS vs Android Hackathon event on the weekend, with team member Ben Hamey saying he hopes the app will be released to the public shortly. “We think Medic is a genuinely useful app and we will be releasing it onto the app store after a bit more refinement,” Hamey said. ----- http://www.ferret.com.au/c/Bizcaps/Healthscope-fast-tracks-rebate-claims-thanks-to-Bizcaps-MCIS-software-n1827718
by Bizcaps Pty Ltd An innovative software solution from leading Australian software developers Bizcaps Pty Ltd is helping a major private healthcare provider streamline their rebate claims processes with increased processing speed and fewer errors. For private hospitals, rapid and accurate processing of health care rebates for costly items such as prosthetics can have a significant positive effect on cash-flow. However, extracting the correct rebate code for each surgical prosthetic can be a complex and time-consuming process. One of the country’s major private health providers, Healthscope Limited has now been able to streamline some of the more complex areas of their rebate claims processes to speed up their rebate claims and reduce costly administrative errors. Operating a network of 48 private hospitals across Australia, Healthscope in a recent quality audit of their prosthesis claim systems discovered that inconsistent practices and a lack of tools were hindering efficiency. ----- http://www.techworld.com.au/article/407952/123456_worst_passwords_2011
If one of your passwords is "654321" or "superman" or "qazwsx" congratulations for having one of the least secure passwords of 2011.
Internet users never learn. No matter how many times we hear about obvious, hackable passwords, people keep using them. And the situation doesn't seem to be getting better. Below is a list of the 25 worst passwords of 2011, compiled by SplashData. The security software developer generated the list from millions of actual stolen passwords, posted online by hackers. Not surprisingly, the most common passwords are also the worst, including "password," "123456" and "qwerty." Even passwords that seem kind of unique, like "trustno1" and "shadow" are actually quite common. And why does "monkey" always show up on these lists? ----- http://www.computerworld.com.au/article/408012/nbn_knife_edge_optus/
Optus CEO, Paul O’Sullivan, says price and spending caps are needed for the National Broadband Network (NBN)
The National Broadband Network (NBN) is on a “knife edge” unless spending and pricing costs are regulated by the Australian Competition and Consumer Commission (ACCC), according to Optus chief executive officer, Paul O’Sullivan. Speaking at a Committee for Economic Development of Australia (CEDA) event in Sydney where the company also celebrated its 20th anniversary, O’Sullivan said the NBN could either be a major success or a huge failure. According to a report from UK-based consulting firm, SPC Network, commissioned by Optus, the NBN must have clear rules and regulations if it’s going to deliver quality services at the lowest cost. “Based on the report and our own analysis, we believe the ACCC has a crucial role to play in policing the NBN,” O’Sullivan said. “There are five issues that need looking at.” ----- http://www.theaustralian.com.au/australian-it/exec-tech/cloud-pushes-the-limits-for-home-user-storage-of-digital-data/story-e6frgazf-1226201801613
WHERE do we put our growing array of digital belongings? The good old PC hard drive is fast clogging up with all the digital stuff of modern life, such as the HD movies spooling off our smartphone cameras, music collections, family snaps and documents of all types. The PC hard drive as a storage medium is vulnerable to failure and online attack. There are plenty of choices for secure, long-term storage of important stuff. There's a bevy of gadgets purpose-built for secure storage and a bunch of storage services that sit in the cloud. ----- Enjoy! David. Posted by Dr David More MB PhD FACHI at Monday, November 28, 2011 3 comments
The following appeared a few hours ago.
A Senate committee will examine enabling legislation for Health Minister Nicola Roxon's electronic patient record system. Source: HWT Image Library THE Gillard government’s $500 million personally controlled e-health record program will come under scrutiny at a Senate inquiry into the enabling legislation tabled in Parliament last week. The Selection of Bills Committee has referred the PCEHR bills for examination of issues related to the system’s design and capabilities, security and the potential for exposure of sensitive information. More here: http://www.theaustralian.com.au/australian-it/senate-to-probe-gillard-governments-e-health-legislation/story-e6frgakx-1226208011456 Here is the official page:
For further information, contact: Committee Secretary
Senate Standing Committees on Community Affairs
PO Box 6100
Canberra ACT 2600
Australia Phone: +61 2 6277 3515 Fax: +61 2 6277 5829 Email: firstname.lastname@example.org http://www.aph.gov.au/senate/committee/clac_ctte/pers_cont_elect_health_rec_11/index.htm Responses are due by January 12 2012. Just the usual nonsense of asking for submissions on serious matters over the holiday period. Treat the public as idiots as usual it seems! David. Posted by Dr David More MB PhD FACHI at Monday, November 28, 2011 0 comments
The question was: Do You Believe NEHTA's 'Tiger Teams' are the Right Approach To Developing the Required PCEHR Standards? Yes - 6 (16%) Probably - 1 (2%) Probably Not - 7 (19%) No Way - 17 (47%) What is a Tiger Team? - 5 (13%) Votes : 36 It looks as though about 70% think the Tiger Team is not the way to go for the PCEHR Standards and almost 15% or readers are not paying attention! Again, many thanks to those that voted! David.
Posted by Dr David More MB PhD FACHI at Monday, November 28, 2011 0 comments
On the 17th November, 2011 there was a daylong meeting of the Tiger Team which is working to specify what is to be the Consolidated View of the PCEHR. As it happens a kind soul has made available some of the documents that were used / came from this meeting. First to provide some context. It is intended that the PCEHR will be accessed via an Orion Systems Home Page for that particular patient. There will be a space for the usual controls and for a document list at the left of the screen - some patient ID across the top of the screen and the Consolidated View (CV), which will include access to the Shared Health Summary and then a range of Event Summaries (Discharge Summaries, Test Results etc) will be at the right. From this point on it would seem the design - which is due to be frozen come November, 30 - would still seem to be rather fluid with a large range of design decisions yet to actually be taken. The focus of the meeting was on presentation of the clinical information in the screen real estate available - there apparently being confidence the data issues around the contents of all the information were already resolved. Time will tell if this is true. You can get a flavour of one of the options being discussed from this screen shot.
(Click image to enlage)
Now this is all well and good if it was planned to develop and implement the PCEHR over a number of years - but really - in 8 months they are dreaming. To allow for a sensible period of testing this means the whole thing needs to be specified, developed and delivered in six or so months. Really? If there is one issue that really I struggle with in all this is why we are going for such apparent complexity so early. This is really going for nuclear fission when we are lucky to be only just moving into the steam age! As I have said more than once why not just have the most basic of Shared Health Records to start off with and then, once that works, slowly add. I note that this is the approach the UK NHS are adopting:
17 November 2011 Rebecca Todd A working group is being arranged to consider how additional information will be added to Summary Care Record via GP systems. A Department of Health SCR Programme Update for October says 73% of out-of-hours doctors using the records feel they have increased patient safety. But 74% also say that having additional information on the record would increase their ability to make informed decisions. The update, included in the minutes of a British Medical Association and Royal College of GPs joint IT sub-committee meeting , says a working group is being put together to consider how additional information could be added. “A working group is being arranged to consider and set a direction of travel for how additional information will be added and maintained via GP practice systems,” it says. “It is essential that this work has input from the professional bodies and patient groups and that a way forward is jointly agreed by all parties. An initial meeting is being scheduled for November 2011.” More here:
http://www.ehi.co.uk/news/primary-care/7320/working-group-to-consider-scr-add-ons Worse I really can’t fathom just how, as this record develops from a recently established record to the longitudinal life-long record just how material can be organised, searched and ordered in useful ways. 10 years of pathology results from a complex patients- some discrete and some in other formats - seem to me to be a real challenge to manage, sort and so on. Just how much of the record needs to be reviewed when a patient is first encountered is also an interesting question. I really think we need to walk before we run. There are already standards for a simple Continuity of Care record from the US and the Shared Care Record from the UK. Surely we could start here rather than taking this over-engineered and almost certainly doomed to fail approach. The number of open issues identified by the Tiger Team on the CV just two weeks before was due to be finalised makes that utterly clear. NEHTA and DoHA think again before it is too late. You might just be able to snatch victory from the jaws of defeat! David.
Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA: Support services for pharmacists and doctors in the United Kingdom – Part 2 Practitioner Health Programme | open full screen