s Australian Health Information Technology week ending 31/01/2013 | I2P: Information to Pharmacists - Archive
Publication Date 01/02/2013         Volume. 5 No. 1   
Information to Pharmacists

Editorial

From the desk of the editor

Well 2013 has certainly begun and I must admit it has been hard to get out of “holiday mode” and back into “pharmacy mode”.
This year is looking quite challenging as many issues left in abeyance in 2012 are bubbling over , so I don’t anticipate a restful year.
One important issue we will cover for some time yet is the quality of drug  evidence in the Australian setting, and to kick off the debate the feature article  “Sense About Science”describes what is happening in the UK to help tidy up science in that country.
Comparisons have been made with the Australian experience and it seems that we have a long way to go before it can be regarded as “tidy”,

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Recent Comments

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News Flash

Newsflash Updates for February 2013

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
Access and click on the title links that are illustrated.

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Feature Contribution

Sense About Science – or Up To Your Ankles in Waste Water

Neil Johnston

My recent holiday reading included catching up on subjects that have slipped off my radar, mainly because the issues themselves have adopted a lower profile.
Then an article in the 6Minutes e-publication caught my eye.
It concerned a UK initiative by a group called Sense About Science”, that has started a campaign to have all clinical trials registered and have the results published, while simultaneously urging the patients to boycott trials if the researchers cannot guarantee the findings will be made public.
They have published a petition (found at www.alltrials.net) and are encouraging people to sign it.
The petition has the support and backing of the BMJ, the James Lind Alliance and Ben Goldacre (author of Bad Pharma) and is designed to put pressure on researchers, pharmaceutical companies and institutions who are in a position to bury research data that may reflect on reputations and drug company profits.

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Face of Priceline - Australian of the Year 2013

Peter Sayers

Few would not recognise Ita Buttrose, an iconic Australian well-deserved of the Australian of the Year Award for 2013. The award was presented in Canberra on Australia Day (January 26 2013), by PM Julia Gillard.
And there must be a lot of backslapping going on in the Priceline camp for their recent signing of her to front for their 200 member pharmacy franchise.
Ita’s profile was already stellar, but with the added impetus of the Australian of the Year Award, the Priceline brand will now increase in value considerably.

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Determining needs and wants…

Joseph Conway

In pharmacy media commentary, I often come across the idea that we need to give people advice on what they need as opposed to what they want. This is understandable given that we have specialist knowledge on medication therapy and live our lives discussing health issues with patients and dispensing their medication. We get to know very intimate details about people and many pharmacists working in community pharmacy get to follow people as they grow older and are a tiny (but important) part of their lives sharing their health issues over ongoing chats at the dispensary counter if they choose to shop at our store.

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Is the ‘weekend’ an anachronism whose usefulness and relevance has passed?

Neil Retallick

When I taught Sunday School, which seems to be about a hundred years ago but was only about forty, we learned from the Bible that on the seventh day, God rested.
After all, he had been busy for six days.
I do not wish to belittle anybody’s religious beliefs in these comments but use them to focus attention on just how much our society has changed.
At the same time I was teaching Sunday School, the shops all closed at mid-day on Saturday and at 5.30pm during the week.
A trip into town to shop on the weekend meant getting up bright and early on Saturday morning and being at the bus stop by 8.30am at the latest.

Comments: 1

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Fitting Your Pharmacy for the Future - Funding & Depreciating for Best Tax Effect

Chris Foster

Editor's Note:
I2P will be developing a series on pharmacy designs - ideas and concepts in respect of clinical services spaces.
In designing such spaces it was realised very early in the exercise, that to be properly integrated in an Australian pharmacy setting it could not be just an “add-on” but a whole of pharmacy redesign.
Similarly with the introduction of automated dispensing machines (original packs and dose administration aids) it is important to design workflows properly to capture efficiencies, and this also entails a “whole of pharmacy” redesign.
2013 may be the year of decision in terms of the type of pharmacy design to house your market offering. To survive you need to be different and there is not a lot to differentiate one pharmacy from the other, even if you belong to a marketing group.

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Ransomware - The New Kid on the Block

Steve Jenkin

Editor's Note:
Late in 2012, a medical practice on the Gold Coast of Queensland came under cyber attack in a unique way.
Instead of patient data being stolen, it was kidnapped in place, by encrypting all practice data so that it could not be read.
A key was then offered at a price so that the data could be opened.
Thus was born "Ransomware", and a a new threat had emerged.
i2P asked Steve Jenkin, our resident IT expert to give some insights to this new threat and what precautions we might all need, to eliminate this new approach to hacking.
If you need an incentive, just imagine if your PBS claim data was locked up for a week and your ability to generate a claim was locked up for six weeks, plus all attendant costs in restoring your data.
Would you survive in your business?
This reference article by Steve is important enough to use as a checklist for your IT provider or for your IT consultant to utilise in the next complete review of your entire system.
Steve's comments follow:

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Workplace Pressure in Pharmacy

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

The psychological definition of stress is a feeling of strain and pressure.  Small amounts of stress may be desired, beneficial, and even healthy.  Positive stress helps improve performance.  It also plays a factor in motivation, adaptation, and reaction to the environment.  Excessive amounts of stress may lead to many problems in the body that could be harmful.  Symptoms may include a sense of being overwhelmed, feelings of anxiety, overall irritability, insecurity, nervousness, social withdrawal, loss of appetite, depression, panic attacks, exhaustion, high or low blood pressure, skin eruptions or rashes, insomnia, lack of sexual desire (sexual dysfunction), migraine and gastrointestinal difficulties (constipation or diarrhoea).  It may also cause more serious conditions such as heart problems.

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Arm Yourself For The Battle For The Mind

Barry Urquhart

Social media, and the internet in general, are largely “blind” media.
They can be frustrating, time-wasting and inefficient.
Entries and enquires about wide-ranging but pertinent topics, products and services elicit countless responses, most of which are irrelevant and unappealing. Information overload abounds.Use of SEO's (Search Engine Optimisers) simply cluster companies, brand and service names, among large, often spuriously ranked groupings.Being on the shopping list has very little quantifiable and lasting value. Nor does the standing of being “first amongst equals”.
Establishing and sustaining unique, differentiated presences in the marketplace is difficult.
In the brave and new world of digital, mobile, on-line, multi or omni-channel reality, the importance, nature and value of effective branding is deepened and broadened.

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Positive thinking has no negatives

Harvey Mackay

One of life's great annoyances is the tendency of folks who ask you to perform an impossible task, list the issues they foresee and the problems that have plagued previous attempts -- and then admonish you to "think positive."
Wow! Does that mean you are so good that you can achieve what no one else has? Or are you being set up to fail?   
Because I am an eternal optimist, I prefer to believe the first premise. Positive thinking is more than just a tagline. It changes the way we behave. And I firmly believe that when I am positive, it not only makes me better, but it also makes those around me better. I think that good attitudes are contagious. I want to start an epidemic!

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Feasting on Fat

Loretta Marron OAM BSc

With the Christmas and New Year opportunities to over-indulge, it was easy for girths to increase a little.
If so, it might be very difficult to lose those extra kilos.
Many advertised products and services allegedly help us lose fat without diet and exercise.
Most will fail; some might even be dangerous.

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Hanukkah, Oxygen Masks and Christmas

Mark Neuenschwander

I've been thinking about Hanukkah, oxygen masks, and the Christmas presents I am duty bound to muster for my kids and grandkids. Thank God dad asked for pajamas.
Today I’m flying from Las Vegas to Seattle. About the only thing I liked about Sin City was the fountain show at Bellagio, the Elvis Christmas songs that popped up here and there, and a pretty good keynote address by Bill Clinton. Just thinking of shopping makes me wonder if the cabin isn’t losing its pressure.

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Antioxidants Prevent Cancer and Some May Even Cure It

Staff Writer

Orthomolecular Medicine News Service, January 24, 2013

Antioxidants Prevent Cancer and Some May Even Cure It

Commentary by Steve Hickey, PhD

(OMNS Jan 24, 2013) It is widely accepted that antioxidants in the diet and supplements are one of the most effective ways of preventing cancer. Nevertheless, Dr. James Watson has recently suggested that antioxidants cause cancer and interfere with its treatment. James Watson is among the most renowned of living scientists. His work, together with that of others (Rosalind Franklin, Raymond Gosling, Frances Crick, and Maurice Wilkins) led to the discovery of the DNA double helix in 1953. Although his recent statement on antioxidants is misleading, the mainstream media has picked it up, which may cause some confusion.

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HMR Moratorium – Killing Jobs in Pharmacy

Joseph Conway

It’s no secret that the Pharmacy Guild has called for a moratorium on HMRs until the alleged abuse of a tiny minority of Independent Pharmacists potentially rorting the system is investigated and the system is changed to reduce the possibility of such rorting.
They say that this is necessary as the budget for HMR’s has been overrun and any potential rorting could put the viability of future pharmacy-centric programs at risk too.
The Guild want payments stopped so that the business rules behind HMR’s are “tightened” to stop this apparent rorting.
If there is actually rorting going on, then I think that it’s in all pharmacists’ interest to “fix” this issue.
I for one have nothing against tightening the rules to stop pharmacists “Warehousing” HMRs?
This is great.

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Part one -HMR Evolution

Neil Johnston

With the furore created when the PGA went to print stating that the funds available for HMR’s were almost exhausted, it created an instant “blame game” and conjecture as to what really lay behind the belated PGA announcement.
I came to a conclusion early that it was a result of PGA mismanagement as the immediate problem, but also coupled with an underlying systemic flaw that was the major problem.
Between them they impact and threaten the long term development and survival of the consultant pharmacist program.
It has prompted me to create an analysis of some aspects of the program to evaluate what has gone wrong.

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Part two - Fixing the HMR Flaws

Neil Johnston

The PGA has succeeded in upsetting a broad spectrum of pharmacists that includes all accredited pharmacists, some employer pharmacists (with designs on creating a business model with professional services at the core), and employee pharmacists who see job opportunities being squandered.
It is obvious that the “engine room” for consultant pharmacists (The Australian Association of Consultant Pharmacy) needs urgent reform and a new focus, or be replaced completely.
And the PGA should stop its interference.

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Part three - a Better Umbrealla Organisation

Neil Johnston

Because a workable umbrella model for management consultants already exists, it is suggested that this model be adapted for consultant pharmacist use.
The existing umbrella model established for consultant pharmacists would need to be altered dramatically and be opened up to other organisations e.g Consumer Health Forum, APESMA)
Or an entirely new organisation could be developed from scratch.
This is, in fact happening and is unrelated to any of my activities.
However, I am suggesting that the umbrella model of organisation provided by the Institute of Management Consultants (Australia) provides an excellent reference to adapt to a consultant pharmacist version.

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Thought Bubbles From a Book Group Refugee

Gerald Quigley

Editor's Note:
One night recently, I received the following email from Gerald:
"My wife has a book-group here. I’m locked in my study and inspired to write!"
That's good news for an editor/publisher - getting copy in on time well in advance!
Then followed (the same night), three separate and disparate thoughts that were not directly concerned with a pharmaceutical issue.
But they all had application for pharmacy improvement, with a bit of applied creativity.
As these "thought bubbles" wafted in over the Internet I began to wonder how I might splice them together with some editorial ingenuity.
The following is the result.

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What Really Causes Kidney Stones (And Why Vitamin C Does Not)

Staff Writer

Orthomolecular Medicine News Service, February 11, 2013

What Really Causes Kidney Stones
(And Why Vitamin C Does Not)

(OMNS Feb 11, 2013) A recent widely-publicized study claimed that vitamin C supplements increased the risk of developing kidney stones by nearly a factor of two.[1] The study stated that the stones were most likely formed from calcium oxalate, which can be formed in the presence of vitamin C (ascorbate), but it did not analyze the kidney stones of participants. Instead, it relied on a different study of kidney stones where ascorbate was not tested. This type of poorly organized study does not help the medical profession or the public, but instead causes confusion.

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For health's sake, time to take on food giants

Staff Writer


Food Industry marketing practices are increasingly being brought under the spotlight as are various other worrying problems regarding additives to manufactured food products, also how food is grown using genetically modified seed and the range of toxic herbicides and pesticides.
These latter substances now pollute the entire food chain and not enough is being done to protect our food chain.
Many illnesses can be traced back to ingestion of unnatural substances over a long period of time.
It's time to grow your own.

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Consultant Pharmacists Should Lead The Way - But They Have No Leaders.

Mark Coleman

Isn’t it time that consultant pharmacists took control of their own direction and carved out a future?
Or is the current system of a single-product (HMR) service controlled by the PGA and the PSA, sufficient to provide an interesting and creative future?
How can the aspirations of consultant pharmacists be serviced by an organisation controlled by two major pharmacy-political bodies, when one of them (PGA) is directly working against consultant pharmacist interests.

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APESMA Campaigns for Pharmacist Lunch Hour Entitlements

Staff Writer

Australian pharmacists have been warned to carefully check exactly how much compensation they are getting for routinely working through lunch after an APESMA survey found 28 per cent of Australian pharmacists reported that they receive no financial compensation at all for the lack of a lunch break.
CEO of APESMA Chris Walton said working through every lunchtime was an unacceptable practice that could cause dangerous levels of fatigue.
APESMA has advised pharmacists who have signed any agreement to remove their lunch breaks to immediately ask their employer to itemise any compensation they are being paid in lieu of all award entitlements such as their lunch breaks.

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CHC Emphasises the Importance of Research

Staff Researcher

In light of a recent paper published in the Royal Society's Open Biology journal, proposing a theory that antioxidants can be detrimental in the late stages of cancer treatment, the Complementary Healthcare Council (CHC) of Australia emphasises the importance of clinical trials and studies into the prevention and treatment of cancer. Executive director of the CHC, Dr Wendy Morrow, highlighted this theory as being interesting and warranting more research.

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Advancing our understanding and treatment of motor impairment

Staff Researcher

NeuRA has secured significant funding to expand research into motor impairment, a problem that arises from many diseases and aging, and a growing public health challenge.
Everything the human body does requires movement, but our muscles—and our brain and nerves that control them—are often the first tissues attacked by a long list of disorders that includes stroke, spinal cord and brain injury, multiple sclerosis, Parkinson’s disease, musculoskeletal injury and cerebral palsy.Prof Simon Gandevia is an expert in the brain’s control of human movement at NeuRA (Neuroscience Research Australia) and will spearhead the nearly $7 million multidisciplinary program of study, funded by the National Health and Medical Research Council of Australia.

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PSA WELCOMES GOVERNMENT’S HMR ANNOUNCEMENT

Peter Waterman

Media releases issued from the office of Tania Pliberseck and the PSA arrived this morning.
What follows is the PSA take on recent events surrounding HMR managent.

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Pharmedia - The Vaccine Poll Hijacked by Pharmacists?

Neil Johnston

Editor's Note:
Professional services development was stymied when the AMA reneged on an agreement to support pharmacist vaccination clinics.
It has caused anger and unprofessional behavior has evolved on both sides.
It also appears that while the professional bodies of the AMA and the PGA attempt to disrupt each other, patients at large will become the eventual losers.
The PGA is central to other clinical service disruptions, even those within pharmacy involving contractor pharmacists.
This is damaging to an orderly development of clinical services in a pharmacy setting and demonstrates that current leaders of the PGA and the AMA are not fit to claim the title of "leader".
We asked Mark Coleman to provide commentary on an article recently published in Australian Doctor.

Comments: 2

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Australian Health Information Technology week ending 31/01/2013

Dr David More

articles by this author...

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!

Visit my blog http://aushealthit.blogspot.com/

This blog has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on how things are progressing in e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Note: Each link is followed by a title and a paragraph or two. 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 payment
.

 

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Thursday, January 31, 2013

I Think This Really Is The Thin End Of A Very Nasty Wedge. Think Carefully Before You Sign Up for A NEHRS / PCEHR.

This popped up a little while ago.

'Grave concerns' over new GP dataset

16 January 2013   Rebecca Todd

GPs and privacy experts have “grave concerns” about an extensive new dataset to be extracted from GP practices.

The NHS Commissioning Board published its first planning guidance for the NHS - ‘Everyone Counts: Planning for patients 2013-2014’ – last month.

It says a new GP dataset will be “requested” from GP practices for submission to the Health and Social Care Information Centre, described as a “statutory safe haven.”

“The patient identifiable components will not be released outside the safe haven except as permitted by the Data Protection Act,” it adds.

Practices will be requested to provide data on patient demographics, events, referrals, diagnosis, health status and exceptions.

This includes information on patients’ alcohol consumption and whether a GP has given exercise or dietary advice or completed a mental health review.

GP practices are expected to provide the data using the General Practice Extraction Service.

“The data will flow securely, via GPES, to the HSCIC, the statutory safe haven, which will store the data and link it only where approved and necessary, ensuring that patient confidentiality is protected,” the guidance explains.

Potential uses for this data are not detailed, however the NHS CB’s national director of patients and information, Tim Kelsey told a conference in December that a “standardised routine set of data” would be required from all GPs to help assess their quality.

Dr Paul Cundy, joint chairman of the BMA and RCGP's joint IT committee, said the committee had no prior warning of the new data set before it was published in December.

The committee has met with Kelsey to discuss the proposals and invited him to its next meeting for “further discussions.”

“It’s an interesting proposal, but as with many simple ideas it has got some complex issues behind it,” Dr Cundy said.

“If you compare this data set with the Summary Care Record data set and the time it took to agree the SCR it’s obvious that we will need to be having quite prolonged discussions.”

“I know that there will be a significant number of patients who will not want their identifiable data to leave the practice.”

“The issue for me is what should a GP do if a patient explicitly dissents from this sort of data set going on to the IC?”

Lots more concerns here:

http://www.ehi.co.uk/news/primary-care/8313/%27grave-concerns%27-over-new-gp-dataset

Frankly this is just horrifying and is so open to abuse it is really worrying. Anyone who thinks the Government’s lust for data is any less than policy makers in the UK is delusional and there is one clear lesson here - do not give any sensitive information to Government agencies that you want to remain in charge of and retain control over.

I am sure the ‘nanny state’ wants to know how much we drink and smoke and eat - but my view is that it is our business and not theirs.

Be both alert and alarmed and keep your sensitive information to yourself. The only saving grace is that it will be a good while before the NEHRS contains enough data to be statistically useful and maybe annoyance on the public’s part and much better governance might just save us!

David.

Posted by Dr David More MB PhD FACHI at Thursday, January 31, 2013

It Would Be Nice If NEHTA Created A ‘Blue Button’ for The NEHRS And GP Vendors Also Adopted It.

There has been some renewed in the downloadable Blue Button in the last week.

See here:

ONC posts tech guide for Blue Button Plus

By Mary Mosquera

The Office of the National Coordinator for Health IT has made available technical descriptions and guidance for its more automated version of the Blue Button feature aimed at giving patients easier access and use of their health information.

ONC announced in a Jan. 16 webinar an initial draft implementation guide for Blue Button Plus (+), a rebranding of its Automated Blue Button Initiative, so vendors and others can begin to incorporate the feature in their health IT system updates.

Blue Button+ will help providers meet requirements for meaningful use stage 2 because it incorporates in their certified electronic health records (EHRs) the function for view, download and transmit information for patients, said Lygeia Ricciardi, acting director of ONC’s Office of Consumer Health.

“But it goes beyond that, most notably by automating the information update functions for them,” she said at the webinar sponsored by the National eHealth Collaborative.

Any provider, developer or others may access the technical guides to accelerate a growing ecosystem of tools to help patients participate in and manage their care, especially through easier, secure access to their health information, Ricciardi said. The health IT tools also enhance communications between patients and their physicians and improve care coordination.

Blue Button+ is being advanced through ONC’s Standards & Implementation Framework community. The full draft implementation guide will be launched by the end of this month, said Pierce Graham-Jones, Innovator in Residence at the Health and Human Services Department, and a member of the S&I community working on the project.

The draft implementation guidance includes how to transmit data to patients in structured format, how to transmit data to patients using Direct secure messaging protocol, and a privacy and security piece.

More here:

http://www.govhealthit.com/news/onc-opens-technical-guide-blue-button-plus

as well as here:

VA Blue Button adds patient summary document tool

By Mary Mosquera

The Veterans Affairs Department has added a new tool through its Blue Button feature so veterans may more easily download a summary of their essential health information. The enhancement is the VA Continuity of Care Document (VA CCD) in xml file format.

The VA CCD uses recognized standards that support the exchange of information between healthcare systems and providers for coordinated and continued care of the patient. VA started Blue Button as an unstructured ASCII text document, a simple download mechanism.

VA has expanded its Blue Button feature with other capabilities, including demographics, active problem list, discharge summaries, progress notes, expanded laboratory results, vitals and readings, pathology reports, radiology reports and electrocardiogram (EKG) list of studies.

“As of today, veterans can electronically download their entire medical record plus CCD summary,” said Peter Levin, VA chief technology officer, on his Twitter account Jan. 20.

Veterans must be authenticated in person at a local VA clinic or hospital or online to confirm their identity to obtain their health information through MyHealtheVet.

More here:

http://www.govhealthit.com/news/va-blue-button-adds-patient-summary-document-tool

It is interesting to think what this all means. Perhaps the NEHRS is even just an idea which has passed its use by date before it even starts.

Think of it - press the Blue Button - collect your EHR record on your USB key and share it as needed. Ultimate privacy control, ultimate personal control and no centralised database to be cracked.

I also think it would be a good deal cheaper than what is presently planned and everyone who wants such a portable accessible EHR could have one for a few dollars.

Of course we would need Standards and so on and some vendor support to provide genuine interoperability at a record level. Hard to see any losers if such a plan was adopted.

What do you think?

David.

 

Posted by Dr David More MB PhD FACHI at Thursday, January 31, 2013 2 comments

Wednesday, January 30, 2013

Talk About A Sense Of Déjà Vu. Australia Has Certainly Seen This Before. It Ultimately Ended Badly For The Provider Involved In Australia.

The following appeared a few days ago:

Should cash-strapped small practices turn to ad-supported EHRs?

Author Name Jennifer Bresnick   |   Date January 22, 2013   |  

Advertising is everywhere.  From your smartphone apps to your radio station to this very article, ads pay the bills for your favorite news outlets, entertainment destinations, and websites.  Sometimes they’re annoying, and sometimes they alert you to a useful product or service you might not otherwise find.  But should they be integrated into your EHR?  With implementation costs soaring into the tens of thousands and no immediate return on such a massive investment, many physicians are saying yes.

The market for EHR advertising revolves around cloud-based services, since advertisers need an internet connection to push ads into their product.  With 41% of physicians using cloud services, the market is robust and growing.  “Advertising is a natural fit in the healthcare sector,” Bill Jennings, CEO of Good Health Media told Practice Fusion, one of the leading ad-based EHRs. “Doctors get it; they’re comfortable with discreet advertising inside their medical practice. The advertising programs give a small medical practice the chance to add a time-saving, life-saving technology solution – for free. It’s a benefit for the advertiser, the doctor and the patient.”

EHR advertising is desirable to large pharmaceutical companies because there’s a high likelihood that the person observing the ad will be a physician.  Physicians spend the most time with EHRs, and are also the decision-makers when it comes to writing prescriptions for brand-name products.  Zach Gursky, VP of sales for Practice Fusion, told American Medical News that 85% of major pharmaceutical companies are running ads with the free service as a result of an explosion of interest over the past year and a half.  Gursky asserts that physicians are finding value in the ads due to the fact that they are highly targeted to them and the types of patients that they treat.

They are also finding value in the fact that web-based EHR systems require little to no cash output in order to use.  Small practices without a large surplus budget for technology upgrades can use certain free EHRs to attest to meaningful use and receive financial incentives from CMS.  These providers don’t need to worry about ongoing maintenance, software upgrades, or an in-house IT staff, which becomes a very attractive prospect.

Lots more here:

http://ehrintelligence.com/2013/01/22/should-cash-strapped-small-practices-turn-to-ad-supported-ehrs/

For those who don’t remember we used to have Pharma ads in Medical Director (MD) and this reduced the price of the software and support. The net effect was a near monopoly.

It was then realised by the profession that the Pharma companies would only be paying if they were making money out of the ads and that this was probably distorting ethical prescribing in the direction of profit and commercial interests.

Gradually antipathy to the whole business grew and eventually MD was forced to give up the sponsorship funds. This levelled the GP system playing field and allowed some real innovation to commence. In the long term this meant MD lost significant market share.

The lesson is that things that are ‘free’ may not turn out to be in the longer run. Certainly GP computing in Australia was not helped by the artificially distorted market in my view.

The US would be wise to nip this trend in the bud.

David.

Posted by Dr David More MB PhD FACHI at Wednesday, January 30, 2013

Tuesday, January 29, 2013

NEHTA Achieves A Personal Best In Fake Helpfulness.

Popped on to the NEHTA website a few days ago and found this page on ePIP.

ePIP Support

From 1 February 2013, the PIP eHealth Incentive eligibility requirements change.

To help practices meet these new eligibility requirements, guidance is available for both organisations providing support to General Practice as well as for General Practices registering independently for the ePIP and meeting each of the five requirements.

Practices are strongly encouraged to read the PIP eHealth Incentive Guidelines and use the ePIP Compliance Checklist contained in the General Practice Registration Workbook to help establish eligibility for the ePIP.

What is ePIP?

The Practice Incentives Program (PIP) eHealth Incentive aims to encourage General Practices to keep up-to-date with the latest developments in eHealth to assist in improving administration processes and enhancing the quality of patient care by, for example, supporting the capacity to share accurate electronic patient records. More Information

Registration Collateral

General Practice Applying Independently

  • Guidance and support materials to register and meet the five ePIP requirements are available here. This includes more detailed information for each requirement, exemptions, compliance dates and associated application forms.
  • More Information

Organisations Offering Registration Workshops for General Practice

  • General Practice Registration workshops - here you will find workshop guidance and support materials for organisations to provide General Practice Registration workshops. This includes webinars, an approach overview, checklists, and tips and tricks for a successful workshop.
  • More Information

NOTE: We will continue to update and make new guidance and support materials available so check this website frequently. You can also sign up for an RSS feed.

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See here:

http://www.nehta.gov.au/registration-support

This heading intrigued me:

Organisations Offering Registration Workshops for General Practice

So I clicked more information only to find this.

Organisations Offering Registration Workshops

Organisations providing workshop registration support to support General Practices registering for ePIP can use these materials to plan and deliver registration workshops.

The workshop has been designed specifically for General Practices registering for ePIP, however the forms and guides can be used by other providers to support them in registering for their NASH PKI certificates and the personally controlled electronic eHealth record (PCEHR).

Practices are responsible for ensuring that they have met each of the five ePIP requirements at the time their ePIP application is submitted.

General Practice Registration Workbook Contents

NOTE: Release notes will be added once a new version is uploaded.

There followed a list of some 30 NEHTA documents dated 17/01/2013 follows.

See here:

http://www.nehta.gov.au/registration-support-organisations

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So, in summary, we are offered a course (actually just a few documents) but no listing of who is offering to explain and each it and when. I think a list of who is running workshops or who to call to have all this explained and taught must have got lost. Or does it not exist? I wonder who the target organisations are and have they been told all this stuff is available and been given a guide on how it is best used? I guess the top document on the list on how to seek help via the help desk is what is your best bet.

More than that it is all a bit circular with no apparent list of where workshops and so on are being offered and referring back to the same page.

I guess NEHTA have provided the documents so they have ‘delivered’ but not actually! Talk about not being able to manage a party in a brewery!

Again we really see just way too little and it being delivered way too late.

David.

Posted by Dr David More MB PhD FACHI at Tuesday, January 29, 2013

AusHealthIT Poll Number 152 – Results – 29th January, 2013.

The question was:

Are NEHTA And DoHA Competent To Be Managing The Delivery Of The E-Health Program In Australia?

Yes - They Are Fabulous 5% (2)

Maybe - Doing An Average Job 5% (2)

Neutral 0% (0)

Probably Not - They Are Not Doing Well 20% (8)

No - It Is An Awful Travesty 63% (25)

I Have No Idea 8% (3)

Total votes: 40

Very interesting. A clear majority are by no means convinced the people in charge have a clue what they are doing.

Again, many thanks to those that voted! 
Please Note: I am always interested in ideas for Polls. Send your suggestions via comment or e-mail!

David.

Posted by Dr David More MB PhD FACHI at Tuesday, January 29, 2013


Monday, January 28, 2013

Weekly Australian Health IT Links – 28th January, 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

The countdown has begun and it looks like less than ½ of the practices who are receiving ePIP payments up until Feb 1, will not be ready by that date for the new regime. Not that, of course, we will have any statistics on all this for a year or two. That will result in some grumpy and frustrated GPs to say the least.

Otherwise it is interesting to see how ‘apps’ are now part of the routine health environment. This change seems to have happened over the last few years and is only apparently accelerating. You can gauge the importance of all this by fact we now have legislation being drafted in the US to regulate them! 

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PCEHR chaos - have your say on just4docs

21 Jan 2013

The PCEHR scheme is in chaos with thousands of practices due to miss out on PIP payments. The issue has generated heated debate on Australian Doctor’s new secure online network for doctors.

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http://www.6minutes.com.au/news/latest-news/gp-practices-invited-to-%E2%80%98seed-pcehr

GP practices invited to ‘seed’ PCEHR

24 January, 2013 Sam Lee

GP practices are now being invited to become ‘seed organisations’ for the PCEHR system, with the release of new guidance on how to sign up and participation agreements tailored for different practice structures.

A new registration guide, released by the Department of Health and Ageing, suggests that most independent GP practices will be suited to sign up to the PCEHR program as a single ‘seed organisation’.  The more complex category of network organisation will be more suited to such as pathology departments within major hospitals.

However, the guidance warns that patients with ‘seed organisations’
may not be able to use access flags to restrict access to other providers within the same organisation.

The guide says GP practices will have to nominate a “Responsible Officer” such as the practice manager, and at least one IT-savvy “Organisation Maintenance Officer’ who will deal with the day-to-day operations of the eHealth record system.

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http://www.6minutes.com.au/news/latest-news/internet-poses-risk-to-gp-reputations

Internet poses risk to GP reputations

24 January, 2013 Kate Cowling

Online forums and search engine autocompletes have the potential to “irreversibly sully” the reputation of Australian doctors, the AMA’s president says.

And any potential solution is not clear-cut, he said, with costly legal pursuits unlikely to “overturn untruths”.

His comment came after it was revealed a Port Macquarie doctor was suing Google for defamation after auto-correct correlated his name with “bankrupt”.

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http://www.mjainsight.com.au/view?post=jane-mccredie-keeping-family-secrets&post_id=11835&cat=comment

Jane McCredie: Keeping family secrets

THE sequencing of the human genome promises unparalleled opportunities to fight disease, identifying the genetic variants that predispose us to various illnesses or protect us from them.

In support of that noble endeavour, thousands of people around the world have donated their de-identified genetic information to free, publicly accessible databases such as those held by the 1000 Genomes Project.

Such projects are an invaluable resource for researchers but, in an age when so much information is available online about all of us, can the donors be assured their genetic information will remain private?

The answer, according to researchers at the Whitehead Institute for Biomedical Research in the US, is definitely not.

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http://www.afr.com/p/national/arts_saleroom/second_opinion_PNcINF6yE7MNXCWmaARXiK

Second opinion

PUBLISHED: 19 Jan 2013 00:33:14

Katie Hafner

The man on stage had his audience of 600 mesmerised. For 45 minutes, the tension grew. Finally, the moment of truth arrived, and the room was silent with anticipation.

At last he spoke. “Lymphoma with secondary hemophagocytic syndrome,” he said. The crowd erupted in applause.

Professionals in every field revere their superstars, and in medicine the best diagnosticians are held in particularly high esteem. Gurpreet Dhaliwal, 39, a self-effacing associate professor of clinical medicine at the University of California, San Francisco, is considered one of the most skilful clinical diagnosticians in practice.

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http://www.mjainsight.com.au/view?post=App+may+solve+photo+legal+risks&post_id=11868&cat=news-and-research&mo=1

App may solve photo legal risks

A NEW smartphone app aimed at making clinical photography legally safe for doctors, patients and practices is just weeks away from release, according to the surgeon involved in its development.

Dr David Hunter-Smith, a plastic and reconstructive surgeon with Peninsula Health in Victoria, said the app would address the legal and security issues inherent in the booming use of smartphones in clinical situations.

News of the app coincides with an article published in this week’s MJA warning clinicians of their legal obligations regarding consent and privacy with clinical photography. (1)

-----

http://www.medicalobserver.com.au/news/doctors-cautioned-on-taking-patient-pics

Doctors cautioned on taking patient pics

21st Jan 2013

DOCTORS have been advised to be vigilant about their legal and ethical responsibilities to patient privacy and consent when taking digital images of physical conditions on smartphones or other devices.

Authors of an article in the recent MJA have warned that with the increase of the practice by clinicians, and the resulting possibilities for these visual records to be used for patient management, medical education or research, doctors should be fully aware of their legal obligations.

Lead author Dr Patrick Mahar, of Melbourne’s Skin & Cancer Foundation, wrote that indemnity providers in both Australia and the UK had identified the “use or misuse of clinical photographs as an emerging medico-legal risk for the medical profession”.

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http://www.computerworld.com.au/article/451309/unsw_project_spotlights_text_mining_language_analysis/

UNSW project spotlights text mining, language analysis

New Text Mining Collaboration project at the University of NSW aims to increase awareness of textual analytics tools

An interdisciplinary group of researchers at the University of NSW is seeking to promote a higher profile for text mining and automatic language analysis among academics.

The group has launched a UNSW-funded project, which went public late last year, that seeks to make it easier to use text mining tools for research and help prevent researchers from reinventing the wheel when it comes to extracting information from unstructured data.

The Web-based Text Mining Collaboration portal, which operates under the auspices of UNSW's Kirby Institute, offers access to online tools as well as bringing together related resources such as case studies and tutorials in an effort to make the technology easily available to the university's community of researchers.

"It's a mixture of our UNSW research outputs as well as commonly used text mining frameworks from around the world," says project lead Dr Stephen Anthony, Research Fellow at the Faculty of Medicine.

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http://www.australianageingagenda.com.au/2013/01/22/article/Calvary-takes-the-ehealth-plunge/OMBRAQKJUW

Calvary takes the ehealth plunge

Published on Tue, 22/01/2013, 11:04:10

Little Company of Mary Health Care - officially Calvary Care - is seeking IT partners for its first three tiered ehealth initiative project in the Hunter region of NSW, just north of Sydney, according to a report in the Australian newspaper’s IT section today.

The article says the organisation, with a turnover in excess of $1 billion, is in discussions with both multi-national and local IT companies with a view to rolling out “a range of cutting edge tele-health services across its nationwide network.”

According to the article by Damon Kitney, Little Company of Mary CEO, Mark Doran said hospital groups would need to establish three-tier systems (home care, hospital care and aged care) to address the country's increasing ageing population, make available more hospital beds and tackle the growing public hospital waiting-list problems.

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http://www.computerworld.com.au/article/451608/twitter_more_informative_health_info_than_search_engines/

Twitter more informative for health info than search engines

The research included analysis of more than 4700 tweets from 114 government health-related organisations.

University research has found that social networks like Twitter have a more powerful role in disseminating public health information than search engines.

The research was carried out by Professor Robert Steele and PhD candidate Dan Dumbrell at the University of Sydney.

“Using new communications technologies to allow people to directly receive relevant and up-to-the-minute public health information could benefit the health of millions and change the paradigm of public health information dissemination,” Steele, head of discipline and chair of health informatics at the university’s Faculty of Health Sciences, said in a statement.

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http://abaki.com/portal/News/practice-2000-health-identifiers-has-been-granted-access-in-production-to-the-hi-service/

Practice 2000 Health Identifiers has been granted access in Production to the HI Service

January 9, 2013

We are pleased to inform that Practice 2000 has been certified by Medicare Australia to a Production access to HI Service. Currently, Practice 2000 has been listed on the PIP eHealth Register of Conformity. For more information, please refer to https://epipregister.nehta.gov.au/registers/healthcare-identifiers

A new version of Practice 2000 that is compatible with eHealth is available to download via http://abaki.com/portal/download/

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http://www.theaustralian.com.au/news/world/twitch-in-time-saves-nine-as-speech-solution-expands-hawking-universe/story-fnb64oi6-1226559600631

Twitch in time saves nine as speech solution expands Stephen Hawking'a universe

  • From: The Times
  • January 23, 2013 12:00AM

STEPHEN Hawking is to take a quantum leap in the world of communication thanks to new technology that will allow him to write faster.

For the past decade, the 71-year-old physicist has composed sentences one letter and word at a time by using a twitch of his cheek muscle to stop a cursor moving across text on a screen. His sentences are then read out by a speech device, producing his distinctive robotic voice.

But the degenerative motor neuron disease from which he suffers has made it harder to control the twitch, and one of science's quickest minds had been reduced to typing only one word a minute.

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http://www.medicalobserver.com.au/news/dna-used-as-data-storage-device

DNA used as data storage device

24th Jan 2013

A GENETIC storage device has been used to ‘download’ all 154 of Shakespeare's sonnets onto strands of synthetic DNA.

British scientists were then able to decode the information and reproduce the words of the Bard with complete accuracy.

The same technique made it possible to store a 26-second excerpt from Martin Luther King's I Have A Dream speech and a photo of the Cambridgeshire laboratory where the work took place.

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http://www.nehta.gov.au/media-centre/nehta-news/997-pip-ehealth-incentive-registration-support-available

PIP eHealth Incentive registration support available

18 January 2013.  The Practice Incentives Program (PIP) eHealth Incentive aims to encourage General Practices to keep up-to-date with the latest developments in eHealth to assist in improving administration processes and enhancing the quality of patient care by, for example, supporting the capacity to share accurate electronic patient records.  From 1 February 2013, the PIP eHealth Incentive eligibility requirements change. 

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http://www.nehta.gov.au/registration-support-organisations

Organisations Offering Registration Workshops

Organisations providing workshop registration support to support General Practices registering for ePIP can use these materials to plan and deliver registration workshops.

The workshop has been designed specifically for General Practices registering for ePIP, however the forms and guides can be used by other providers to support them in registering for their NASH PKI certificates and the personally controlled electronic eHealth record (PCEHR).

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http://www.theaustralian.com.au/australian-it/health-apps-win-nsw-awards/story-e6frgakx-1226560198637

Health apps win NSW awards

  • From: AAP
  • January 23, 2013 3:53PM

SMARTPHONE and tablet apps are set to take over outdated magazines in doctors' waiting rooms as health providers update the way they manage data.

Four developers have won the NSW government's apps4nsw competition, which this year focused on e-solutions for health.

"I love apps. I use apps to do everything," NSW Health Minister Jillian Skinner said at an awards ceremony at NSW parliament.

"These ideas have the potential to help the people of NSW make better choices about their health."

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http://www.smh.com.au/technology/technology-news/australian-internet-speeds-fall-to-40th-place-globally-20130125-2dazu.html

Australian internet speeds fall to 40th place globally

Date January 25, 2013 - 12:27PM

Australian internet speeds have fallen again compared to the rest of the world, says a new survey.

Average Australian connection speeds fell 2.5 per cent in the third quarter of 2012 as the country sank to 40th in the world, according to Akamai Technologies' third quarter "State of the internet" report.

Australia dropped from 39th position globally in the second quarter of 2012, being beaten by five countries in the region. Australia came out on top of New Zealand, however, which ended up in 46th place.

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http://www.smh.com.au/digital-life/consumer-security/google-working-on-password-alternatives-20130121-2d1tr.html

Google working on password alternatives

Date January 21, 2013

Samantha Murphy

The topic of passwords has made headlines in the past year — from high-profile hacks to web users repeatedly not picking the right ones — but Google has its sights set on making the login-process much more secure in the future.

How secure, you may ask? Consider logging into Gmail with a high-tech ring worn on your finger or a key card that plugs into your computer's USB port.

As detailed in a research paper in IEEE Security & Privacy Magazine and reported on by Wired, Google is already looking into password alternatives in the form of passdevices. The initiatives have also been confirmed by Mashable.

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Enjoy!

David.

Posted by Dr David More MB PhD FACHI at Monday, January 28, 2013

 

Sunday, January 27, 2013

This Is Really Sad - Twitter Being Abused

I have been following #qldfloods and #bigwet on Twitter today.

Was great until 1 hour ago - now an epidemic of porno spam.

What a pity.  Sad a useful service is being abused big time. What jerks.

David.

Posted by Dr David More MB PhD FACHI at Sunday, January 27, 2013

 

They Simply Don’t Seem To Be Able To Keep It Up. Surely A Full, Properly Working System Is Not All That Hard?

Had my usual weekly visit to my NEHRS Record.

Findings were as follows.

First the response time is just awful. Even the News Ltd Home Page and The SMH are 10 times as quick. Comparisons with Google and Amazon and simply not worth making.

Second it now seems you can register for a NEHRS if you wish - so that has been fixed during the week.

Third we have:

Service availability

  • Home
  • Service availability

This page identifies scheduled outages to the eHealth record system.

The Personally Controlled Electronic Health Record System (PCEHR) is undertaking essential maintenance from 4am Wednesday 30 January to 7am Wednesday 30 January (AEDST).

The PCEHR System will not be available between 4am and 7am Wednesday 30 January .

We apologise for any inconvenience.

Contact the eHealth helpline on 1800 723 471 for assistance during this period.

See here:

http://www.ehealth.gov.au/internet/ehealth/publishing.nsf/content/availability

It just seems that never a week goes by when it all works as it should.

David.

Posted by Dr David More MB PhD FACHI at Sunday, January 27, 2013

 

Aus Health IT Poll

Should The Introduction of the Revised ePIP Conditions be Slowed Down Until Proper Support and Education Has Been Provided To All Affected Practitioners?

Yes

Propably

Probably No

Definitely Not

I Have No Idea

See results

panel management

 

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