s Australian Health Information Technology | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists

Editorial

From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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Recent Comments

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News Flash

Newsflash Updates for July 2014

Newsflash Updates

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

Comments: 1

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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

It started with “tablet” computers deployed on shelves inside the retailer Coles, specifically to provide information to consumers relating to pain management and the sale of strong analgesics.
This development was reported in i2P under the title Coles Pharmacy Expansion and the Arid PGA Landscape”
In that article we reported that qualified information was a missing link that had come out of Coles market research as the reason to why it had not succeeded in dominating the pain market.
Of course, Woolworths was working on the same problem at the same time and had come up with a better solution - real people with good information.

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

Editor's Note: The understanding of a pharmacy's presentation through the research that goes into the design of fixtures and fittings that highlight displays, is a never-ending component of pharmacy marketing.
Over the past decade, Australian pharmacy shop presentations have fallen behind in standards of excellence.
It does not take rocket science - you just have to open your eyes.
Recently, our two major supermarkets, Woolworths and Coles, have entered into the field of drug and condition information provision - right into the heartland of Australian Pharmacy.

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The sure way to drive business away

Gerald Quigley

I attended the Pregnancy, Baby and Children’s Expo in Brisbane recently.
What an eye and ear opening event that was!
Young Mums, mature Mums, partners of all ages, grandparents and friends……...many asking about health issues and seeking reassurances that they were doing the right thing.

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

It should be the scandal of the century.
It potentially affects the health of almost everyone.
Healthcare providers and consumers alike should be up in arms. But apart from coverage in a few credible news sources the problem of ‘Marketing Based Medicine,’ as psychiatrist Dr Peter Parry terms it, hasn’t as yet generated the kind of universal outrage one might expect.

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Community Pharmacy Research - Are You Involved?

Mark Coleman

Government funding is always scarce and restricted.
If you are ever going to be a recipient of government funds you will need to fortify any application with evidence.
From a government perspective, this minimises risk.
I must admit that while I see evidence of research projects being managed by the PGA, I rarely see community pharmacists individually and actively engaged in the type of research that would further their own aims and objectives (and survival).

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

Most of us leave a tremendous impact on pharmacies we work for (as proprietors, managers, contractors or employees)—in ways we’re not even aware of.
But organisational memories are often all too short, and without a central way to record that impact and capture the knowledge and individual contributions, they become lost to time.
It is ironic that technology has provided us with phenomenal tools for communication and connection, but much of it has also sped up our work lives and made knowledge and memory at work much more ephemeral.

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Academics on the payroll: the advertising you don't see

Staff Writer

This article was first published in The Conversation and was written by Wendy Lipworth, University of Sydney and Ian Kerridge, University of Sydney
In the endless drive to get people’s attention, advertising is going ‘native’, creeping in to places formerly reserved for editorial content. In this Native Advertising series we find out what it looks like, if readers can tell the difference, and more importantly, whether they care.
i2P has republished the article as it supports our own independent and ongoing investigations on how drug companies are involved in marketing-based medicine rather than evidence-based medicine.

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

Editor's Note: This is an early article by Mark Neuenschwander we have republished after the soul-searching surrounding a recent Australian dispensing error involving methotrexate.
Hmm. There’s more than one way you could take that, huh? Like Someday when I get around to it (I’m not sure) I may admit that I was wrong about something. Actually, I’ve been thinking about the concept of admitting wrong. So don’t get your hopes up. No juicy confessions this month except that I wish it were easier for me to admit when I have been wrong or made a mistake.
Brian Goldman, an ER physician from Toronto, is host of the award-winning White Coat, Black Art on CBC Radio and slated to deliver the keynote at The unSUMMIT for Bedside Barcoding in Anaheim this May. His TED lecture, entitled, “Doctors make mistakes. Can we talk about it?” had already been viewed by 386,072 others before I watched it last week.

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Dispensing errors – a ripple effect of damage

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

Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June
http://aca.ninemsn.com.au/article/8863098/prescription-drug-warning

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Take a vacation from your vocation

Harvey Mackay

Have you ever had one of those days when all you could think was, “Gosh, do I need a vacation.”
Of course you have – because all work and no play aren’t good for anyone.
A vacation doesn’t have to be two weeks on a tropical island, or even a long weekend at the beach. 
A vacation just means taking a break from your everyday activities. 
A change of pace. 
It doesn’t matter where.
Everyone needs a vacation to rejuvenate mentally and physically. 
But did you also know that you can help boost our economy by taking some days off? 
Call it your personal stimulus package.

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Explainer: what is peer review?

Staff Writer

This article was first published in the Conversation. It caught our eye because "peer review" it is one of the standards for evidence-based medicines that has also been corrupted by global pharma.
The article is republished by i2P as part of its ongoing investigation into scientific fraud and was writtenby Andre Spicer, City University London and Thomas Roulet, University of Oxford
We’ve all heard the phrase “peer review” as giving credence to research and scholarly papers, but what does it actually mean?
How does it work?
Peer review is one of the gold standards of science. It’s a process where scientists (“peers”) evaluate the quality of other scientists' work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already knew.
Most scientific journals, conferences and grant applications have some sort of peer review system. In most cases it is “double blind” peer review. This means evaluators do not know the author(s), and the author(s) do not know the identity of the evaluators.
The intention behind this system is to ensure evaluation is not biased.
The more prestigious the journal, conference, or grant, the more demanding will be the review process, and the more likely the rejection. This prestige is why these papers tend to be more read and more cited.

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Dentists from the dark side?

Loretta Marron OAM BSc

While dining out with an elderly friend, I noticed that he kept his false tooth plate in his shirt pocket. He had recently had seven amalgam-filled teeth removed, because he believed that their toxins were making him sick; but his new plate was uncomfortable. He had been treated by an 'holistic dentist'. Claiming to offer a "safe and healthier alternative" to conventional dentistry, are they committed to our overall health and wellbeing or are they promoting unjustified fear, unnecessarily extracting teeth and wasting our money?

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Planning for Profit in 2015 – Your key to Business Success

Chris Foster

We are now entering a new financial year and it’s a great time to reflect on last year and highlight those things that went well and those that may have impacted negatively in the pursuit of your goals.
It's also a great to spend some time re-evaluating your personal and business short, medium and long term goals in the light of events over the last year.
The achievement of your goals will in many cases be dependent on setting and aspiring to specific financial targets. It's important that recognise that many of your personal goals will require you to generate sufficient business profits to fund those aspirations

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Attracting and Retaining Great People

Barry Urquhart

Welcome to the new financial year in Australia.
For many in business the past year has been described as a challenging period.
Adjectives are a key feature of the English language.  In the business lexicon their use can be, and often is evocative and stimulate creative images.  But they can also contribute to inexact, emotional perceptions.
Throughout the financial pages of newspapers and business magazines adjectives abound.
References to “hot” money draw attention and comment.  The recent wave of funds from Chinese investors, keen to remove their wealth from the jurisdiction and control of government regulations is creating a potential property bubble in Australia.

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Updating Your Values - Extending Your Culture

Neil Johnston

Pharmacy culture is dormant.
Being comprised of values, unless each value is continually addressed, updated or deleted, entire organisations can stagnate (or entire professions such as the pharmacy profession).
Good values offer a strong sense of security, knowing that if you operate within the boundaries of your values, you will succeed in your endeavours.

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Evidence-based medicine is broken. Why we need data and technology to fix it

Staff Writer

The following article is reprinted from The Conversation and forms up part of our library collection on evidence-based medicines.
At i2P we also believe that the current model of evidence is so fractured it will never be able to be repaired.
All that can happen is that health professionals should independently test and verify through their own investigations what evidence exists to prescribe a medicine of any potency.
Health professionals that have patients (such as pharmacists) are ideally placed to observe and record the efficacy for medicines.
All else should confine their criticisms to their evidence of the actual evidence published.
If there are holes in it then share that evidence with the rest of the world.
Otherwise, do not be in such a hurry to criticise professions that have good experience and judgement to make a good choice on behalf of their patients, simply because good evidence has not caught up with reality.

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Laropiprant is the Bad One; Niacin is/was/will always be the Good One

Staff Writer

Orthomolecular Medicine News Service, July 25, 2014
Laropiprant is the Bad One; Niacin is/was/will always be the Good One
by W. Todd Penberthy, PhD

(OMNS July 25, 2014) Niacin has been used for over 60 years in tens of thousands of patients with tremendously favorable therapeutic benefit (Carlson 2005).
In the first-person NY Times best seller, "8 Weeks to a Cure for Cholesterol," the author describes his journey from being a walking heart attack time bomb to a becoming a healthy individual.
He hails high-dose niacin as the one treatment that did more to correct his poor lipid profile than any other (Kowalski 2001).

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Culture Drive & Pharmacy Renewal

Neil Johnston

Deep within all of us we have a core set of values and beliefs that create the standards of behaviour that we align with when we set a particular direction in life.
Directions may change many times over a lifetime, but with life experiences and maturity values may increase in number or gain greater depth.
All of this is embraced under one word – “culture”.
When a business is born it will only develop if it has a sound culture, and the values that comprise that culture are initially inherent in the business founder.
A sound business culture equates to a successful business and that success is often expressed in the term “goodwill” which can be eventually translated to a dollar value.

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Pharmacy 2014 - Pharmacy Management Conference

Neil Johnston

The brave new world of health and wellness is not the enemy of Pharmacy, it is its champion.
Australian futurist, Morris Miselowski, one of the world's leading business visionaries, will present the Opening Keynote address on Pharmacy's Future in the new Health and Wellness Landscape at 2.00pm on Wednesday July 30.
Morris believes the key to better health care could already be in your pocket, with doctors soon set to prescribe iPhone apps, instead of pills.
Technology will revolutionise the health industry - a paradigm shift from healthcare to personal wellness.
Health and wellness applications on smartphones are already big news, and are dramatically changing the way we manage our personal health and everyday wellness.

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Generation and Application of Community Pharmacy Research

Neil Johnston

Editor’s Note: We have had a number of articles in this issue relating to pharmacy research.
The PGA has conducted a number of research initiatives over the years, including one recently reported in Pharmacy News that resulted from an analysis of the QCPP Patient Questionnaire.
Pharmacy Guild president, George Tambassis, appears to have authored the article following, and there also appears to be a disconnect between the survey report and its target audience illustrated by one of the respondent comments published.
I have asked Mark Coleman to follow through, elaborate and comment:

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Australian Health Information Technology

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.

 

Friday, November 30, 2012

It Seems Health Information Exchange Throws Up Similar Problems All Over.

The following appeared last week.

Monday, November 19, 2012

Patient Consent for Information Exchange Comes Into Focus

by Ken Terry, iHealthBeat Contributing Reporter

Federal and state laws require that patients give permission or be allowed to withhold consent for health information exchanges to use their individually identifiable health information (IIHI) for purposes other than direct patient care. Consequently, as health care providers start to adopt new care delivery models that necessitate clinical data exchange, patient consent is becoming a hot issue.

Despite the existing regulations -- or because of them, in some cases -- patient consent involves legal, technical and practical issues that are far from being resolved. Which circumstances require patient consent, which parties can be allowed to access particular information and whether patients must opt in to health information exchange or should be allowed to opt out are all open questions.

One reason for the lack of clarity is varying state requirements. According to the Office of the National Coordinator for Health IT, for example, slightly more than half of states are planning to deploy an opt-out model in their statewide HIEs. The rest are using or plan to use various kinds of opt-in approaches.

While the federal HIPAA law allows treating providers to exchange patient information directly without a patient's consent, some states place restrictions on those direct exchanges, according to Micky Tripathi, CEO of the Massachusetts eHealth Collaborative. There also are differences among states in whether they require prior consent for the aggregation of data by an HIE, he pointed out.

But moves are afoot to introduce some national uniformity in this area. Last March, ONC issued a program information notice to its state HIE grantees that includes guidance on patient consent. The key concept in this guidance is "meaningful choice," described as follows:

"Where HIE entities store, assemble or aggregate IIHI beyond what is required for an initial directed transaction, HIE entities should ensure individuals have meaningful choice regarding whether their IIHI may be exchanged through the HIE entity. This type of exchange will likely occur in a query/response model or where information is aggregated for analytics or reporting purposes."

ONC and the Health IT Policy Committee, a federal advisory body, say that states can use opt-in or opt-out models as long as they offer patients meaningful choice, which requires advance notice, "full transparency and education" and revocability, among other things. Simply providing a "boilerplate form" in a physician's office or directing patients to read material posted on a website is not enough, Kathryn Marchesini, senior analyst and adviser to ONC's chief privacy officer, said.

"We're focusing on engaging the patient in an interactive manner so they understand the options that they have," she said.

Lots more here:

http://www.ihealthbeat.org/features/2012/patient-consent-for-information-exchange-comes-into-focus.aspx

Here are some useful links from the article.

MORE ON THE WEB

The article provides a really useful summary of the consent issues that can be faced - including by the NEHRS / PCEHR which is (after all) at core just a Health Information Exchange on a rather grand level.

It is interesting that among the US States about ½ have gone for an opt-out approach and the other half an opt-in.

The full article is well worth a read for all the wrinkles experienced.

David.

Posted by Dr David More MB PhD FACHI at Friday, November 30, 2012 0 comments

Thursday, November 29, 2012

The US ‘Fiscal Cliff’ Might Make A Mess Of E-Health In The US. Could Be Ugly.

This appeared a few days ago.

The Fiscal Cliff and Meaningful Use: Be Very Afraid

By Joseph Goedert

NOV 16, 2012 8:11pm ET

During the congressional tax/budget debate coming very soon, someone in the Republican Party is going to demand another $20 billion or so cut from an entitlement program or another government program that is near and dear to the Democratic Party. Someone in the Republican Party will mention that boondoggle health information technology initiative in the hated stimulus bill, and someone in the Democratic Party will decide that’s where another $20 billion in savings can come from. Whatever federal funds are left to support electronic health records meaningful use, health I.T. workforce training, health information exchanges, best practices dissemination, regional extension centers and anything else in the HITECH Act will be gone.
Don’t believe all the talk of how health I.T. has bi-partisan support. Nothing but the most sacred cows will be considered sacred in the upcoming budget battle. Since health I.T. doesn’t pass the sacred test, the spigot is in danger of running dry unless the nation’s physicians and hospitals rise up en masse and scare the hell out of their congressional representatives and senators.
Yes, AMA, you have to stop whining about ICD-10 and focus elsewhere on the real here and now. Yes, AHA, all of your hospitals are spending millions of dollars on EHRs and soon won’t be getting those rebate checks, unless you also turn them loose to fight for what they were promised. Yes, insurers and employers, if you want to have any government funding for information systems that will support bending the cost curve and moving to payment models better than fee-for-service, you also have a lot of work to do. And you all need to do it now.

More here:

http://www.healthdatamanagement.com/blogs/fiscal-cliff-electronic-health-records-meaningful-use-45265-1.html

The US ‘fiscal cliff’ is a series of taxation measures and spending cuts which have already been legislated and which begin to bite come January 1, 2013. The net effect on US GDP will be a contraction of the order of 4% of GDP next year - and given the fact US growth is only about 2% presently, this - if unchanged - may turf the US back into recession according to the non-partisan Congressional Budget Office.

There is going to have to be some serious ‘horse trading’ to avoid this cliff given the political divide we have in the US. At present the President rather has the upper hand in getting some concessions as he has a veto over any legislation that might prevent tax rises.

As the article points out there is a very large Health IT incentive program and you can bet those who want some spending cuts will want to wind that back big time.

We live in pretty interesting  times as, if the US does not sort this out - as most expect - we will also be hit down under.

I am reminded of Winston Churchill’s comment on the Americans - ‘They will always do the right thing - after having exhausted all other possibilities’ We can but just wait and watch.

David.

Posted by Dr David More MB PhD FACHI at Thursday, November 29, 2012

Wednesday, November 28, 2012

The Commonwealth Funds Provides A Primary Care And Health IT Report. Useful Stuff.

This report has had a lot of coverage in the last week. For example:

UK GPs top for use of EMRs

15 November 2012   Rebecca Todd

More than two thirds of UK GPs use electronic medical records and can also order tests or prescriptions online, manage patients lists or generate patient information electronically, a new survey reveals.

The 2012 Commonwealth Fund International Health Policy Survey of 8,500 primary care doctors in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, the United Kingdom and the United States, places the UK at the top of the table in their use of electronic records.

The report, published today, shows that more than two thirds (68%) of GPs in the UK said they have ‘multi-functional HIT capacity.’

Lots more here:

http://www.ehi.co.uk/news/primary-care/8202/uk-gps-top-for-use-of-emrs

and here:

Aussie GPs lag behind on e-record use

21st Nov 2012

Danielle Cesta

AUSTRALIA’S high rate of GPs keeping electronic patient records has declined since 2009 and Australia lags behind other countries in terms of electronic exchange of patient summaries with doctors in other practices, new research shows.

A survey by the Commonwealth Fund of 10 countries – Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Switzerland, the UK and the US – found progress in the use of health information technology in healthcare practices, particularly in the US.

Yet a high percentage of primary care physicians in all 10 countries reported they did not routinely receive timely information from specialists or hospitals.

Of the 500 Australian GPs surveyed, the use of electronic medical records was high but fell from 95% to 92% from 2009 to 2012 while the other nations mainly recorded increases.

Australia also had one of the lowest rates of GPs reporting they could electronically exchange patient summaries and test results with doctors outside their practice, at 27% – third last when compared to the other nine countries, with only Canada and Germany trailing.

More here:

http://www.medicalobserver.com.au/news/aussie-gps-lag-behind-on-erecord-use

Here is the link to the original report:

http://www.commonwealthfund.org/Publications/In-the-Literature/2012/Nov/Survey-of-Primary-Care-Doctors.aspx

The key part worth quoting is the summary of findings:

Key Findings

  • Two-thirds (69%) of U.S. primary care physicians reported using EMRs in 2012, up from less than half (46%) in 2009. Both U.S. and Canadian doctors expanded their use of health information technology (HIT), though the two countries lag the U.K., New Zealand, and Australia in EMRs and use of HIT to perform a range of functions, like generating patient information or ordering diagnostic tests.

  • In the U.S.—the only country in the survey without universal health coverage—59 percent of physicians said their patients often have trouble paying for care. Far fewer physicians in Norway (4%), the U.K. (13%), Switzerland (16%), Germany (21%), and Australia (25%) reported affordability was a concern for their patients.

  • More than half (52%) of U.S. doctors said they or their staff spend too much time dealing with insurers’ restrictions on covered treatments or medications—by far the highest rate in the survey.

  • In each country, only a minority of primary care doctors reported always receiving timely information from specialists to whom they have referred patients, while less than half said they always know about changes to their patients’ medications or care plans.

  • U.S. physicians were the most negative about their country’s health system, with only 15 percent saying the system needs only minor change.

The full article and associated downloads are well worth a download and read. The report clearly identifies some gaps that Australian GPdom could do well to work on - as well as some areas that are going pretty well.

A part of the report I found interesting regarding GPs was the apparent drop in use of EMRs by a few per cent since the last survey in 2009 and the ongoing low level of connectivity and patient focussed services offered in Australia for patients electronically. There is a market opportunity for someone there I believe.

It is also of interest how few Australian GPs presently use secure messaging exclusively to transmit prescriptions rather than transmit the prescription and also print out a copy for the patient to present to pharmacist - to scan the barcode to download the prescription. Just a system difference I guess.

David.

Posted by Dr David More MB PhD FACHI at Wednesday, November 28, 2012

Tuesday, November 27, 2012

It Looks To Me Like Those Operating The NEHRS Are Not Very Good At Their Job. Additionally No One Is Using It.

This very revealing article popped up today in The Australian.

More bumps in e-health road

THE Gillard government's personally controlled e-health record system is facing more bumps in its rollout following frequent disruption to its software vendor testing environment.

In the past seven months, only five vendors have passed the requirements for their software to be connected to the live e-health production platform. There are more than 250 software vendors who need their 300-400 products certified for the PCEHR.

The PCEHR is intended to be a secure electronic summary of people's medical history that is stored and shared in a "network of connected systems".

Software used by hospitals, GPs, allied health professionals, dentists and radiologists is often custom-made and needs to be compliant with the web-based national PCEHR system.

The longer it takes to test the systems, the longer it will take to roll out the software to hospitals, GPs and others who need to use it.

Sources close to the e-health project told The Australian the test environment had been going offline two to three times a week. This included planned and unplanned outages. The Department of Health and Ageing declined to comment on the outage frequency.

However, a spokeswoman said: "Obviously the test environment exists so things can be trialled before going live in the main system. That's the normal way IT systems like this operate the world over."

As recently as last Tuesday, the test system was offline for nine hours, but the spokeswoman said the test environment was stable.

She declined to provide reasons for unplanned outages.

The test environment had been available to software vendors since April this year, she said, adding that unavailability of the test environment had no impact on the live system.

"Software vendors are not permitted to connect to the (live) production system without passing testing in the software vendor test environment," the spokeswoman said.

"The test environment has absolutely no impact on the access to or functionality of the main system -- that is, patient and doctor use of the main system is not affected at all."

She declined to say how many times the test platform had been offline since it became available.

Meanwhile, 19,617 people had registered for an e-health record, the spokeswoman said.

The full article is here:

http://www.theaustralian.com.au/australian-it/government/more-bumps-in-e-health-road/story-fn4htb9o-1226524459540

Looks like the system is unstable and no one much is using it. Worse those who have to use the test environment are being messed about.

As for clinical use this paragraph says it all.

“As of last Thursday there were 16 shared health summaries and one discharge summary uploaded into the PCEHR, the spokeswoman confirmed.”

Amusingly in a separate article we discover the geniuses who are running the program are so worried people might be alarmed about how things are being done that they have blocked the management minutes from FOI. This really shows they have something to hide! See here for article:

http://www.theaustralian.com.au/australian-it/government/department-keeps-details-secret/story-fn4htb9o-1226524460937

All in all this just seems to be going from bad to worse...At this stage it seems to be costing $20,000 per summary. The Return on Investment on all this is a bit dubious to say the least.

David.

Posted by Dr David More MB PhD FACHI at Tuesday, November 27, 2012 7 comments

Monday, November 26, 2012

Weekly Australian Health IT Links – 26th November, 2012.

Here are a few I have come across the last week or so.

Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

Again a very quiet week. We have seen some interesting comparative work on IT use in General Practice and a number of (rather small) telehealth initiatives.

My weekly visit to the NEHRS revealed that the performance is still pretty dreadful - 5-10 seconds from click to complete page being painted (on a fast internet link).

At least my name remained stable over the week!

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http://www.medicalobserver.com.au/news/aussie-gps-lag-behind-on-erecord-use

Aussie GPs lag behind on e-record use

21st Nov 2012

Danielle Cesta

AUSTRALIA’S high rate of GPs keeping electronic patient records has declined since 2009 and Australia lags behind other countries in terms of electronic exchange of patient summaries with doctors in other practices, new research shows.

A survey by the Commonwealth Fund of 10 countries – Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Switzerland, the UK and the US – found progress in the use of health information technology in healthcare practices, particularly in the US.

Yet a high percentage of primary care physicians in all 10 countries reported they did not routinely receive timely information from specialists or hospitals.

Of the 500 Australian GPs surveyed, the use of electronic medical records was high but fell from 95% to 92% from 2009 to 2012 while the other nations mainly recorded increases.

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http://www.6minutes.com.au/news/latest-news/australian-gps-drag-the-chain-on-e-mail

Australian GPs drag the chain on e-mail

20 November, 2012 Julie Robotham

Australia’s general practices lag the world in communicating electronically with patients even though more than 90% store patient records electronically.

In an international survey of primary care doctors, only 20% of the 500 polled in Australia said they accepted patients’ questions or concerns by e-mail.

Even fewer – 7% - allowed patients to go online to book appointments or request referrals, and just 6% accepted electronic requests for script refills, according to the study from US health policy foundation The Commonwealth Fund.

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http://www.6minutes.com.au/news/latest-news/gps-see-specialists-as-poor-communicators

GPs see specialists as poor communicators

21 November, 2012 Paddy Wood

GPs think specialists are poor communicators who rarely provide timely information about patients and often alter medications without notice.

In a survey of 500 Australian GPs, just 13% said specialists made information about patients available when it was needed.

Less than a third agreed they were always advised of changes that specialists made to their patients’ medications or care plans, and 32% said they always received a report from specialists with “all relevant health information.”

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http://www.pharmacydaily.com.au/news/script-exchanges-together/20771

Script exchanges together

FRED IT’s eRx Script Exchange is set to become linked to rival MediSecure, with the government providing almost $10 million in funding to make the systems interoperable. According to an application revealed by the Australian Competition and Consumer Commission, the so-called ‘Electronic Transfer of Prescription (ETP) Prescription Exchange Service Interoperability Initiative’ aims to “significantly improve the uptake and use of electronic prescriptions”. E-prescribing is a significant policy component of the Fifth Community Pharmacy Agreement, and according to early analysis there are large numbers of electronic prescriptions being lodged by prescribers “ but the number being downloaded by dispensers is quite low” - due to patients presenting to a pharmacy which is not connected to the prescription exchange containing the e-script.

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http://www.nehta.gov.au/media-centre/nehta-news/989-vendor-invitation-secure-message-delivery

Invitation to Participate in the SMD-POD Project

20 November 2012.  NEHTA is pleased to invite Secure Messaging Vendors to participate in the Secure Message Delivery – Proof of Inter-connectivity and Deployment (SMD-POD) project.  The purpose of the project is to provide financial assistance to Secure Messaging Vendors to "provide proof that standards-based secure messaging can be deployed in a scalable way, utilising National Infrastructure Services, and to also demonstrate that different conformant Secure Messaging Vendor products are capable of interconnecting within the Australian Primary Care sector and with other healthcare providers".

General Practice is a key sector; the inter-connectivity to other healthcare providers is vital because GPs communicate with each other and also to others, such as Medical Specialists and Allied Health Professionals. In addition, hospitals with gateways can also introduce Secure Messaging to the customers of all participating Secure Messaging Vendors. This activity will allow more healthcare providers to participate and use technology (eHealth).

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http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr12-mb-mb123.htm

Projects to Better Connect Health and Aged Care

Applications have been opened by Minister for Mental Health and Ageing Mark Butler, for more than $17 million in projects to better connect Australia’s aged care system with the health and hospitals systems.

16 November 2012

Applications were opened today by Minister for Mental Health and Ageing Mark Butler, for more than $17 million in projects to better connect Australia’s aged care system with the health and hospitals systems.

“Successful applicants will carry out innovative projects that will see aged care providers work intensively with healthcare providers and medical insurers,” Mr Butler said.

“This will help give older people better access to complex health care, including palliative and psycho-geriatric care.”

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http://www.minister.dbcde.gov.au/media/media_releases/2012/184

New Telehealth Centre officially opened at Princess Alexandra Hospital

The Minister for Broadband, Communications and the Digital Economy, Senator Stephen Conroy, and the Queensland Minister for Health, Mr Lawrence Springborg today officially opened a new telehealth centre at Princess Alexandra hospital, which is making healthcare more accessible to people living in regional and remote Queensland.

The centre is part of the $5.1 million Princess Alexandra Hospital Online Outreach Services project (PAH Online), which is jointly funded by the Australian and Queensland governments through the Digital Regions Initiative program.

"This centre is a glimpse into the future of healthcare delivery right across Australia," Senator Conroy said.

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http://ehealthspace.org/news/feds-announce-33m-aged-care-telehealth-program

Feds announce $3.3m aged care telehealth program

Posted Mon, 19/11/2012 - 16:31 by Will Turner

Virtual access to general practitioners will be trialled under a $3.3 million five year telehealth pilot at residential aged care facilities (RACF) announced by the federal government.

Commencing in February 2013, the program will involve up to 30 RACFs and is intended to develop a business case for video consultations as a means of delivering better GP access to residents.

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http://sydney.edu.au/news/84.html?newsstoryid=10488

Better access to specialist neurological care for regional NSW

9 November 2012

People in regional NSW will have remote access to multiple sclerosis clinics in Sydney thanks to a new telemedicine facility in Dubbo.

The facility will improve the quality of life for people with multiple sclerosis (MS) and other neurological diseases, who often find travel to be physically and mentally exhausting and, for some, unaffordable.

"It is logistically impossible for many patients with multiple sclerosis to travel to our clinic on a regular basis, potentially compromising their medical care," said Dr Michael Barnett, leading MS neurologist and researcher at the University of Sydney's Brain and Mind Research Institute (BMRI).

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http://apo.org.au/research/state-broadband-2012-achieving-digital-inclusion-all

The state of broadband 2012: achieving digital inclusion for all

Read the full text

PDF     The state of broadband 2012: achieving digital inclusion for all

30 September 2012With this Report, the Broadband Commission expands awareness and understanding of the importance of broadband networks, services, and applications for generating economic growth and achieving social progress. High-speed affordable broadband connectivity to the Internet is essential to modern society, offering widely recognized economic and social benefits (Annex 1). The Broadband Commission for Digital Development promotes the adoption of broadband-friendly practices and policies for all, so everyone can take advantage of the benefits offered by broadband.

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http://www.smh.com.au/technology/sci-tech/the-dilemmas-behind-creating-a-better-you-20121121-29qeb.html

The dilemmas behind creating a better you

Date November 22, 2012

David Ewing Duncan

Cutting-edge therapies are under way that may lead to a host of physical enhancements.

If a brain implant were safe and available and allowed you to operate your iPad or car using only thought, would you want one? What about an embedded device that gently bathed your brain in electrons and boosted memory and attention? Would you order one for your children?

In a future election, would you vote for a candidate who had neural implants that helped optimise his or her alertness and functionality during a crisis, or in a candidates' debate? Would you vote for a commander in chief who wasn't equipped with such a device?

If these seem like tinfoil-on-the-head questions, consider the case of Cathy Hutchinson. Paralysed by a stroke, she recently drank a canister of coffee by using a prosthetic arm controlled by thought. She was helped by a device called Braingate, a tiny bed of electrons surgically implanted on her motor cortex and connected by a wire to a computer.

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http://www.mjainsight.com.au/view?post=Martin+Delatycki%3A+Genetic+explosion&post_id=11504&cat=comment&mo=1

Martin Delatycki: Genetic explosion

THE announcement in 2003 that the human genome had been sequenced brought much excitement to both the scientific and the general community. Almost 10 years on, what has changed as a result?

We can now diagnose many disorders, allowing individuals and families options in terms of medical care and preventive treatments. Discovery of new genetic causes of disease is a daily event. Discovering genes took many years in the 1990s but can now take a matter of weeks.

We are now on the cusp of a quantum leap in what can be done. Next-generation DNA sequencing, which is also called massive parallel sequencing, allows the exome or genome to be sequenced in hours.

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http://www.computerworld.com.au/article/442389/uxc_wins_40m_contract_gold_coast_hospital/

UXC wins $40m contract for Gold Coast hospital

UXC will supply all ICT infrastructure for the hospital.

UXC has won contract with Lend Lease worth more than $40 million to provide and install ICT equipment at the new Gold Coast University Hospital at Southport.

UXC will supply all ICT infrastructure for the hospital.

The contract includes a data centre, wired network and wireless LAN, unified communications, IP telephony and firewalls and security.

-----

http://www.zdnet.com/au/sydney-hospital-ditches-pcs-chooses-zero-clients-on-wheels-7000007562/

Sydney hospital ditches PCs, chooses zero clients on wheels

Summary: How do you deploy an additional 200 to 300 desktops in a hospital that just doesn't have the room? The answer is: you don't — not physically, anyway.

By Michael Lee | November 19, 2012 -- 05:40 GMT (16:40 AEST)

Speaking at VMware's vForum 2012 event in Sydney last week, Sydney Adventist Hospital (SAH) solutions architect for Information Services John Hoang led the audience through the way in which the private hospital uses virtualised and mobile workstations in a bid to move toward a paperless, digital hospital.

Hoang said that SAH had been "dreaming of what we would consider a healthcare nirvana — a complete paperless, digital hospital. One where we're able to capture all patient data electronically, deliver information to clinicians in a digestible matter, and do so in a manner that is synergistic to the way clinicians work."

-----

http://www.computerworld.com.au/article/442775/privacy_commissioners_seek_greater_power_breaches_increase/?fp=16&fpid=1

Privacy commissioners seek greater power as breaches increase

Regulators lack "clear mandate," said New Zealand privacy commissioner Maria Shroff

Privacy commissioners of Australia and New Zealand said they need more enforcement authority to combat data breaches and other privacy concerns.

Regulators “have to be responsive” to increasing privacy incidents, New Zealand privacy commissioner Maria Shroff said in a speech this morning at the International Association of Privacy Professionals (IAPP) Privacy Summit. If breaches continue to occur, “people will lose trust.”

The Office of the Australian Information Commissioner (OAIC) received 1357 privacy complaints in the 2011-2012 fiscal year, Australian Privacy Commissioner Timothy Pilgrim told the Privacy Summit in a separate speech.

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http://www.theregister.co.uk/2012/11/20/nsw_information_comissioner_sends_wrong_email/

NSW Information Commissioner sends email to wrong list

Do as I say, not do as I do

By Simon Sharwood, APAC Editor

Posted in Government, 20th November 2012 05:27 GMT

The Information Commissioner in the Australian state of New South Wales, an officer whose job it is to offer and enforce best information management practice for the State, has apologised after sending an email to the wrong list.

The email in question advised of a conference at which the Commissioner, Deirdre O’Donnell, is due to speak.

But the mail, intended for members of the NSW Public Sector Right to Information/Privacy Practitioners Network, ended up elsewhere.

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http://downloads.zdnet.com/product/2129-75810899/

e-med Medical Dictionary

By Wednesday Digital | November 23, 2012

Download

The e-med Medical Dictionary is a searchable database of medical information that can be used as a starting point for medical enquiries. The app can also be used by anybody to initiate free consultations with the e-med nurse and contains extra functionality for current e-med members.

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http://www.theage.com.au/national/government-cracks-down-on-identity-fraud-20121121-29qnf.html

Government cracks down on identity fraud

Date November 22, 2012

Jane Lee

PEOPLE who use the internet or a phone to use other people's identities to commit a crime could be sentenced to five years in jail under a new law.

The law, passed on Wednesday, expands the crime of identity fraud to include a number of activities such as flying interstate or booking domestic flights online using a fake identity.

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http://ehealthspace.org/news/big-future-ehealth-usa-and-uk

Big future for ehealth in USA and UK

Posted Mon, 19/11/2012 - 08:29 by Will Turner

Barack Obama’s reelection is being seen as a major step forward for ehealth in the USA, while the UK government has committed to 100 percent patient access to ehealth records by 2015.

The main reason put forward by health IT experts why Obama’s victory is a win for ehealth is the secure future of the Affordable Care Act, which was the president’s major health reform in danger of repeal by Republican contender Mitt Romney.

-----

http://www.computerworld.com.au/article/442464/windows_8_pc_orders_weak_says_analyst/

Windows 8 PC orders weak, says analyst

Sales at Asian firms that assemble PCs for HP, Dell and others show lower expectations for Windows 8 pop

Computer sellers have scaled back their expectations of the sales pop they'll get from Windows 8 this year, according to an analyst.

Brian White, of Topeka Capital Markets, said that his checks of Asian computer manufacturers -- the relatively unknown firms that build desktop and notebook PCs to specifications issued by the likes of Hewlett-Packard and Dell -- found that orders last month climbed by less than half the average of the last seven years.

"With all of the sales numbers out for our ODM Barometer, October sales rose by 2 per cent month-over-month and below the average performance of up 5 per cent over the past seven years," White said in a note to clients earlier this month. "This is weaker than our preliminary estimate of up 5 per cent month-over-month in October and speaks to the continued challenges in the PC market."

-----

Enjoy!

David.

Posted by Dr David More MB PhD FACHI at Monday, November 26, 2012

Does Anyone Know Who Else Is On This Group? Any e-Health Experts?

I was asked this and have no idea.

They are meant to make the NEHRS safe.

Clinical safety audit program for the Personally Controlled Electronic Health Record (PCEHR)

The Commission has established an independent Clinical Governance Advisory Group (CGAG) and a clinical safety audit program for the Personally Controlled Electronic Health Record (PCEHR).

This national clinical governance function complements and strengthens the work being performed by the National E-Health Transition Authority in assuring the safety and quality of the standards and specifications supporting the PCEHR and will provide external assurance on PCEHR clinical safety issues.

The CGAG meets quarterly to consider the clinical safety audits of the PCEHR and other clinical safety issues relating to the PCEHR and provide advice to the Department of Health and Ageing. The CGAG comprises experts from across Australia, and is chaired by the Chief Medical Officer Professor Chris Baggoley.

Page is here:

http://www.safetyandquality.gov.au/our-work/safety-in-e-health/

Google - asked for “Clinical Governance Advisory Group” - finds the UK entity but not much from Australia.

Any clues?

David.

 

Posted by Dr David More MB PhD FACHI at Monday, November 26, 2012 1 comments

AusHealthIT Poll Number 146 – Results – 26th November, 2012.

The question was:

How Do You Rate The Design Of The User Interface Of The NEHRS / PCEHR?

Excellent 5% (2)

Pretty Good 3% (1)

Neutral 0% (0)

Not Good 21% (8)

Plain Incompetent 64% (25)

I Have No Idea 8% (3)

Total votes: 39

Very interesting. It would seem the vast majority (85%) feel NEHTA has failed to deliver a decent design for the NEHRS / PCEHR.

Again, many thanks to those that voted!

David.

Posted by Dr David More MB PhD FACHI at Monday, November 26, 2012 0 comments

 

Sunday, November 25, 2012

Standards Australia Lets The Side Down Badly. What On Earth Gives?

In researching one of the other blogs this weekend I had occasion to visit the Standards Australia e-Health Site.

You two can visit it at:

http://www.e-health.standards.org.au/Home.aspx

There was only one glaring problem. The site is just unusable with Firefox 17. Just awful!

Interestingly the site looks just fine on both IE 9 and Safari (via an iPad).

What this means to me is that the web site has not been developed to appropriate international standards.

One question - just why would that be from Standards Australia?

Amazing!

David.

Posted by Dr David More MB PhD FACHI at Sunday, November

 

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