s An Insider's Comment on NEHTA's Performance | I2P: Information to Pharmacists - Archive
Publication Date 01/12/2009         Volume. 1 No. 7   
Information to Pharmacists


From the desk of the editor

Welcome to the December 2009 edition of i2p - Information to Pharmacists E-Magazine.
When i2P first began in February 2000, it was decided that a fortnightly publication might prove to be the optimum publishing cycle.
This thought was soon dispelled as it was found that having sufficient content to maintain this cycle became a problem.
Oh for those quieter times!
The cycle then became monthly and has been maintained up to now.
The problem is now coping with the volume of news and opinion that is generated on a daily basis.
Very much the reverse of the year 2000 - a statement for our time and how the pace of pharmacy life has increased.

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Recent Comments

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For some pharmacists the truth will be ‘inconvenient’. WHY is it so??

James Ellerson

Sir Winston Churchill said “Truth is incontrovertible, malice may attack it and ignorance may deride it, but, in the end, there it is.”
Elvis Presley said “Truth is like the sun. You can shut it out for a time, but it ain't goin' away.”

At the PAC 2009 Conference John Menadue’s forthright messages made it abundantly clear that the sun was shining very brightly indeed.
Here are the ‘message sticks’ that resonated with me:

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About that "Un-Invitation"

Dr John Dunlop (PGDipPharm, MPharm, DPharm(Auck), FACPP, FNZCP, FPSNZ, MCAPA)

It was interesting reading John Menadue’s speech given at the Pharmacy Australia Congress in Sydney in October.
It was even more interesting to read of the UN-invitation by the Queensland branch of the College of Pharmacy Practice and Management, the stance taken by the Pharmacy Guild of Australia and the Pharmaceutical Society, to support only pharmacy activities provided from within a community pharmacy.
How draconian is that?
Research has demonstrated, as has the low uptake of new professional services from within a community pharmacy, that the existing community pharmacy model is not compatible with the implementation of these new professional opportunities.
The two major arguments put forward are ‘lack of time’ and ‘lack of funding’.

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A Green Pharmacy is Gold

Neil Retallick

Simon Divecha, Director of GreenMode, a consultancy that assist business and people to find their carbon and sustainable advantages spoke at the recent Pharmacy 2009 Conference.
Simon has assisted businesses including BP Solar, Origin Energy, Lend Lease, ANZ and IAG.
His challenge to community pharmacy is to identify and take advantage of the opportunities that exist for businesses that have such close relationships with their local communities.

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What are we doing to ourselves?

Heidi Mahon

Over the last months, I've noticed the position taken by both the Guild as well as individual pharmacists on our on-line forums.

In his recent address Mr John Menadue poses the question - are pharmacists the most change-resistant health profession?

And if so, what is our future likely to hold?
What can we do about it?

Personally, I have to agree with him - if we as a group - and not just the Guild, DON'T take innovation as a prerequisite for how we practice our profession, then in 20 years time, what will we have left?

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Picture - the wood for the trees

Pat Gallagher

Another year has gone by and what have we done with technology in the health sector?
A good question that deserves a long and detailed review as a written dissertation by somebody learned and influential in health informatics, government, consulting or from the many agencies, departments and committees engaged in delivering e-health service to the Australian public; notably as a value proposition for the tax payers in the greater voting public cohort.

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Advancing Self Care

Neil Johnston

Imagine a pharmacy that had a range of eye catching kiosks that utilised easy to use touch screen technology.
Not passive kiosks, but kiosks that are interactive with customers/patients to efficiently provide a perceived need.
It’s not a new idea, but the marketing of health care through kiosks certainly represents an organised method of transferring information to customers/patients and assisting them to make good health decisions.
One current form of kiosk that is beginning to take hold in Europe and the US is the vision kiosk.

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Wind Farm will Power Sydney's Desalination Plant

Staff Writer

Source: AAP NewsWire

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Communications Technology - a nudge from the big end of town

Staff Writer

National Health IT assumed prominence recently when the National Business Council of Australia wrote directly to prime minister, Kevin Rudd, urging him to create a focus on communications technology and to invest appropriate funds.
I wonder if they were aware of the organisational performance 0f NEHTA and their inability to date, to actually deliver suitable infrastructure and systems.
And with $'s millions already wasted by NEHTA I am sure there is hesitancy by government to spend even more, given the dismal track record to date.
Health communications is stuck in a deep groove.
But it is interesting to note that the Business Council of Australia see productivity and investment opportunities in health if only the primary health players could integrate better and talk to one another.
Shared health communications underpins this potential benefit as the many writers for i2P have continually pointed out.
With the big end of town taking more interest, maybe government and health professionals can align themselves more fluidly.
A read of David More's blog article from a NEHTA insider in this edition of i2P, leaves you still wondering how an alignment can take place without removing the NEHTA structure completely.

Health info needs urgent technological injection

Source: Industry Search -24/11/2009


Read the BCA letter in full here

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Powering up by osmosis

Staff Writer

An unusual form of renewable energy has emerged recently in a novel format involving the use of fresh water and salt water interaction across a membrane that creates osmotic pressure.
This pressure has been demonstrated to be able to drive a turbine that can produce an electric current.
Osmotic pressure is well known in medicine with adjustments having to be made to eye drop and injection formulas to minimise the pain associated with the administration of these medicine forms.

The process is a more controllable form of natural energy when compared with weather-dependent versions of energy generation (solar, wind, tidal etc) and has a reasonably small and discrete footprint in the environment.
With a bit of imagination it is not too far of a stretch to have the salt water filtered through another form of membrane to create fresh water to be recycled within a closed system.

Norway tries osmotic power to harnessing power of salt

Source: Industry Search


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Insuring the Disabled

Staff Writer

Prime Minister Kevin Rudd is to be commended for the initiative in having a look at the feasibility of creating a no fault disability insurance scheme.
Disability can cause disaster to any family structure and can be a constant drain on financial resources that can add to further stresses up to, and involving bankruptcies.
By putting in place a proper financial underpin, each family member is enabled to be productive and self-sustaining. This can create a net gain to the taxation base when viewed globally, to include service providers and industries that can feed off that activity stream.

PM calls for national disability reforms

Source:DPS Guide to Aged Care


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Should patents apply to the natural world?

Staff Writer

I can't but help wonder if the move to be able to patent all things natural is a smart move.
Take for example the Neam tree that grows wild in the northern part of Australia.
The leaves of this tree make a great insect repellent with no known side effects.
An entrepreneurial Australian a few years back, decided to grow these trees and was surprised to have legal documents served on him claiming royalties and damages from some obscure US company that had registered a patent for all things Neam.
Unfortunately, there was no legal defence for the Australian grower.
Now there is an outcry by vested interests because the Australian government has resisted pressures to allow the patenting of human genes.
All sorts of calamities are therefore predicted for the local biotech industries.
But I wonder if these claims will prove to be valid?

Follow the debate in this article:

Ban drives 'biotech industry to its knees'


Source: AAP

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Public Hospitals - Time they were fixed

Staff Writer

Queensland Health struggles through another drama after using instruments that had been used on patients and left unsterilised.
But it's not just Bundaberg Hospital that is sick - the entire Australian hospital system needs a radical overhaul.
The Rudd government had promised to "fix" the problem after taking office, but so far has not made any noticeable progress.
Read about the latest problem.

Qld Health cleaning up after dental sterilisation scare

Source: ABC Online


By Chris O'Brien

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Patient uses initiative to attract nurses

Staff Writer

If anyone has ever been a patient in a hospital and tried the buzzer to get assistance from a nurse, then here is a new innovation to get attention.
Not that the nursing fraternity should shoulder the blame.
It's the politicians and the lack of political will to solve this issue and many others.
Congratulations to the patient and his initiative in dialling triple O.
Read the full story here:

Man rings triple-0 from hospital bed

Source: ABC Online

by Cate Grant


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What's good for climate is good for health

Staff Writer

Health professionals from around the world are slowly waking up to the fact that climate change can induce adverse effects on health.
At i2P we have been carrying messages for just on two years, regarding climate change effects, including research reports from our own writer Con Berbatis, in the hope that official pharmacy would see the need and develop policies and strategies for pharmacists to adopt.
Now, with the formation of the International Climate and Health Council a recognised forum is available to be addressed.
Will pharmacists be given a seat at the table?
Perhaps the Pharmaceutical Society of Australia should find out.

Health Professionals Around The World Launch The International Climate And Health Council

Source: Medical News Today


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Ageing slowly and safely

Staff Writer

The ageing process is relentless with function loss noticeably diminishing over the age of 60.
Supplementation of nutrients holds one key to slowing down some of the processes, in particular the loss of muscle mass and the subsequent aches and pains that follow as the skeletal system is no longer held together in an optimum manner.
This process can be a contributor to falls and more serious damage.
Not being able to adequately stay on your feet as you age, robs you of your independence.
It would seem that a strategy of slowing down slowly might be prudent for the age demographic entering retirement - the "baby-boomers".

Antioxidants could help preserve muscle strength

Source: Reuters Health
By Marilynn Larkin

Found at this link

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Are we planning for future skill shortages?

Neil Johnston

National Seniors Agency have published a report indicating that Australia will have a shortfall of 1.4 million workers by 2025.
This shortage will also be reflected in the profession of pharmacy.
It is pointed out that a smart move would be to match an improved workplace to match specific requirements for mature-aged employees and thus retain them for longer periods..
APESMA has recently published an online survey in an endeavour to poll employed pharmacists on the issues that affect them specifically. Obviously, this is a move in the right direction, and much of what they are polling has a direct relationship to mature-aged employees.

So what is community pharmacy doing to retain their senior pharmacists?

Very little, it seems.

i2P asked Mark Coleman to comment and his commentary appears below the news item:

Comments: 1

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An Insider's Comment on NEHTA's Performance

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.

Editor's Note: I noticed this item on David More's blog regarding NEHTA's poor performance on issues that just keep repeating themselves and becoming worse with the passage of time.
The post is from an "insider" who seems to have a good knowledge of Australian IT.
It is a detailed comment and makes compelling reading, and requires no further introduction except from David More:

Thursday, November 12, 2009

This is Really Sad - Take a Careful Read of This Comment. Utterly Confirms Previous Post and It Really Needs More Prominence!

Anonymous has outdone him/her self!

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Begin Quote -----


I haven't worked within NEHTA but have participated in a number of their consultations and do have some friends that work there. It's very sad but I think your correspondent's reflections are true. I'm writing this blog posting anonymously because my employer is working with NEHTA, and I know that the kind of 'falling out of favour' that your writer describes doesn't just apply to employees, it also applies to the suppliers who are contracted to work with NEHTA.

One rule of working with NEHTA - frank and fearless advice is most certainly not welcome in NEHTA. Not from employees, not from consultants, not from vendors, not from anyone.

I saw a chain of small consultancies engaged to provide advice on the NASH program. I won't say their names. The amazing thing was as each consultancy was engaged, they gave very solid advice that the course of action that the NEHTA folks were taking with regard to NASH was impractical, unnecessary and grossly more expensive than estimated. Unfortunately, as each provided advice, their advice was rejected and then their consultancy was terminated. Step in the next consultancy to be asked the same question. The NASH program is now at the point of either collapse or rebirth - but don't hold your breath. My understanding is that it's about to be turned into a specification project, not a delivery project. That is, NEHTA will specify the contents of digital certificates, key management processes etc, not implement any national infrastructure. NASH has already spent a bucketload of money though so like I said don't hold your breath. Vendors participating in the secure messaging program (PIP) have been told not to expect NASH to be operational anytime in the future so the specs have instead assumed the use of the existing Medicare HESA certificates.

Which brings me to what I thing is the most damning change that has come about in NEHTA over the last six months. They don't care one bit anymore about the outcomes of eHealth, their focus out of fear is on the process. The mantra has become: "if we deliver a documented specification, ram it through an arbitrary consultation process, then get it legitimised by some group or standards body", then we're successful. It is irrelevant to the management of NEHTA that the specifications are not used or adopted in any way by the industry. Their job is done - they've produced the document.

Take one spec as an example:

NEHTA have a team of people working on the Australian Medicines Terminology. This is an important piece of work and we really do need a common medication vocabulary adopted in Australia. It would save lives and enable better quality care through medication management.

But look at the AMT specs. They've gone through 2 major and 20 minor revisions since 2007. But almost three years later who's using them: No one - not one single vendor, not one single healthcare provider. No one.

Now I would think NEHTA would take that as feedback to get engaged in actual adoption, stimulate and foster adoption, drive education, skill up other participants in eHealth, invest in industry partners who want to adopt AMT. Is NEHTA doing any of that? NO. They're succesful (by their definition) - the document has been produced.

We now have NEHTA publishing another raft of specifications on the electronic transfer of prescriptions. Excruciating detail on how an electronic prescription exchange must work! Is AMT mentioned - only as an eventual goal at some point in the future. The horse has already bolted - eRx and MediSecure are operational exchanges and NEHTA's writing a spec for how their web services should appear!!! But again, NEHTA are delivering a document.

NEHTA's also still talking about the Identifiers service (UHI, IHI) being operational by December. Remember Peter Fleming's remark : "2009 is The Year of Delivery"

Reality is a vague and abstract concept. Adoption is irrelevant.

David, I think you're right. It is well past time that this issue was critically reviewed by the Auditor General, and I think you are right to question the leadership provided by Peter Fleming and David Gonski.

I think it sad that 18 months ago, many of us were vaguely hopeful of progress - that some fresh blood and particularly someone with the previous stature of David Gonski.

( I just did a google search on David Gonski and found his wiki page: http://en.wikipedia.org/wiki/David_Gonski. Kind of curious that it makes reference to his chairmanship of CocaCola, Investec and others, but not a single reference to his chairmanship of NEHTA. Perhaps it's in his best interest to keep that one quiet)

I don't want to come across as entirely critical of NEHTA. There are some passionate, talented, dedicated people there who really believe in what they are doing. It's just very sad that:

(a) they are unsupported by effective management and attacked for voicing contrary opinions to the group consensus. Dissenting voices are removed, unqualified yesmen are promoted

(b) despite bringing in some good people, they've broken links with the people who are really delivering change in the health provider community. They're working in a vacuum, ignoring reality but somewhat mindlessly progressing to simply deliver document after document of tedium

(c) they're poorly governed. The Boston report said so three years ago. The DeLoitte strategy said so last year, but no substantive changes ever get made.

(d) they are surrounded by apologists. Jane Halton's remarks to the Senate estimates a few weeks ago were appalling and misleading. She has no idea of the true state of eHealth and made so many deceitful half-truths in that hearing that she should be reprimanded for contempt of the senate.

(e) they have taken a view that style is more significant than substance. Just once, I would love to hear that just one (only one) product of NEHTA's has been incorporated into a single working system in Australia, anywhere.

Come to think of it, can any of your readers point to an example. Just one, anywhere, any product (AMT, SNOMED, identifiers, secure messaging, NASH). After almost five years, surely there is one????? I'm sure Peter Fleming and Jane Halton would be happy to pay you a finder's fee, as they clearly don't know of any examples.

If it is the case that they haven't been deployed anywhere, then I'd like to ask for my $200million in taxpayers money back. If they have been, then that would give me such tremendous hope. Anyone know?

End Quote -----

Posted without comment. None is needed!


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