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Tuesday, 31 May 2016

UK health IT 'glitch': Hundreds of thousands of patients have potentially been given an incorrect cardiovascular risk estimation after a major IT system error

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This in the UK.

What is euphemistically referred to as an "IT system error" is, in reality, the mass delivery of a grossly defective medical device adversely affecting hundreds of thousands of patients.  I'm surprised not to see that other kindly euphemism, "glitch" (http://hcrenewal.blogspot.com/search/label/glitch):

http://www.pulsetoday.co.uk/your-practice/practice-topics/it/gps-told-to-review-patients-at-risk-as-it-error-miscalculates-cv-score-in-thousands/20031807.article

11 May 2016  
By
Hundreds of thousands of patients have potentially been given an incorrect cardiovascular risk estimation after a major IT system error, Pulse can reveal.

The MHRA has told GPs they will have to contact patients who have been affected by a bug in the SystmOne clinical IT software since 2009.

Of course, this refrain appeared, a corollary of "Patient care has not been compromised" (http://hcrenewal.blogspot.com/search/label/Patient%20care%20has%20not%20been%20compromised) when health IT crashes and outages occur:

The regulator says that means that ‘a limited number’ of patients may be affected, and the risk to patients is ‘low’.

At best, it's good that only a "limited number" of patients were "affected."  I guess they feel they can justify a "limited number" of patient harms for the glory of a medical Cybernetic Utopia.

At worst, how do "the regulators" know exactly who was affected?  Answer: they don't and this is boilerplate BS meant to CYA.

But Pulse has learnt that the 2,500 practices using SystmOne are having lists sent to them of around 20 patients per partner who may need to be taken off statins, or be put on them, after their risk is recalculated.

Statins are not an innocuous medication.  From WebMD at http://www.webmd.com/cholesterol-management/side-effects-of-statin-drugs?page=2#1:

The most common statin side effects include:
Statins also carry warnings that memory loss, mental confusion, high blood sugar, and type 2 diabetes are possible side effects. It's important to remember that statins may also interact with other medications you take.


Not to mention the risks of not being on a statin if you truly need one.

And this number could increase if a practice provides NHS Health Checks routinely. In addition, the lists being sent to practices only go back to October 2015, but practices will be sent further lists potentially dating back to 2009 over the next few weeks.

Wait!  The "regulators" said that ‘a limited number’ of patients may be affected.  They are clairvoyant, I would imagine.  Maybe one of them is Harry Potter?


The "regulators", who have the same powers as the man-wizard above, know through clairvoyance that only a limited number of people were affected, and risk to them low.

A statement from MHRA to Pulse said: 'An investigation has been launched into a digital calculator used by some GPs to assess the potential risk of cardiovascular disease (CVD) in patients.

'We are working closely with the company responsible for the software to establish the problem and address any issues identified.

The problem is incompetence and negligence.  One wonders what testing was performed before this was unleashed on the public in the UK.

TPP told Pulse they were working to address the ‘Clinical Safety Incident’ and that the QRISK calculator was provided as an advisory tool to support decision making. They added they were working to ensure the issues were addressed and GPs are informed of affected patients ‘as soon as possible’.

‘Clinical Safety Incident’ - what a wonderful euphemism for "healthcare IT debacle."


Deputy chair of the GPC’s IT subcommittee Dr Grant Ingrams told Pulse it would be ’loads of work’ to sort out.

He said: ‘It affects everyone who has had a QRISK, and SystmOne are sending out messages to say “look at these patients”. But then you have to see if the change is significant, and whether you would have made a different decision at the time, or put them on a different treatment’

It will probably be more work than if such a system had never been constructed.

Dr Ingrams said: ‘There’s potential harm both ways…What happens when a patient who had been of a high risk and this hadn’t been identified and they’ve now had a stroke or heart attack?  ‘Similarly if someone had a low risk and they’ve been put on a statin and had a side-effect who’s responsible? That’s the clinical risk.’

Answer: the company that produced this grossly defective software, and those "regulators" who allowed it on the market without independent and thorough testing, are responsible.

Dr William Beeby deputy chair of the GPC’s clinical and prescribing subcommittee, said the bug ‘certainly had the potential to impact on patient confidence’ and this could create even more work  ... ‘It’s the tool we’ve been told to use. So if the tool is inaccurate, then you start to lose confidence and the doctors will then lose confidence as well.’

Patient confidence (let alone physician confidence) in cybernetics already took a big hit in the UK several years back, as at my Sept. 2011 post "NPfIT Programme goes PfffT" at http://hcrenewal.blogspot.com/2011/09/npfit-programme-going-pffft.html.

However, it seems, hyper-enthusiast overconfidence in health IT, including that of the "regulators", would not be injured even if bad health IT caused more casualties than the bombings and V2 attacks suffered by the UK in WW2.


After the health IT debacles involving billions of wasted pounds in the UK, perhaps the UK's "regulators" need to look upon health IT as fondly as this piece of technological wizardry.

A TPP spokesperson told Pulse: 'TPP is dealing with the Clinical Safety Incident involving the QRISK2 Calculator in SystmOne. The tool is intended to support GPs in assessing patients at risk of developing cardiovascular disease and in developing treatment plans. The QRISK2 Calculator is presented within SystmOne as an advisory tool.

"Advisory tool"?  That the doctors can safely ignore?  Hogwash.

’We are actively working to ensure the issues identified are addressed and to ensure that clinicians are informed of any patients that may have been affected as soon as possible.’ 

Until the next health IT "bug" arises, that is.

-- SS


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HIT Mayhem, Canadian Style: Nanaimo doctors say electronic health record system unsafe, should be shut down, non-medical PR hacks say it's perfectly safe

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Some candid honesty:

To hell with doctors and nurses and their concerns about horrible health IT.  

That seems the international standard in 2016 regarding their concerns.  There's just too much money to be made in this business to worry about such piddling annoyances as maimed and dead patients.

Doctors, after all, don't know anything about computers, and cybernetic medical experiments on unconsenting human subjects are just good fun.

This new example from Canada:

http://www.theprovince.com/health/local-health/nanaimo+doctors+electronic+health+record+system/11947563/story.html

Nanaimo doctors say electronic health record system unsafe, should be shut down

By Cindy E. Harnett
Victoria Times Colonist
May 27, 2016

Implementation of a $174-million Vancouver Island-wide electronic health record system in Nanaimo Regional General Hospital — set to expand to Victoria by late 2017 — is a huge failure, say senior physicians.

Who cares what they say?  They're just doctors, so sayeth the imperial hospital executives.. 

After a year of testing, the new paperless iHealth system rolled out in Nanaimo on March 19. Island Health heralds the system as the first in the province to connect all acute-care and diagnostic services through one electronic patient medical record, the first fully integrated electronic chart in the province.

EHR pioneer Dr. Donald Lindberg, retired head of the U.S. National Library of Medicine, called such total command-and-control systems "grotesque", and that was in 1969 (See http://hcrenewal.blogspot.com/2014/06/masters-of-obvious-aat-athens-regional.html).  He observed back then:



But he's a doctor too, so what does he know, sayeth the hospital executives.

But nine weeks after startup, physicians in the Nanaimo hospital’s intensive-care and emergency departments reverted to pen and paper this week “out of concern for patient safety.”

Who cares what they say?  apparently not the executives, per Toni O'Keeffe, Vice President and Chief, Communications and Public Relations, http://www.viha.ca/about_viha/executive_team/toni_okeeffe.htm, as below.  The system's perfectly safe!
Doctors said the system is flawed — generating wrong dosages for the most dangerous of drugs, diminishing time for patient consultation, and losing critical information and orders.

“The whole thing is a mess,” said a senior physician. “What you type into the computer is not what comes out the other end.

“It’s unusable and it’s unsafe. I’m surprised they haven’t pulled it. I’ve never seen errors of the kind we are now seeing.”

Doctors are so concerned, they want Island Health to suspend the implementation.

“Take it away and fix it and test it before you bring it back — stop testing it on our people,” said one doctor. “Why wasn’t this introduced in Victoria first? If they went live in Victoria first, they would have a riot.”

(Is there anything unclear there, I ask?)

SHUT UP DOCTORS.  IT''S PERFECTLY SAFE, sayeth the administration.

The doctors, who fear reprisals, spoke to the Times Colonist on condition of anonymity.

If doctors did not fear reprisals I'd have a full time job writing on EHR debacles.  I could almost have one now.

The $174-million system started with a 10-year, $50-million deal for software and professional services signed in 2013 with Cerner Corporation, a health information technology company headquartered in Kansas City. Thus far, the company has been paid close to $12 million. The remaining $124 million is to be spent by Island Health for hardware, training and operating the system.

I wonder just how much graft there may be, driving what seems an international phenomenon of bad health IT with doctors and nurses complaining (e.g., examples of mayhem at http://hcrenewal.blogspot.com/2013/07/rns-say-sutters-new-electronic-system.html), patients being harmed and dying (e.g., ECRI Deep Dive study at http://hcrenewal.blogspot.com/2013/02/peering-underneath-icebergs-water-level.html), yet hospital execs and government officials gleefully moving full steam ahead.

The system is being used in Nanaimo’s hospital, Dufferin Place residential care centre (also in Nanaimo), and Oceanside Health Centre in Parksville.

Since March 19, mobile touch-screen computer console carts have been rolling around hospital hallways. Voice-recognition dictation software immediately transcribes a doctor’s verbal notes into a patient’s electronic record, and scanners track each bar-coded patient bracelet around the hospital. But doctors complain the new technology is slow, overly complicated and inefficient.

Today's clinical IT is needlessly and blindingly complex.  But hospital executives are, in my increasing view, too ignorant to recognize the necessity of simplicity in critical functions such as clinical medicine.  Their jobs are child's play in comparison.  (I should know; I once was a health IT  executive after having practiced medicine for a number of years.)

“The iHealth computer interface for ordering medications and tests is so poorly designed that not only does it take doctors more than twice as long to enter orders, even with that extra effort, serious errors are occurring on multiple patients every single day,” wrote one physician at the Nanaimo hospital.

In view of current warnings and that which is known, and has been known for many years from the literature about bad health IT, each and every adverse outcome of injury that occurs represents hospital executive gross negligence:

Gross negligence is a conscious and voluntary disregard of the need to use reasonable care, which is likely to cause foreseeable grave injury or harm to persons, property, or both. It is conduct that is extreme when compared with ordinary Negligence, which is a mere failure to exercise reasonable care.  http://legal-dictionary.thefreedictionary.com/gross+negligence

I leave it to the reader to classify patient deaths.

“Tests are being delayed. Medications are being missed or accidentally discontinued.”

My mother and other patients in whose litigation I have provided informatics expertise were injured and/or died from precisely that type of mistake.

Doctors can’t easily find information entered by nurses, the physician wrote.

There are also complaints about the pharmacy module of Cerner’s integrated system — the only joint build between Island Health and Cerner.

iHealth implementation staff brought in to input orders for physicians this week entered eight drug mistakes on one day and 10 on another, while there were no mistakes in the paper orders, doctors said. “If the experts can’t enter it correctly, what is the average Joe going to do?” one doctor said.

Suffer, and take on all the liability, of course.

Another problem, they said, is patients’ drug orders disappearing from the system.

Australian informatics expert Jon Patrick wrote of such issues in 2011 as at this link: http://hcrenewal.blogspot.com/2011/03/on-emr-forensic-evaluation-from-down.html.  His technical paper was ignored, and pushback for having written it draconian.

Here's the administration's view:

... But Island Health spokeswoman Antoniette O’Keeffe said the system is safe and doing what it’s intended to do.

To hell with the doctors concerns and with the patients.

“We are not going back to paper,” she said. “We can’t go back to paper. We don’t have the mechanics to go back to paper.”

I'll be generous about the stupidity represented by that statement.  What she means is, we've jsut blown tens of millions of dollars on computers.  We'd get out asses kicked by the Board if we admitted we blew it and went back to paper.

Island Health acknowledges that documentation for staff doing emergency-department patient intake was a challenge, noting Nanaimo is the busiest emergency department on the Island.

A mere "challenge."  How about "was not possible in a 24 hour day?"

Nanaimo has some of the top physicians in the country and “we respect the feedback they are giving us, and so we are listening to them and we are tweaking and modifying the system,” O’Keeffe said.

We respect their feedback.  They say it should be shut down, but "the system is safe and doing what it’s intended to do."

Challenges include getting medication orders into the system, getting clinical staff trained, work flow and documentation, O’Keeffe said.

More staff have been added to speed up admissions and others are working around the clock in the intensive-care and emergency departments to input handwritten physician orders into the system, O’Keeffe said.

Cerner is working with Island Health staff, “and they’ll be here until we get this fully implemented,” O’Keeffe said.

Ms. O'Keefe. bad health IT is never "fully implemented."  (e.g., http://hcrenewal.blogspot.com/2013/11/weve-resolved-6036-issues-and-have-3517.html) Instead, clinicians learn to work around bad health IT, except when the risk of doing so slips through and patients get maimed or killed.

Island Health credits the system’s electronic warnings for catching about 400 human-caused medication errors and conflicts at three sites, saying it’s a sign that the system is working. It will produce a warning, for example, if the dosage is too high for a patient’s weight, if the drug is not appropriate for a particular disease or if there’s a drug conflict.

Across the country, thousands of medication mistakes are made daily due to human error, “and this system is designed to catch them,” O’Keeffe said.

Doctors respond that so many irrelevant flags pop up, it creates confusion, while the computer loses or duplicates drug orders.

Ms. O'Keefe and her administration are obviously blissfully unaware of how health IT can cause medication errors en masse impossible with paper, e.g., "Lifespan (Rhode Island): Yet another health IT 'glitch' affecting thousands", http://hcrenewal.blogspot.com/2011/11/lifespan-rhode-island-yet-another.html.  Of course, many hospital executives are ill-informed, lacking the curiosity of  the average scientist or physician.

The system was a decade in the making for Island Health. Twenty-three clinical teams were involved in developing various components and there was user-group testing, modifications and feedback, O’Keeffe said. Training has gone on for the last year, she said. “You can only bring a system so far and then you have to put it in a real environment to test it.”

At best - test it - yes, on unsuspecting human subjects known as patients, doctors and nurses.  The ones who are harmed and the ones who die are worthy human sacrifice for the glory of computing, eh, Ms. O'Keefe?

At worst - what is wrong with this industry that each and every installation of this technology is an experiment?

Is it that the technology has exceeded the intellectual horsepower of available personnel?  In my experience that has seemed to be the case.

By the end of the implementation, it’s expected family doctors will also be able to access patient files started in acute-care settings. Island Health is working on that component now, O’Keeffe said. Once the system is working smoothly in Nanaimo, it will be installed in the north Island and then Victoria hospitals in 12 to 18 months, O’Keeffe said.

Runaway trains cannot be stopped.

Canadian lawyers, take note.

-- SS

Addendum: An Op-Ed on this matter is here:

http://www.timescolonist.com/opinion/op-ed/comment-new-computer-system-a-detriment-to-health-care-1.2264274  

It is grim, written by a doctor under a pseudonym (Dr. Winston Smith is the pseudonym for a doctor in Nanaimo - that says much about fear of retaliation):
One health record. Making care delivery easier for health-care providers. Safer health care. These are the claims Island Health has made publicly for its new electronic health-record system iHealth, introduced initially at Nanaimo Regional General Hospital in March and intended to roll out across Vancouver Island in the coming months.
These are goals physicians share — many of whom enthusiastically use electronic records in their clinics. Despite “bumps in the road,” Island Health claims the implementation of the system is going well.
But these claims are untrue. iHealth does not provide a single health record: It offers no less disjointed and poorly accessible a collection of patient information in differing programs and sites than the previous system.
The system is cumbersome, inefficient, not intuitive — and not simply because it is a new system, but because of its very nature. It’s like trying to make a DOS-based computer work like an Apple or Windows-based system: You can perform many of the same functions, but it is slow, takes multiple steps and is inefficient.
Even the youngest generation, who have grown up with computers, and those with computing science degrees can’t make it work effectively.
The system’s ordering function is faulty and requires multiple separate steps and choices to order a simple medication: A processing issue safety experts know is highly likely to cause error.
And the system sometimes makes default changes in medication orders without the knowledge of the ordering physician. Single orders for medications disappear from the record, so that duplicate orders are initiated by unknowing doctors.
The consequence of these problems is that hospital-based care delivery is slower, more inefficient, more prone to error. Health-care providers are found interacting with their mobile computer monitors in already overcrowded hallways rather than providing direct patient care.
Nurses and doctors have less of a holistic appreciation of their patients and their illnesses because of the disjointed complexity of the electronic record rather than the simple navigability of the previous paper record and charting.
And communication with the computer system has supplanted direct discussion between health-care team members: Like trying to manage complex illnesses through text messages.
Health-care delivery is slower, so surgical operations are cancelled or delayed and patients leave the emergency department without being assessed; patients are not seen in a timely fashion or at all by specialists; medication errors are regular, so patients are medicated inappropriately or even overdosed; and some of our most experienced and valued health-care providers opt for early retirement or leave rather than continue the frustration and moral distress that this system has generated.
And the effect of iHealth is not restricted to the hospital, as some specialists have reduced their outpatient service because of the increased workload iHealth has caused.
In short, health care is not easier or better. The quality of care is worse and access is reduced. Improvements can be made and have been, but the system is fundamentally flawed. The impact on work efficiency and quality will never return to previous levels — a fact even the Island Health iHealth “champions” acknowledge.
Worse, iHealth is unsafe and dangerous. Medicine strives to be evidence-based, but there’s no evidence electronic record systems improve quality of care, and plenty of evidence they do the opposite — particularly this one.
Doctors have expressed their concerns to Island Health. Rather than suspending the system, the health authority’s response has been simply to delay its rollout beyond Nanaimo. It’s OK to let our community suffer while they tinker.
Dr. Brendan Carr, the CEO of Island Health, tells us he’ll “do whatever it takes to make this work,” even while continuing to risk worsening quality of care and expending more of our taxpayer dollars — $200 million so far, a fraction of which applied to delivery of health-care services could provide inordinately better health-care outcomes than any electronic record can do.
The medical community has finally taken matters into our own hands in the interests of patient safety, quality of care and access. A number of departments are refusing to continue using the system and instead returning to the previous one.
Why does Island Health not withdraw this system? In sum, they’ve spent a lot of taxpayers’ dollars on iHealth, a product of Cerner, which has been sued by hospital systems in the United States.
And as with many such systems, the objective has not been better patient care, but has been more Orwellian: Improved administrative data and control — no wonder Island Health is loath to give it up.
Well, Dr. Carr, the patient should be paramount. I and my family and my community are not expendable. No electronic record system should be introduced that will not explicitly improve health care, patient safety and access.
Any deterioration in health care is not an acceptable outcome. Suspend the iHealth experiment. Stop wasting taxpayer dollars. Sue for our money back for having been sold a lemon (as other jurisdictions have done).
Spend our tax dollars on services, infrastructure and equipment that will improve health care, not make it worse.
Dr. Winston Smith is the pseudonym for a doctor in Nanaimo.
- See more at: http://www.timescolonist.com/opinion/op-ed/comment-new-computer-system-a-detriment-to-health-care-1.2264274#sthash.rWwQcJZA.dpuf

... The system is cumbersome, inefficient, not intuitive — and not simply because it is a new system, but because of its very nature. It’s like trying to make a DOS-based computer work like an Apple or Windows-based system: You can perform many of the same functions, but it is slow, takes multiple steps and is inefficient.

Even the youngest generation, who have grown up with computers, and those with computing science degrees can’t make it work effectively.

The system’s ordering function is faulty and requires multiple separate steps and choices to order a simple medication: A processing issue safety experts know is highly likely to cause error.

And the system sometimes makes default changes in medication orders without the knowledge of the ordering physician. Single orders for medications disappear from the record, so that duplicate orders are initiated by unknowing doctors.

Deadly.

The consequence of these problems is that hospital-based care delivery is slower, more inefficient, more prone to error. Health-care providers are found interacting with their mobile computer monitors in already overcrowded hallways rather than providing direct patient care.

This was not what the pioneers intended.

Nurses and doctors have less of a holistic appreciation of their patients and their illnesses because of the disjointed complexity of the electronic record rather than the simple navigability of the previous paper record and charting.

That sums up a major problem with today's health IT well.

The medical community has finally taken matters into our own hands in the interests of patient safety, quality of care and access. A number of departments are refusing to continue using the system and instead returning to the previous one.

This type of revolt, showing who really owns the hospital, needs to become commonplace.

Why does Island Health not withdraw this system? In sum, they’ve spent a lot of taxpayers’ dollars on iHealth, a product of Cerner, which has been sued by hospital systems in the United States.

And as with many such systems, the objective has not been better patient care, but has been more Orwellian: Improved administrative data and control — no wonder Island Health is loath to give it up.

Indeed.

The CEO is himself a physician:

Well, Dr. Carr, the patient should be paramount. I and my family and my community are not expendable. No electronic record system should be introduced that will not explicitly improve health care, patient safety and access.

This anonymous doctor needs to speak to my mother, who I visited yesterday along with my father, on U.S. Memorial Day - at the cemetery after her encounter with bad health IT.

Read the whole Op Ed at the link above.

-- SS
New computer system a detriment to health care
New computer system a detriment to health care
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I Wonder Why We See Such Angst Regarding Telstra Working On The National Cancer Screening Register.

I Wonder Why We See Such Angst Regarding Telstra Working On The National Cancer Screening Register.

Komentar
This announcement appeared a few days ago.

National Cancer Screening Register

Following a competitive tender process that commenced on 10 August last year, the Federal Department of Health has appointed Telstra Health to develop and operate the new National Cancer Screening Register.
Page last updated: 26 May 2016
26 May 2016
Following a competitive tender process that commenced on 10 August last year, the Federal Department of Health has appointed Telstra Health to develop and operate the new National Cancer Screening Register (the Register), which will support the renewed National Cervical Screening Program and the expansion of the National Bowel Cancer Screening Program.
The commitment to establish a national cancer screening register was first announced in the 2015-16 Budget. Following a detailed Request for Tender (RFT) process, a contract for the service provider was signed on the 4th May 2016.
The Department of Health will now work with Telstra Health to implement the Register. There will also be significant collaboration with the Department of Human Services and the state and territory governments to transition nine separate cancer screening registers into a single National Cancer Screening Register. The Register is expected to be operational to align with the commencement of the renewed National Cervical Screening Program on 1 May 2017.
The Register will create a single view for Australians participating in cervical and bowel cancer screening, meaning for the first time: one record for each participant.
By integrating the Register with GPs’ desktops, GPs will be able to identify patients’ screening eligibility and history to support real time clinical decision-making. Health professionals, including pathology providers, will have improved access to their patients’ information.
It is estimated that over the next four years, streamlined invitation and reporting will benefit approximately 1.4 million women aged 25 to 74 years (both HPV vaccinated and unvaccinated), who will be invited to participate in cervical screening and almost 10 million eligible Australians aged 50 to 74 years, who will be invited to participate in bowel screening.
The register will be established under national legislation and the data included in the register continue will be owned by the Commonwealth (Health Department) and cannot be used for any other purpose. Any misuse of data could be an offence under the Criminal Code. All data are subject to privacy laws such that only personal information that is directly related to the Register may be collected, used and disclosed.
It should also be noted that the core software on which the Register will be built is already in use in Australian clinical settings and has built-in provisions to protect and hold patient and clinical information securely. All data will be stored in Australia in secure data storage facilities.
The Department of Human Services was eligible to participate in the tender, but did not apply.
Here is the link:
http://www.health.gov.au/internet/main/publishing.nsf/Content/mr-yr16-dept-dept002.htm
Within a day or so of this appearing we had panicked articles like the following.

Telstra attacked over $220 million cancer screening register contract win

The Federal Government has awarded a contract - estimated to be worth up to $220 million - to Telstra Health to construct and manage a new National Cancer Screening Register, a decision which has been attacked by union peak body the ACTU and not-for-profit Group, Pro Bono Australia, in defence of a Not For Profit which unsuccessfully tendered for the contract.
Under the five-year contract tendered by the Department of Health Services, Telstra Health’s growing health services business will develop the national bowel cancer register, as well as eight state and territory based cervical cancer registers, into a single digital cancer screening register.
Critics, including some in the healthcare sector, have raised data privacy and governance issues over the awarding of the contract to Telstra, although under the contract the government will retain ownership of the intellectual property and data stored on the new register, which is expected to start operating in the first half of 2017.
But, the ACTU has attacked the decision, accusing the Government of turning over a “sensitive national cancer screening register”, and claiming it is just the first step in the “selling-off of Australia’s public medical records system to corporate operators”.
More here:
http://www.itwire.com/government-tech-news/technology-tenders/73042-telstra-attacked-over-$220-million-cancer-screening-register-contract-win.html
and here:

Health consumer groups warn Telstra could profit from cancer register

Date May 26, 2016 - 5:29PM

Jane Lee

Legal affairs, health and science reporter

Public health and consumer groups have questioned whether Telstra and other private companies could profit from millions of Australians' cancer screening records.
Fairfax Media has reported that Telstra Health - a division of the listed company - has been awarded a government contract to manage a new national cancer screening register next year.
The register - merging data from nine non-profit run registers - will allow GPs to access a single record of their patients' cervical and bowel cancer screening history. It will also show their eligibility for future tests from next May. 
Telstra Health's managing director, Shane Solomon, said this would make it easier for patients to keep up to date with upcoming screenings through mail and potentially mobile text messages, and would overcome duplication when people changed doctors or moved interstate.
The Department of Health released a statement on Thursday to assuage privacy concerns, saying federal laws would ensure that "the data included in the register (will) continue to be owned by the Commonwealth and cannot be used for any other purpose".
Mr Solomon said Telstra would not charge for access to data and denied that it could be used to help develop the company's products.
The company said in a statement that people would be allowed to access their own records online, and that their GPs would need consent to do so.
Yet consumer health groups warned more information was needed about how the contract protected patient records from commercial gain.
Alison Verhoeven, chief executive officer of the Australian Healthcare and Hospitals Association said that while the register could increase the number of people screened for cancer, it was unknown who would control access to the data and publish public reports.
Ms Verhoeven said she was concerned that  "a proliferation of private organisations could be housing data many of us hold dear in a commercial environment over which there is very little control and capacity to contribute to."
More here:
http://www.smh.com.au/federal-politics/political-news/health-consumer-groups-warn-telstra-could-profit-from-cancer-register-20160526-gp4igz.html
and here:
Thursday, 26th May 2016 at 11:15 am

Telstra Health Wins Multi-Million-Dollar Contract Over NFPs

Telecommunications giant Telstra has been chosen over Not for Profits to be awarded a multi-million-dollar contract to manage a new National Cancer Screening Register (NCSR) in a move some members of the public have called “privatisation by stealth”.
The contract, which has reportedly been allocated $178.3 million over five years, is expected to be announced by Health Minister Sussan Ley on Thursday.
The controversial move – which follows a public tender call which closed on 8 October 2015 –  will see sensitive medical records placed under corporate management and signals an end to the current state-based registers for cervical cancer screening programs and the national bowel cancer screening register.
Previously the responsibility of compiling and maintaining the registers had fallen to state-based Not for Profit organisations, including the Victorian Cytology Service which was overlooked for the national contract in favour of Telstra, despite its experience in the field.
Fairfax Media has reported that Telstra Health has approached VCS for access to its expertise, staff, and other resources.
VCS Associate Professor Marion Saville said they were disappointed with the decision.
“We can confirm that VCS was shortlisted for the NCSR. We are of course very disappointed in the outcome of the tender process considering our longstanding expertise in operating successful cancer screening registers,” Saville said.
“As an organisation we will continue to work constructively towards the goal of protecting Australians from the impact of cancer through screening.
More here:
http://probonoaustralia.com.au/news/2016/05/telstra-health-wins-multi-million-dollar-contract-nfps/
It seems to me that all these complaints are either sour grapes from organisations that missed out on the work or are from individuals who have not realised that there are clear plans in place to protect personal information and that already their myHR information is probably in the hands of commercial for-profit contractors such as Accenture.
With the protections outlined in the press release it seems to me all this is hysterical over-reaction from individuals who don’t understand how careful and risk averse the DoH is! The system is being developed by people who already operate patient registries and are fully aware of the sensitivity of the information and the risks to their reputation (and their clients) if something goes wrong. Additionally the whole program is being led by and academic cancer clinician who knows both the risks and the benefits of what is being done.
Of course, virtually all your private information is already controlled by people in the private sector such as GPs, Google, Banks and so it goes on. As our Reserve Bank Governor said recently I reckon people should possibly ‘chill out’.
Let’s just wait till be see what emerges before becoming anxious and concerned!
David.
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Monday, 30 May 2016

Weekly Australian Health IT Links – 30th May, 2016.

Weekly Australian Health IT Links – 30th May, 2016.

Komentar
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

Two big bits of news. Telstra winning the operation of the National Cancer Screening Register and the NT Government announcing a major clinical e-Health program in its budget. Both are about $200M announcements.
Also a range of smaller items on the NBN as well as more moves in cloud based systems.
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http://www.smh.com.au/federal-politics/federal-election-2016/election-2016-telstra-wins-contract-to-manage-your-health-records-20160525-gp3go9.html

Election 2016: Telstra wins contract to manage your health records

Date May 26, 2016 - 12:15AM

Mark Kenny

Chief political correspondent

The Turnbull government is pushing ahead with plans to place sensitive medical records under corporate management and will announce on Thursday that Telstra Health - a division of Telstra - has been awarded the contract to manage a new national cancer screening register from next year.
The lucrative contract, which one industry source estimated at as high as $180 million over three years, will be announced by Health Minister Sussan Ley.
It signals an end to a series of smaller registries managed on a not-for-profit basis, but is a separate program from another plan to outsource Medicare's chronically inefficient payment delivery system, which Labor has decried as privatisation of Medicare by stealth.
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http://www.health.gov.au/internet/main/publishing.nsf/Content/mr-yr16-dept-dept002.htm

National Cancer Screening Register

Following a competitive tender process that commenced on 10 August last year, the Federal Department of Health has appointed Telstra Health to develop and operate the new National Cancer Screening Register.
Page last updated: 26 May 2016
26 May 2016
Following a competitive tender process that commenced on 10 August last year, the Federal Department of Health has appointed Telstra Health to develop and operate the new National Cancer Screening Register (the Register), which will support the renewed National Cervical Screening Program and the expansion of the National Bowel Cancer Screening Program.
The commitment to establish a national cancer screening register was first announced in the 2015-16 Budget. Following a detailed Request for Tender (RFT) process, a contract for the service provider was signed on the 4th May 2016.
The Department of Health will now work with Telstra Health to implement the Register. There will also be significant collaboration with the Department of Human Services and the state and territory governments to transition nine separate cancer screening registers into a single National Cancer Screening Register. The Register is expected to be operational to align with the commencement of the renewed National Cervical Screening Program on 1 May 2017.
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http://www.itnews.com.au/news/sa-govts-legacy-software-showdown-set-for-december-419922

SA govt's legacy software showdown set for December

Federal court to decide whether hospitals can be forced to upgrade.

By Paris Cowan
May 23 2016 3:37PM
The South Australian government will go head-to-head with its supplier of critical rural patient systems in a ten-day December trial over the state's refusal to stop using the product despite its licences having long expired.
The state is the last remaining user of the CHIRON patient administration software, which continues to be installed in 12 of its 75 hospitals that have yet to receive the newer electronic patient administration system (EPAS) progressively being rolled out in SA.
The 1980s product was withdrawn from the market by its owner Global Health in March last year, but with no decommissioning plan in place, the SA hospitals have refused to stop using the product despite no longer holding valid licences.
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http://www.medicalrepublic.com.au/medical-directors-helix-system-might-signal-rapid-radical-changes-primary-care/
25 May, 2016

Medical Director’s Helix might catalyse radical change

Posted by Jeremy Knibbs
Medical Director’s entry into the cloud patient-management system race last week with MD Helix may have signalled the beginning of the most rapid and radical change in primary care since PIP incentivised the Computerisation of GP surgeries 15 years ago
The announcement by Medical Director has effectively legitimised the idea of a cloud-based system for nearly half the GPs in the country (who are MD’s current desktop customers). The race is now on for the hearts and minds of those GPs who see the enormous potential to increase their practice efficiency and their communication with their patients through the system’s patient-connected apps.
The timing of the announcement, at the precise date of the formal launch of much mooted cloud-based start-up, MediRecords, at the Sydney GPCE , was not likely to have been a coincidence. It looks targeted directly at MD’s customer base to at least put some doubt in the minds of anyone who is thinking of switching to the MediRecords system in the near term.
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http://www.itwire.com/it-industry-news/strategy/73021-find-a-relevant-medical-conference-or-event-easily.html

Find a relevant medical conference or event easily

When medical practitioners want to find a ski trip, sorry, conference, to attend they go on an endless internet search of Australian and international websites. On a serious note continuing professional development (CPD) happens regardless of locale.
The professional development and events market is filled with numerous courses and seminars, face-to-face and online, making the choices endless for the busy healthcare professional who simply wants to find the right course to learn a new speciality or update on existing knowledge and earn CPD points. Worse still is the time wasted sifting through the plethora of unnecessary courses, events and conferences.
HealthcareLink  has gathered together many of the relevant Australian courses, events and conferences for medical doctors, nurses and midwives, allied health, oral health, and management and administration.
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http://www.theaustralian.com.au/federal-election-2016/federal-election-2016-new-medicare-it-system-up-in-the-air/news-story/848a87cc1804e6784ec90fa1600f541b

Federal election 2016: new Medicare IT system up in the air

  • The Australian
  • May 23, 2016 12:00AM

Sean Parnell

Health reforms and budget management initiatives are dependent on a new Medicare payment system that the ­Coalition has not funded and Labor is warning voters not to allow it to be privatised.
The future of the Medicare IT system is unclear and the suggestion it might be outsourced has fuelled Labor’s campaign against health cuts.
The Australian understands a decision whether to outsource or upgrade internally must be made soon after the election as the system is reaching its use-by date.
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http://www.abc.net.au/news/2016-05-24/nt-budget-2016-dave-tollner-plan-pushes-deficit-to-$800m/7439986

NT budget 2016: Tollner plan pushes deficit to $800m

May 24, 2016
The Northern Territory Treasurer has described the Government's budget as "fiscally responsible", despite a forecast deficit in next financial year of $794 million - four and a half times larger it was expected to be a year ago.
In handing down his final budget before his retirement from politics, Dave Tollner announced a "near record" outlay of $1.7 billion on infrastructure in the NT.
The budget is expected return to surplus by 2019/20, two years later than projected, with a $12 million surplus.
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https://delimiter.com.au/2016/05/25/nt-govt-commits-186m-e-health-record-system/

NT Govt commits $186m to e-health record system

By Daniel Palmer 
25/05/2016
news The Northern Territory has announced plans to spend $186 million on a jurisdiction-wide, integrated electronic health record system.
Implemented as part of the 2016 Budget, the investment will be spread over five years as part of the Core Clinical Systems Renewal Program (CCSRP).
Minister for Corporate and Information Services Peter Styles said the program to upgrade the existing core clinical information systems will be the “largest ICT reform ever undertaken” in the Territory.
“For the first time clinicians will be able to electronically access patient records from any public health care facility, anywhere in the Territory,” he said.
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http://www.itnews.com.au/news/nt-sinks-186m-into-8216largest-ever8217-clinical-systems-replacement-420036

NT sinks $186m into ‘largest ever’ clinical systems replacement

Outdated hospital IT to get the boot.

By Paris Cowan
May 25 2016 12:12PM
The NT government has committed $186 million to the replacement of four of its critical clinical systems with a single, integrated patient information database that will be accessible in real-time from any one of the territory’s hospitals or medical centres.
The core clinical systems renewal program will take five years to complete and represents a comprehensive overhaul of the health system’s operational IT environment.
It will deliver the NT’s doctors and clinicians a single view of a patient, integrating data that is currently stored in four different systems - CareSys, the clinical workstation system, the primary care information system, and the community care information system.
Changes to a record made anywhere in the state will be updated and appear in the system in real-time.
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http://www.hospitalhealth.com.au/news/big-data-surgeons-perspective/

Big Data – A surgeon’s perspective

ahhb
on May 25, 2016 at 8:03 am
Things don’t always go to plan and sometimes complications happen. Professor Andreas Obemair explores how Big Data could make all the difference.
Big Data refers to the concept of very large datasets that can be linked to one or more other datasets. While Big Data is often referred to in the context of business, in this article I will focus on its potential in the healthcare environment.
Many years ago, when I was a medical student, databases were few and far between. Research involved trawling through journal articles at the university library. I physically studied countless hospital charts and extracted information from 500 patients to research the association of obesity with breast cancer prognosis. Big Data did not exist then.
And now……
Recently, my research group showed that surgical removal of the uterus, tubes and ovaries improves survival chances in breast cancer sufferers. We identified 20,000 women diagnosed with breast cancer from the Queensland Cancer Registry and linked this data with data from the Queensland Hospital Admitted Patients Data Collection and the Australian National Death Index. Compared to 30 years ago when it took countless hours to extract data from 500 hospital charts, the time it took to obtain information from 20,000 records was minimal and the impact was much larger.
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https://www.nehta.gov.au/about-nehta/nehta-publications/reports/benefit-and-evaluation-reports/1089-evolution-of-ehealth-in-australia-achievements-lessons-and-opportunities

Evolution of eHealth in Australia - Achievements, lessons, and opportunities

The national eHealth program in Australia is now at an important turning point as it moves into a new stage under the Digital Health banner. It is timely to take this opportunity to review the significant achievements made to date, to analyse lessons learned, and most importantly, to use this information to inform the future of digital health in Australia.
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http://www.nzherald.co.nz/business/news/article.cfm?c_id=3&objectid=11643340

Orion Health targets return profit in 2018, lifts revenue 26pc

By Paul McBeth
11:10 AM Monday May 23, 2016
Orion Health is targeting a return to profit in 2018 after reporting a 26 per cent increase in annual revenue as a weaker New Zealand dollar bolstered returns and a smaller tax expense helped narrow the health software developer's loss.
The Auckland-based company posted a loss of $54.4 million, or 34.2 cents per share, in the 12 months ended March 31, from a loss of $60.8 million, or 42.3 cents, a year earlier.
The bottom line was helped by a tax expense of $1.7 million, down from $10.1 million in 2015 when $5.7 million of tax assets from previous losses and $1.3 million of deferred tax balances were de-recognised. Revenue climbed 26 per cent to $207 million as the exporter benefited from a weaker kiwi dollar, and on a constant currency basis sales rose 12 per cent.
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http://www.startupsmart.com.au/advice/funding/melbourne-accelerator-program-announces-its-latest-intake-with-twice-as-many-applicants-as-last-year/

Melbourne Accelerator Program announces its latest intake with a focus on diversity

Denham Sadler  
Wednesday, 25 May 2016
The Melbourne Accelerator Program has revealed the 10 startups that will be taking part in its latest program after receiving twice as many applications than last year.
Over 120 early-stage companies applied for the five-month accelerator program and after a three-stage selection process, 10 have been selected to receive $20,000 in funding, office space at the University of Melbourne, mentoring, development workshops and pitching opportunities in Melbourne, Sydney and Silicon Valley.
MAP does not take any equity from the participating startups, and at least one of the company’s founders must be an alumni of the University of Melbourne.
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http://rustreport.com.au/issues/latestissue/aussies-urged-to-change-linkedin-passwords-after-100-million-users-breached/
WA Gov to get patients to hospital faster with new app
The WA government has launched a new WA Emergency Waiting Times app, designed by WA innovation and technology services house Readify, which will help Perth residents quickly and easily choose which hospital to go to in an emergency. Readify’s WA team developed the app on their own initiative in response to Government Chief Information Officer Giles Nunis’ public commitment to use Government open data in smart ways, and to demonstrate that innovation can greatly benefit the public without costing a fortune. The app uses existing Perth hospital emergency wait time data, and taps into mobile device geolocation, local maps and traffic data to give people needing to go to the hospital in a non life-threatening emergency an aggregated travel + wait time. Perth residents can now see whether it is worth driving a bit further than the closest hospital to attend an emergency department that is not as busy, make their decision quicker, get directions and jump in the car.
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http://www.lexology.com/library/detail.aspx?g=af322fa4-46f2-4ad9-934c-47e5fb2471c5

Data Breach Response Plans: A Life Hack for IT Attacks

Griffith Hack
Australia May 20 2016
The Australian government has pledged increased spending to secure Australia’s cyber capabilities. However, organisations still need to consider investing resources to manage and minimise cyber attacks.
Cyber attacks can suspend business, diminish stakeholder trust and damage the brand. Additionally, if an organisation fails to take reasonable steps to protect the personal information it holds, business owners may also find they need to deal with the Privacy Commissioner for breaching privacy laws.
Security challenges for companies
There are many security challenges facing individuals and companies. One cause of concern is spear-phishing emails which generally target individuals who are likely to have information or access sought after by the attacker. Often social media profiles, such as LinkedIn profiles, are used to mine information. Once enough information is collated the attacker builds a believable story and sends an email that appears to be from an individual or business that the recipient knows. CERT Australia received reports from a number of Australian businesses of fraudulent emails claiming to be from a senior executive within the company, requesting financial staff transfer funds to an external bank account.
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http://www.smh.com.au/federal-politics/political-news/peter-young-spoke-out-about-a-mans-death-suddenly-the-afp-was-looking-at-his-phone-records-20160524-gp2fs6.html

Peter Young spoke out about a man's death. Suddenly, the AFP was looking at his phone records

Date May 24, 2016 - 5:13PM

Nicole Hasham

Environment and immigration correspondent

The Department of Immigration sought an investigation by the Australian Federal Police which resulted in a whistle-blowing psychiatrist having his phone records accessed, it has emerged.
Guardian Australia reported on Tuesday that the AFP had compiled hundreds of pages of file notes and reports involving Sydney-based psychiatrist and detention centre critic, Peter Young, including documents that show his phone records had been investigated.
The probe followed media reports that contained details of the medical records of Hamid Khazaei, a Manus Island asylum seeker who died in September 2014 after a cut on his leg progressed to septicaemia.
Dr Young oversaw the mental health of asylum seekers in all Australian-run detention centres from 2011 to mid-2014. He told Fairfax Media he was no longer in the position at the time of Mr Khazaei's death and did not have access to his medical records, and suggestions he was responsible for the leak were "absolutely ridiculous".
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http://www.australiandoctor.com.au/news/latest-news/police-snooping-on-many-refugee-doctors-advocates

Police snooping on more refugee doctors, advocates claim

Michael Woodhead | 26 May, 2016 | 
Police surveillance of doctors advocating for asylum-seeker health may be more widespread than the single case that came to light this week, doctors fear.
The warning has been made by Sydney GP Dr Barri Phatarfod (pictured), co-founder of Doctors for Refugees, after the Guardian reported that the Australian Federal Police (AFP) had compiled hundreds of pages of files and reports about Dr Peter Young, a former medical director of mental health for Australia’s detention centres, after he publicly criticised the way asylum-seekers were treated in detention.
Dr Phatarfod added that, as a result, private patient information may also be being accessed by the police.
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http://www.zdnet.com/article/85-percent-of-voters-support-the-nbn/

85 percent of voters support the NBN

Likely Labor voters both support and oppose the project in the higher numbers, while proportionally, Liberal voters give the NBN the highest level of support.
By Chris Duckett | May 24, 2016 -- 22:30 GMT (08:30 AEST) | Topic: Networking
The National Broadband Network (NBN) continues to have widespread support throughout the electorate, with an exclusive ZDNet survey undertaken by Metapoll revealing that the project currently enjoys clear majority support with Australians.
The survey reveals that 86 percent of the sample back the NBN, with only 15 percent against the project. The results excluded those that responded with "don't know".
Conducted over the week of May 15 to 21, the survey asked: "Based on what you've heard, do you support or oppose the National Broadband Network (NBN), and will it influence your vote at the upcoming federal election?"
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Enjoy!
David.

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