Wednesday, 15 June 2016

I Have Heard Of Some Health IT Fiascos But This One Is Right Up There!

I Have Heard Of Some Health IT Fiascos But This One Is Right Up There!

Dr Terry Hannan spotted this amazing yarn.

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

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

Nine weeks after rolling out the paperless iHealth system, Nanaimo hospital’s intensive-care and emergency departments have reverted to pen and paper “out of concern for patient safety.”

Photograph by: Sherry Yates Young , Vancouver Sun

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.
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.
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.”
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.”
The doctors, who fear reprisals, spoke to the Times Colonist on condition of anonymity.
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.
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.
“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.
“Tests are being delayed. Medications are being missed or accidentally discontinued.”
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.
Lots more here:
It’s hard to know what one can add. It seems pretty clear that the implementation testing phase just did not deliver the warning that more work was needed before going live.
It also seems clear that the engagement with clinicians in terms of education might have been a little weak - to say the least.
David.
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Tuesday, 14 June 2016

This News Has Two Aspects To It And Needs A Quality Response From The New ADHA.

This News Has Two Aspects To It And Needs A Quality Response From The New ADHA.

This appeared a few days ago.

Announcement of NEHTA’s Transition to the Australian Digital Health Agency

Created on Monday, 06 June 2016
On 1 July 2016 NEHTA’s assets and liabilities will by law become the assets and liabilities of the Australian Digital Health Agency (Agency), a new Commonwealth corporate entity.
The Agency is created by the Public Governance, Performance and Accountability (Establishing the Australian Digital Health Agency) Rule 2016 (PGPA Rule). The transition will occur by operation of Section 74 of the PGPA Rule. In accordance with Section 73 of the PGPA Rule, the Commonwealth Minister for Health has specified the “transfer day” for the transition to be 1 July 2016. On 1 July 2016 all the assets and liabilities of NEHTA will statutorily vest in the Agency.
A link to this PGPA Rule can be found at https://www.legislation.gov.au/Details/F2016L00070
A link to the Ministers notification of the “transfer day” can be found at http://www.health.gov.au/internet/ministers/publishing.nsf/Content/5973595577926D9DCA257FA800231933/$File/SL034.pdf
Here is the link:
So it seems we are in the last few days of an organisation I have to say I will certainly not miss!
On the positive side there is now an opportunity for the new Australian Digital Heath Agency to do better.
For this to happen the following is needed in my view.
First we need an honest, in depth review (as opposed to the joke NEHTA published a few weeks ago - see here http://aushealthit.blogspot.com.au/2016/05/nehta-delivers-itself-its-own-scorecard.html ) to establish what is useful out of what has been done by NEHTA, what should be retained, what needs to be redone and improved. Additionally we need to ensure all the relevant stakeholders are properly represented by competent and experienced representatives to ensure the maximum value is preserved while the strategic errors are corrected where needed.
Second - after this is done a full report and new strategy for the ADHA should be published - after proper consultation - which defines exactly what the ADHA should be involved in and do and what they should not do - as well as how the ADHA interacts with the private sector, the clinical sector, HI experts, the consumers and the jurisdictions and federal government. There should, of course, be an evidence based review of the myHR program - not that I expect that to happen.
Third we need a total cultural transformation in those staff who come over from NEHTA so they understand just who it is they work for and to whom they are accountable and what they should be doing to advance quality use of technology within the health sector. (That the ADHA is subject to FOI might help - but I would much prefer prompt publication of working papers and minutes so FOI is hardly ever needed). I would also like the see the CEO producing a public monthly summary of just what is happening within ADHA so we can all understand the progress on each agreed work streams and so on.
Fourth I think we need a permanent CEO to be appointed ASAP.
Last I would like to see all meetings of reference and advisory committee committees (as well as the Board meetings) be made available via recorded web-casts so we can all understand just what is driving the decision making if we are concerned.
The response to these suggestions will drive how I judge the ADHA in making the cultural shift from NEHTA.
David
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Monday, 13 June 2016

Weekly Australian Health IT Links – 13th June, 2016.

Weekly Australian Health IT Links – 13th June, 2016.

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

A very quiet week with the Election dominating the news. Only a few more weeks and normal service will be resumed I hope.
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Poll results: pharmacy supports MedsASSIST

The AJP’s poll on codeine monitoring tool MedsASSIST have shown that Australian pharmacy strongly supports the program.

Last week we asked, “Is your pharmacy using MedsASSIST?” after posters in our forum section suggested some owners were unenthusiastic about the clinical decision support tool because of the possibility of lost sales.
Sixty-five per cent of our respondents – 140 readers – ticked, “Yes, it’s a great initiative” in the poll.
A further 8% said that while they had some reservations about MedsASSIST, it had been rolled out in their pharmacies; and another 5% said their pharmacy is planning to implement it.
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Overdoses lead to warnings about opioid painkillers such as Oxycontin, Fentanyl

Date June 4, 2016

Stephanie Wood

Senior Writer

Prescription painkillers: treatment and addiction

When the cure becomes the problem, the rise of prescription opioids.
It gives him a reason to get out of bed and shave. It makes a change from a doctor's surgery. Even though he might not feel like going, David Johns turns up once a month at a bright Surfers Paradise cafe for a chronic pain support group meeting.
No one's required to be at the top of their game for this occasion and Johns is a mess despite his painkillers: Endone, a short-acting version of the synthetic opioid oxycodone hydrochloride, and Targin, a long-acting form. "It's just another day," he says. He's mostly a mess, these days.
For Jenny, a slim and elegant 63-year-old member of the group who prefers not to give her last name, it's a good day; last night she took a sleeping pill, which gave her respite from the nightly ravages of her crumbling spine. Four Endones helped Gaynor Kemmett, a 56-year-old former graphic designer with pearly skin and black waist-length hair, get out her Chevron Island front door. Opioids such as Endone and Targin are on the national Poisons Standard list of Schedule 8 drugs, drugs of addiction. They belong to a group of medications, along with morphine, that are either derived from opium or are opium-like compounds that act on the brain's central nervous system to reduce pain.
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Vodafone to link exoskeletons

  • The Australian
  • 12:00AM June 11, 2016

Chris Griffith

Exoskeletons can make a huge difference to people suffering severe illness and disability.
And by connecting them to the internet, they can transmit data about a wearer’s activities, download self diagnostic software, and where needed, access patient data.
So it’s no surprise that an international communications company such as Vodafone is seeking a major role in providing mobile communications for such a device.
As a result, Vodafone in the US says it will connect up the world’s first and only exoskeleton approved by the US Government’s Food and Drug Administration (FDA).
Because the agreement is global, it means Vodafone Australia can offer communications should the Ekso GT sell here.
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Doctor versus robot

6 June, 2016 
A British startup claims it has created a smartphone app that’s as good if not better than a doctor at recognising common health problems.
The firm, Babylon Health, says it will put its “artificial intelligence” doctor app up against the real thing this week in a head-to-head contest.
The app’s developers told the Daily Mail on the weekend they were “100% confident” they would come out on top.
Known as Check, the app acts like a triage nurse, asking a series of questions to advise users whether their problem is nothing to worry about, something they should see their GP about, or a triple-0 emergency.
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  • Updated Jun 8 2016 at 12:15 AM

Oneview Healthcare closes in on aged care contract

Hospital software provider Oneview Healthcare is close to signing its first contract with an Australian aged care provider.
The Irish company, which joined the ASX in March after raising $62 million, has developed a technology platform for hospitals that does away with paper charts for activities like monitoring medications, ordering meals and patient education. 
The bedside service is available on screens that are leased to the facilities, although in future it will likely be delivered to patients' smartphones.
The company is focused on getting into hospitals in Australia, the United States and the Middle East, although aged care is also seen as a lucrative opportunity to diversify.
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ACT Health starts the chase for new CIO

CIO will oversee the development of a ten year ICT strategy
Jennifer O'Brien (CIO) 08 June, 2016 09:16
ACT Health is officially on the hunt for a CIO, six months after the departure of Judy Redmond, who was in the post for five years and was pivotal in the implementation of an e-health strategy.
The ACT government’s health directorate is offering up to $228,000 to fill the role, which is currently held by acting CIO Warren Prentice, who was formerly a program manager for the Australian Department of Defence.
Prentice has been directly contracted as a public service, senior executive to plan the transition of the organisation to a more mature ICT operating model, according to a LinkedIn post.
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Tech moguls declare era of artificial intelligence

Date June 3, 2016

Liana B. Baker

Artificial intelligence and machine learning will create computers so sophisticated and godlike that humans will need to implant "neural laces" in their brains to keep up, Tesla Motors and SpaceX CEO Elon Musk told a crowd of tech leaders this week.
While Musk's description of an injectable human-computer link may sound like science fiction, top tech executives repeatedly said that artificial intelligence (AI) was on the verge of changing everyday life during a discussion at a tech industry conference in California this week.
It is no secret that tech companies are diving into AI analytics research, an industry that is forecast to grow to $US70 billion ($96.9 billion) by 2020 from just $US8.2 billion in 2013, according to a Bank of America report.
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The first eHealth platform in the world to combine IHE and openEHR

Article posted on: June 7, 2016
Story highlights: 
  • Open and agile architecture with a health data platform as its cornerstone is required to build a Postmodern EHR.
  • Marand’s Think!EHR PlatformTM is the first health data platform to offer interoperability based both on IHE and openEHR.
  • World-class clinics and eHealth systems have opted for Think!EHR PlatformTM: Moscow’s eHealth system, NHS England, Sirio-Libanes, Sao Paolo and others.
AMSTERDAM, THE NETHERLANDS - (HealthTech Wire / News) — Tomaž Gornik, CEO of Marand says that postmodern EHR is the next stage in the development of EHRs. A vendor-neutral health data layer is required to connect all the apps and applications into one coherent system. Postmodern EHR is a modular clinical information system wherein data is decoupled from applications, and where all applications are required to use (capture, store, retrieve, analyse) health data in a standardised, vendor-neutral format. Most healthcare organisations are beginning to realise that their data is more valuable than their applications. In the Postmodern EHR approach, introducing, renewing and replacing apps, devices, and cloud services is far easier and faster compared to legacy monolithic EHRs due to a multivendor environment built on an open and agile architecture.
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Computer Vision Syndrome could be damaging your eyes

Date June 7, 2016

Jane E. Brody

Joanne Reitano is a professor of history at LaGuardia Community College in Queens, New York. She writes wonderful books about the history of the city and state, and has recently been spending many hours – sometimes all day – at her computer. But while sitting in front of the screen, she told me, "I developed burning in my eyes that made it very difficult to work."
After resting her eyes for a while, the discomfort abates, but it quickly returns when she goes back to the computer. "If I was playing computer games, I'd turn off the computer, but I need it to work," the frustrated professor said.
Reitano has a condition called computer vision syndrome. She is hardly alone. It can affect anyone who spends three or more hours a day in front of computer monitors, and the population at risk is potentially huge.
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E-communication key to cutting Medicare costs, says new AMA vice-president

Kathryn Ryan | 7 June, 2016 | 
The rebate freeze aims to cut Medicare costs, but if the government is really looking to make savings then it needs to invest in e-communications, according to the new GP vice-president of the AMA.
Digital communication between GPs, hospitals and other health services needs to be front and centre of future conversations with government on health funding, says Victorian GP Dr Tony Bartone (pictured).  
The new AMA vice-president will push for more investment in e-communications as a way to save money in the long run, and he wants to see major improvements in computerised hospital discharge systems and real-time prescriptions monitoring.
All political parties have to stop looking at general practice as a soft target for savings, says Dr Bartone, citing the current Medicare rebate freeze as a case in point, and start concentrating on making the health system more efficient.
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Avoiding ransomware is not that hard

Ransomware is the big, scary infosec threat of 2016, but stopping it in its tracks is easier than you think.
By Chris Duckett and Stilgherrian | June 6, 2016 -- 05:54 GMT (15:54 AEST) | Topic: Security TV - Video Series
Ransomware has been labelled as the biggest threat in information security today, and while there are more variants and a lot more attempts to get it onto systems than ever, some basic hygiene goes a long way towards preventing it from messing up your computer.
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Announcement of NEHTA’s Transition to the Australian Digital Health Agency

Created on Monday, 06 June 2016
On 1 July 2016 NEHTA’s assets and liabilities will by law become the assets and liabilities of the Australian Digital Health Agency (Agency), a new Commonwealth corporate entity.
The Agency is created by the Public Governance, Performance and Accountability (Establishing the Australian Digital Health Agency) Rule 2016 (PGPA Rule). The transition will occur by operation of Section 74 of the PGPA Rule. In accordance with Section 73 of the PGPA Rule, the Commonwealth Minister for Health has specified the “transfer day” for the transition to be 1 July 2016. On 1 July 2016 all the assets and liabilities of NEHTA will statutorily vest in the Agency.
A link to this PGPA Rule can be found at https://www.legislation.gov.au/Details/F2016L00070
A link to the Ministers notification of the “transfer day” can be found at http://www.health.gov.au/internet/ministers/publishing.nsf/Content/5973595577926D9DCA257FA800231933/$File/SL034.pdf
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3 June, 2016

Top eight medical technologies that will change the world

Posted by Felicity Nelson
Human history can be reduced to moments of discovery – and leaps in medical technology are among the most significant
Medicine is undergoing similar revolutions today but the full impact of many of these advances remains to be seen. This is our selection of the most transformational technologies shaping medicine today.
1. Sharpening the genetic scissors
In the past, gene therapy has used relatively crude mechanisms, with new strands of DNA being injected into human cells using harmless viruses as vectors. This strategy has worked for some diseases that are caused by a missing gene, but not for those requiring a genetic sequence to be snipped out or replaced. The discovery in 2007 of CRISPR, a nifty pair of genetic scissors, has opened up a new era of genetic engineering by giving scientists the ability to edit human DNA. Potentially, this powerful new technology could allow abnormal genes, such as those for cystic fibrosis, to be deleted.
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  • Updated Jun 6 2016 at 8:04 PM

Amazon Web Services storm outages serve as a warning of cloud risk to businesses

Australian businesses have been warned they need to spread the risk in their cloud computing operations across different regions after the Sydney storms on Sunday knocked out the operations of numerous Amazon Web Services customers.
The ferocious storms that hit NSW, left AWS clients including Domino's Pizza, Foxtel, The Iconic, Stan and Domain without websites or key systems for hours.
It served as a warning that sending systems to the cloud, rather than hosting them on-premise did not remove the risk of costly failures.
The failure represents a major embarrassment for the company, which generated $US2.57 billion revenue in the latest quarter, based largely on the fact that it is perceived as being hugely reliable.
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Government-Telstra cancer register deal needs screening

  • Antony Harrowell
  • The Australian
  • 12:00AM June 7, 2016
Stumbling down rabbit holes can lead to unexpected places; just ask Alice, she found herself in a Wonderland of strange characters and odd situations.
Her fall may be fictional, but it reflects the same rabbit hole in which Australians may find themselves if the latest deal between the federal government and Telstra is allowed to see the light of day without intense scrutiny. Like Alice, this is a dark comedy that may have severe consequences.
Telstra was recently awarded a $220 million contract by the government to establish a Cancer Register, which is unclear in its objective. That is, to provide “a robust IT solution-based support system for the expanded National Bowel Cancer Screening Program and the renewed National Cervical Screening Program” or a full “National Cancer Screening Register”.
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Telstra Health to help improve patient care in China

Nurdianah Md Nur | June 7, 2016
Hospitals in China are now able to use Telstra's analytics tools to improve patient care.
The move is the result of a five-year agreement between Telstra Health — the e-Health division of Australian telco Telstra — and the Shanghai Institute of Medical Quality, a non-profit organisation that aims to improve hospital management efficiency and patient satisfaction through data analysis and business intelligence.
As part of the collaboration, clinicians and hospitals managers will be able to access Telstra Health's Quality Investigator programme to easily measure and analyse mortality, re-admission rates, and length of stay. This will help healthcare organisations improve clinical quality and patient safety.
In addition, Shanghai General Hospital has joined Telstra Health's Global Comparators network, which brings together senior clinicians and managers from leading hospitals worldwide to share knowledge and best practice to improve patient care. The hospital is the first Asian participant in the network, which carries out research collaborations to tackle problems encountered by healthcare systems worldwide, according to Telstra.
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Privacy concerns over cancer register

Australia June 9 2016
Telstra Health has won the tender to manage the National Bowel Cancer and Cervical Screening data register. The company will be responsible for collating and amalgamating the data currently stored on separate State databases into one national register and overseeing the register’s operations.
Concerns have arisen over the potential for inadvertent and unauthorised breaches of private information, heightened by recent instances of data released by Telstra.
While the exact nature of the privacy protections outlined in the tender are unknown and it remains unclear whether sufficient avenues will be available to allow consumer actions against Telstra Health as an incentive to strengthen the company’s privacy policies, the Commonwealth privacy legislation will apply to the register and any misuse of data could be an offence under the Criminal Code.
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25Mbps NBN is 'good enough': Barnaby Joyce

The minimum speed provided by the NBN is sufficient for those in rural areas, the deputy prime minister has said.
By Corinne Reichert | June 7, 2016 -- 04:55 GMT (14:55 AEST) | Topic: NBN
Internet speeds of just 25Mbps are "good enough" for those living in regional and remote parts of Australia, according to Deputy Prime Minister Barnaby Joyce.
Joyce, speaking on the ABC's Q&A program on Monday night, admitted that those living in remote areas won't get the highest-quality internet service on the federal government's National Broadband Network (NBN), but said the speeds provided are sufficient for their needs.
"It's a bit of a slip to say that well 25Mbps is fine for us," questioner Elizabeth Wakeford argued back.
"Just because you are remote, Barnaby, you still need more than 25Mbps," added National Farmers' Federation vice president Fiona Simson.
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Western Sydney Local Health District creates permanent CTO role

Until now the chief technology officer position has been temporary
Rohan Pearce (Computerworld) 09 June, 2016 14:24
Western Sydney Local Health District (WSLHD) has begun accepting applications for the role of chief technology officer.
“This role has been temporary to date and has been filled in an acting capacity,” a spokesperson told Computerworld Australia.
“Over the past year, the Western Sydney Local Health District has undertaken a major transformation of its IT services and is now seeking a permanent chief technology officer,” the spokesperson said.
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Five hidden Windows 10 tricks you should use

Date June 6, 2016 - 1:50PM

David Nield

Windows 10 has officially been with us for close to a year now, but even if you've spent a lot of time with the OS since its launch, you may not have found everything it has to offer. Here are five of our favourite hidden features that we've discovered over the course of the last year, and why you might want to start using of them.

1. The hidden battery report

If you're using Windows 10 on a tablet or laptop, then you're going to want to keep an eye on battery levels — something you can do with a quick glance down at the notification area. There's a more detailed and thorough battery report available too, giving you useful information on its overall health and how much use you're getting between charges.
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Enjoy!
David.
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Sunday, 12 June 2016

AusHealthIT Poll Number 324  – Results – 12th June, 2016.

AusHealthIT Poll Number 324 – Results – 12th June, 2016.

Here are the results of the poll.

Should The Federal Government Or State Governments Be Blamed For The Failure To Implement Anti 'Dr Shopping' Systems Nationally?

The States Are To Blame 0% (0)

The Feds Are To Blame 3% (3)

Both Are Hopeless In This Regard 35% (33)

The Systems Are Not Needed 46% (43)

I Have No Idea At All 15% (14)

Total votes: 93

An interesting result - it seems a majority do not think we should have systems to detect and prevent ‘doctor shopping’ with all its attendant, and often fatal, risks. I disagree.

Only fair turnout of votes.

Again, many, many thanks to all those that voted!

David.
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