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Rob Galbraith | Email this | Comments
Here are a few I have come across this week.
Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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Now here is an interesting join the dots exercise.
We had this appear a few days in an opinion piece.
December 10, 2010
Ian Birks*
The Australian Government's E-health conference last week wrapped up two days of focus on the national development of e-health initiatives and Personally Controlled Electronic Health Records (PCEHRs).
There has been a strong government investment in e-health, ranging from $A466 million over two years to deliver better patient records, to Senator Conroy's announcement at the conference of a $A4 million e-health trial in NSW. This investment is essential and welcomed by the ICT industry as the right way forward. However, a key requirement for the success of schemes such as the PCEHR will be consumer engagement. Basing the PCEHR initiative on an opt-in system is something that may ultimately hinder its success.
Many of those users who stand to benefit the most from a personally-controlled record may not understand the benefits on offer. To base the success of the system on the requirement for users to actively opt-in is a risk.
Australia must embrace the opportunities offered by a digital economy on a wide scale if we are to see the benefits. Any user should have the right to opt-out based on personal preferences or concerns, but without high levels of engagement the system will not deliver the potential benefits on offer.
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*Ian Birks is CEO of the AIIA
So what we have is the CEO of the Australian Information Industry Association (AIIA) telling us that the planned PCEHR should be ‘opt-out’ rather than ‘opt-in’ and being rather dismissive that any one might indeed actually opt out (preferences and concerns being cited rather than the obvious range of genuine issues such as discrimination and so on)
If you have a look at the AIIA board of directors it is clear this organisation is focussed on the ‘big end of town’ - IBM, HP, Telstra, Microsoft and so on and that their main interest is in growth of the ICT sector.
What a godsend then that the Government has decided to invest close to a $billion in e-health and related activities. Think what the money-making opportunities are!
It seems to me it might be a worry for the AIIA if the consent model keeps the whole effort going a little more slowly and so slows cashflows. That 'opt in', is unquestionably the right way to go initially, as we learn if the PCEHR is a good idea and if the benefits are real and sustainable, seems not to interest the AIIA - or am I just too cynical?
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07/12/2010.
From the editor
Michael Woodhead
In an article in the MJA last week, Professor Enrico Coiera, Director of the Centre for Health Informatics at the University of NSW made the case for a national shared record (PCEHR), but warned that building summary care records (SCR) was not the way to do it.
We reported this incorrectly as saying that Professor Coiera was not in favour of a PCEHR at all. In fact, Professor Coiera was saying that a centralised summary care record system is not justified for several reasons.
It would, for example, require centralised summary databases, the classic “top-down” approach to e-health. This is something Nicola Roxon appeared to have ruled out this week, when she told the national e-health summit that "the government is not going to build a massive data repository … we don’t believe it would deliver any additional benefits to clinicians or patients – and it creates unnecessary risks.”
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http://www.theaustralian.com.au/australian-it/leak-of-draft-e-health-document-raises-privacy-concerns/story-e6frgakx-1225966635891
PATIENTS will have limited control of their medical information, as a leaked document shows consumer access will be confined to a portal.
While Health Minister Nicola Roxon said consumers would "truly control" their personal electronic health records at her e-health forum last week, attendees did not see a draft concept of operations, showing a patient portal tacked on to a public/private providers' shared e-health record system (SEHR).
The confidential draft for the $467 million personally controlled e-health record (PCEHR) system was produced by the National E-Health Transition Authority, just before the forum.
The Australian has obtained a key system design diagram, which shows there is no mechanism for consumers to manage access by their doctors.
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ALMOST two-thirds of GPs have switched to paperless medical records, with the others maintaining a hybrid mix of paper and electronic records.
The annual GP activity report by the Australian Institute of Health and Welfare shows 98 per cent of GPs are using computers for some clinical purposes.
Eighty-five per cent are using desktop systems to print out prescriptions, while 72 per cent are receiving pathology test results online and 54 per cent are also ordering pathology tests online.
While the data -- from the Bettering the Evaluation and Care of Health (BEACH) survey of GPs -- confirms previously noted trends, the big shift to electronic medical record systems is a surprise.
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http://www.theage.com.au/victoria/states-long-wait-for-surgeons-knife-20101209-18rez.html
December 10, 2010
SCORES of Victorians waited longer than the national median waiting time for surgery last year, including for heart, lung and brain procedures, new figures show.
In many cases, Victorians also waited longer than a year to go under the knife during the past financial year, depending on where they lived and what type of surgery they were waiting for.
The online pharmacy data, released by the state government, revealed that Victorians waited 21 times the national median time for vascular surgery.
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http://www.sciencedaily.com/releases/2010/12/101203091457.htm
ScienceDaily (Dec. 6, 2010) — Could information technology and data mining techniques be used to improve the diagnosis and treatment of depression? That's the question scientists in Australia hope to have answered in a forthcoming issue of the International Journal of Functional Informatics and Personalised Medicine.
Maja Hadzic, Fedja Hadzic and Tharam Dillon of the Digital Ecosystems and Business Intelligence Institute, at Curtin University of Technology, in Perth, explain how depression is rapidly emerging as one of the major health problems now facing society. They add that the World Health Organization has predicted that depression will be the world's leading cause of disability by 2020. "We are noticing a spread of a depression epidemic throughout the whole world," the team says. "Usually, an epidemic, such as a swine flu epidemic, has a pathogen associated with it. But, there is no pathogen involved with the depression epidemic." Indeed, the precise causes of depression have not yet been identified although it is clear that many different biological, psychological and social factors are at play in its development.
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Smartphone and tablet applications to fuel the trend of consumers taking healthcare into their own hands, according to the analyst firm
Mobile devices such as smartphones and tablets will drive a market that allows consumers to take healthcare in their own hands, according to analyst firm, Ovum.
The comment comes off the back of the Government’s demonstration of an e-health record iPhone application last week. The app allows patients to control their health records and gives doctors expedited access to those records.
There are numerous health apps available on Apple’s iTunes App Store.
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http://www.zdnet.com.au/medicare-launches-online-health-directory-339307859.htm
By Josh Taylor, ZDNet.com.au on December 9th, 2010
update Australian healthcare providers with health identifiers will now be able to gain information on other providers via an online directory, Medicare has announced today.
An individual health identifier is a 16-digit number that Medicare allocated to every resident of Australia following the passing of legislation in July this year. The government intends to use this number as the foundation for the construction of a personally controlled e-health record. Healthcare providers and institutions were also issued with a number.
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12 disparate patient management systems to be replaced
Acquisition has brought growth benefits but added an IT headache for Australian private health provider Healthe Care.
Faced with the challenge of trying to unite multiple facilities to create a more efficient business and provide improved customer service, the provider is now rolling out a common patient management system across 12 hospitals.
So far the system is in two of its hospitals with a view to completion in 2011. The move follows Definity Consulting conducting an IT architecture survey in 2009.
One of Definity's recommendations was to streamline the delivery of IT services by outsourcing IT support under a single managed services agreement.
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http://www.cio.com.au/article/370955/victoria_extends_rural_telehealth_trial/
Live telemetrics, high definition video conferencing to be rolled out across all 16 hospitals in Loddon Mallee area
Telehealth video conferencing and live telemetrics equipment for trauma and critical will be extended to all 16 regional Victorian hospitals administered under the Loddon Mallee Rural Health Alliance following a successful, 20-month trial across four of the units.
The initial $5.2 million trial was funded under the Federal Government’s $118.6 million Clever Networks initiative and took place from June 2008 across hospitals in Mildura, Swan Hill, Machuka and Bendigo, connected to four metropolitan hospitals in Melbourne. The trial involved the deployment of eight mobile Virtual Trauma and Critical Care Units (ViTCCU) and seven fixed units across the regional hospitals, along with software and smart vitals devices from a consortium of companies including Telstra, Cerner, KPMG and Polycom.
The units were connected by a 100 megabits per second (Mbps) link provided by Telstra, running separately to the hospitals’ existing networks in order to avoid potential congestion.
Specialists at the Melbourne sites provided advice to primary treating doctors initially for critical care patients.
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The hospital has implemented a number of electronic systems to automate and improve hospital practices
Bendigo Health is jumping on the e-health bandwagon, announcing a $100,000 upgrade of its health systems, in an effort to automate hospital practices, increase operational efficiency and patient safety levels.
The hospital, located in Victoria, has deployed a number of systems from AeroScout, including the Real Time Location System (RTLS), patient and temperature monitoring system, and staff safety technology.
The hospital’s information and communications technology manager, Phil Coppin, told Computerworld Australia, the new systems help the facility provide better clinical care, meet regulatory compliance around medications and pathology and improve staff safety to comply with occupational health and safety legislation.
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IBM Australia has kept its stranglehold on the federal Health Department, with a renegotiation of its service agreement over the next four years.
Briefing documents for the incoming Gillard government show former finance minister Lindsay Tanner gave the department approval to open discussions on a contract extension.
IBM has provided ICT services to Health since the department outsourced its IT infrastructure to the industry giant in 1999.
The current contract, estimated at $126.6 million, is due to expire in June 2011. The agreement has twice been renegotiated -- in December 2003 and again in December 2008.
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http://www.cdc.gov/eid/content/16/12/1960.htm
Sandra J. Carlson, Craig B. Dalton, David N. Durrheim, and John Fejsa
Author affiliations: Hunter Medical Research Institute, Wallsend, New South Wales, Australia (S.J. Carlson, C.B. Dalton, D.N. Durrheim); Hunter New England Population Health, Newcastle, New South Wales, Australia (S.J. Carlson, C.B. Dalton, D.N. Durrheim, J. Fejsa); and Newcastle University, Newcastle (C.B. Dalton, D.N. Durrheim)
Suggested citation for this article
Abstract
We compared the accuracy of online data obtained from the Flutracking surveillance system during pandemic (H1N1) 2009 in Australia with data from other influenza surveillance systems. Flutracking accurately identified peak influenza activity timing and community influenza-like illness activity and was significantly less biased by treatment-seeking behavior and laboratory testing protocols than other systems.
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SA developer PowerHealth Solutions has been engaged to help the Irish Health Service Executive reform health services through the introduction of patient-level costing and activity-based funding. www.powerhealthsolutions.com
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http://www.racgp.org.au/ehealth/ecommunications
One of the steps in the process of developing the foundations to enable a national e-health system is to ensure the benefits of e-health can be realised as soon as possible. To achieve this, the National E-Health Transition Authority (NEHTA) is focusing their efforts on e-communications in practice by implementing and delivering early e-health services for the most commonly exchanged health information.1
NEHTA was established by the Australian, State and Territory governments to develop better ways of electronically collecting and securely exchanging health information.The College works with NEHTA, where our directions are aligned, and to ensure that general practice needs are reflected in NEHTA’s work.
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http://www.e-health-insider.com/news/6488/isoft_sale_%27one_of_the_options%27
08 Dec 2010
ISoft is planning to sell its iSoft Business Solutions subsidiary, according to the Sunday Times.
The newspaper claims that the software firm - which is in negotiations with its bankers over debts of AUS $240m (£152m) - is planning to offload the subsidiary, which designs finance systems for the NHS.
The paper reports that iSoft Business Solutions has offices in Dublin and Belfast and made a loss of £634,000 last year despite sales of £3.5m. It says iSoft has yet to find a buyer.
ISoft declined to comment on the sale. However, during its annual general meeting last week, chairman Robert Moran said: “We have previously announced that we are considering a limited number of asset sales or business closures in order to reduce debt and improve cash flow. This process continues.”
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A PROPOSAL for every new home built after January 1 to be connected with fibre cable for the National Broadband Network has been abandoned.
This came after the Gillard government admitted the magnitude of the task meant the plan would have to be phased in.
Federal Communications Minister Stephen Conroy said yesterday new houses in developments of fewer than 100 premises - common in cities and towns - would be connected to Telstra's copper network or wireless services with slower internet speeds, and only later would be hooked up to the NBN.
The government wants the NBN Co to prioritise the delivery of the super-fast fibre in larger property projects.
An estimated 1.9 million new premises will be constructed while the $36 billion NBN is being rolled out.
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http://www.infonews.co.nz/news.cfm?id=61613
By Pharmacy Guild of New Zealand
From today, all Auckland pharmacies will have access to important patient information through TestSafe. A metro Auckland DHB initiative, TestSafe is a data repository that enables community pharmacists to access only relevant and pre-defined patient information through a secure health intranet connection.
TestSafe is part of a regional initiative by the three Auckland DHBs (Auckland, Counties Manukau and Waitemata) to improve relevant information sharing among community and hospital health care providers. It brings together results from DHB facilities, community laboratories and now community pharmacies.
At this stage, community pharmacists will have access to selected laboratory results and dispensing information for their patients. It is anticipated TestSafe will eventually include relevant information from hospital discharge notes that will give the pharmacist a more complete picture of the patient’s condition and treatment plan.
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http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10692593
5:30 AM Tuesday Dec 7, 2010
Sensitive medical records of hundreds of thousands of Aucklanders are in the hands of community pharmacists after they joined a computer network in a move expected to improve healthcare delivery.
By last year 1.1 million Auckland patients had diagnostic test results and drug dispensing reports stored on the TestSafe system run by the region's district health boards.
Set up in 2006 to improve healthcare safety and efficiency by sharing community laboratory test results among public hospital clinicians, TestSafe has been expanded by including some radiology and various other test results, plus drug dispensing reports.
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http://www.stuff.co.nz/technology/4425154/DHBs-start-electronic-patient-records
TOM PULLAR-STRECKER - The Dominion Post
Last updated 05:00 06/12/2010
Hospitals patients in the lower North Island should find doctors and nurses have better information on their prior care following a project that has been kicked off by the region's six district health boards to integrate health information technology systems.
Capital & Coast ICT director Stuart Wakefield is heading the project, which he said was a step on the way to creating a national system of online electronic health records by 2014.
Mr Wakefield said hospital staff would be able to get a single view of patient information that was stored on multiple software systems in the region through a portal they could access with one logon and password. "Most of this information is able to be shared today – it is just not particularly efficient the way that we do it."
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GOOGLE has made its most direct challenge to Microsoft with the launch of its new operating system that aims to defeat Windows.
It is a battle for the future of personal computing.
Users of computers running Chrome OS will be able to get online much more quickly as the system will turn on instantly and automatically log on to the web within seconds.
In the first public demonstration of the software in San Francisco, Google showed that a user can be surfing the net within 60 seconds of switching on their computer.
Chrome also brings users a step closer to being able to store all photographs, music and emails online rather than on a hard drive. The files would be kept in the "cloud" on the internet and be accessed from any device with an internet connection.
Eric Schmidt, Google chief executive, said: "Cloud computing will define computing as we know it."
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Enjoy!
David.
Q. Is there a better chance to get erectile function back after robotic prostatectomy? Is there an advantage with robotic prostatectomy over an open prostatectomy in terms of getting erectile function back?
A. Yes. Compared to open surgery to remove the prostate, there is an advantage to robotic surgery. With robotic surgery, the doctor can see the nerves more clearly. That means there is a better chance to keep those nerves safe from lasting harm. For a man who had good sexual function before surgery, it will still take a few months to a few years to return to sexual activity. There is no guarantee that you will have recovery of sexual function like you had before surgery. However, you will have a better opportunity for recovery by following Dr. Patel's treatment plan.
Q. What does the doctor have to do to "save" the nerves?
A. The main goal is to remove all of the cancer if possible. If the doctor is able to save the nerves, he has to peel, stretch and move the nerves away from around the prostate gland. So during the surgery the nerves are disturbed and do have some traumA. It takes time for nerves to heal and work again after they go through the trauma of surgery.
Q. How long will it be until I can have normal sexual activity after a robotic prostatectomy?
A. Better recovery of sexual function is expected after this method of surgery when the patient continues to follow the treatment plan. A person's age and past sexual function are the other key factors that affect recovery. With the robotic method, it generally takes a few months to a few years for a man to regain ability similar to before surgery. A few men will be able to have an erection 1 month after surgery. The norm is longer.
Q. If a man is taking blood pressure medication or is overweight, can that affect his ability to have an erection after a robotic prostatectomy?
A. Yes. Some blood pressure medications and some other medicines can have that effect. A man who is physically active and close to his normal body weight has a better chance of regaining a level of function like before surgery.
Q. If a person has trouble getting an erection before surgery, will it still be an issue afterward?
A. Yes it can be. If a man is having an issue before surgery then he is more at risk of not being able to get an erection after surgery. That is why it is very important to follow your ED treatment plan.
Q. What do you mean when you say follow Dr. Patel's protocol?
A. Some patients who have robotic prostatectomy at OSUMC are placed on a special treatment plan for ED. Dr. Patel designed a treatment plan (protocol) for ED for his patients. If you are on this protocol it means that you will take oral medicine and use a vacuum erection device (VED). This rehabilitation begins 4 - 5 weeks after the catheter is removed.
The medicines that are used are cheap cialis, viagra or Levitra. These are taken 2 - 3 times a week at bedtime to improve blood flow. The blood flow is to help the traumatized nerves and tissues to recover. The medicines continue until the man regains his usual level of sexual function.
The VED is used each day. For best results VED is done in two sessions each day. This helps the penis to keep its usual size and ability to have an erection during the healing process. The VED sessions continue until the man regains his usual level of sexual function. On this protocol the person continues to return for follow-up appointments and evaluation. If the person is not able to get erections on his own, then the treatment plan may be changed. Other therapies may be added to the treatment such as MUSE or injection therapy.
Q. What is injection therapy and what does it do?
A. This is the process of injecting a mixture of medicines into the side of the penis. This is done to produce an erection satisfactory for sexual activity. The man does the injection himself just before he wants an erection. Two clinic appointments are needed to start this therapy.
Q. Is this process of injection therapy painful?
A. Is it NOT painful, but you feel something. In fact, most men state that it was not as bad as they thought it would be, and that it was beneficial for them.
Q. What is MUSE and what does it do?
A. MUSE is a medicated pellet. It is placed in the urinary opening with a disposable applicator. A man would use this before he wants an erection for sexual activity.
Q. How many appointments do I need to follow-up for this ED protocol?
A. That depends on the person's needs and motivation to regain a level of sexual function like before surgery. Usually there are follow up visits every 3 or 6 months for the first year. Communication via phone or e-mail is available for questions between visits or for a person who live out-of-state.
Q. Can someone else come along to appointments?
A. We encourage a man to bring his spouse or partner to appointments.
Q. Having ED is embarrassing to me. How does The James deal with that issue?
A. That is a good question. Each person is treated with respect, in confidence and professionally. Each person's individual situation is important. Our goal is to help him through this process to feel comfortable again.
I can't fully remember how I became a vampire. I have a vague recollection of getting rejected by some girl I had a crush on at work. That night I proceeded to get right fucked up by drinking some Colt 45s while inhaling a gasoline soaked rag. At one point I was lying on the floor, approaching my slumber when one of the greatest vampire movies of all time came on TV: Dracula 2000.
I don't know if it was Dracula's charisma or Geri Ryan's breasts, but I was a man possessed. I got in my car and somehow drove to the closest cemetery. I don't fully remember what happened next. I met someone or something. I was given a choice and I chose a life I now regret.
I am here to warn all you goth kids and borderline emo/goth kids, that being a vampire isn't nearly as great as Dracula 2000 made it out to be. So please heed these words:
1) Vampires don’t have nearly as much sex as you’d think. You can get a boner, but it’s super hard to maintain. You have to drink a lot of blood to keep it up and logistically it's just too difficult to fuck at the same time, all the while keeping the girl under your vampire spell.
2) If you're in the right frame of mind and you have a large male before you, you might manage to rub the odd one out while continually feasting. But you can do that now without the aid of special vampire powers and without having a big fat guy attached to your mouth.
3) I've tried Viagra and order cialis and they are of no help, nor is coke. Trust me everyone, this is super lame.
4) Well yeah, now I can get all the pussy I want with my super seductive vampire powers, but all I can do is go down on the girl before I drink her blood. Most of my buddy vampires think I’m a lesbian or something.
5) Drinking blood isn’t nearly as euphoric as they make it seem in the movies. Most vampires overact or overplay the whole drinking blood thing because they haven’t had sex in centuries and it makes them regret becoming a vampire just a tiny bit less.
6) Women vampires are worse than all human women on their periods put together. They’re prone to massive mood swings and are emotional as shit and so damn cranky when they’re hungry. And if you ever meet a vampire who was turned while she was on her period as a human, just turn into a bat and get the fuck out of there.
7) For some reason chick vampires are just as high maintenance as they were in human form, taking as many as 2 hours to get ready to go out and eat. They’re eternally the same age and don’t have to worry about wrinkles, but are still super insecure. They also hate being called chicks. LOL!
I could go on forever but the sun is upon me and I must return to my coffin for my daily rest.
If you're still not convinced, keep in mind that my coffin is an old porta potty. Goth and emo douches, you have been warned.
