Here are a few I have come across the last week or so.
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General Comment
Were it not for the ongoing concern regarding ePAS this would go down as a very quiet week, perhaps reflecting that the �silly season� is coming upon us a little early.
Otherwise, again we see lots of private sector activity in the space this week.
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Nassim Khadem
Published: December 3, 2016 - 12:15AM
If there was one event in 2016 that characterised Australia's total lack of preparedness against cyber attacks, it was the epic failure of the Census on August 9.
The Australian Federal Police is still investigating who was responsible for the attack on the nation's first e-Census.
Alastair MacGibbon, special adviser to the Prime Minister on cyber security, in his review of the events surrounding the e-Census debacle, hints it may never be clear: "Attribution of malicious actors online is difficult and denial of service incidents are hard to trace."
MacGibbon's 91-page report explains in detail how one of the government's once most-respected agencies, the Australian Bureau of Statistics, together with technology giant IBM, failed miserably on Census night.
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Some GPs aren�t sure whether new digital technology is going to live up to the hype. Apparently they�re not alone.
UK health think-tank Nuffield Trust recently looked at the evidence for seven types of digital technology for primary care patients to work out whether the world is headed towards �a digital utopia� or �dystopian distraction�.
They examined the research for wearable technology, online triage, online health information, online appointment booking, telehealth, e-records and apps.
They concluded that there�s not enough evidence to show that patient technology actually improves health outcomes. There�s some evidence that some technology boosts patient engagement and their experience. But that�s about it.
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In the time since I left Ocean Informatics (the company I started with Dr Sam Heard and others in the late 1990s), I have been working with Intermountain Healthcare as well as various other openEHR vendor companies, notably DIPS (Norway) and Marand (central/south-east Europe). With both groups I am working on what could be described as the next layer of the open EHR: process.
For the whole time I have worked in health informatics (24 years and counting), clinical professionals have wanted two things: decision support, and workflow support. Both of these things properly belong to the world of clinical process. It�s taken many years to get a sufficiently good architecture of healthcare data and basic semantics in place to seriously attack process, but we�re ready to go there now. What we need now is a conceptual model of collaborative healthcare delivery during a whole care episode, extending into ongoing care and monitoring, leading to a new architecture for implementing process support.
We know a couple of crucial things at the outset: clinical process is an emergent phenomenon, not a deterministic one; and, any credible solution must be inherently adaptive, i.e. allow changes and exceptions to the clinical workflow during its execution.
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Auditor finds problematic workflow.
Follow-up appointments for discharged Adelaide patients are being automatically deleted on a daily basis due to configuration issues with South Australia's EPAS system, the state's auditor general has revealed.
The maligned $422 million EPAS platform has long been a challenge for the state due to cost overruns, usability issues, and delays. Earlier this month it suffered a nine-hour outage across three major Adelaide hospitals. In its annual report into the state health department's IT systems tabled yesterday, the SA audit office revealed user error with the system had resulted in follow-up appointments for 258 discharged patients being cancelled between June and August this year. EPAS handles appointments for things like medical imaging, pathology, medications, general care and diet.
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November 30, 2016
South Australia's troubled electronic patient records system is under fire again after it deleted treatment appointments for 258 discharged patients.
A report from the Auditor-General's Department shows 258 EPAS treatment orders were cancelled between the end of June and mid-August after the patients had been discharged from hospital.
The orders relate to follow-up appointments such as X-ray services.
South Australia's Salaried Medical Officers Association (SASMOA) president David Pope said it was a serious mishap.
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Exclusive � State Political Editor Daniel Wills, The Advertiser
November 30, 2016 9:09am
CLAIMS the State Government has deliberately delayed opening the new Royal Adelaide Hospital to �cover up� failings in a troubled-plagued computer system crucial to its operation are the basis of an $800 million-plus lawsuit its builder is preparing. The SA Health Partnership group delivering the $2.1 billion project comprises several companies, including the Hansen Yuncken Leighton Contractors Joint Venture, which is responsible for building the biggest infrastructure project in SA�s history.
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- The Australian
- 12:00AM November 30, 2016
Meredith Booth
Builders of the troubled $2.3 billion Royal Adelaide Hospital twice requested extra time to complete the project because of problems with the government�s electronic patient record system, parliament has been told.
However, South Australian Health Minister Jack Snelling yesterday insisted the flawed records system had not contributed to delays, but conceded it would not be ready to be fully rolled out in the new hospital.
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Created on Wednesday, 30 November 2016
She urged GPs to explore available tools and resources that can enhance primary care and also have a say in the development of Australia�s digital health future.
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- Updated Nov 28 2016 at 11:00 PM
Productivity Commission chairman Peter Harris has warned against rushing to implement technology-based laws to regulate customer data sharing across industries, saying the government must enact broad new standards that set the scene for long term, future-proof open access to a wealth of valuable data.
While supportive of the principals behind the parliamentary inquiry findings � that consumers and emerging businesses benefit by banks opening up access to customer data � Mr Harris said he hoped a new era of innovation and productivity gains could be ushered in by broader legislation that enshrined standards and principles of openness, rather than legislating based on current technology options, which could quickly become outdated.
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An aged care provider�s website that enables clients to customise their home care package has taken out top honours at the sector�s annual technology awards last night.
BaptistCare won both the best consumer-friendly product award and the overall winner award at the Information Technology in Aged Care (ITAC) 2016 awards in Melbourne.
The provider�s YouChoose website allows customers to design their own home care package online by tailoring their services to meet their financial and personal needs.
Launched in response to the introduction of consumer directed care, the website allows consumers to take full control of the services they receive across four areas � health, home, community and independence.
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Apple has plans to build an app to diagnose Parkinson's disease and two separate but related cardiac devices, the website MobiHealthNews has reported, based on emails exchanged between the company and the US Food and Drug Administration.
The emails were obtained by the website through a Freedom of Information request.
The correspondence showed that the FDA and Apple had discussed the way apps are reviewed before they are put up on the App Store, the software framework ResearchKit, diagnostic apps and working with the FDA in an "unregulated" way. -----
- Updated Nov 28 2016 at 3:00 PM
by Leonard Kleinman
Australia's new mandatory data breach disclosure law is attracting a lot of attention, and a lot of criticism. But it will also have some interesting � and perhaps unintended � consequences.
Most commentary has been about the fact that it will give Australia some of the strictest disclosure rules in the world. That is a good thing to some people and a bad thing to others.
Some critics, such as the recently formed group Data Governance Australia, are still trying to stop the law.
The chief executive of Data Governance Australia, Graeme Samuels, former head of the ACCC, says the legislation is "heavy-handed" and wants instead an industry voluntary code of conduct.
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Labor lashes out at Coalition for failing to pass a bill that it failed to pass in 2013.
With Australian Parliament risen for 2016 and members headed towards their summer breaks, Australia appears set to be without a working data breach notification scheme until sometime in 2018.
Parliament is currently undertaking its third attempt to pass data breach notification laws, following previous attempts being stranded in the Senate by both Labor and Coalition governments. Due to commencement provisions in the legislation, unless otherwise proclaimed, any laws passed would take effect 12 months after gaining Royal Assent, which is likely to rule out 2017 for a working notification scheme.
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Authored by Anne Duggan
ASKED what tools they have to improve the care they offer patients, few doctors or other health professionals would think of data. Better drugs, devices and tests tend to get the credit, perhaps with a nod to better work practices and clinical evidence.
But data are no longer the preserve of the statistician or academic researcher. Around the world, data are being re-imagined and democratised, and that revolution is transforming our understanding of health care in ways that we are only starting to explore. This has implications for a range of medical specialties and even individual clinicians.
Earlier this month (November 2016), the Australian Commission on Safety and Quality in Health Care published the interactive version of the Australian Atlas of Healthcare Variation, which presents a clear picture of substantial variation in health care use across 36 clinical activities, including dispensing of specific medicines, such as ADHD drugs; diagnostic and surgical procedures, such as cataract surgery and lower-back computed tomography scans; and treatments for chronic diseases, such as diabetes and asthma. -----
Expansions yet to pay off.
Telstra's ability to offset the fall in its traditional revenue streams by diversifying into a range of technology and other businesses is in doubt.
So far, Telstra's funding of 44 start-ups since 2013, the $235 million spent acquiring 18 health-related companies, the purchase of more than 30 companies by its venture-capital division, and its financing of a mining technology arm, have come to little.
Lumped together with the company's underperforming media department, the entire gamut of these operations � which include a range of technology businesses from cloud computing to app delivery specialists - contributed just $908 million, or 3.4 percent of Telstra's income, in the fiscal year ended in June.
In particular, high hopes for a $330 million investment in tech start-up Ooyala, a video platform, have all but faded, with Telstra mostly writing off in August what it called "a rapidly growing business" six months earlier. Ooyala was the biggest single investment by Telstra�s venture capital arm.
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Australia-wide, not-for-profit, community health and aged care provider Silver Chain has deployed a Microsoft Dynamics 365 cloud solution to implement a more mobile workforce that could rely on real-time patient care information.
Silver Chain needed to better support its mobile workforce and ensure governance and transparency for hospitals and GPs. The day-to-day running of Silver Chain is more than a business imperative: it is a matter of life and death for many of its patients. The answer was to configure a Microsoft Dynamics 365 solution hosted securely in an Australian Azure data centre to allow equal, real-time access by all its users.
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Will replace pagers with task management system.
Monash Health is preparing to overhaul its �inadequate� unidirectional paging infrastructure with a modern clinical task management solution to remove the risk of delayed treatment for patients.
In tender documents the public health service said its current system requires clinicians to manually respond to new tasks with a telephone call, a process that interrupts patient care.
Because the requests can be sent from multiple areas within each hospital, clinical staff can in some cases receive multiple requests for the same task. This can lead to unnecessary stress, as well as some tasks potentially being overlooked, Monash Health said.
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November 28, 2016
CLINICLOUD�s goal is to be at the centre of patient lead care by delivering thoughtfully designed tools, services and access to leading physicians through telemedicine partners. CliniCloud connects parents and patients with doctors. The CliniCloud Medical Kits allows for the closely monitoring of every fever, chill, cough, wheeze or cold. The kit contains a non-contact thermometer, digital stethoscope and Smartphone app. The company is currently expanding the availability of CliniCoud with new partnerships with Amazon Launchpad and a retailer with stores in the United States. www.clinicloud.com -----
New Zealand-based healthcare tech solutions provider Orion Health is claiming 110 million patient health records under its management worldwide as the company pursues further global expansion.
The dual Australian, New Zealand-listed Orion (NZX/ASX:OHE) has reported its interim results for the six months to the end of September this year, with operating revenues of $104 million, including a rise in recurring revenue of $46 million.
The operating loss for the six months was $17 million, a $10 million improvement from the first half of 2016, which the company says reflects a big step up in performance in North America, a levelling off of investment in research and development at $32 million, while at the same time managing overheads.
Orion chief executive Ian McCrae says the number of patient health records managed by Orion Health software is estimated to now be more than 110 million � an important metric which, he says, evidences Orion Health�s steady progress towards its goal of being the �custodian of the world�s health records�.
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1st Available Limited (�1stAvailable�) (ASX: 1ST), the Australian online health portal, has announced that the largest independent network of 440 optometrists in Australia, ProVision, has selected 1stAvailable as its partner to manage online optical appointment bookings. ProVision provides independent optometrists with comprehensive business support, enabling them to benefit from its collective resources and buying power. Following a highly successful pilot of 1stAvailable�s platform for 20 optical practices, which began in August 2016 and was completed in November 2016, ProVision has begun active promotion of 1stAvailable�s platform to its members. More than 80 ProVision practices have already signed on to use 1stAvailable�s services. These includes many businesses also using 1stAvailable�s easyRECALL value-added product. This product replaces labour intensive costly phone calls, letters and basic SMS messages used by practices today, with an automated digital service that improves patient re-booking enabling them to book an appointment online with just three clicks. -----
Enjoy!
David.