Pulse+IT Blog

Déjà vu all over again

Remember 2012? No, neither do I, but this time five years ago the biggest deal in eHealth was the imminent launch of a fab new national IT project that heralded the dawn of a new age in healthcare. This system would link health professionals together, improve the flow of information throughout the entire health system, save the government eleventy billion dollars in needlessly duplicated lab tests, and better yet, allow patients to see their own health information for the very first time.

And it was just four years ago that the minister for health at the time, Tanya Plibersek, fronted up at the HIC conference and announced a massive $8 million grant to NEHTA to get pathology and diagnostic imaging onto the system. This was greeted as big news by Pulse+IT and by everyone else. Test results were going to be the deal breaker, the game changer, the thing that would put the PC in the PCEHR.

Big week for health IT bigwigs

It was a big week for Australian Digital Health Agency CEO Tim Kelsey, who in addition to being able to announce a pretty big deal for the My Health Record – Sullivan Nicolaides Pathology is about to start uploading pathology reports to the system for people living in northern Queensland – also had the thrill of attending Senate Estimates hearings in Canberra, where we imagine his bum went numb while he waited interminable hours for some plodders to get through questioning the ever-patient John Skerritt from the TGA about the state of medicinal cannabis.

Professor Skerritt's interrogation took hours on Monday night, but it could have been worse for Mr Kelsey and his gang of EGMs from the agency, who apparently also turned up in Canberra but were not called upon to answer anything. Senate Estimates enthusiasts are still recovering from the oddities of years gone past, such as former senator John Madigan's fixation on the TGA's appalling attitude towards the deleterious effects on citizens of Lyme disease and wind turbine sickness, one of which doesn't exist in Australia and one of which doesn't exist at all.

Late in the evening Mr Kelsey was able to get one very short word in edgeways before health technology proceedings were wrapped up after about 25 minutes. Most of the interest in the brief session was on the claim in the federal budget that the government expects to save $305 million over four years through “health system efficiencies” and fewer duplicated lab tests due to the MyHR. Senator Lisa Singh remained unconvinced by Paul Madden and Bettina Konti's arguments about this, and to be honest, so do we.

Also having a big week were the CIOs of our most populous states, with Zoran Bolevich from NSW, Andrew Saunders from Victoria and Richard Ashby from Queensland fronting up for a chat with Mr Kelsey at a conference in Sydney on Wednesday. It was nice to hear from Dr Bolevich about the relatively smooth progress of the Cerner Millennium roll-out, which in NSW is known as eMR2. As those who have been around the traps a bit will remember, the first attempt at rolling out Cerner was a bit of a disaster, not helped by a very long and detailed report on the failings of the system by Jon Patrick in 2011 which received wall to wall coverage in the local newspapers.

We vultures in the media pounced on that report ravenously, but some who have stuck around later learned that the system wasn't as bad as it was made out to be. We hope Dr Ashby in Brisbane has also recovered from his travails over the last few weeks, when the local newspapers smelled blood about the hiccup with the Cerner ieMR up there. The Courier Mail had four reporters covering the story at one stage, which seems a bit much for a yarn about slow log-ins to a computer system. However, Dr Ashby should thank his lucky stars that he doesn't have to put up with what Bill Le Blanc does in Adelaide. That's pure torture, that is.

As Cerner is rolled out in NSW and Queensland, and has a good foothold in Victoria, it was interesting to read a report from US analysts KLAS this week that showed that while Cerner and Epic are dominant in the US market, with Allscripts, McKesson and Meditech not far behind, outside of the US it is InterSystems that has racked up the most wins in the last couple of years.

Here in Australia, InterSystems has a reasonable footprint in Victoria with TrakCare and is set to roll out at the smashing new Bendigo Hospital later in the year. It has also been implemented at Macquarie University Hospital in Sydney, where it displaced a best-of-breed conglomeration. All eyes next week will be on the Northern Territory, where an announcement on its big core clinical systems renewal program is imminent.

Our money is on InterSystems. We hear that of the four shortlisted vendors, Telstra Health was the first casualty, with Allscripts and Epic asked to park their bids while TrakCare was put through its paces. The dotted line is about to be signed in what is the biggest ICT contract in Territory history so we trust they'll get it right. Otherwise it could be the NT News going after NT Health CIO Stephen Moo, and considering its predilection for crocodile yarns, that could be truly terrifying.

Our poll last week asked: Do you think the healthcare workforce is adequately prepared for the digital health revolution? A brave few said yes, but an overwhelming 92 per cent said no.

We have to get better at the cyber

As noted cybersecurity expert Donald Trump warned just last year, we all have to do better on the cyber, and we certainly have to get tough on cyber and cyber warfare. As the self-described father of a 10-year-old who is unbelievable at the cyber, Mr Trump accepted that it “might be hardly doable” because the security aspect of cyber is very, very tough, but nonetheless we do have to try.

Quite right, Donald. Just last week we were discussing in these very pages the global fright caused by the WannaCry scare, and we asked the local health IT industry if it thought our hospitals were prepared for a large-scale ransomware attack.

Big boys don't WannaCry

As the dust began to settle on last week's interesting federal budget and we began to digest the interesting news that the My Health Record will become opt-out earlier than expected, news suddenly started to erupt about the WannaCry ransomware attack, which caused a flurry of outraged squawking when it seemed to knock a whole lot of UK hospitals offline.

As soon as the news broke out so did the heroes of the day, the masked infosec avengers who took to social media to tut-tut about how terrible it was that the NHS still seemed to run on Windows XP. It later emerged that it doesn't really and that the affected hospitals seemed to have their business continuity plans in order, but that didn't stop every alleged expert from demanding that hospitals update all their software to Windows 10 overnight, just like they do on their home PC.

Opt-out is now the only option

Either there's a big announcement of some sort in next week's budget or the Department of Health just moves at a glacial pace, but this week saw the belated release of the evaluation report on the opt-out trials of the My Health Record held last year, six months after it was submitted.

Unsurprisingly, the evaluation found in favour of opt-out, as did the vast majority of consumers and healthcare providers surveyed. Many consumers also thought it should be compulsory for providers to participate in the system – which would cause a mass revolt from doctors and is never going to happen – and they seemed to display far less concern over privacy and security than the privacy crowd pontificates about.

Sorry Bill, but this was a Labor health budget

It must be utterly galling to Labor leader Bill Shorten and his team that after four years of the government attacking public spending as part of its 'debt and deficit disaster' narrative, the polls prove so dire for the Coalition that they promptly turn around and steal all of Labor's more popular health and education policies.

After dumping $2.2 billion worth of unlegislated budget repair measures from the disastrous 2014 health budget, on Tuesday night the government then went full socialist, newly embracing Medicare, splashing out on medicines and even returning ownership to the state government of a hospital it “saved” in a significant electorate leading up to the 2007 election. Give us Mercy indeed.

Telehealth pilots begin the move to business class

The memorable phrase first coined by Adelaide GP Tori Wade that telehealth in Australia has “more pilots than Qantas” got a nice little workout at the Australian Telehealth Conference (ATC2017) in Melbourne this week, but while it may be in vogue for a little bit longer, the consensus seems to be that we are beginning to see the move from itty bitty pilot projects to embedding telehealth as business as usual in the provision of healthcare.

That may not necessarily be true as yet in primary care, predominantly due to the funding model, but it is certainly beginning to be seen in secondary care, particularly for outpatients services for rural patients and but also in emergency care in regional areas where specialists are hard to come by. All states and territories are now taking telehealth seriously, even the small ones, and a lot of the thanks for that is due to a mixture of political enthusiasm for sexy tech but also the hard yards that a number of clinical groups in a number of states have done over the years.

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