Medical histories on internet

By:Anna Caldwell and David Earley

AN alarming privacy breach by one of Queensland's biggest pathology labs has splashed patient medical histories over the internet.

The names, contact numbers and private details of at least 100 patients, and potentially hundreds more, were plastered on the website of Brisbane-based Sullivan Nicolaides.

The breach has cast serious doubt on the safety of electronic patient record systems, and angry patients were last night demanding answers.

The Courier-Mail yesterday viewed 102 patients' details before it alerted the lab to the security breach, which has been blamed on a processing error.

Kay Faulkner from Brisbane was devastated to hear the details of her recently deceased husband were so easily accessible.

"This is disgusting," she said.

"Dishonest people can easily misuse the details of someone who has died so for me this is a serious breach."

Rick and Cindy Gore from north Queensland said the security lapse was "completely unacceptable".

"We were never given a password or website to access so there is no reason for this information to be online - it is not like we could log on and check it ourselves."

The use of electronic records in medicine has jumped as software systems become more sophisticated. But the failure at Sullivan Nicolaides has shown the potential for online records to fall into the wrong hands.

All patients affected by the breach were referred to Sullivan Nicolaides by their GPs for the management of warfarin doses, a blood-thinning drug.

Most were from Queensland and northern NSW, with the files dating back to 2007 and 2006.

The records detail relevant medical history, current medications, as well as patient's next of kin.

Sullivan Nicolaides CEO Michael Harrison initially refused to reveal how many patients records were violated and accused The Courier-Mail of "acting like terrorists".

He later apologised and said 103 files were breached, although The Courier-Mail believes it could be many more.

Mr Harrison said the company had taken the security problem "very seriously", and within an hour of being alerted, the records were removed.

He said patients' details were only meant to have been accessed by authorised doctors and staff.

"Honestly, we are flummoxed (by the breach)," he said.

Despite the violation, Mr Harrison said e-health was the future of medicine. "I don't want this to be adverse publicity for e-heath because electronic health records are crucial to ensuring patients get the right care."

Chair of the Privacy and Security Forum and board director of the Health Informatics Society of Australia Peter Croll said that although private medical records should never be publicly available, there was nothing in the law requiring a breach to be reported.

"Obviously it's totally inappropriate," Mr Croll said.

Qld launches 'Tiny Tom' telepaediatric healthcare

By: Alex Serpo

The University of Queensland's Centre for Online Health (COH) and Royal Children's Hospital in Brisbane have launched a joint paediatric service for remote communities using an in-house developed videoconferencing system called "Tiny Tom".

COH deputy director, Dr Anthony Smith said the new service linked clinicians at Mackay Base Hospital by video with the neonatal intensive care unit at The Townsville Hospital.

"What this service essentially does is act as a bridge — it connects the babies and the parents ... but it also connects the Mackay clinicians with the specialists in Townsville, improving collaboration and communication in the care of babies," he told ZDNet.com.au.

Excellent close-up video images of baby "Rihanna" are shared real-time via video-conference.

COH researcher Nigel Armfield said the system was constructed from various components including a Sony video-conferencing unit, a battery, UPS and some remote management equipment.

"In hardware terms it's not rocket science, it's off-the-shelf things that have been put together to make a useful product," Armfield said. Tiny Tom includes remote control systems for diagnostics and testing, along with switching the system on and off.

Dr Smith said that together with the additional access to specialists, Tiny Tom also provides economic benefits. "In two of our sites we were able to demonstrate savings of about AU$600,000", he said.

Mining giant Xstrata has provided AU$335,000 over the past three years to the COH via the Royal Children's Hospital Foundation for the project.

The funding has allowed the COH to extend its "telepaediatric" service into a number of regional areas, including Townsville and Mackay for neonatal care; Gympie and Nambour Hospital for general paediatric support; and Mount Isa and Emerald Hospitals for specialist paediatric support.

Along with the expansion of the service, Dr Smith predicted telemedicine would become increasingly commonplace.

"I think our aim here is to do this type of work in a systematic way. Our focus is on developing these models which we suspect will not only be used for other paediatric centres, but also for other areas [including] geriatrics," he said.

Launch of the "Tiny Tom" mobile telepaediatric system in the Neonatal Intensive Care Unit at Townsville Hospital (27 June, 2008).

State seeking e-health damages

By: Sean Parnell

THE Queensland Government has raised the stakes in its legal row with developer TrakHealth and is seeking almost $100 million in compensation for a failed e-health contract.

When Queensland Health scrapped a $30 million hospital software contract with TrakHealth three years ago, the company took Supreme Court action to recoup $18 million in losses and unspecified damages.

TrakHealth, which was to supply a patient administration system and a clinical information system, accused the government of compromising the project and damaging its reputation.

"Queensland Health's behaviour was unreasonable and unconscionable," a TrakHealth spokesman argued at the time, as the company sought work elsewhere.

In its defence, Queensland Health involved US-based InterSystems, which now owns TrakHealth, and database pioneer Terry Ragon, filing reams of documents in the Brisbane Supreme Court to demand $21.5 million in compensation.

Queensland Health argued that TrakHealth misrepresented itself and its product, MedTrak, ahead of an order being placed in 2003, while Mr Ragon, the founder of US-based InterSystems, failed to intervene to limit Queensland Health's losses.

Earlier this month, Queensland Health amended its defence and counterclaim to seek $98.2 million in compensation to cover the increased cost of delivering such software in the current market.

Queensland Health estimates it would cost $132 million to have a similar system installed now, not to mention the cost of keeping other systems going in the meantime, well beyond the $33.81 million involved in the original deal.

"To put Queensland Health in the position in which it would have been had the plaintiff performed its obligations under the contract, it would be necessary to procure from a different software supplier a product equivalent to that which the plaintiff contracted to deliver," court documents state.

A spokesman for TrakHealth, InterSystems and Mr Ragon declined to comment.

It is understood they have until today to file documents in the Supreme Court to respond to Queensland Health's amended defence and counterclaim.

A Queensland Health spokesman said e-health remained pivotal to the future of sustainable healthcare and the department had committed to a massive information and communications technology strategy.

"This strategy aims to create a consolidated holistic view of patient care by enabling ICT investment over the next four to seven years," the spokesman said.

"It will ensure Queensland is moving towards supporting the electronic collection, transmission, safe storage and access of patient and clinical information that supports the improvement of patient care."

Queensland Health's priorities in the strategy are discharge summaries, results reporting, order entries, electronic clinical notes, statewide scheduling and comprehensive medication management.

The department, which plans to introduce new technology systems and capability "where necessary", has engaged alliance partners EDS (for enterprise architecture) and PricewaterhouseCoopers (for change and program management) to assist with this stage of the strategy.

In the Australian market, TrakHealth is most active in Victoria, but it also has contracts in Asia, New Zealand and Britain.

Govt woes don't trouble TrakHealth

By: Ben Woodhead

MEDICAL software heavyweight InterSystems is eying big ticket hospital software projects in South Australia and Western Australia as it moves to capitalise on its acquisition last year of local firm TrakHealth.

But the company has acknowledged that the spectre of TrakHealth's legal battle with the Queensland Department of Health in relation to a failed patient and clinical systems initiative still looms over its meetings with other public sector organisations.

"Obviously everyone asks questions about it but moving on what's important is that we have a good product," TrakHealth chief operating officer Christine Chapman said.

Ms Chapman declined to confirm if the company was holding settlement discussions with Queensland Health over the hospital software project, which collapsed acrimoniously in late 2006.

TrakHealth subsequently said it would pursue $18.2 million in damages from Queensland Health but the health agency promptly fired back with a $21.9 million counterclaim against TrakHealth.

The matter is expected to go to trial in the Queensland Supreme Court this year if the two parties are unable to reach a settlement.

Ms Chapman said that InterSystems is now hiring software developers locally as it works to build up TrakHealth's development team following the acquisition in May last year.

The company has added six new developers over the past 12 months and has hired a full time recruiter to look for additional staff.

The hiring comes as InterSystems works to sell TrakHealth's TrakCare product into its international customer base, which includes a number of organisations with large healthcare operations such as the US Department of Veterans Affairs.

The company is also looking at public sector opportunities in Australia including Western Australia's $335 million eHealthWA project and a South Australia Department of Health patient software initiative worth tens of millions of dollars.

Ms Chapman said that InterSystems, a long time partner of TrakHealth, had acquired the company because of the strengths of its intellectual property.

She poured cold water on suggestions that the purchase was prompted by TrakHealth's weak financial position, which included losses worth more than $40 million over the last four years.

She also said that past financial performances did not reflect on the future sales prospects for the TrakCare product.

"Healthcare is a bigger company business," Mr Chapman said."(TrakHealth) was a small company and it was not able to bid on a lot of the bigger contracts."