The need for best practice standards in electronic governance of patient medical records to facilitate innovation

Background : Optimising the use of electronic data offers many opportunities to health services, particularly in rural and remote areas. These include reducing the effect of distance on access to clinical information and sharing information where there are multiple service providers for a single patient. The increasing compilation of large electronic databases of patient information and the ease with which electronic information can be transferred has raised concerns about the privacy and confidentiality of such records.
Aims & rationale/Objectives : This review aims to identify legal and ethical standards for areas of electronic governance where a lack of clarity may currently impede innovation in health service delivery.
Methods : This paper describes best practices for storage and transfer of electronic patient data based on an examination of Australian legislative requirements and a review of a number of current models. This will firstly allow us to identify basic legal requirements of electronic governance as well as areas of ambiguity not fully addressed by legislation. An examination of current models will suggest recommendations for best practice in areas lacking sufficient legal guidance.
Principal findings : We have identified the following four areas of importance, and shall discuss relevant details:
1) Patients' right of ownership to electronic patient records. 2) Custodial issues with data stored in centralised health care institutions 3) IT Security, including hierarchical level access, data encryption, data transfer standards and physical security 4) Software applications usage.
Discussion : Our examination of several models of best practice for the transfer of electronic patient data, both in Australia and internationally, identifies and clarifies many unresolved issues of electronic governance. This paper will also inform future policy in this area.
Implications : Clarification will facilitate the future development of beneficial technology-based innovations by rural health services.
Presentation type : Poster

Best books of the year

This article identifies favourite publications from 2003 selected by the following writers: Tony Birch, Neal Blewett, Ian Britain, Alison Broinowski, Paul Brunton, Inga Clendinnen, Martin Duwell, Morag Fraser, Andrea Goldsmith, Kerryn Goldsworthy, Peter Goldsworthy, Bridget Griffen-Foley, Clive James, Gail Jones, Nicholas Jose, Brian McFarlane, Brenda Niall, Ros Pesman, Peter Porter, Peter Steele, Chris Wallace-Crabbe, and Robyn Williams.

Who receives the most help? The most needy or those with the best marketers? (Editorial)

Presents an editorial overview of the tussle between who is best at the receiving end- the needy or the best marketer. Adoption of traditional marketing strategies to counter challenges from charitable organizations; Development of the entire market into focusing of the product's social responsibility; Shifting of practice from effective marketing to simply generating more resources from donors; Provision of a neutral field by evaluating charities on what they do rather than their marketing strategy.

Changing journalism for the likely present

Media convergence and newsroom integration have become industry buzzwords as the ideas spread through newsrooms around the world. In November 2007 Fairfax Media in Australia introduced the newsroom of the future model, as its flagship newspapers moved into a purpose-built newsroom in Sydney. News Ltd, the country’s next biggest media group, is also embracing multi-media forms of reporting. What are the implications of this development for journalism? This paper examines changes in the practice of journalism in Australia and around the world. It attempts to answer the question: How does the practice of journalism need to change to prepare not for the future, but for the likely present.

Early in November 2007 The Sydney Morning Herald, the Australian Financial Review and the Sun-Herald moved into a new building dubbed the ‘newsroom of the future’ at One Darling Island Road in Sydney’s Darling Harbour precinct. Phil McLean, at the time Fairfax Media’s group executive editor and the man in charge of the move, said three quarters of the entire process involved getting people to ‘think differently’ – that is, to modify their mindset so they could work with multi-media.

The new newsroom symbolised the culmination of a series of major changes at Fairfax. In August 2006 the traditional newspaper company, John Fairfax Ltd, changed its name to Fairfax Media to reflect its multi-platform future. In March 2007 Fairfax launched Australia’s first online-only daily publication in Queensland, brisbanetimes.com.au. In May 2007 Fairfax completed its merger with Rural Press to become the biggest media company in Australasia, with annual revenues of about $2.5 billion and market capitalisation of about $7 billion. Two months later Fairfax got even bigger when it acquired at least one radio station in all Australian capital cities plus television studios when it bought Southern Cross Broadcasting. Fairfax is expected to bid for one of the two digital television licences made available by the changes to media ownership laws promulgated in May 2007.

The aim in moving Fairfax from a print to a multi-platform company was to reach as large an audience as possible. ‘We have a total readership in print of over 4 million per day and online of over 5 million per month’, CEO David Kirk said at the time of the Rural Press merger. ‘Our brand of quality, independent, balanced journalism will serve and support more communities than ever’ (Kirk 2007). A few months earlier chairman Ron Walker had written in the company’s annual report: ‘Fairfax is evolving into a truly digital media company’ (2006: 2). Within five years Fairfax would be a significantly bigger Internet company that distributed its content ‘over more media’, Kirk wrote in the same report (2006: 5).

Kirk developed a three-pronged strategy. The first part of the strategy involved the need to ‘defend and grow our newspaper publishing businesses’ – that is, to consolidate and develop the existing newspapers, whose circulations were holding steady during the week and improving on Saturdays. The second part involved plans to ‘accelerate the revenue and earnings of our digital business’. The third part was ‘to build a digital media company for the twenty-first century’ (Fairfax annual report 2006: 3). In June 2007 Kirk appointed Tim Mannes project leader for the Fairfax Media-Rural Press integration. ‘The purpose of the integration work is to bring the two companies together and build what is truly Australasia’s leading media company’, Mannes wrote in a memo to all staff on 7 June 2007. ‘It’s vital throughout this process that we maintain continuity and momentum and protect the interests and needs of our customers’ (2007: 1).

The business model appears attractive. Kirk said Fairfax’s increased scale and diversity would mean it relied less on classified lineage advertising in major metropolitan newspapers, so it could ‘rapidly develop the best online response to changing media advertising patterns’. In the two years to 2006, online’s contribution to Fairfax’s profits had grown from 1 per cent to 14 per cent with ‘much more to come’. Online’s share of the national advertising pie had grown from 2 per cent in 2002 to 10 per cent in 2006 (Beverley 2007: 6) and had jumped to 14 per cent in 2007. Analysts said they were happy with Fairfax’s move ‘from a newspaper company to a media company’ and banks such as Credit Suisse upgraded their profits forecast (AFR 19 September 2007: 37).

Planning for the move to One Darling Island Road in Sydney’s Darling Harbour started early in 2006. Fairfax CEO David Kirk took personal responsibility. He and chairman Ron Walker visited integrated sites around the world, along with a group of editorial bosses. The favoured site was The Daily Telegraph in London, which embraced convergence from June 2006. CEO Murdoch McLennan hired a consultant from Ifra, Dr Dietmar Schantin, director of the Newsplex, to facilitate the move from mono-media to multi-media at The Telegraph. Schantin said change was less about new technologies and more about altering the established mindset. The focus must be on the audience: ‘The whole idea of audience orientation seems to be quite new for some newspapers. In the past it was more “we know what is good for our readers and so we distribute the content”.’ Newspapers were a service industry whose service was information and news, he said. Newspapers had to learn to ‘serve’ its audience with the things the audience wanted to know, on any appropriate platform. ‘We start from the audience. What they want is a very important point. That does not mean that a newspaper should just do what the audience wants. The newspaper [also] needs to stick
to its core values’ (Luft 2006, Coleman 2007: 5).

Tom Curley, CEO of the world’s biggest newsgathering organisation, Associated Press, gave an important speech to the annual Knight-Bagehot dinner in New York in November 2007. The news industry had come to a fork in the road and needed to take bold steps to secure the audiences and funding to support journalism’s essential role for both the economy and democracy, he said. Otherwise the media industry would find itself ‘on an ugly path to obscurity’. He similarly emphasised the need to serve the audience: ‘Our focus must be on becoming the very best at filling people’s 24-hour news needs. That’s a huge shift from the we-know-best, gatekeeper thinking. Sourcing, fact gathering, researching, storytelling, editing [and] packaging aren’t going away’
(Curley 2007).

Kirk appointed a ‘newsroom of the future’ committee from editorial (reporters and photographers), IT and HR. The committee initiated a study tour by editorial executives of leading integrated and converged newsrooms in the UK and the US in April 2007. This became known as the ‘Tier 1’ course and involved the editor and deputy editor of The Age, and the news editor of The Sydney Morning Herald. The Herald’s editor went to the annual conference of the World Association of Newspapers in Cape Town, South Africa in June 2007 because that event featured convergence as one of its main themes (PANPA Bulletin June 2007: 6). The committee designed a two-day awareness course for senior editorial managers, known as ‘Tier 2’, that was run in Sydney in July 2007. The ‘Tier 3’ program for all editorial staff started in August 2007 and this ‘multi-media awareness program’ continued until the end of the year. A ‘Tier 4’ course for about 10 per cent of editorial staff (about 40 journalists), where they learned a range of multi-media skills, was scheduled to start after the Beijing Olympics in 2008. The author facilitated most of the Tier 2 and 3 courses.

The Tier 3 and 4 courses have profound implications for journalism education in Australia because they represent the start of major changes to how journalists work in Australia. The process reflects evolution in newsroom practices around the world. In November 2006 Ifra, the international media research company, asked newspaper executives worldwide about their priorities for 2007. The survey attracted 240 responses from 43 countries and results appeared in January 2007. Integration, editorial convergence and cross-media strategies attracted the most attention. Four in five executives rated it one of their top priorities, and half made it their main priority in terms of allocating ‘significant’ funds (Ifra 2007: 34). Ifra repeated the survey in November 2007 and published the results in January 2008. Expanding web strategies was first on the list for 2008, just ahead of editorial convergence strategies, which topped the list in 2007. Improving video and audio content jumped 14 places, and mobile phone strategies leapt 9 places between 2007 and 2008 to be near the top of the list (Ifra 2008: 8).

Including the siblings of youth substance abusers in a parent-focused intervention : a pilot test of the best plus program

Substance use is common among young people and can escalate into significant problems for affected individuals and their families. Family responses can influence the course of youth substance use and its consequences for family members, including parents and siblings. Family-level interventions developed to date have neglected the important role that siblings can play. This article describes a pilot test of an intervention designed to assist parents and siblings affected by youth substance use and related problems. The BEST Plus intervention consisting of professionally-led, multifamily groups sequenced over eight sessions is described with reference to the intended therapeutic processes. Professionally observed and self-reported changes for family participants including siblings suggested that the program had a beneficial therapeutic impact. This evaluation of early impacts suggests the BEST Plus program
offers a promising means of assisting families to respond to substance use problems in young people.

Family recovery from youth substance use related problems : a pilot study of the BEST plus program

Youth substance use related problems are increasingly common, and families experience considerable stress in attempting to cope with these problems. A pilot study of 34 Australian parents from 21 families (38% sole parent families) participating in an 8-week group program, designed to assist families recover from youth substance use related problems, provided the context to explore family change processes. Participants reported a number of significant improvements over the course of the four groups that ran from late 2003 and through 2004. Regression analyses found general support for the program logic model in identifying significant associations between program-targeted parent changes and post-program improvements in stress symptoms and cohesive family behaviors. The study's limitations are noted.

Where is a corporation's "centre of main interests" in international insolvency?

The international community has long sought the appropriate means by which insolvencies involving several jurisdictions should be conducted. Central to the solution proposed is the view that jurisdictions should primarily co-operate with the proceeding underway in a company's "centre of main interests". This concept will be of increasing importance to Australia with the passing of the Cross Border Insolvency Act 2008 , which enacts domestically the provisions of the United Nations Commission on International Trade Law Model Law on Cross Border Insolvency. This article examines how this concept was intended to operate, the actual provisions of the relevant Instruments together with how it has been judicially interpreted. It will be shown that while some certainties concerning the operation of this concept have been achieved, determining this actual location remains surrounded with considerable vagueness. This article proceeds to suggest the most appropriate interpretation of this "centre of main interests" concept.

Expanding the realm of best practices in cooperative industry-based learning in information systems and information technology : an inter-institutional investigation in Australian higher education

The professional fields of information systems and information technology are drivers and enablers of the global economy. Moreover, their theoretical scope and practices are global in focus. University graduates need to develop a range of leadership, conceptual and technical capacities to work effectively in, and contribute to, the shaping of companies, business models and systems which operate in globalised settings. This paper reports a study of the operation of industry‐based learning (IBL) at three Australian universities, which employ different models and approaches, as part of a series of investigations of the needs, circumstances and perspectives of various stakeholders (program coordinator, faculty teaching staff, the students, industry mentors, and the professional body). The focus of this paper is a discussion of salient pragmatic considerations in an attempt to conceptualize what constitutes best practice in offering industry‐based learning for higher education students in the disciplines of information systems and information technology (Asia‐Pacific Journal of Cooperative Education, 9(2), 73‐80).

Best of friends

This book is a folk tale about how cats and mice came to dislike each other.

Effective farmer groups for defining best practices for sustainable agriculture

Practitioners and farmers are practical people. They are likely to be more comfortable with a process that develops monitoring tools and benchmarks for natural resource management than a process of group development and social capital formation. Yet the two are intrinsically linked. Policy makers and extension workers need to understand the link, and how to use a knowledge of social processes when designing the more concrete process of developing and implementing best practice monitoring and benchmarking with groups.

This paper reflects on the experience of establishing and working with farmer groups as they go through a process of identifying environmental issues, setting and monitoring environmental benchmarks and identifying and implementing sustainable farming practices to meet the benchmarks.