The relaunch of the UK’s patient.co.uk website, with plans to offer a series of apps, including one that will allow patients to make medical appointments on their smartphones – according to eHealth Insider – has got me thinking about the lack of anything that compares even remotely in Australia.

Patient.co.uk describes what it is offering as “Trusted Medical Information and Support”, and I couldn’t help but compare the link it offers to a Guardian story which quotes a report by US scientists on the dangers of sugar to one our Medical Observer ran just a day or so ago, in which some of our scientists condemn their US counterparts’ call for measures to curb sugar consumption.

The expert opinion in Australia, it seems, is that tooth decay is “the only disease proven to be related to excess frequent sugar consumption” and “sugar is just another form of over-consumed calories … no more metabolically deadly than starch or fat calories”.

That’s not the opinion of Dr Robert H. Lustig, one of the authors of the US report, which was also picked up by Time magazine. Lustig’s 2009 lecture, “Sugar: The Bitter Truth” [below], sparked a New York Times piece by health writer Gary Taubes posing the rhetorical question, Is Sugar Toxic?

When you have such diversity of opinion, it seems to me that patients need all the trusted information they can get.

If I were writing on health, I wouldn’t be prepared to just present two sets of opposing opinions. I’d want to know why doctors in Australia seem to be taking a more benign view of the medical implications of sugar, and the potential for its role in commerce to influence research and government policies.

Having read  UK nutrition authority, John Yudkin’s 70s book, Pure, White and Deadly, which linked sugar to type 2 diabetes  and elevated triglycerides, I’m not so sure that Lustig isn’t on to something.

In an environment in which television seems to be constantly switching from food programs to radical weight loss programs, it would seem to me to be a worthy topic for, say, Q&A.

Anyone with the slightest idea of large-scale software development would have been staggered by the surpassing silliness contained in yesterday’s piece in the Medical Observer, in which “ehealth consultant” David More trots out his analysis of the problem which has brought the desktop software side of the PCEHR project to a temporary halt.

According to More, it would have been terribly easy to avoid trouble: “Had they planned properly they would have had a consistent data model for all the sites and they would have noted that there was this issue [at the outset],” he said. “It just reflects incompetence, frankly. If they knew what they were doing they would have addressed these problems before they started.”

The only illumination one could gain from that is that More simply had no idea of the cause of the problem, no inkling of a solution, and insufficient humility to admit that in truth, he’s not much of an ehealth expert. It really is long past time lazy journalists scratched him out of their sadly tattered contact books.

The very idea that you can anticipate every problem before you begin a hugely complex IT project and construct a data model that uncovers every deviation is ludicrous.

The very nature of software development is that it’s a process of getting things right. The recipe is largely the following: Develop, test, identify bugs, fix them. Endlessly repeat.

What happened in this particular case is that the wave site developments were a dynamic operation, with the developers constantly engaging with NEHTA staff to identify problems and challenges. As issues arose, NEHTA made changes to the specifications to address them. In parallel with that, the specifications were being run through further quality assurance testing.

As the work proceeded through 2011, NEHTA kept the sites informed about the changes that were being implemented to resolve their concerns, allowing them to integrate them in the work.

What when wrong, essentially, was that in October, the change log was finalised. The list of issues NEHTA provided at that point of things that would be fixed in November omitted a number of new items that had been included in response to feedback or problems, or new issues that were still to be identified during testing in November.

That meant developers working on the October change log would have had to upgrade their software later to reflect the changed specifications.

NEHTA decided that rather than have that happen, it was better to call a halt, have everyone build to the November specifications, and deploy the software once.

The main impact is that they deploy later than expected. Rather than February it’s more likely to be May. Of course this will be worked out between NEHTA and the sites, but it’s the sort of rational reaction coming from sites, rather than the sort of hysteria coming from some commentators.

Anyone who’s actually involved in doing ehealth, as opposed to just talking about how others should do it, will know that you have feedback loops on early versions of specs to later ones. They will also know that keeping a complete change log is essential. That is how you address this sort of issue before the project starts. Data models have nothing to do with it.

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It’s already been something of an annus horribilis for CSC, but the final days of 2011 have brought even worse news for the company’s shareholders, with the announcement that it might be forced to write off the $1.5 billion value of a disputed contract with the NHS.

Over at eHealth Insider, there’s a summary of the year’s events that details the serial catastrophe for the company, starting in February with its missing yet another deadline for the delivery of its Lorenzo patient records system. That accelerated in May, with a scatching assessment of the CSC contracts by the National Audit Office which essentially delcared that the original vision of an integrated care records service would never be delivered; the £2.7 billion already spent had not delivered value for money and the remaining £4.3 billion looked like being an equally fruitless investment. In August, the public accounts committee suggested that doing a new deal with CSC was, umm, not altogether sensible.

Even that failed to quash occasional outbreaks of optimism, along the lines that a memorandum of understanding in May indicated that revised terms might not be a complete disaster for CSC, and suggestions it might be more expensive to drop CSC than to patch something together, somehow.

Now in a filing to the US Securities and Exchange Commission, the company reveals that itwas recently informed that the memorandum of understanding and the proposed amendment would not be approved by the U.K. government, and that it expected further discussions in January over proposals that would make modifications to the scope and value of the contract,which “differ materially” from those in the memorandum of understanding.

Until those negotiations are completed, CSC said it could not estimate the amount it would have to write down in the third quarter of its 2012 fiscal year, but the total could be equal to its net investment in the project, which was $1.5 billion as of Nov. 30. It is possible  that the company will take on additional costs as well.

Last month, CSC revealed a Securities and Exchange Commission investigation of its accounting in the Nordic region had been recently expanded to Australia. It posted a $2.88 billion loss for its fiscal second quarter on a large write-down that reflected the investigation, declines in its stock price – off 50 per cent this year – and challenges in its business.

This briefing will focus on Pre and Post Retirement, Tax Saving and Wealth Building Strategies. In addition, we have a special guest speaker to present on travelling through Western Australia:

The agenda for the evening will include:

Market Update
We have seen great volatility in markets of late and so to help understand why and what to expect in the future a brief market update will be provided.

Building Wealth and Saving Tax Pre and Post Retirement – Clive Staple, State Sales Manager of AXA Australia.
Clive Staple of AXA will provide insight on saving tax while building wealth in your pre and post retirement stage of life. The presentation is designed to give insight of how you can increase retirement savings without impacting on your cash flow. In addition, tips on how preparation for retirement can give you a greater income and/or benefits in retirement.

Tips for Travelling Western Australia – Pip O’Connell from Postcards WA.
Special guest speaker, Pip O’Connell, presenter for Postcards WA and the face of Rottnest Island, will be presenting some great holiday destinations in WA to give you ideas for your next holiday adventure. Flight Centre will also be presenting some special deals exclusive to those who attend.

Date: Monday 29th August
Time: 6.30pm start (light refreshments provided)
6.30pm – 6.45pm Market Update
6.45pm – 7.30pm Clive Staple
7.30pm – 7.40pm Break
7.40pm – 8.15pm Pip O’Connell

Venue: Bluewater Grill, 56 Duncraig Road Applecross 6153
RSVP: Please RSVP by Monday 22^ndAugust if you are attending or not attending.

Many have asked if a friend or family member can come to these events and in response to your request we would like you to invite those that you feel would enjoy and benefit from this seminar.

Please email info@profusionplanning.com.au or call (08) 9316 3050 to register your place. If you have a friend or colleague that would also like to attend please enquire when registering your place.