Thursday, March 30, 2017

It Is Good To See The Value Of Telemedicine Being Confirmed Over The Long Term.

This appeared last week.

UC Davis tracks 18 years of telemedicine and finds benefits beyond the bottom line

Rather than only looking at how the technology reduces costs and improves outcomes, researches focused on related time, transportation and environmental factors. 
March 23, 2017 10:58 AM

Telehealth use is growing but the question of whether the technology reduces costs and improves outcomes remains a point of contention.
Whereas the bulk of such analysis focuses on the bottom line of health plans and employers, researchers at University of California Davis instead are looking on how it impacts patients at a more basic level: transportation costs.
Spanning nearly two decades – and undoubtedly many fluctuations in gas prices and internet connectivity capabilities – the study, which was published in the online journal Value in Health, examines 18 years of UC Davis’s own clinical records from 1996 to 2013, evaluating inpatient and outpatient interactive video visits for 19,246 patients.
Typically, the patient would still visit their primary care doctor, but they would then together consult a UC Davis specialist via video. The cost savings were measured based on patient travel to a telemedicine center near their home versus traveling to UC Davis Health in Sacramento for specialty care.
Collectively, telemedicine visits saved patients nearly nine years of travel time, five million miles and $3 million in costs. Of course, on a more granular, individual level, those numbers are a little more modest: over 20 years, one person could see a cost savings of four hours of driving time, 278 miles and $156 in direct travel costs.
The study was regional, but California is a big state, and many rural areas are underserved not just by medicine but also adequate and reliable public transportation. As such, principal investigator James Marcin pointed out, the very real costs of gas, mileage and time are all measurable savings from telemedicine to patients.
“Our findings confirm the benefits of telemedicine in terms of real savings to patients and to the environment,” Marcin, who is also chief of the UC Davis Division of Pediatric Critical Care Medicine, said in a statement. “Because telemedicine is cheaper and more convenient for patients in remote areas, they are more likely to seek medical care. Many patients do not have the time or resources to access healthcare many miles from home.”
UC Davis has been using telemedicine since 1992, and now offers services spanning more than 30 clinical specialties in over 150 locations, representing 56 out of California’s 58 counties. The technology has advanced over the years, and Marcin expects to see more cost savings to the patient as more affordable, sophisticated tools are developed to allow for telemedicine visits to take place entirely within a location of the patient’s choosing. But there is a benefit to having consultations with the primary care physician present as well, the study noted, as they can receive valuable education from the remote specialist to improve their regular care with the patient.
More here:
There is another report from the same author here with a link to the article:

Telemedicine saves time, travel costs, even air quality, new study finds

March 22, 2017
While telehealth policies, technological advancements and utilization continue to grow, whether it actually reduces healthcare costs and improves outcomes is still a point of some contention. As the bulk of such analysis focuses on the bottom line of health plans and employers, researchers at University of California Davis instead are looking on how it impacts patients at a more basic level: driving costs.
Spanning across two decades – and undoubtedly many fluctuations in gas prices and internet connectivity capabilities – the study, which was published in the online journal Value in Health, examines 18 years of UC Davis’s own clinical records from 1996 to 2013, evaluating inpatient and outpatient interactive video visits for 19,246 patients. Typically, the patient would still visit their primary care doctor, but they would then together consult a UC Davis specialist via video consultation. The cost savings were measured based on patient travel to a telemedicine center near there home versus traveling to UC Davis Health in Sacramento for specialty care.
Lots more here:
All in all remote access to a tertiary centre provided locally seems to make life easier and maybe save some money. Who has seen Australian success stories? Would be great to hear about.
David.

Wednesday, March 29, 2017

An Interesting Article In The Conversation Asking Why The MyHR is Not Being Used More?

This appeared on the Conversation a few days ago.

Why aren’t more people using the My Health Record?

March 24, 2017 2.49pm AEDT
My Health Records were a big government investment, but they’re just not being used.

Authors

  1. Bronwyn Hemsley  Associate Professor in Speech Pathology, University of Newcastle
  2. Jacqueline Meredith  Research Assistant, University of Newcastle
  3. Shaun McCarthy  Director, University of Newcastle Legal Centre, University of Newcastle
The My Health Record is an online summary of personal health information that patients can share with health providers. As many as one in five Australians have a My Health Record.
But recent statistics show the My Health Record is only being used by a small percentage of consumers, and even then not to its fullest uses. So how can we get a greater return on the estimated A$1.2 billion taxpayer dollars invested in the system?

1. More health professionals need to add information

To date, approved health-care providers in the system have uploaded only about 1.7 million clinical documents, for the 4.6 million Australians who have a My Health Record. Just over one third of these clinical documents are Shared Health Summaries - listing health conditions, allergies, medications, and immunisations.
Information about health-care recipients is also added to the My Health Record from other sources – including Medicare and the Pharmaceutical Benefits Scheme, along with pharmacy medications information and hospital discharge summaries. Some health-care providers might be willing to share clinical documents, but hold concerns about privacy and may be unsure how sharing the information will improve patient care.
The shared health information in the My Health Record could help many patients recall vital health information. It could be particularly useful for those who struggle with medication management, have multiple health conditions, enter hospital frequently, or have multiple health providers.
The main purpose of the My Health Record is to improve the quality, safety and efficiency of patient care. Reducing medical errors related to the poor exchange of health information between patients and their health providers, or across multiple health providers, is a high priority.
We need more health information added into the system before it’s going to be useful for more people in supporting their health-care decisions. Patients prompting their GP or practice nurse to upload a Shared Health Summary at each visit could increase use of the system, which is designed to improve patient control over their health information.

2. We need to add more information ourselves

Many consumers with a My Health Record have only had one since June 2016 through a trial of “opt-out” sites. Lacking experience or guidance in using the My Health Record, they will not know what they can upload or why, or how to use the technology.
Currently, there are only about 80,000 “Consumer Entered Health Summaries” in the My Health Record. These summaries contain emergency contact details and very brief information on allergies and medications. There are also about 35,000 “Consumer Entered Health Notes” – similar to a health journal or diary.
Fewer than 900 people have uploaded a copy of their Advance Care Directive - a critically important document outlining a person’s wishes for future medical treatment - into the My Health Record. As it is the only national online repository for Advance Care Directives that can be accessed anywhere, more legal information websites need to prompt people to store their Advance Care Directive in the My Health Record.
Not knowing how to use computers, navigate the My Health Record, or save and upload documents will prevent many people from taking advantage of the system.

3. More people need to know how to use it

Currently, the My Health Record places high demands on reading and e-health literacy, making it difficult for many people to use. This could be a barrier for a large number of people.
People with low health literacy, people who lack engagement with digital health, people who lack access to a computer and the internet, and people with limited English literacy could struggle with these online records.
Information about the My Health Record needs to be inclusive, easier to read, and translated into many languages – and use pictures and videos – to enable everyone to use the system.

4. The people who need it most need support to use it

As many as one in five Australians have a disability. Anyone with a condition that affects their ability to explain their health history to others might need help to use the My Health Record. This includes people with dementia, stroke, traumatic brain injury, intellectual or developmental disability, autism spectrum disorder, motor neurone disease, Parkinson’s disease, and people with a wide range of social, physical, cognitive, or sensory impairments affecting communication.
People with communication difficulties have three times the risk of preventable harmful adverse events in hospital, relating to their problems communicating their needs to health providers. The My Health Record might be particularly helpful for this group, who are at risk of exclusion because of their communication impairments and low levels of digital inclusion.
While the My Health Record is set up for use by all Australians, people with communication difficulties and their families may need additional information, funding, and other supports to enable their participation. They might also need help to identify who would be their Nominated or Authorised Representative in the system.
Future enhancements of the My Health Record need to take into account the views and experiences of people with multiple health conditions who are engaging with the My Health Record. Gathering their stories of experience could lead to a greater understanding of the types of support needed for more people to use and benefit from this important e-health initiative.
You can find the original article here:
I pass this on in the hope we can start a conversation about what are the other problems with the myHR.
Comments welcome indeed hoped for!
David.

Tuesday, March 28, 2017

The AMA Points Out Some Home Truths On What Is Needed From The National Digital Health Strategy.

This appeared last week.

Don’t-give-us-high-level-give-us-down-earth-ama-says

17 Mar 2017
The proposed national digital health strategy should be a simple, straightforward list of proposed projects and their benefits, rather than a high-level strategy document, Australia’s peak doctors’ body says.
In its submission to the Australian Digital Health Agency (ADHA), the AMA says it has long advocated for a strategic plan for digital health.
But it warns that clinicians must be involved in both the development of the proposed National Digital Health Strategy (NDHS) and its implementation, saying too many e-health projects around the world have failed because they were developed without consultation with the people who had to use them.
“The AMA is aware of the long track record, both locally and internationally, of e-health projects falling over for failing to consider the social aspects of development and implementation,” the AMA says.
“If no other lessons have been learnt from Australia’s approach to e-health, clearly a ‘build it and they will come’ approach, without coalface clinical involvement, will fail.”
Clinician involvement must not stop at the ‘strategy’ level.
“There is a need for co-produced development and operational plans so providers can see where critical services are heading, over what time frame, and what this means for them,” the AMA said.
“Many doctors and other healthcare providers have a level of scepticism about high level strategy documents, preferring instead to have access to a simple, clear, prioritised and costed list of projects, with tangible products and benefits able to be understood by the non-technocrat.”
The AMA also said that the strategy should have a more balanced and complete coverage of all health practitioners’ needs, compared to the historic over-emphasis on patient-controlled health records – the My Health Record (MyHR) - and support for e-health in general practice.
“This must include specific support for medical specialists other than GPs to take up digital health, including but not limited to the MyHR,” it said.
“The NDHS should also clearly acknowledge that digital health has important and direct implications for the way health care is organised, for health financing and funding, and for existing payment models.
More here:
You can read the full submission from this link:
It is really useful to read the AMA’s summary of their seven page submission. The points made on the directional and clinician related aspects seemed pretty good to me, including their point on the rather overbalanced emphasis currently in evidence regarding the myHR. (Comments on the commercial aspects of digital health  I will leave to others).
I also note their frustration as well as the recognition of just how difficult all this all is!
David.

Monday, March 27, 2017

Weekly Australian Health IT Links – 27th March, 2017.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

A really quiet week until the Council of Australian Governments leapt in and decided we are all going to  be given a myHR. Time will tell how that works out.
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Don’t-give-us-high-level-give-us-down-earth-ama-says

17 Mar 2017
The proposed national digital health strategy should be a simple, straightforward list of proposed projects and their benefits, rather than a high-level strategy document, Australia’s peak doctors’ body says.
In its submission to the Australian Digital Health Agency (ADHA), the AMA says it has long advocated for a strategic plan for digital health.
But it warns that clinicians must be involved in both the development of the proposed National Digital Health Strategy (NDHS) and its implementation, saying too many e-health projects around the world have failed because they were developed without consultation with the people who had to use them.
“The AMA is aware of the long track record, both locally and internationally, of e-health projects falling over for failing to consider the social aspects of development and implementation,” the AMA says.
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Design Aid program to help make Diabetes finger pricking a thing of the past

We’re proud to announce that Deakin University’s non-invasive smart solution for blood glucose monitoring project will be the first recipient of our Design Aid program.
The Design Aid program is part of our mission to give underfunded digital health projects access to world class design.
The winning project is specifically looking to design and implement a state-of-the-art smartphone-based non-invasive glucose monitoring solution using terahertz technology. The project is based on years of collaboration between Australia, the United States and Canada and is about to enter the Visualisation and Prototyping phase of the project – ideally suited to our user experience design expertise in the health sector.
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Why aren’t more people using the My Health Record?

March 24, 2017 2.49pm AEDT
My Health Records were a big government investment, but they’re just not being used.

Authors

  1. Bronwyn Hemsley  Associate Professor in Speech Pathology, University of Newcastle
  2. Jacqueline Meredith  Research Assistant, University of Newcastle
  3. Shaun McCarthy  Director, University of Newcastle Legal Centre, University of Newcastle
The My Health Record is an online summary of personal health information that patients can share with health providers. As many as one in five Australians have a My Health Record.
But recent statistics show the My Health Record is only being used by a small percentage of consumers, and even then not to its fullest uses. So how can we get a greater return on the estimated A$1.2 billion taxpayer dollars invested in the system?

1. More health professionals need to add information

To date, approved health-care providers in the system have uploaded only about 1.7 million clinical documents, for the 4.6 million Australians who have a My Health Record. Just over one third of these clinical documents are Shared Health Summaries - listing health conditions, allergies, medications, and immunisations.
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Illawarra cancer network investigates HoloLens’ potential

Microsoft’s mixed-reality headset could deliver training for nurses at ISCaHN as part of a broader mobility program at the cancer network
Rohan Pearce (Computerworld) 21 March, 2017 08:40
Microsoft’s mixed-reality HoloLens headset will be used for nurse training by the Illawarra Shoalhaven Cancer and Haematology Network (ISCaHN) if a proposal currently under consideration goes ahead.
Kenneth Masters, Illawarra Shoalhaven Local Health District’s oncology information system manager, said the purchase of two headsets has already been approved by ISCaHN’s IT steering committee and directors and was just awaiting a final sign-off from finance.
The initial use for the headsets would be training for nurses in the patient care environment. The headset could allow virtual assets to be set up in a critical care environment, displaying patient information at a bedside and making that same information visible to different nurses.
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Gene therapy: What personalized medicine means for you

From CNET Magazine: What if the next pill you took were tailored to your genetic makeup? That day is almost here.
Sci-Tech
by Marguerite Reardon March 22, 2017 5:30 AM PDT @maggie_reardon
Thuy Truong thought her aching back was just a pulled muscle from working out. But then came a high fever that wouldn't go away during a visit to Vietnam. When a friend insisted Truong, 30, go to an emergency room, doctors told her the last thing she expected to hear: She had lung cancer. Back in Los Angeles, Truong learned the cancer was at stage 4 and she had about eight months to live.
"My whole world was flipped upside down," says Truong, who had been splitting her time between the San Francisco Bay Area and Asia for a new project after selling her startup. "I've been a successful entrepreneur, but I'm not married. I don't have kids yet. [The diagnosis] was devastating."
Doctors at the University of Southern California took a blood sample for genetic testing. The "liquid biopsy" was able to detect tumor cells in her blood, sparing her the risky procedure of collecting cells in her lungs.
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Contractor army wanted for Qld Health's middleware overhaul

By Allie Coyne on Mar 23, 2017 10:24AM

Getting into meaty part of big transformation.

Queensland Health has put a call out to the market for an army of IT contractors it can turn to for help with its long-running middleware overhaul.
In late 2015 the department revealed its intention to incrementally replace its massive legacy environment by implementing new plumbing between the systems.
Addressing the middleware means the agency can overhaul small pieces at a time without impacting stability of other systems and applications.
Later that year it chose Fujitsu to help it implement Orion Health's integration software into its sprawling environment.
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Opportunities for providers as seniors adopt digital healthcare

By Natasha Egan on March 24, 2017 in Technology
A majority of Australian seniors are using digital devices to manage their health, signalling a critical role for consumer-focused technologies in aged care, new report finds.
The report draws on Accenture’s 2016 survey of 7,840 consumers in seven countries – including 241 Australians aged over 65 – and their views on health and healthcare technology.
With a majority of older people reporting they use technology to manage their health at least monthly, the analysis concluded there were many opportunities for aged care providers to offer digital services to Australia’s four million seniors.
Lead author and Accenture Australia principal director – healthcare Ian Manovel said more seniors were using digital health technology than they had been expecting.
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Government cracks down on fake doctors after NSW doctor is impersonated

Sue Dunlevy, National health reporter, News Corp Australia Network
March 24, 2017
FAKE doctors will face longer jail sentences and tougher financial penalties under a crackdown agreed by state and federal ministers after a recent NSW case.
And every Australian will be given an e-health record unless they take action to opt out under a change that could have major privacy implications.
A major overhaul of the regulation of medical practitioners was agreed by state and federal ministers meeting in Melbourne on Friday.
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NSW hospital patients not told their medical records were found in public areas

20 March, 2017
NSW hospital patients have had their confidential details compromised on multiple occasions, including medical records being found in a public carpark.
Many of the most serious privacy breaches have been reported in the Central Coast Local Health District, which runs Gosford and Wyong hospitals.
In 2015, a patient's emergency assessment paperwork was discovered on the ground near Gosford Hospital.
However, the patient concerned was never informed because the Health District said there was not a "serious risk of harm".
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Patients should be able to add notes to their clinical record

20 March 2017
THE ISSUE
Patients have their own agenda for what they plan or hope to do in a consultation, but most clinical software packages don’t provide any means for them to enter this into their clinical record.
Instead, for most clinical software systems, GPs and practice nurses act as the patient’s scribe, with an attendant likelihood of errors, bias, mis-emphasis and selective recording tailored to fit with the GP’s or practice nurse’s agenda.
Sometimes the patient’s agenda or reason for consultation is not recorded at all.
The Health Engine online appointment system allows patients to add notes to their booking with their reason(s) for making the appointment, but those notes do not automatically become part of the patient’s clinical record. As with all communications with or about patients, they should.
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Govt to launch mass data-harvest on Australia's pensioners

Noel Towell
Published: March 23, 2017 - 5:16PM
The federal government is to begin the mass-harvesting of financial information on hundreds of thousands of Australian pensioners as it steps up the "automation" of the nation's welfare system.
Centrelink is to be given the power to force superannuation funds and other sources of income for retirees to hand over the details of payments made to their members.
The move is expected to save up to $38 million each year in reduced administration for Centrelink and fewer overpayments of the age pension.
The welfare reform bill that passed late on Wednesday night contained the clause empowering Centrelink to demand the information, which is expected to be in the form of data-sets, from super funds and other "income stream" providers.
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Balancing act on the right to use, access and protect data

  • Anthony Wong
  • The Australian
  • 12:00AM March 21, 2017
In today’s digital and connected economy, data has become a vital resource that, when combined, could unlock new forms of value, connect previously unseen linkages and provide insights to stimulate growth and innovation in the digital economy.
Organisations of all sizes are taking steps to exploit the competitive advantage that big data, social media and the Internet of Things offer in profiling and analysing customer buying patterns.
Data drives revenue
Facebook reportedly generates 96 per cent of its revenues through targeted advertising that leverages user data, while Google’s sophisticated search capabilities attracted advertising revenues of more than $US57 billion last year. Between them, the two companies accounted for over 70 per cent of digital advertising, creating a global duopoly.
In this data-driven world, however, it’s often the case that the people who generated the data have little or no control over what happens to it once it has been captured. Even our ability to access data relating to personal transactions in areas such as banking, telecommunications and health has become more challenging in our increasingly paperless environment.
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Angus Taylor: we’re delivering on digital projects and promises

  • Angus Taylor
  • The Australian
  • 12:00AM March 21, 2017
Earlier this month the member for Chifley, Ed Husic, published an opinion piece in this paper highlighting the purported weaknesses of the Coalition’s digital strategy. Unfortunately, the piece was a masterclass in why Labor will never truly understand how to lead.
Given that it rather conveniently forgot to address the years of underinvestment in IT and digital under Labor’s watch, it’s perhaps pertinent to look at the transformative work going on inside government to remedy the past mistakes.
As the Assistant Minister to the Prime Minister for Cities and Digital Transformation, I see every day how this government is delivering on its promises — from infrastructure development to industrial relations reform to energy security. In my own portfolio I’m proud of how the Digital Transformation Agency is delivering real reform through an unprecedented government- wide overhaul that the Labor Party didn’t bother to pursue when it had the chance.
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Digital healthcare ‒ addressing cyber security risks for medical devices in the digital age

Australia March 16 2017
Addressing cyber security threats in medical devices proactively will help mitigate the risks associated with the rise of these technologies.
Healthcare, as with most sectors, is becoming increasingly digitised in the modern age. This presents both opportunities and risks for healthcare systems ‒ in particular, the cyber security of medical devices that employ wireless technologies and software.
Recently, the Australian Therapeutic Goods Administration (TGA) and the United States Food & Drug Administration (FDA) have actively addressed this issue. The TGA had previously noted the possibility of unauthorised users gaining remote access to Hospira's Symbiq Infusion System and LifeCare PCA3 and PCA5 Infusion Pump Systems, while both regulatory bodies have turned their attention to potential vulnerabilities in implantable cardiac devices.
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Automated patient check-in for Gold Coast Health

By Australian Hospital + Healthcare Bulletin Staff
Tuesday, 21 March, 2017
Gold Coast Health has launched an automated patient check-in system across its five busiest departments at the Gold Coast University Hospital (GCUH). The check-in system is part of the Q-Flow patient optimisation framework that includes a series of kiosks that patients use to register their presence on arrival, as well as a backend patient management system that organises patient records.
Demand for Gold Coast Health’s services is only increasing, with growth in the number of total patients being seen in clinics across the city going from 699,000 in 2014–15 to 835,000 in 2015–16.
Gold Coast Health has partnered with patient flow management software specialist NEXA to integrate Q-Flow with GCUH’s core systems. The system is helping to eliminate patient queues, while capturing critical performance data from many of the hospital’s departments.
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Government pushes ahead with work on Centrelink payment system

Accenture gets lead systems integrator role on first phase of WPIT
Rohan Pearce (Computerworld) 22 March, 2017 13:31
Accenture has been chosen as the lead systems integrator for the first part of a program to overhaul Centrelink’s payment system.
Human services minister Alan Tudge said that the selection of the company as preferred tenderer for systems integrator services on the first phase of the Welfare Payment Infrastructure Transformation (WPIT) Program was still subject to commercial negotiations.
DHS is currently planning a range of WPIT-related projects including a new online user interface for welfare payments, a new payment utility to deliver payments faster, and work on designing an end-state technology solution for future phases of WPIT.
The government said in October that Capgemini and Accenture were shortlisted for the role.
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Codeine handling ‘suboptimal,’ says study

Newly published research has shown that in roughly a quarter of direct product requests for non-prescription combination analgesics containing codeine, pharmacists weren’t involved

Researchers from LaTrobe University conducted 145 covert pharmacy visits in which one of two scenarios took place, each of which involved a direct product request for Nurofen Plus.
The scenarios involved identical reasons for use, symptoms and medical history but varied previous product use: one involved a first-time user while the other had used the products regularly for the past month.
The research was undertaken between July and August 2015, well before the Pharmacy Guild’s MedsASSIST program began to roll out in March 2016. The product category is to be upscheduled to prescription-only on 1 February 2018.
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National Clinical Terminology Service: Website User Survey

Created on Monday, 20 March 2017
In October 2016, the Australian Digital Health Agency launched the National Clinical Terminology Service (NCTS) website www.healthterminologies.gov.au to provide our customers with a one-stop shop to access our terminology products, tools, applications and supporting resources. We are conducting a survey to seek your feedback on the website and to help identify future improvements to the service.
Click on the link below to start the survey. You have until Thursday 13th April 2017 to complete it. Thank you for your participation!
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National Product Catalogue Data Quality in Health Program

Created on Friday, 24 March 2017
GS1 Australia and the Australian Digital Health Agency (the Agency), in partnership with the Healthcare Industry, are continuing to implement the National Product Catalogue Data Quality Improvement Program to address healthcare industry concerns relating to data quality within the National Product Catalogue (NPC).
Key highlights include new data quality reporting passing the pilot phase of the project with reports now scheduled to be released to the Healthcare Industry by July 2017. This is a significant step forward to improved medical product data being available across healthcare systems via the National Product Catalogue.
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Digital Health in an Era of Precision Medicine — The Genome Generation

Thursday, 23 March 2017
As the Chief Medical Adviser for the Australian Digital Health Agency (the Agency), I'm privileged to have the opportunity to meet with many inspiring people – clinicians, health consumers, researchers and innovators who help us think about the way our organisation can best serve Australians to get a good deal out of our investment in digital health services and technologies. We are delivering key services at the Agency that will enable our health system to remain world-leading in its innovation and ability to support a high standard of health and well-being for our citizens. Our continued efforts to improve and expand our understanding of how our services underpin and interrelate to the broader health and care ecosystem depends upon us continually looking outwards, reflecting and learning about future directions for health and care clinical priorities, as well as focussing on striving for internal excellence in our organisation.
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Enjoy!
David.

Sunday, March 26, 2017

Is It Possible To Really Believe Anything We Hear From Government Regarding The myHR? Are They Really Ignoring Their Own Legislation?

Towards the end of 2015 modified update legislation relating to the then PCHER was passed through the Commonwealth Parliament.
This legislation was triggered in response to the earlier Royle Review of the PCEHR commissioned by Minister Dutton when the Abbott Government was elected.
Here is a link that covers the outcome of that review from late 2014 – including a link to the actual report.
The summary of the 2015 legislative outcome is as follows.

Re-booting ehealth

Australia November 16 2015

In brief

  • The uptake of eHealth records has been low, with only 10% of Australians having registered, an insufficient population for an effective national system.
  • The ‘re-booting’ of eHealth, announced by Minister Ley in May 2015, has progressed with the passing of the Health Legislation Amendment (eHealth) Bill 2015 (Cth) by both houses of Parliament.
  • The most dramatic reform is a shift from an ‘opt-in’ to an ‘opt-out’ approach to enrolment, which is likely to give the system the necessary ubiquity to drive utilisation and innovation.
  • The regulation of the use of health identifiers and health information has been strengthened as a corollary of the adoption of an ‘opt out’ model.
  • Further reform is expected, with the expansion of the role of the National eHealth Transition Authority under a new structure, to be called the Australian Commission for eHealth.
Most interesting are the comment on the recently approved opt-out approach to the myHR.
Here it is as part of a much fuller review.

“Adoption of an ‘opt out’ enrolment model

The most substantive change introduce by the Bill is an amendment to the MHR Act to allow the creation of a ‘My Health Record’ for an individual unless they opt out.
The Bill requires that a trial of the ‘opt out’ model must first be undertaken to determine whether the change in model leads to participation in the system at a level that ‘provides value to users of the system’ before the model can be adopted throughout Australia.
The requirement for a trial is an unusual approach; it suggests a degree of uncertainty as to whether the poor take up of the PCEHR is explained by personal choice or apathy. It is also unclear whether anything short of an overwhelming level of ‘opt out’ in the trial would influence the Commonwealth to abandon the rollout, given the clear imperative to establish a functioning eHealth record system in Australia.
Here is the link to the legislative review:
This was the state of play till Friday when this was sprung on the unsuspecting public.

COAG Health Council Communique - 24 March 2017

The Federal and state and territory Health Ministers met in Melbourne at the COAG Health Council to discuss a range of national health issues. The meeting was chaired by the Victorian Minister for Health, Jill Hennessy.
Page last updated: 24 March 2017
24 March 2017
The Federal and state and territory Health Ministers met in Melbourne today at the COAG Health Council to discuss a range of national health issues. The meeting was chaired by the Victorian Minister for Health, the Hon Jill Hennessy.
Health Ministers welcomed the Hon Dr Jonathan Coleman, the New Zealand Health Minister, the Australian Capital Territory Health Minister, Meegan Fitzharris MLA, the New South Wales Health Minister, the Hon Brad Hazzard, the Commonwealth Health Minister, the Hon Greg Hunt and the Hon Roger Cook, the new Health Minister from Western Australia, to their first COAG Health Council meeting.
Major items discussed by Health Ministers today included:

Health Practitioner Regulation National Law Amendment Law 2017

Advancing the clinical trial environment

Expiring National Partnership Agreements (NPAs)

Update on medical research at Commonwealth and state level

Pre-exposure prophylaxis for the prevention of HIV

Meningococcal W

Ear disease and hearing loss in Aboriginal and Torres Strait Islander children

Other items

Ministers considered a number of other important national health matters, noting ongoing cooperation and work on issues including long term health reform, digital health, childhood obesity, the implementation of the Health Care Homes program, end of life care and the medicinal cannabis.
Ministers agreed that the Fifth National Mental Health Plan will re-emphasise its objective of Suicide Prevention and will therefore become the Fifth National Mental Health and Suicide Prevention Plan.
Ministers agreed to a national opt out model for long term participation arrangements in the My Health Record system.
Here is the link to the full communique with the comments on all the earlier matters included.
Note the bold text in the last 2 lines – seemingly meant not to be noticed or commented upon! This rather reminds us all of a Department getting out the controversial / bad news late on a Friday afternoon in the hope it is not noticed!
So we are left with 2 choices – either there is a secret evaluation report of opt-out but we have not been shown it or a decision has been taken ignoring the legislated requirement of a trial and presumably a report on said trial(s).
Either way it looks to me the Health Department and the ADHA would appear to be trying to reduce our confidence in the transparency and proactivity of their communication.
We really need to see better than this for the sake of both the e-Health community and the public. Observing co-design in actuality as well as in announcements  would be really good as no-one wins if things are done like has just been done here!
David.