Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Friday, February 05, 2016

So The Gateway To The PCEHR Needs Some Serious Work. What A Surprise!

This turned up last week:

Troubled myGov website to be taken from Human Services and given to Digital Transformation Office for streamlining

Date January 28, 2016 - 10:30PM

Noel Towell

Reporter for The Canberra Times

The federal government's troubled myGov website is set to be taken over by the Prime Minister's pet public service project the Digital Transformation Office.
Fairfax understands that moves are already under way for the DTO to take over the management of the web portal from Commonwealth service delivery workhorse the giant Department of Human Services.
Neither agency would confirm that a takeover was under way but one government IT expert said the move would be a chance to make a real difference for the digital change project which has so far produced little more than "wishy-washy" statements.
The myGov site was launched in 2013 and is used by several million Australians as a portal to access their Centrelink, Medicare, Child Support, Department of Veteran Affairs, e-health, and DisabilityCare accounts.
But serious problems have emerged with the security and operability of the site, with users complaining of being locked out of their accounts, outages and other glitches.
A storm of criticism was aimed in mid-2015 at the myTax portal, linked to the myGov system, for its performance at the end of the 2014-2015 financial year as millions of taxpayers tried to finish their tax returns.
In July, the DTO's high-profile boss Paul Shetler warned the Australian government was failing in its online service delivery effort and that it was "not good enough in the age of Uber and Airbnb".

Now Mr Shetler, who did not respond to requests for comment for this article, looks set to get the chance to see if his agency can better do better than the much maligned DHS.
A DTO spokeswoman would not answer questions about the looming takeover but replied with a statement.
"The Digital Transformation Office is responsible for digital service delivery across government," she said.
But government IT expert Matthew Sorell of the University of Adelaide who believes myGov is "not appalling", says that running myGov would be a chance for the DTO to prove itself.
More here:
Other links that are on the same topic:
All we can think is that it is a good idea for some experts to see if they can fix things up a bit. Right now the whole thing is pretty clunky. Of course they could save themselves a whole lot of pain by just giving up on the PCEHR etc.
David.

Thursday, February 04, 2016

The Macro View - General And Health News Relevant To E-Health And Health In General.


February 4 Edition
Here is some other of the recent other news and analysis.
Clearly the big news in the last few weeks has been macroeconomic. Last week we saw Japan decide to move to negative interest rates on some deposits in an attempt to force more economic activity. The markets saw this as good - but I fear it may be the opposite!
This week - we have seen a bit of a rally in markets - so what happens next week will be interesting.
Out of the blue we now see a bun-fight on health insurance costs. Will be fun to watch.
In OZ we are sort of stuck in a rut and seeking direction. With Parliament back all may (or may not) become clearer!
Here is a summary up until the end of last week (and zilch seems to have changed since up till the time of posting):
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General Budget Issues.

Tax reform: Morrison pours cold water on adding GST to health and education

Date January 24, 2016 - 7:23PM

James Massola

Political correspondent

Treasurer Scott Morrison has pledged Australians will be "winners" when the Turnbull government finally reveals its election-year tax reform package, while effectively ruling out imposing the GST on health or education. 
In a pitch to households and the Liberals' core small business constituency, Mr Morrison said the government would seek a strong mandate for tax reforms that are likely to include changes which reduce personal and business tax rates to drive economic growth.
And in a sign the federal government will attempt to limit the scope of direct compensation paid to households arising from any tax changes, as recommended in modelling leaked to Fairfax Media last year, Mr Morrison pointed out the carbon tax compensation package put in place by Labor had been kept by the Coalition, despite the repeal of the tax, and therefore a "lag compensation" was already in the system.
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  • Jan 24 2016 at 8:19 PM
  • Updated Jan 24 2016 at 8:19 PM

Australia can't tax its way to surplus, Scott Morrison says

Scott Morrison has said Australia should aim for a "desirable" surplus. Andrew Meares
by Primrose Riordan
Treasurer Scott Morrison has warned against aiming for a surplus when spending is higher than a quarter of GDP, saying higher taxes is not a good way to fix the budget.
The Treasurer also said the government needed to get a firmer grip on new expenditure such as spends on infrastructure and security.
"We have to work harder on curtailing the new expenditure because ... there's been spends on infrastructure, increased security requirements, things like this – we have to get that under control," he told Sky News on Sunday.
The most recent budget update revealed the federal budget deficit has blown out by $26 billion over four years since May and the forecast return to balance has been pushed out by at least another year, to 2020-21 at the earliest.
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Tax reform: Economists urge Treasurer Scott Morrison to 'have guts'

By business reporter David Taylor
Posted yesterday at 4:36pm
The Commonwealth Treasurer may be talking about keeping the tax debate open, but economists are calling on Scott Morrison to show some policy "guts" and get real about tax reform.
For a government undertaking a once-in-a-generation economic balancing act, tax reform is a daunting but necessary task.
However complicated it becomes, the Treasurer has it boiled down to just one catch phrase.
"How is the tax system actually stopping people who are actually out there backing themselves, achieving the goals they want to achieve?" Treasurer Scott Morrison said on Sky News yesterday.
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Morrison builds case for GST reform

Scott Morrison has foreshadowed a likely ambitious election-year contest over the GST with his declaration that only a tax package with a major GST reform can deliver the government’s goal of a growth agenda with serious income tax relief.
Setting the benchmarks for the year, the Treasurer said yesterday he wanted a “strong mandate” at the election for a tax reform agenda. He said it was a “fantasy” to think increasing taxes on multinationals or other measures short of a GST package would deliver meaningful income tax and company tax cuts.
Interviewed on Sky News’s Australian Agenda program yesterday, Morrison gave the firmest sign so far that the Turnbull government will seek re-election on an ambitious agenda designed to lay the foundations for a long-run Coalition government.
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Treasury secretary John Fraser: Australia has a spending and a revenue problem

Date January 29, 2016 - 8:59AM

Gareth Hutchens

PM denies triple-A credit rating at risk

Malcolm Turnbull denies Australia's credit rating is at risk from debt, telling 3AW's Neil Mitchell rating agencies had already given the government's fiscal strategy "big ticks". Courtesy ABC News 24.
Treasury secretary John Fraser says it has been getting harder to forecast budget deficits and surpluses, and aggregates like GDP growth, as the global economy becomes more integrated.
He has also challenged the claim by Treasurer Scott Morrison that Australia does not have a revenue problem, saying successive falls in tax receipts have been the "main driver" of every budget downgrade since 2014.
Speaking publicly for the first time in 2016, Mr Fraser has set out the budgetary problems facing the Turnbull government this election year.
  • Jan 28 2016 at 5:27 PM
  • Updated Jan 28 2016 at 9:14 PM

Morrison already sweating MYEFO trade forecast

Australia's terms of trade look to be falling faster than the government forecast in its budget update just six weeks ago, raising the spectre of multi-billion dollar write-downs in projected revenue that would make it even harder for Treasurer Scott Morrison to balance the budget.
Lower prices for iron ore, coal and liquefied natural gas accelerated a five-year-long plunge in the terms of trade in the December quarter.  
The measure of Australia's export income, which is a crucial driver of the budget, is now about half its 2011 peak and at a decade-low. The terms of trade fell between 4.5 per cent and 5.2 per cent last quarter, according to estimates by four analysts based on Australian Bureau of Statistics trade data out on Thursday.
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Australia’s AAA credit rating not at risk says Scott Morrison

  • The Australian
  • January 29, 2016 12:58PM

Rosie Lewis

Scott Morrison says Australia’s prized AAA credit rating is not at risk, as he backed Treasury secretary John Fraser’s call to rein in government spending.
The nation’s top economic adviser last night warned the Turnbull government its credit rating would be in jeopardy unless urgent efforts were made to cut spending, raising the spectre of a federal interest bill of more than $2 billion a month within a decade.
In a landmark speech to the Sydney Institute, Mr Fraser sounded the alarm about Australia’s chronic fiscal malaise, arguing that weaker-than-expected revenues, falling commodity prices and forecasting errors were no excuse for not taking tough decisions about the nation’s budget deficit.
He called for further cuts to the government’s ballooning welfare bill and for spending promises to be offset with new savings. He also signalled that federal government spending of more than 25 per cent of national income was unacceptable.
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Business Day Economic Survey: budget outlook bleak but housing market will have soft landing

Date January 30, 2016 - 1:32AM

Gareth Hutchens and Peter Martin

BusinessDay survey points to major concern over China

The results of the annual BusinessDay financial survey paints a gloomy outlook with startling responses around China's reporting of growth rates.
Treasurer Scott Morrison faces a bleak economic outlook framing his first budget in May with leading economists warning of weakening growth and stagnant wages through the rest of 2016.
More than two dozen economists from leading banks and universities have warned that Australia will face below-trend economic growth this year, a further collapse in mining investment, and a lacklustre 12 months on the sharemarket.
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Health Budget Issues.

Cancer survivors slam Federal Government pathology cuts

January 26, 2016 12:00am
Chad Van Estrop Moorabbin Kingston Leader
CANCER survivors say Federal Government plans to slash pathology funding will force the needy to choose between the crucial testing and comfortable living.
Government plans to slash bulk-billing incentive payments to pathologies — providing services such as pap smears and blood tests — from July saving $650 million over four years.
Ormond resident Jan Armstrong said an intense round of pathology in 2012, after her breast cancer diagnosis, uncovered kidney cancer.
“If I didn’t have those tests the kidney cancer wouldn’t have been found. It would have killed me,” she said. “I’d hate to see someone else go undiagnosed because of funding changes.”
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Hospital performance getting worse and now facing budgetary 'black hole', says AMA

Date January 28, 2016 - 1:31AM

Harriet Alexander

Health Reporter

The federal government is under pressure to reform taxes following a report card on public hospitals that shows the most urgent patients are waiting longer at the emergency departments, bed ratios are deteriorating and elective surgery waiting times are static.
The Australian Medical Association is using its annual report on the performance of public hospitals to call for an overhaul of health funding, which faces slower growth from July next year when new funding arrangements come into effect.
AMA president Brian Owler said hospitals would be insufficiently funded to meet the rising demand from 2017, when the states and territories were facing a "black hole".
A Treasury analysis found $57 billion would be removed from the health system over 10 years.
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Public hospitals face funding crisis warns AMA president Brian Owler

  • AAP
  • January 28, 2016 10:18AM
Australia’s already overstressed public hospitals are facing a funding crisis, doctors warn.
The Australian Medical Association says its latest hospitals report card points to an imminent crisis due to federal funding cuts.
“Things will get much worse in coming years unless the Commonwealth reverses its drastic cuts from recent budgets,” AMA president Professor Brian Owler said.
“The states and territories are facing a public hospital funding `black hole’ from 2017 when growth in federal funding slows to a trickle.” The report found 68 per cent of emergency department patients classified as urgent were seen within the recommended 30 minutes, while bed number ratios had deteriorated.
Elective surgery waiting times and treatment targets are largely unchanged.
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Public hospitals to be ‘biggest financial challenge’ faced by state governments

Just 68% of emergency department patients classified as urgent were seen within 30 minutes, a report from the Australian Medical Association says
As of next year public hospital funding will become the biggest financial challenge faced by state and territory governments, a report from the peak organisation representing doctors the Australian Medical Association, warns.
The annual assessment of the country’s public hospital system, launched by the association’s president Professor Brian Owler on Thursday, found many hospitals failed to meet key performance benchmarks for emergency department waiting and treatment times in 2014-15.
Only 68% of emergency department patients classified as urgent were seen within half an hour, a reduction of 12% from the previous year and well short of a performance target of 80%, the report found.
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28 Jan 2016 - 4:34pm

Funding crisis for public hospitals: AMA

The AMA is calling for the federal government to fix health funding in the next budget, saying Australia's public hospitals are facing a crisis.
Source:  AAP
28 Jan 2016 - 7:56 AM  UPDATED YESTERDAY 4:34 PM
Australia's already over-burdened public hospitals are facing an imminent funding crisis, doctors warn, as debate continues over increasing the GST.
"The states and territories are facing a public hospital funding `black hole' from 2017 when growth in federal funding slows to a trickle," said AMA president Professor Brian Owler.
"If we want people living their full life expectancy, if we want to see people living longer, being healthier out there in the community, we have to resource our healthcare system."
The AMA's latest public hospitals report has found that overall, performances were "virtually stagnant and even declining in key areas" despite improvements in previous years.
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MEDIA RELEASE
Friday, 29 January 2016

Wise budget should ensure health and wealth

As the Turnbull Government talks of the importance of innovation to all sectors of the economy, it is time to ask what of innovation in healthcare?
Released today, the Consumer’s Health Forum submission to the Federal Budget provides ideas on where we need to centre the debate: investments in prevention, primary health care, new ways of keeping pressure off hospitals and infrastructure that will drive a truly people-centred health system.   
Instead of short-range strategies that see cuts in health as a federal debt-reduction strategy, we need a long-term health plan that looks at how we distribute and get better value out of our existing health dollar, as well as where we need to make wise investments in health as a nation, the Consumers Health Forum says.   
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Health Insurance Issues.

  • Jan 29 2016 at 5:27 PM
  • Updated Jan 29 2016 at 5:27 PM

Turnbull government urges health funds to reduce premium increases

by Ben Potter
Health Minister Sussan Ley is urging private health funds to pare back premium increases in the $19 billion sector amid a pitched election year battle over health spending.
The federal health department emailed the funds on Friday asking them to resubmit claims for premium increases of about 6 per cent to take effect on April 1.
"The fact that they have come back and asked for a resubmission at this late stage makes the intention very clear," said Rachel David, chief executive of Private Healthcare Australia, the funds' lobby.
"They are seeking a discount on behalf of the consumer and we as an organisation understand that."
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Ley blocks health fund rises

Andrew Tillett
January 30, 2016, 12:45 am
The Turnbull Government is trying to minimise an election-year backlash from health fund members by ordering insurers en masse to scale back their requests for premium increases.
In an unprecedented move, Health Minister Sussan Ley yesterday told all 35 funds to resubmit their applications for premium rises — some of which would have been three times the inflation rate.
But the decision to reject all of the funds’ proposed increases risks opening a new front in her war with medical stakeholders after already getting doctors and pathologists offside.
WA’s main fund HBF criticised Ms Ley for her blanket approach, warning that forcing insurers to absorb rising health costs was unsustainable.
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Fee hikes crackdown on health insurers

  • The Australian
  • January 30, 2016 12:00AM

Sean Parnell

Private health funds have been ordered to open their books and justify their bid to increase premiums, in what the insurance industry last night described as an unprecedented departure from regulatory process.
In an effort to secure a better deal for members, Health Minister Sussan Ley yesterday wrote to insurers formally requesting they either seek a lesser premium increase or provide the financial statements to prove it was necessary to pass on higher costs.
Ms Ley’s intervention comes only a week before health funds have traditionally been notified of the outcome of the application process. Premiums normally increase on April 1.
Annual premium increases of about 6 per cent have prompted many members to claw back their level of cover to reduce costs, inevitably leading to an increase in complaints. Regulators and some industry figures fear the premium increases are unsustainable and last year convinced the government to consider major reforms to prevent members dumping their cover altogether and flocking to the public system.
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Sussan Ley orders private health insurers to justify their premium increases

Date January 30, 2016 - 9:37AM

Adam Gartrell

National Political Correspondent

The Turnbull government has ordered private health insurers to justify their planned premium increases in an effort to secure a better deal for consumers.
In what's being billed as an unprecedented intervention in the normal regulatory process, Health Minister Sussan Ley has written to all private insurers asking for "additional information" regarding possible premium increases this year.
"I have held increasing concerns the current process used to assess and approve premium increases does not allow government a rigorous assessment of an insurer's full financial position," Ms Ley said in a statement on Saturday.
The federal government holds a significant stake in the private health sector by providing about $6 billion in rebates every year, Ms Ley says.
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Health insurers defend premium increases

  • AAP
  • January 30, 2016 1:49PM
Private health insurers are warning the Turnbull government there are no short-term fixes towards achieving affordable healthcare.
Private Healthcare Australia, which represents the insurance industry, also defended premium increases, saying insurers are working to keep them as low as possible.
The comments from the group's chief executive, Dr Rachel David, came in response to an announcement by Health Minister Sussan Ley that she was stepping in to demand insurers justify their increase requests.
Ms Ley has asked all providers to resubmit an application for a lower premium increase or to provide evidence of extenuating circumstances.
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Pharmacy Issues.

Pharmacy under review

29 January, 2016 Chris Brooker 
The Federal government’s controversial Review of Pharmacy Remuneration and Regulation has kicked off.
A number of industry sources have told Pharmacy News the review panel has commenced preliminary consultations with industry stakeholders.
A spokesperson for the Department of Health confirmed that the review "has commenced, including initial stakeholder meetings".
"The Review Panel is committed to consulting broadly to gain an extensive view of the pharmacy sector in Australia and the factors contributing to patient health outcomes and the quality use of medicines," the spoesperson said in a statement.
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Health is also clearly still under review as far as its budget is concerned with still a few reviews underway and some changes in key strategic directions. Lots to keep up with here with all the various pre-budget kites being flown! Enjoy.
David.

Wednesday, February 03, 2016

How Sure Are You This Sort Of Stuff Will Not Start Happening As The Usage Of The PCEHR Rises?

This appeared in the UK last week:

'State snooping' fears as civil servants are handed new power to examine detail in every sick note given out by GPs

·         Government can view data in sick notes and only the name will be hidden

·         GPs say it's snooping because before the data was completely anonymised

·         Civil servants say the new power will help them deal with work sickness  

A new power allowing civil servants to see the detail in all sick notes handed out by GPs has been branded 'state snooping' today.
Critics fear that now the Department for Work and Pensions have access to the data from next month it will be used to name and shame surgeries who issue the most 'fit notes'.
Data on the number of people GPs signed off as 'unfit' or 'maybe fit' used to be completely anonymised.
Now it will include their gender, health problem, location and how long they are off sick for.
GPs will need to inform patients their data is being taken, but cannot withhold information unless their patient has a good reason to object.
Family Doctor Association chairman Dr Peter Swinyard said: 'I think that is state snooping.
'Although I am sure some civil servant thought it was a terrific idea somewhere, I am not entirely sure I agree. I don't know if patients understand that when I write a fit note, some bureaucrat is going to be able to have a look at it.'
GP and data sharing campaigner Dr Neil Bhatia said he was 'not sure why' practice-level data was required, 'other than to compare practices, create league tables, name and shame'.
The data will also say what type of health condition the person has and the location of where the note was issued.
More here:
If people allow all this PCEHR nonsense to proceed - see just what my happen with the DoH having vast fun mining all the data they are collecting.
You can bet this is the sort of stuff they have in mind. I am sure I am going to opt-out of this nonsense before it gets to cause humongous trouble.
If you trust your detailed health information to the Government you deserve all they then do with it!
David.

Tuesday, February 02, 2016

We Now Have The Law And Regulations For The Australian Digital Health Agency. Some Interesting Points.

This appeared late last week.

Public Governance, Performance and Accountability (Establishing the Australian Digital Health Agency) Rule 2016

- F2016L00070
Rules/Other as made
This rule establishes a corporate Commonwealth entity under section 87 of the Public Governance, Performance and Accountability Act 2013 to be named the Australian Digital Health Agency. Provides functions, governance arrangements, reporting requirements and transitional provisions to transfer assets and liabilities from the National E-Health Transition Authority Ltd.
Administered by: Finance
Made
28 Jan 2016
Registered
29 Jan 2016
Date of Ceasing
To be ceased 01 Apr 2026
Reason for Ceasing
Here is the link:
Most of the terms look to me to be pretty routine. What I was interested in was the input to the Board of Clinical and Technical advice. (There are also similar committees for Jurisdictional, Security and Privacy and Consumer issues.)
From the explanatory memorandum we read:
Item 45 Functions of Clinical and Technical Advisory Committee
This item outlines the functions of the Clinical and Technical Advisory Committee.
The functions of the Clinical and Technical Advisory Committee are:

·         providing advice on the efficient and effective delivery of clinical care through the use of digital health, which may include a range of digital health systems and solutions;

·         providing advice to the Board about the architectural integration of digital health systems (including the integration of digital health systems and solutions to ensure their interoperability);

·         making recommendations to the Board in relation to priorities for investment in, and development and implementation of, national digital health systems;

·         providing advice to the Board on changes (which may include improvements) to the design of digital health systems to improve the useability and usefulness of digital health systems for clinicians and health consumers; and

·         providing advice to the Board on proposed improvements to digital health systems to improve their usability for clinicians and users of the systems, including health consumers.
From the regulations we read the following:

Division 2—Clinical and Technical Advisory Committee

             (1)  The Clinical and Technical Advisory Committee consists of a Board member (other than the Board Chair) and up to 10 other members.
             (2)  The Board member must be:
                     (a)  a Board member with the skills, experience or knowledge mentioned in paragraph 19(3)(a); or
                     (b)  if there is no such Board member—a Board member nominated by the Board.
             (3)  A person is not eligible to be appointed as a member of the Clinical and Technical Advisory Committee unless the person is:
                     (a)  a medical practitioner with specialist registration; or
                     (b)  a registered pathologist; or
                     (c)  a medical practitioner with specialist registration in diagnostic imaging; or
                     (d)  a registered nurse practitioner; or
                     (e)  a registered nurse; or
                      (f)  a registered allied health practitioner; or
                     (g)  a registered pharmacist; or
                     (h)  a registered dental practitioner; or
                      (i)  a Chief Information Officer (however called) of a public hospital; or
                      (j)  a Chief Information Officer (however called) of a private hospital; or
                     (k)  a Chief Information Officer (however called) of a non‑health related entity; or
                      (l)  a Chief Medical Officer (however called) of a hospital; or
                    (m)  a Director of Nursing (however called) of a hospital; or
                     (n)  a Clinical Information Officer (however called) of a hospital; or
                     (o)  a person with experience in health industry software; or
                     (p)  a rural doctor; or
                     (q)  a member of the Consumer Advisory Committee with skills, experience or knowledge in consumer health advocacy; or
                      (r)  a Fellow of the Australian College of Health Informatics.
             (4)  The Chair of the Clinical and Technical Advisory Committee is the Board member mentioned in subsection (2).
             (5)  Subject to this section and any written directions of the Board, the Clinical and Technical Advisory Committee may determine its own procedures.
                  The Clinical and Technical Advisory Committee has the following functions:
                     (a)  to provide advice to the Board about the efficient and effective delivery of clinical care using digital health;
                     (b)  to provide advice to the Board about the architectural integration of digital health systems;
                     (c)  to make recommendations to the Board in relation to priorities for investment in, and development and implementation of, national digital health systems;
                     (d)  to provide advice to the Board on changes to digital health system design to improve clinical usability and usefulness based on experience with the use of digital health systems;
                     (e)  to provide advice to the Board on proposed innovations and measures to improve the efficiency and effectiveness of digital health systems for clinicians and users of the systems.
----- End Extract.
What I found interesting was that non-rural doctors who are not specialists seem not to be able to be members. I wonder does that exclude people from the AMA and RACGP who are not specialists?
It is also interesting that the Fellows of the Aust. College Of Health Informatics are eligible for membership but not HISA CHIA’s and senior HIMAA people etc. I wonder how that happened.
To me the biggest gap in all this is the lack of an overall catch all that would allow the committee to advise on all relevant e-Health matters. Would be good to see that included!
David.