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."

Thursday, August 04, 2016

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

August 4  Edition.
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A week where we have all sorts of macro-economic news dominating little Australia with the central banks in the US, UK and Japan all adjusting policy of leaving things as they are for now.
The news this week globally was a little grim.
COMMENT
  • July 29 2016 - 5:08AM

The world isn't ready for another banking crisis

·         Satyajit Das
As Europe braces for the release of its bank stress tests, the world could be on the verge of another banking crisis.
The signs are obvious to all. The World Bank estimates the ratio of non-performing loans to total gross loans in 2015 reached 4.3 per cent. Before the 2009 global financial crisis, they stood at 4.2 per cent.
If anything, the problem is starker now than then: there are more than $US3 trillion ($4 trillion) in stressed loan assets worldwide, compared to the roughly $US1 trillion of US subprime loans that triggered the 2009 crisis.
European banks are saddled with $US1.3 trillion in non-performing loans, nearly $US400 billion of them in Italy. The IMF estimates that risky loans in China also total $US1.3 trillion, although private forecasts are higher. India's stressed loans top $US150 billion.
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Elsewhere we have had some Australian news suggesting that lowering of interest rates is coming soon. As of the weekend Australian 10 year bond rate is sitting around 1.83% which is close to the lowest ever while the share market seems to be going higher and higher – which makes no sense in conventional economics. Something is going to have to give and it may not be pretty – but it may take a long time for things to play out.
Australia’s circumstances are not looking all that flash this week:
  • Jul 25 2016 at 11:45 PM

The time bombs in the Australian economy are just starting to explode

by Ross Garnaut
Australia's 45th Parliament faces the most challenging economic environment for a quarter of a century. Real incomes per person have been stagnant or falling since the China resources boom began its retreat in the September quarter of 2011. Multi-factor productivity is negligibly higher than a decade ago. While real output has been growing only moderately below what were once considered to be trend rates, recent growth depends overwhelmingly on increases in resource export volumes that are outweighed by falls in prices, or on unsustainable expansion of government and housing expenditure. The official budget forecasts are built on unlikely export prices, growth and inflation rates and count as savings measures that have been rejected repeatedly by the Parliament, yet still point to continuing deficits. Budget weakness continues at a time when the vulnerability of Australian commercial banks to a closure of global debt markets is greater than during the GFC – when only the strength of the Commonwealth balance sheet allowed the banks to continue normal operations.
After two decades in which rising incomes and wealth for most Australians eased discomfort with moderately increasing inequality, the end of the resources boom has brought sharper differentiation in economic conditions across regions and amongst citizens as well as declines in real living standards for many people.
Outside Australia there is low productivity growth and business investment in all the high-income economies. Private investment tending to fall well short of savings in the developed countries and China has led to the lowest real interest rates ever, and taken the world financial system into unknown territory. There is retreat from the open movement of goods, services, capital and people that have made the past three quarters of a century the most economically dynamic time in human history. China, the world's biggest trading economy, struggles to balance short-term growth against the necessity of structural change for long term development. A difficult external strategic environment raises the spectre of unexpected burdens, including in Papua New Guinea where the significance of the collapse of the rule of law has escaped the notice of most Australians.
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Oh dear – a very important read.
Here are a few other things I have noticed.

General Budget Issues.

Low inflation due to international factors beyond RBA’s control

  • The Australian
  • 12:00AM July 25, 2016

David Uren

Weak price growth in the June quarter is expected to provide the Reserve Bank with the excuse it needs to cut its benchmark rate to a fresh record low of 1.5 per cent next month — however, new research shows the fall in inflation around the world is predominantly driven by global forces that domestic monetary policy is powerless to address.
The June quarter inflation report, to be released on Wednesday, is expected to show the underlying rate of inflation was around 0.4 per cent which would put the annual rate at 1.4 per cent.
This would be slightly below the Reserve Bank’s forecast in its May monetary policy statement of 1.5 per cent. The minutes of the bank’s last meeting flagged that inflation was expected to remain low for an extended period given the subdued growth in labour costs and low cost pressures around the world.
The March quarter’s underlying inflation growth of only 0.15 per cent was a shock to both the Reserve Bank and to market economists and a further surprise in the June quarter remains possible.
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Threat of recession still looms large

  • The Australian
  • 8:45AM July 28, 2016

Robert Gottliebsen

Using conventional criteria the set of economic numbers that were released yesterday should have produced an Australian recession.
But we have not gone into recession and indeed the share market is trading at around year-high levels and Australian dwelling prices, at least in Sydney and Melbourne, have risen.
Most economists concentrate on whether there is going to be a rate reduction next week. I am not going to get into that game because I want to look at the deeper forces — why there should have been a recession; why it didn’t happen and whether we can keep avoiding such dangers.
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Central banks encourage irrational hedonism

In 1648 a Dutch water authority issued a bearer bond inscribed on goatskin to Niclaes de Meijer that promised to pay him 5 per cent in perpetuity to finance improvements to a local dike. The bond is now owned by Yale and, 368 years later, is still paying interest, even though the rate halved to 2.5 per cent in the 17th century.
Yale professors Geert Rouwenhorst and Will Goetzmann write that the life of such perpetual loans has typically been "cut short by imprudent financing, government recall or the misfortunes of wars and revolutions".
Here in Australia we see perpetual notes in the form of the preferred equity issued by banks, called "hybrids", that have no legal maturity (only optional refinancing periods or mandatory equity conversion dates).
These hybrids lost 40 per cent of their value during the 2008-2009 crisis. But mark-to-market investors, which represent most of us, are told to ignore this volatility and focus on the claim that the major banks will never go bust.
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COMMENT
  • July 30 2016

China will keep doing its own thing

Ross Gittins
On the prospects for China's economy, it's easy to be wrong. We analyse unfamiliar things by comparing them with things we understand, but in its massive size and economic history, China is one of a kind.
That's one conclusion I've drawn from a visit to China as a guest of the Australia-China Relations Institute, at the University of Technology, Sydney, and the All-China Journalists Association.
In recent years people in the world's financial markets have gone from ignoring the Chinese economy to assuming it works the same way a developed economy does.
Hence the consternation in global share markets last year and again early this year when China's share market took a sharp dive. Surely this meant its economy was in big trouble.
Well, maybe, but not for that reason. China is still a developing, middle-income economy and its share market is a relatively recent creation of its government, lacking the strong links with the real economy we're used to in the West.
As Professor Peter Drysdale, of the East Asian Bureau of Economic Research at the Australian National University, has explained, the worth of China's share market is equivalent to about a third of its gross domestic product, compared with more than 100 per cent in developed economies.
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Health Budget Issues.

Health authorities failing regions: report

July 24, 20169:00pm
Belinda Merhab AAP
Frontline health services are failing to target regions with high rates of preventable hospital admissions, a new report shows.
The Grattan Institute report has found 38 areas in Queensland and 25 in Victoria where potentially preventable hospitalisations, for conditions like asthma or diabetes, have been at least 50 per cent higher than the state average every year for a decade.
It found Primary Health Networks - 31 organisations responsible for delivering local primary care services across the country - are receiving inadequate data that doesn't allow them to identify these hot spots in order to fix the problem.
"This is unacceptable really," report author Stephen Duckett told AAP.
"More has to be done."
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Malcolm Turnbull to meet key health bureaucrats

  • The Australian
  • 9:53AM July 25, 2016

Sean Parnell

Prime Minister Malcolm Turnbull will today meet with health department officials for the first time since the Coalition’s re-election bid for was almost derailed by Labor’s so-called ‘Mediscare’ campaign.
The Australian understands Mr Turnbull and his reappointed Health Minister, Sussan Ley, will meet with key bureaucrats to discuss the Coalition’s election promises and broader issues confronting the portfolio.
Neither would comment on the meeting yesterday but the Prime Minister appears keen to take a greater role in health policy and, in particular, communicating the Coalition’s plan to crossbench senators, stakeholders and the community.
Key to the Turnbull government plans this term is the trial of Health Care Homes, where patients with chronic illness enrol with a GP clinic or Aboriginal health service for regular treatment and monitoring through services funded through bundled payments.
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Time to take health seriously

Michael Gannon
Monday, 25 July, 2016
THERE has been much conjecture since election night about the significance of health policy, and the use of a “scare campaign” in changing votes.
The Coalition attacked Labor over its “Mediscare” campaign, which deliberately painted a picture of a fully privatised Medicare. The Prime Minister subsequently called it an “extreme act of dishonesty”.
The Australian Medical Association (AMA), too, was critical of the opposition’s Medicare privatisation claims. There is, and was, no move to privatise Medicare. All that was announced, and later withdrawn, was a plan to look at outsourcing some backroom administration arrangements in the antiquated payments system, something that the AMA would still welcome and support.
Nevertheless, the political reality is that health played a major part in this election, and it was the Coalition that created and nurtured the fertile ground that allowed the scare campaign to grow and thrive.
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Sussan Ley talks tough on defending changes to healthcare

  • The Australian
  • 12:00AM July 26, 2016

Sean Parnell

Health Minister Sussan Ley last night defended the Medicare freeze and vowed to consult with medical practitioners on any changes to be made by the Turnbull government.
Promoting new models of paying for healthcare, Ms Ley reiterated that the freeze on indexation was appropriate — “If you can’t pay for something, you can’t deliver it” — and refused to say if or when it would be lifted.
Asked on ABC radio whether health policies had hurt the Coalition at the election, Ms Ley instead referred to Labor’s claims Medicare would be privatised, saying, “the Medicare lie, the outrageous lie, I’m sure it did”.
The privatisation claim arose largely from secretive government plans to upgrade the Medicare payments system and prompted an unexpected, mid-campaign pledge from Malcolm Turnbull that the system would not be outsourced.
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Facebook post claims cancer patients are being denied treatment thanks to government cuts

July 25, 20165:30pm

AMA chief wanted to hear more from Ley

THE Federal Health Minister has denied government health cuts have led to cancer patients being denied treatment after a viral Facebook status claimed pensioners were being refused scans.
“I was really concerned to read Sue’s post on the weekend, as there are no changes to Medicare-rebated diagnostic imaging services which would justify the experience she has outlined,” a spokesperson for Sussan Ley, Minister for Health and Aged Care, told news.com.au.
“Sue kindly got in touch with my office this afternoon and we are now working through her situation in a bid to address her concerns.
“Can I again make it very clear; Commonwealth bulk billing incentives for Diagnostic Imaging providers remain in place for all concession card holders and anyone under 16 now and into the future.”
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  • July 28 2016 - 12:00AM

Finding scapegoats won't make healthcare safer

·         Jeffrey Braithwaite
Some would be dissatisfied with the state government's explanation that it was a "systems failure" that tragically killed one newborn baby and seriously injured another when the wrong gas was connected to an outlet in the operating theatre of a Bankstown hospital.
But, NSW Secretary of Health Elizabeth Koff was right when she said "we failed as a system". It is systems, not individuals, that are responsible for devastating errors in complex organisations like hospitals. And it is also here that potential solutions lie.
It is difficult to imagine circumstances more devastating than the needless death or injury of a newborn child. For every serious error that occurs in our hospitals, particularly one that takes a life, a "no stone unturned" investigation or inquiry is, of course, essential, as is the support of all those affected.
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Couch potatoes ‘cost us $800 million a year’

  • The Australian
  • 8:30AM July 28, 2016

John Ross

Inactivity costs Australia more than $800 million a year and taxpayers foot most of the bill, a world-first study has found.
Researchers from four Australian universities have calculated that sedentary lifestyles gouged $805m from the national economy in 2013 in direct healthcare costs and lost productivity through illness, disability and shortened lives.
The findings, published in The Lancet, come from the first analysis of the worldwide economic effects of a “global pandemic” of inactivity. The team found five major diseases caused by sedentary lifestyles — coronary heart disease, stroke, type 2 diabetes and breast and colon cancer — cost the world about $90 billion a year.
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  • July 28 2016 - 6:00PM

Dumpling days numbered as aged-care profit motive creeps on

·         Michael Bachelard
Vereniki day is a favourite at Kalyna Care. 
The traditional eastern European dumpling, often served with cabbage, is part of the identity of many residents at the Delahey home formerly known as the Ukrainian Elderly People's Home.
But all this is under threat, as not-for-profit aged-care homes like Kalyna face the pinch of competition and reduced government funding. 
Without much fuss, big listed or private for-profit companies are taking over the residential aged-care industry.
"Eighty-five per cent of aged care, disability and mental health care will be privatised over the next five years," predicts Michael Goldsworthy from not-for-profit representative group, Better Boards Australia.
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Health Insurance Issues.

  • Jul 25 2016 at 4:35 PM

Private health funds accused of misusing patient data for commercial gain

Private health insurers that also own dental surgeries are misusing data obtained through the HICAPS claiming system for commercial benefit, the Australian Dental Association has warned a Productivity Commission inquiry into expanded data sharing.
The inquiry, for which submissions close on July 29, is examining the benefits and costs of data being shared more widely between public sector agencies, private sector organisations, the research sector, academics and the community. 
In a submission by Australian Dental Association (ADA) president Dr Rick Olive, the peak body said the way some private health insurers were already behaving should be a warning on the perils of data sharing.
Dr Olive said contracts between dentists and private health insurers had clauses relating to the use of confidential information in HICAPS, which were "too generous" to insurers. They are allowed to access data about the charging practises of individual dentists and practices which use the HICAPS system, and drill down to analyse the specific procedures performed and the identity of patients receiving them.
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Pharmacy Issues.

Pharmacists may have conflict over natural therapies: review

  • The Australian
  • 12:00AM July 27, 2016

Sean Parnell

Pharmacists have a conflict of interest in selling unproven drugs and therapies to supplement their incomes from dispensing med­icines, an independent review has been told.
The Review of Pharmacy Remuneration and Regulation was a key commitment in the $18.9 billion pharmacy agreement negotiated by the federal Coalition government last term. The review panel — headed by Stephen King from the Productivity Commission — held back the release of its discussion paper until after the July 2 election.
Apart from perennial issues of fees, business models and location rules, the paper questions the very nature of what pharmacists do, and what they charge, and asks should they be put to better use. “It was put to the panel that community pharmacists face conflicts of interest between their role as retailers and as healthcare professionals,” says the paper, noting pharmacists can sell over-the-counter, complementary therapies and other retail ­products.
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Pharmacy location rules in question

The King Review discussion paper is scrutinising location and ownership rules, and supermarket restrictions

Currently there are 11 pharmacy location rules agreed to by the Department of Health and the Pharmacy Guild of Australia within the Sixth Community Pharmacy Agreement, which specify where pharmacies can be opened – with a focus on spacing them out across urban areas.
These regulations cover both the relocation of existing pharmacies and the establishment of new ones, and were introduced in 1991 after it was discovered most pharmacies in urban areas were clustered together while rural and remote areas had significantly poorer access.
While some have submitted to the recently released Pharmacy Remuneration and Regulation Review panel that the current location rules allow pharmacies to provide a range of high-quality services to the community, others have argued that they limit access to, and affordability of, prescription medicines.
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Pharmacist up-selling concerns aired

July 27, 20165:12pm
Belinda Merhab AAP
It's feared patients are being sold medicines they don't need when they walk into their local chemist by pharmacists seeking profits.
An independent panel, tasked by the federal government to review the regulation and pay of pharmacists, has raised concerns about the role of pharmacists as both retailers and healthcare professionals.
It's heard that some consumers worry their pharmacist may be unnecessarily up-selling them over-the-counter products or complementary medicines they don't need to make money.
It's also heard concerns about whether complementary medicines, such as vitamins, with no evidence-based health benefits should be sold in pharmacies at all, given it could "misinform consumers of their effectiveness".
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  • July 28 2016 - 3:46PM

Pharmacist conflicts of interest and 'up-selling' patients flagged in major federal government review

Kate Aubusson
Pharmacists could see their PBS funding cut if they don't limit the space they devote to retail products, and restrictions put on the types of products they sell under potential reform measures canvassed by a major federal government review.
A pharmacist's dual role as retailer and healthcare professional had blurred the line between treating people as customers or patients, the Pharmacy Remuneration and Regulation review panel has heard.
It meant community pharmacists face a conflict of interest by offering patients unnecessary over-the-counter and complementary medicines to boost their earnings, according to the review's discussion paper released this week.
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Review to probe pharmacy conflict of interest

28 July 2016
DO pharmacists have a conflict of interest as both retailers and healthcare professionals? Are they upselling unproven treatments to help line their pockets? Should they receive Medicare rebates for the advice they give to patients?
These are just some of the many questions that will be addressed as part of the first independent, comprehensive review of community pharmacy in close to 20 years.
A discussion paper from the Review of Pharmacy Remuneration and Regulation - also known as the King Review - was belatedly released on Wednesday, after having been held back until after the federal election.
The paper sets the agenda for a thorough examination of pharmacy - not just of the perpetual issues of business models and location rules, but of the very nature of what pharmacists do.
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Superannuation Issues.

Morrison spruiks super message to G20 finance ministers in China

  • The Australian
  • 12:00AM July 25, 2016

Glenda Korporaal

Scott Morrison has promoted the fiscal benefits of the government’s proposed crackdown on superannuation tax concessions at the G20 finance ministers meeting in China at the weekend.
The Treasurer said he had told the meeting the government’s cutbacks in super tax concessions and the elig­ibility for the Age Pension were about “protecting the integrity of the tax base” and “having a sustainable treatment of retirement incomes”.
The G20 ministers had discussed the importance of having as many people as possible in the tax system. “The more people you have in the tax system, and which are part of the system, the more you are able to address the equity issues between those who receive and those who pay taxes,” he told the meeting in Chengdu, capital of Sichuan province in China’s southwest.
Mr Morrison said he had ­spoken about the need for a sustainable tax system.
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Morrison justifies super plan

- on July 25, 2016, 6:21 am
Treasurer Scott Morrison has used a meeting of the world’s top finance ministers and central bankers to back in his plans to curtail superannuation benefits to well-off Australians.
Mr Morrison, speaking on the sidelines of the meeting of G20 finance ministers in Chengdu, China, said his planned changes to super were part of a wider effort to make the tax system more sustainable and up-to-date.
The superannuation changes, including a move to cap concessional contributions at $500,000 starting from 2007, have caused troubles within the Federal Government since they were announced in the May Budget.
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  • Jul 27 2016 at 9:59 AM

Scott Morrison says 'taxes will inevitably rise' if super savings don't pass

Treasurer Scott Morrison who has vowed to stick with the government proposed changes to superannuation to make savings that are opposed by some Liberal MPs, has warned taxes could rise if the measures do not pass.
He also said the changes will help reassure ratings agencies of Australia's AAA status after Moody's, Standard & Poors, and Fitch Ratings warned the government and the Senate that Australia's AAA credit rating will be threatened if budget repair is derailed in the next parliament.
"The changes we've made to superannuation do a number of things they make the superannuation system more fair and more sustainable and they make a significant contribution to bringing the budget back towards balance.
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  • Jul 27 2016 at 11:45 PM
  • Updated Jul 28 2016 at 8:10 AM

Scott Morrison says super rebels are defending the rich

Treasurer Scott Morrison has urged those opposed to a $500,000 lifetime cap on non-concessional superannuation contributions to consider that scrapping the proposal would benefit only the very wealthy.
Stepping up his push against the backbench and those in the industry who want the proposal dumped or heavily amended, the Treasurer raised the prospect of tax increases as an alternative to spending cuts should changes cause a loss in revenue.
"We need to ensure we continue to get this under control otherwise the deficit will be higher, the debt will be higher, more taxes will inevitably rise. This is not something the government is interested in doing," he told Sky News.
The $500,000 lifetime cap, which would be backdated to 2007, is causing the most angst because it is deemed retrospective. Last week, Queensland Nationals MP George Christensen, who represents the working class seat of Dawson, said he would cross the floor if it were not changed.
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Save Our Super: Turnbull and O’Dwyer are breaking super promises

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

Grace Collier

In Melbourne’s Malvern Town Hall on June 20, about 250 people gathered for a Save Our Super meeting. On the stage sat three empty chairs representing Malcolm Turnbull, Bill Shorten and assistant treasurer Kelly O’Dwyer. The Prime Minister and the Opposition Leader had promptly declined the invitation to attend. O’Dwyer, the local member of parliament and the person with carriage of the superannuation issue, declined to attend at the last minute.
“Not only did she not attend, until mid-afternoon on the day of the meeting she had not even responded,” says Jack Hammond QC, founder of the community-based group Save Our Super. “Worse, the response only came after I phoned a senior member of the Liberal Party, advised that Kelly had not responded to earlier messages, and said it was a very bad look.”
O’Dwyer was contacted for comment but did not respond.
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I look forward to comments on all this!
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David.

Some Are Actually Making An Effort To Make Practical Improvements In The Technology Supporting Healthcare!

This appeared a little while ago.

Taking Bids on the Hospital of the Future

In Silicon Valley, Kaiser is testing new hardware and software.

July 22, 2016 — 9:00 PM AEST
Leo, a 68-year-old retiree, is out shopping when his heart rate becomes irregular. He doesn’t notice, but his wrist monitor does, and it notifies a distant team of doctors. They dispatch a driverless car packed with sensors and medical gear to get a closer look at him and, if necessary, bring him to the pharmacy or emergency room.
This is the future as imagined by Kaiser Permanente, which has built a mock-up of Leo’s home in a test facility not far from its Oakland, Calif., headquarters, and is looking for equipment makers who can help fill the rooms’ empty spaces. As Silicon Valley’s principal hospital system and insurer, Kaiser has a history of focusing on advances rooted in technology, but in the past few years, instead of forcing its 10.6 million patients to use the systems on offer, it’s begun pushing hardware and software makers to respond to patient demands, and supply what it thinks they’ll want in 10 years. “It frees us up so we don’t get so stuck on the realities of today,” says Chief Executive Officer Bernard J. Tyson.
The auditions take place in a spartan 37,000-square-foot warehouse in the Oakland suburb of San Leandro. There, the model apartment for Leo—with spots marked out for motion detectors, sleep trackers, and a smart fridge—abuts mock hospital rooms, an operating room, and a neonatal intensive care unit, where doctors and nurses test equipment and practice new procedures.
Other staffers and patients try out some of the less exotic equipment, too, including telehealth software and a TV entertainment system that lets patients lying in hospital beds review their treatment plans, order food, call a janitor, or adjust the blinds on their windows using a remote, a keyboard, or their smartphone. Kaiser physicians now handle more patients via telehealth (59 million a year) than they do in person (50 million). Jennifer Liebermann, who runs the test facility, says patient feedback guided development of the TV remote system rolling out to a handful of hospitals and helped fine-tune it over the course of two years to make sure it was easy to use. Kaiser rejected at least one system interface, she says, after elderly patients deemed it too confusing.
Lots more (with pictures) here:
Compare and contrast how those who actually deliver care and politicians envision the future. I think I much prefer the former!
David.

Wednesday, August 03, 2016

I Never Thought Pok̩mon GO Would Feature On This Blog РWell Now It Does!

This appeared last week:

Pokémon GO as a health tool

Christopher Timms
Monday, 25 July, 2016
THOUSANDS of Australians have been walking the streets, parks and beaches of their cities with eyes glued to their smartphones following the recent release of a game called Pokémon GO.
Pokémon GO is a new, free, smartphone game that augments reality and requires users to walk around in the physical world to progress through the game. The smartphone’s camera captures the surrounding environment and integrates Pokémon characters into the scene.
Players are rewarded for exploring their environment and walking between certain landmarks, or “PokéStops”, which tend to be places of cultural significance, museums, scenic lookouts or even government buildings.
Walking is an integral part of the game Рallowing players to capture more Pok̩mon, hatch eggs or obtain useful tools, such as health potions.
It’s the walking part of the game that may just make Pokémon GO an exciting tool that health care professionals should be aware of, and one that highlights the need for further discussion about the use of video gaming in health care.
An in-game feature, called a “lure”, can be used to create a location abundant in Pokémon. Now, imagine how the ability to attract people to locations could be used for health. If particular demographics could be targeted, potential uses might be a rare Pokémon appearing near a health careers booth in a rural area, near a dietitian’s stall or appearing at a mental health awareness event.
These are things health care providers should be thinking about, talking about and be familiar with for our patients. 
Gaming is prevalent in the patients we see, simply because so many people play. The Bond University Digital Australia Survey 2016 showed that 98% of homes with children have video games, the average age of video game players is now 33 years old, 47% of video game players are female, and approximately 68% of the population plays. This is a huge percentage of patient demographics from school age through to our oldest citizens.
While many doctors are familiar with using a game to distract a crying child in the emergency department, there is a much broader potential in paediatrics.
Twenty years ago, the use of video games at school was limited to crunching numbers on Math Blaster. Health care professionals might now be required to discuss Pokémon GO as a weight-loss tool or know to ask if a teenager is experiencing cyber bullying via a game.
In America, in 2010, the state of West Virginia committed to installing the active video game DanceDance Revolution in all 765 of its public schools to encourage students to exercise.
In the same way we learn about Peppa Pig so we can interact with our younger patients, we should understand gaming in order to better connect with our patients who are gamers.
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Dr Christopher Timms is a GP registrar based in Port Macquarie, NSW.
Lots more here:
Congratulations to Dr Timms for making the game understandable for non-players and then for explaining how the game might have some health benefits!
Normal service will now be resumed!
David.

Tuesday, August 02, 2016

Just Stop This Blame Rubbish! It Is Totally Clear Who Is To Blame!

I am a specialist anaesthetist.

On this nonsense of who is responsible for the gas mess up disaster at a Sydney Hospital it is utterly clear.

Some utterly incompetent and utterly guilty person did not check what gas was coming out of each pipe in the Hospital.

He/She needs serious jail time. You need (as a clinician) to be utterly sure what comes out when you open a gas flow - and you can hardly check every time in every place.

The engineers need to make this utterly certain and safe or go to jail.

Simple!

David

Yet Again We Find The Department Of Health Really Struggles With Technology.

This appeared last week:
27 July, 2016

Too many steps, too many clicks

Posted by Julie Lambert
Medicare’s new PBS authority service went live on 1 July promising an “online solution” for doctors to get approval for most authority PBS medications, as well as increased quantities and repeats.
But the lack of an interface with medical desktop software makes for a slow and clunky experience, leading early users to say they’ll stick to the phone.
“We’ve been asking for 15 years for an authority system that links with clinical software, but that is apparently not what they are delivering,” Dr Nathan Pinskier, chair of the RACGP’s eHealth and Practice Systems committee, told The Medical Republic.
It appears the Department of Human Services expects medical software vendors to sort out the many problems with the online service.
“The system allows prescribers to get a PBS authority approval online using either the Health Professionals Online Services (HPOS) or an upgraded version of their existing prescribing software that integrates web services,” DHS General Manager Hank Jongen said in a statement to TMR last week.
“A small number of prescribers have started using HPOS to request PBS authority approvals, and we expect the rollout of upgraded prescribing software in coming months to prompt a significant shift to the online channel.”
For now, the lack of an interface with clinical software means doctors need to pick their way through 20 steps online for each application for authority approval.
“There are a number of steps which are really quite annoying,” Sydney GP Dr Brian Morton, one of the few GPs to take part in the trial, said.
Dr Morton said he did not mind having to register for a Provider Digital Access Account (PRODA), but there were many instances of red tape and legalistic language that were not doctor or patient friendly.
More here:
Yet again we see the left and right hands failing to talk and co-operate to deliver a sensible outcome for the GPs.
Rather than inventing nonsense strategies for compulsory enrolment in the myHR program maybe the ADHA could be trying to sort out stupid, time wasting issues like the one above.
It would be hard to say credibly that the DoH is from the Government and here to help! They are clearly just wanting things to remain as annoying as ever!
David.

A Little Food For Thought.

Has anyone else noticed that the inaugural CEOs of both NEHTA and the ADHA were former journalists.

Just saying.....

David.

Monday, August 01, 2016

Weekly Australian Health IT Links – 1st August, 2016.

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 fair bit going on with HIC 2016 and the Minister sprouting a lot of fantastical rubbish while having her henchmen introduce more systems for GPs that don’t seem to actually work very well
Same old, same old!
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Commonwealth establishes Australian Digital Health Agency to complement My Health Record

​The federal government has established an Australian Digital Health Agency, which will work with the public and private sectors in a bid to foster digital health innovation.
By Asha Barbaschow | July 26, 2016 -- 02:33 GMT (12:33 AEST) | Topic: Government : AU
The federal government has announced the establishment of the Australian Digital Health Agency and an advisory board comprised of doctors, informatics specialists, digital experts, and customer service executives tasked with ensuring the nation's health system is technologically up to date.
Speaking at the Health Informatics Conference 2016 in Melbourne on Monday, Minister for Health Sussan Ley said the new agency will set the national agenda for technical and data standards, promote clear principles for interoperability, and open source development within the health system.
"I want the central role of the agency to foster digital health innovation and importantly, when we see new innovative technologies emerge with a strong benefit to clinicians and patients, the agency will be able to invest to deliver national outcomes," she said.
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Practices need $100k extra to make Health Care Homes work: RACGP

Tessa Hoffman | 28 July, 2016 | 
The average practice needs an extra $100,000 a year in funding to implement the Health Care Homes model otherwise it will fail, the RACGP has warned.
This is the first time a practice-level figure has been placed on the cost of the scheme, which was announced by Health Minister Sussan Ley in March as one of the biggest reforms of Medicare in 30 years.
The college issued the figure in response to news that no new money would be made available by the government for the program, above the $21.3 million pledged to pay for IT, infrastructure and training.
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27 July, 2016

Too many steps, too many clicks

Posted by Julie Lambert
Medicare’s new PBS authority service went live on 1 July promising an “online solution” for doctors to get approval for most authority PBS medications, as well as increased quantities and repeats.
But the lack of an interface with medical desktop software makes for a slow and clunky experience, leading early users to say they’ll stick to the phone.
“We’ve been asking for 15 years for an authority system that links with clinical software, but that is apparently not what they are delivering,” Dr Nathan Pinskier, chair of the RACGP’s eHealth and Practice Systems committee, told The Medical Republic.
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Health insurers join Nib to expand ‘trip advisor’ platform

  • The Australian
  • 12:00AM July 29, 2016

Sarah-Jane Tasker

Up to six million Australians will soon have access to an online healthcare platform, labelled the “trip advisor” of the sector, as private health insurers push for cost transparency to give consumers choice of medical procedures.
Health insurers Bupa and HBF have joined NIB to expand NIB’s Whitecoat initiative, which allows consumers to find, book, review and pay for healthcare treatment with their provider.
Graeme Samuel, who recently advised the federal government on making private health insurance more responsive to consumers, said Whitecoat was a quantum leap forward in terms of consumers having accessible information to make an informed choice on the cost and quality of healthcare they received. “Consumers will be empowered through meaningful and accessible information to make an informed choice, he said”
Launched in 2013 by NIB, Whitecoat includes 210,000 health care and ancillary providers, more than 35,000 registered provider profiles and access to more than 250,000 reviews. The site has had more than two million visitors.
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  • July 29 2016 - 12:15AM

Health insurance companies encourage consumers to rate doctors on new website

Harriet Alexander
Specialist fees will be published and consumers will review their quality of care in a new rate-my-doctor website likely to anger the medical profession.
Health insurance companies NIB, Bupa and HBF have joined forces to publish customer feedback and gap fees for individual doctors, following rising disgruntlement among members about price gouging by specialists.
The website – an expanded version of NIB's health provider directory Whitecoat – will initially publish prices, customer reviews and allow customers to book and pay for their appointments online.
Whitecoat currently covers GPs, dentists, physiotherapists and other allied health professionals, but not specialists.
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Minister Ley welcomes Whitecoat joint venture

Minister for Health Sussan Ley has welcomed the announcement that some private health insurers will increase the amount of information Australians can access about their health services.
Page last updated: 29 July 2016
29 July 2016
Minister for Health Sussan Ley has welcomed the announcement that some private health insurers will increase the amount of information Australians can access about their health services, as the Turnbull Government continues to lead the push for greater transparency and choice for consumers.
The Turnbull Government made private health insurance a priority during the election, with a key promise to simplify policies, weed out junk products, cut down on fine print and simplify billing arrangements to make it easier for Australians to shop around and reduce bill shock.
Ms Ley said the Whitecoat initiative – a joint venture between NIB, HBF and Bupa – was another step in the right direction towards helping Australians be fully-informed when they shop around for private health insurance, and demonstrated the importance of having insurers at the table in the development of reform.
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Royal College of Pathologists Australasia (RCPA) Terminology and Information Model v1.0 Release

Created on Friday, 29 July 2016
The Royal College of Pathologists of Australasia (RCPA) Pathology Terminology and Information Models v1.0 has now been published on the Australian Digital Health Agency website.
These resources have been developed by the RCPA as part of the National Pathology Terminology and Information Standardisation Plan. Information about its development can be accessed on the RCPA website.
You can download the resources, along with a release note and terms of use, from the Agency website:
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Wearable health technologies: will their benefits (and risks) flow beyond the ‘white, worried and well’?

Editor: Marie McInerney Author: Marie McInerney and Ruth De Souza on: July 25, 2016
Activity trackers, smart watches, health apps, personal heart rate monitors. These new technologies promise to transform health, health literacy and health care.
But to date, these wearable health technologies have been largely marketed towards those who have been dubbed ‘the white, the worried and the well’.
What might they mean for culturally and linguistically diverse communities and the health workforce that supports them – and who should be involved in shaping the research around that?
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Inside the race to overhaul Medicare's payments system

By Paris Cowan on Jul 26, 2016 6:34AM

Back to the drawing board for Canberran IT dinosaur.

Fifteen minutes in the national spotlight hasn’t brought the creaky Medicare payments system any closer to a long-overdue replacement, but Canberra insists it is working on bringing the platform into the modern day.
The 30-year-old IT back-end responsible for processing public healthcare rebates rose to an unusual level of notoriety in the last week of the election campaign, amidst squabbling over whether its proposed hand-off to the private sector amounted to an attack on the national health safety net.
Now it is set to become the federal government’s next biggest IT challenge, after a public backlash forced Prime Minister Malcolm Turnbull to promise no element of the system would be privatised.
The political solution dashed plans to shift the payments function to a private sector organisation - like a bank or private health insurer - and take the multi-million-dollar job off the government’s hands.
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Centrelink, Medicare platforms support similar processes

  • Antony Harrowell
  • The Australian
  • 12:00AM July 26, 2016
The ability to entertain and make people laugh draws us to the razor sharp wit of comedic genii.
We revel in comedians’ ability to interpret life differently, and it is the mastery of ­Abbott and Costello, Laurel and Hardy, Martin and Lewis or Hope and Cosby that keep us laughing.
Each is a comedy legend. Each brought to the table a proposition complementing the other. Each had an element the other didn’t and each fed off the other comically. Operating in comedic silos may not have delivered the laughter they would create. Non-partnering would have set the dial for disappointment, which brings into the question the federal government’s lack of strategy on Medicare and Centrelink.
And this raises the conundrum: why stop at one when two present a more logical benefit for the incorporation of a unified platform offering that delivers greater efficiencies and synergies?
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Qld Health chasing $3.6m in overpayments

July 27, 20164:07pm
By Jamie McKinnell AAP
Queensland's health minister has shut down a "gratuitous scare campaign" after the opposition suggested debt collectors may start chasing current health staff for past payroll mishaps.
Money is still being recovered from the 2010 health payroll bungle, which cost taxpayers an estimated $1.2 billion.
On Wednesday it emerged former Queensland Health staff were being sent more debt recovery letters.
The department's director-general, Michael Walsh, told a budget estimates hearing a $900,000 contract with debt recovery company Australian Receivables was renewed in February.
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Technology: facial recognition to eye scans and thought control

  • The Australian
  • 12:00AM July 28, 2016

Chris Griffith

You stare at a ceiling light and it switches on. The same applies when you stare at the coffee machine or focus your eyes on the button showing your preferred washing machine cycle. You refocus on the “on” button and away it goes.
Looking intently at the television switches it on and you watch a streaming channel. The ads all look appealing. Somehow the TV knows which ads you like from your mood when watching earlier ones. And your home robot slinks around the corner, out of sight, having discerned you are in a filthy mood.
This isn’t telepathy. It isn’t the distant future. It’s part of how we are about to communicate with electronic devices. It’s potentially our most intimate interaction with machines.
Devices that scan your eyes, judge where you look, glean your mood and act on electrical signals from your brain are not science fiction. Versions exist now and they’re coming to your phone, tablet, notebook and PC.
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Robots to roam the halls of new Monash Children's Hospital

By Paris Cowan on Jul 29, 2016 6:55AM

Service tunnel home to automated delivery fleet.

The new Monash Children’s Hospital in Victoria set to open early next year will be home to a fleet of delivery robots ferrying everything from food to clean sheets and medicine to its young patients.
The 230-bed facility will be linked to the existing supply hub at the Monash Medical Centre by an above-ground tunnel that will become the main thoroughfare for the autonomous trolleys as they carry up to 400kg of supplies at a time from storage rooms and kitchens.
Monash Health has invited robot manufacturers to demonstrate their wares to the hospital’s officials and prove their machines can whisk around the new hospital without running into obstacles, other robots, or most importantly, workers and patients.
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EPAS – Social Media Campaign

Safer drug prescribing, continuity of patient care and quicker and easier access to patient’s records are a few of the many benefits of EPAS. A series of videos was produced to explain the many benefits to the main stakeholders of EPAS.
Completed
June 2016
Medium
Social Media 
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Pokémon GO as a health tool

Christopher Timms
Monday, 25 July, 2016
THOUSANDS of Australians have been walking the streets, parks and beaches of their cities with eyes glued to their smartphones following the recent release of a game called Pokémon GO.
Pokémon GO is a new, free, smartphone game that augments reality and requires users to walk around in the physical world to progress through the game. The smartphone’s camera captures the surrounding environment and integrates Pokémon characters into the scene.
Players are rewarded for exploring their environment and walking between certain landmarks, or “PokéStops”, which tend to be places of cultural significance, museums, scenic lookouts or even government buildings.
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Health insurers accused of exploiting billing data

By Paris Cowan on Jul 28, 2016 10:58AM

For competitive leg-up.

The Australian Dental Association has accused major health insurers of mining the HICAPS billing system for commercially sensitive data to give its in-house dental providers a competitive advantage in the market.
The ADA made the claims in its submission [pdf] to the Productivity Commission's data sharing inquiry, complaining that problematic cases of data use in the health sector are giving industry Goliaths a head-start over smaller players.
It said the HICAPS user agreement is “too generous” when it comes to clauses relating to the use of confidential information, and accused private health insurers of using claims submitted to them via the gateway to compile massive databases on the pricing regimes and patronage levels of dental practices in the market.
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Monash Health in Australia Integrates Elsevier's Order Sets Into EMR System to Standardize Care and Improve Patient Safety

01:00 ET from Elsevier
MELBOURNE, Australia, July 27, 2016 /PRNewswire/ --
Integration to be Rolled out Across Victoria's Largest Public Health Service Provider's Network as Part of Wider Digital Transformation Program 
Elsevier, a world-leading provider of scientific, technical and medical information products and services, today announced that Monash Health, the largest public health service provider in the state of Victoria, Australia, will integrate Elsevier's Order Sets into its electronic medical record (EMR) system as part of its major digital transformation effort.
The decision to integrate Order Sets into its EMR system will help Monash Health achieve greater operational efficiencies by reducing redundancies and maximizing already limited resources to deliver better outcomes for patients, physicians and other healthcare providers.
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Compumedics Ltd signs $3M contract for medical diagnostic systems

Wednesday, July 27, 2016 by Proactive Investors
Compumedics Ltd (ASX:CMP), a leader in medical devices for sleep, brain and ultrasonic blood-flow monitoring has secured a new three year contract valued at a minimum of $3 million.
The deal will see Compumedics distribute neuro-diagnostic and monitoring systems to Bestmed across south and central China.
Bestmed is one of Compumedics’ seven distribution partners across China, Hong Kong and Macau.
The deal builds on existing arrangement for the distribution of sleep and neurological monitoring devices in other provinces of China.
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Cybersecurity portfolio assistance is safe start

  • Anthony Wong
  • The Australian
  • 12:00AM July 26, 2016
Cybersecurity has gained greater prominence with Malcolm Turnbull’s decision to name Dan Tehan as Minister Assisting the Prime Minister on Cyber Security, adding to his other portfolios. While the ACS certainly cannot take credit for this decision, we hope that our role in highlighting cybersecurity as a key issue in our election manifesto provided some impetus for the creation of this position.
The ACS believes cybersecurity represents perhaps the biggest threat to Australia fully capturing the benefits of the digital age. The government’s own cybersecurity strategy showed cybercrime already costs Australia more than $1 billion per annum and potentially as much as $17bn, with demand for cybersecurity services and related personnel expected to grow by 21 per cent over the next five years. The frequency and impact of attacks has increased in recent months and represents a cautionary tale for those who think they are immune.
In April, hackers stole $81 million from the central bank of Bangladesh by exploiting weaknesses in the global financial messaging system known as Swift, which had been billed as the Rolls-Royce of payment networks. Since then, another 12 banks have been investigated for possible Swift-related breaches. In the US, hospitals have been targeted by hackers who used ransomware to lock access to their data, threatening patients’ lives, until the facilities paid hefty ransoms to have their data unlocked.
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Microsoft releases anniversary update to Windows 10

  • The Australian
  • 12:00AM July 26, 2016

Chris Griffith

A trilogy of Microsoft Windows 10 milestones happen in the next week. The first is on Friday, when Microsoft’s latest operating system turns one year old. It’s also the last day you can upgrade a computer from Windows 7 or 8/8.1 to Windows 10 for free. From Friday, Australians will pay from $179 to upgrade to Windows 10, the same price for clean installs.
The third event is Microsoft’s release of an anniversary update to Windows 10, called Redstone 1. Current users won’t have to buy it or explicitly install it as it comes as a routine Windows update, as do feature updates going forward. The rollout will begin on August 2.
In 12 months, Windows 10 has erased the awful memories of Windows 8 OS. Microsoft says more than 350 million devices run Windows 10, and users have spent more than 135 billion hours using it. Just how Microsoft knows this is a mystery.
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  • July 28 2016 - 1:41PM

CX330: Galaxy's loneliest baby star discovered wandering far from stellar nurseries

Marcus Strom
It's younger than humanity; a baby star barely a million years old wandering far from any stellar nursery.
CX330, about 25,000 light years from Earth in the Milky Way's galactic bulge, has been described as the galaxy's loneliest star. It is confounding astronomers, who aren't sure why it is forming so far from where you'd expect such a star to form.
"We tried various interpretations for it, and the only one that makes sense is that this rapidly growing young star is forming in the middle of nowhere," said Chris Britt, lead author of a study on CX330 recently published in the Monthly Notices of the Royal Astronomical Society.
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Enjoy!
David.

New CEO For ADHA Announced.

Appointment of CEO for the Australian Digital Health Agency

Minister for Health, Sussan Ley, has announced the appointment of Mr Tim Kelsey as the Chief Executive Officer of the Australian Digital Health Agency which is responsible for all national digital health services and systems.
 Page last updated: 01 August 2016
PDF printable version of Appointment of CEO for the Australian Digital Health Agency - PDF 337 KB

1 August 2016

Minister for Health, Sussan Ley, today announced the appointment of Mr Tim Kelsey as the Chief Executive Officer of the Australian Digital Health Agency which is responsible for all national digital health services and systems, with a focus on engagement, innovation and clinical quality and safety. 

“Most importantly, the new Agency is the system operator for the Government’s recently launched My Health Record System which is a secure, online summary of people’s health information that can be shared with doctors, hospitals and healthcare providers with the permission of patients. This gives people more control of their health and care and with access to new digital apps and online services the Australian community is benefiting from the modern information revolution,” Minister Ley said.

“I am, therefore, delighted to announce that following an extensive national and international search Mr Tim Kelsey has accepted the permanent role of CEO to head up of the Australian Digital Health Agency. He is internationally regarded as a leader in digital health, in both the private and public sectors, and has a proven track record in delivery of digital health services.” 

Ms Ley said that previously Mr Kelsey was the first National Director for Patients and Information in NHS England. This role combined the functions of chief technology and information officer with responsibility for patient and public participation, marketing, brand and communications for the national commissioner for health and care services. He was also the first chair of the National Information Board in England which successfully oversaw design of a new digital health strategy for the NHS. 

Before becoming a director of NHS England, he designed and launched NHS Choices website – the national online information service which has transformed access to apps and mobile digital services for patients and citizens in England. In 2000, he co-founded Dr Foster, an organisation which pioneered public access to online information about local health services. 

More recently, Mr Kelsey has been working with Telstra Health to focus on ways to use its technology capabilities to support transformation in the costs and quality of healthcare in Australia. 

‘He is the right choice for the appointment as CEO of the Australian Digital Health Agency to further the Australian Government’s commitment to use digital health to create a world-class health system for all Australians,” Minister Ley said.

Mr Kelsey will commence in his new CEO role with the Australian Digital Health Agency in mid-August 2016.



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David