The Australian E-Health Press provided a good serve this week. It included these:
First we have:
Plan to link rebate access to GPs’ e-health capability
Elizabeth McIntosh - Friday, 7 August 2009
DOCTORS have welcomed the National Health and Hospitals Reform Commission (NHHRC) report’s e-health recommendations, but have questioned the intent of linking Medicare rebates to e-health capabilities.
The e-health proposals, which cost an estimated $1.8 billion, include person-controlled electronic health records for all Australians by 2012.
However, the NHHRC also called on the Government to mandate that payments for health and aged care services should eventually be dependent on the provider’s ability to transmit information to a patient’s personal e-health record, and to other health providers.
.....
But AMA e-health committee chair Dr Peter Garcia-Webb believed the proposal would not have a significant impact on general practice.
“General practice has taken huge strides in becoming electronic,” he said.
“There needs to be some thought to encourage e-health [among specialists].”
What was now needed was an overarching e-health framework and direction, he said.
.....
More here (subscription required):
http://www.medicalobserver.com.au/News/0,1734,5031,07200908.aspx
I am not quite sure where the AMA is coming from here. They seem to think this awful plan to force GPs and Specialists to send private patient information off to some undefined PHR in the sky is a good thing and that a overarching e-health framework and direction is needed. Yohoo! We have a framework (The Deloittes Strategy as recommended by AHMAC and the NHHRC) and we really need to actually start planning to implement and fund it – not just continue the navel gazing. The development of PHRs is towards the end of the priority list – we have a few other things to sort out first!
Second we have:
Pharmacy condemns codeine decision
6 August 2009 | by Simone Roberts
Tighter controls on over-the-counter codeine combinations will not address the problem of misuse of the products and will put significant pressure on pharmacists, say the profession's peak bodies.
Both the Pharmacy Guild of Australia and the Pharmaceutical Society of Australia (PSA) have expressed disappointment with the National Drugs and Poisons Schedule Committee (NDPSC) decision to upschedule OTC combination analgesics containing codeine (CACC) to Schedule 3 in a bid to address concerns of misuse and abuse of the products.
The Guild said the scheduling changes would only mask the problem and were unlikely to influence individual misuse behaviour.
It said it was regrettable that the committee rejected its proposal to adopt real-time monitoring and reporting of these products through its NotifyRx technology, calling it a "missed opportunity".
"This technology underpins the extremely successful Project STOP which has done so much to prevent the illegal diversion of pseudoephedrine," the Guild said in a statement.
More here:
http://www.pharmacynews.com.au/article/pharmacy-condemns-codeine-decision/493427.aspx
I really wonder where we are going with all this. We have the Guild pushing a technology solution to what I have to say I see as a real ‘non-problem’. Looking at the reasons for all this it is very hard to actually see the obvious statistic – what proportion of those who take these medications do so irresponsibly (i.e. is this really substantial problem?) and what is the evidence that what is proposed here will make a difference? I could not find that basic piece of information. Given Panadeine and similar have been available easily for the whole of my adult life (40+ years) one really wonders what has suddenly changed.
Third we have:
Alarm grows over high CT radiation
Adam Cresswell, Health editor | August 08, 2009
Article from: The Australian
THE amount of cancer-causing radiation exposure in CT scans can vary fourfold or more with different machines, even when identical tests are performed, radiology experts say.
After two separate warnings this week that some doctors appear to be ordering high-radiation CT scans inappropriately, the federal government's radiation watchdog said calibration discrepancies might be further increasing the unnecessary dose of X-rays some patients received.
The Australian Radiation Protection and Nuclear Safety Agency, which monitors the exposure of the population to medical and other sources of radiation, said it was working with professional groups to set benchmarks to guide how much radiation patients should receive for particular tests.
The agency's acting chief executive, Peter Burns, said there could be large variations in radiation output for some procedures. "It can vary by about three or four times ... for the same procedure," he said.
The National Prescribing Service journal Australian Prescriber this week published a paper warning of widespread overuse of chest CT scans, which expose patients to 400 times more ionising radiation than a plain X-ray.
A report in The Australian prompted the Medicare watchdog to say it was "horrified" at apparently unnecessary CT scans being ordered.
More here:
http://www.theaustralian.news.com.au/story/0,25197,25899092-23289,00.html
Not quite Health IT, but certainly Health Technology and it certainly needs to be used carefully used. The obvious solution is, of course, to use MRI and not CT scans in those at risk of getting any significant radiation dosage as MRI is radiation free and can get similar (if not better) images. Pity they are a bit more expensive.
Fourth we have:
Secret surgery waiting lists exposed
Article from Sunday Mail
August 09, 2009 12:01am
THOUSANDS of people are languishing for years on a hidden waiting list for elective surgery, despite State Government boasts of a 98.5 per cent reduction in overdue elective surgery lists.
While Government figures show only 32 patients were on official overdue waiting lists at the end of June, the unofficial list shows some people have been waiting a decade just to see a specialist before they even make it onto the official lists.
The revelation comes as the Sunday Mail confirms:
SENIOR doctors have written a protest letter over a move allowing Health Department employees other than clinicians to reassign patients to less urgent categories - with longer acceptable waiting periods for surgery - without being seen by a doctor.
PATIENTS with serious elective surgery conditions, including a woman with only one eye which needed surgery, were moved to lower priority categories in late June, allowing the Government to meet ambitious end-of-financial-year targets.
SPECIALISTS have signed a letter expressing grave concern about the "negative impact the overwhelming focus on elective surgery is having on both outpatient follow-up and emergency surgery".
Full article here:
http://www.news.com.au/adelaidenow/story/0,27574,25901723-2682,00.html
Is it really is hard to understand why it is impossible to keep track of waiting lists? No! It is in incumbent Government’s interests to muddy and confuse waiting list information to avoid any real political scrutiny. Sad about that!
Fifth we have:
Reversal on doctor register
Siobhain Ryan | August 08, 2009
Article from: The Australian
CANBERRA will be forced to make further changes to a national scheme cracking down on rogue health workers after it struck resistance from a key health union and was found wanting by ALP backbenchers.
A Labor-led Senate committee has recommended that a draft bill to register and accredit hundreds of thousands of health professionals be amended to curb ministers' powers and make their decisions more transparent.
More here:
http://www.theaustralian.news.com.au/story/0,25197,25899017-23289,00.html
I wonder how this legislation will relate to the proposed IHI legislation at covers health care providers.
Sixth we have:
Commentary
12:51 PM, 7 Aug 2009
Stephen Bartholomeusz
The NBN number crunch
Now that the board of the new National Broadband Network company, NBN Co, has been assembled, the moment of truth is nearing. There is little prospect that NBN Co can be financially sustainable on a standalone basis, which means the original concept of a giant public/private partnership will founder without massive and ongoing government subsidies.
The telecommunications team at Goldman Sachs JB Were has just released a major (92-page) report on the NBN. They estimate it will cost $37 billion to build – $41 billion if Telstra isn’t prepared to sell the ducts, pits and pipe that constitute the most strategic element of its ‘last mile’ network to NBN at a 33 per cent discount to the analysts’ $12 billion valuation – but be worth negative $9 billion in net present value terms.
As they conclude, ‘’it is difficult to see the market ascribing any value to an equity investment in a company such as this.’’
On their forecasts NBN Co won’t be free cash flow positive until 2025.
They argue that Telstra will be prepared to sell its passive infrastructure to NBN Co for $8 billion – a $4 billion discount to its assessed value – to demonstrate that it is a good corporate citizen (and presumably to try to avoid regulatory punishment for non-cooperation).
Telstra would also significantly reduce its maintenance capital expenditures and selling its assets to NBN Co would avert the threat that the NBN would ’go aerial’ and, in the longer term, leave Telstra’s existing network intact but eventually obsolete.
However, the Goldman analysts don’t believe Telstra will accept equity in NBN Co as consideration, given their view of its equity value. They believe it will be politically unpalatable for the government to pay cash for the assets, saying the most likely outcome was a mixture of cash, the transfer of some Telstra debt, and some kind of annuity stream.
More here:
It is interesting just how long it is going to take to make this actually make some of its cost back. I sure hope the intangible and economic benefits flow before then!
There is more on the NBN here:
PM’s national broadband plan really is no net gain
Chris Berg
A libertarian view asking if this maybe could be better thought out. The major consulting report on all this that is planned will be interesting when released.
See here:
http://business.watoday.com.au/business/mckinsey-wins-big-broadband-role-20090806-ebin.html
McKinsey wins big broadband role
Ari Sharp
August 6, 2009
CONSULTANT McKinsey & Company has emerged as a major part of the next phase of the national broadband network (NBN), snaring a role as joint lead adviser for the project's implementation study and having two of its former partners join the board.
Lastly the slightly more technical article for the week:
KDE 4.3 released for a ‘greatly’ improved experience
Functionality and usability combine for highly anticipated upgrade
Rodney Gedda 05 August, 2009 09:06
After six months of development the KDE project has released the most anticipated upgrade of the KDE 4 series, KDE 4.3, which promises to greatly improve the overall user experience of the open source desktop environment.
KDE 4.3, codenamed “Caizen”, has had the goal “polish, polish, polish”, according to its developers, who were scorned for beginning the KDE 4 series with a basic 4.0 release that did not have all the features of the 3.5.x predecessors.
With this release being the fourth of the KDE 4 series, the momentum and pace of development is definitely increasing with some 2000 feature requests implemented in the past six months alone.
Other statistics from development team indicate 10,000 bugs fixed and approximately 63,000 changes committed by nearly 700 contributors since 4.2.
More here:
It is astonishing just the amount of work that gets done in these major open-source projects.
See the results here:
http://www.kde.org/screenshots/kde350shots.php
Windows is really going to have to try very hard indeed to stay ahead!
More next week.
David.
1 comment:
How will a comprehensive PHR be maintained as a comprehensive medical record if all therapeutic medication for the patient is not recorded? OTC sales from any source (Pharmacy, supermarket, garage) need inclusion.
Why?
The quantity and frequency "simple" medication is thought to be "needed" by a patient is vital to their health care providers understanding of their condition(s) & psychological state.
A perception that a OTC medication such as a pain reliever or complementary medicine will benefit a patient will assist a practitioner in diagnosing and treating what may be an underlying condition.
If it is a regular perceived need, perhaps it may be contributing to a primary health condition or adversely affecting a treatment program.
Any initiative to record OTC medication in a patient's PHR should be viewed as an e-health benefit to the individual.
I realise the difficulty in third parties purchasing a patient's medication and there are far more serious matters to be resolved to implement PHR's for better health outcomes.
Just seems an opportunity to move therapeutic medicines to where they will have more potential to be properly accounted to a patient's PHR.
Patients are notoriously poor at reporting their administration of "simple treatment" medication voluntarily and worse, not disclosing known self abuse.
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