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"


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

Monday, January 23, 2017

Weekly Australian Health IT Links – 23rd January, 2017.

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

General Comment

It seems the silly season has shrunk a little – with quite a lot seemingly happening.
A new minister, Telstra Health out spruiking its wares and all sorts of steps in medication management – both public and private.
Enjoy the browse.

Govt proposing automation for health dept

The Australian Government is proposing to extend the use of automation based on big data, to the health department, even though its efforts to do the same with Centrelink have not exactly been a success.
An amendment proposed to the National Health Act of 1953 would, "enable the minister, the secretary or the Chief Executive Medicare to arrange for the use of computer programs to make decisions and determinations, exercise powers or comply with obligations and do anything else related to those actions".
It would also "enable approved pharmacists whose premises have been affected by disaster or exceptional circumstances to supply pharmaceutical benefits at alternative premises in the same locality for a limited period and be paid for claims at the full rate; and ensure that entitlements for concessional beneficiaries and their dependants will apply for pharmaceutical benefits until midnight on the day of a person’s death".

A quick guide to Greg Hunt, the new health minister

18 January 2017
Former lawyer and long-time Liberal politician Greg Hunt has officially been named Health Minister in the wake of Sussan Ley’s implosion amid an expenses scandal.
Here are 10 things to know about him:
·         He was born into a political family in Melbourne in 1965. His father, Alan, was a member of the Victorian parliament for more than 30 years.
·         He attended Melbourne Law School, where he captained the Australian Universities Debating Team while working casually as a steelworker, fruit picker, waiter and storeman and packer. He became an associate to the Chief Justice of the Australian Federal Court in 1992.
·         He subsequently attended Yale University as a Fulbright Scholar, obtaining a Master of Arts in International Relations.

Arthur Sinodinos claims innovation as Turnbull reshuffles cabinet again

Cabinet secretary Arthur Sinodinos has been announced as the country's new minister for Industry, Innovation and Science.
By Asha McLean | January 17, 2017 -- 23:51 GMT (10:51 AEDT) | Topic: Innovation
Australian Prime Minister Malcolm Turnbull has announced new changes to his ministry, following the resignation of Health Minister Sussan Ley last week, amid concerns over her travel expenses.
Former Minister for Industry, Innovation and Science Greg Hunt has now moved into the health minister role, with Arthur Sinodinos taking on the vacated innovation portfolio.
Sinodinos is currently a senator representing New South Wales, and was previously former prime minister John Howard's senior economic adviser and chief of staff. Sinodinos was acting in the health minister role immediately following Ley's resignation.
18 January, 2017

My Health Record ‘threat to public trust’

Posted by Julie Lambert
The Australian government is endangering trust in the My Health Record system by failing to reveal its full list of objectives and obtaining patients’ consent.
This is the conclusion of Professor Danuta Mendelson, Deakin University’s Chair of Law (research) and law lecturer Gabrielle Wolf, writing in the Journal of Law and Medicine last month.
In their analysis, the MrHR system falls short of its statutory objectives such as overcoming the fragmentation of healthcare, but the intentions of successive governments in advancing eHealth records have gone far beyond the reasons set out in the statutes.

Qld health service expects to save millions with telehealth

By Paris Cowan on Jan 17, 2017 6:31AM

Aussie-first deployment targets most frequent visitors.

For someone who suffers from a chronic disease, the local hospital can become an unwanted second home.
The burden of regular visits to doctors and specialists can easily compound an already debilitating medical condition.
For hospital operators, the cost of treating frequent visitors outstrips the price of all other patients combined.
This is why Queensland’s West Moreton Health and Hospital Service decided chronic disease sufferers should top its priority list for a personalised telehealth push, which it has dubbed MeCare.
  • Updated Jan 19 2017 at 11:00 PM

Telstra aims to turn e-health into a healthy earner

Telstra is aiming to make e-health a material contributor to earnings in the long-term and is taking its health business into the next stage of development, group executive of new business Cynthia Whelan said.
After a launch nearly two years ago, there has been little noise from the division and Ms Whelan admitted there has not been a lot of clarity around Telstra Health's progress and what the plans for the division are.
"We've completed that acquisition phase of the business, now we're moving into the integration phase," Ms Whelan told The Australian Financial Review.
"We've now amassed a portfolio of foundational companies."

The pitfalls of taking clinical photos on your phone

16 January 2017
Technology often evolves faster than the law — and this is as true in healthcare as it is in many other industries.
One example is the in-built camera in your smartphone. Phone cameras, with increasingly high resolution, are taking off as a clinical tool, allowing doctors to photograph symptoms without waiting for professional clinical photography units, according to a recent article in the Medical Journal of Australia.
GPs can photograph skin lesions, for example, and send the photos to a dermatologist for their opinion.
But without a clear medicolegal framework, doctors who do this could be asking for trouble, say the researchers from Australia and Qatar.

National Medicines Safety Program Established

Created on Thursday, 19 January 2017
The Australian Digital Health Agency is pleased to announce the establishment of a new national Medicines Safety Program.
The Agency’s Executive General Manager Clinical and Consumer Engagement and Clinical Governance, and Chief Clinical Information Officer Dr Monica Trujillo said the program will work with consumers and healthcare providers to explore how digital health can improve the safety and quality of medicines usage in Australia.
Dr Steve Hambleton, former president of the Australian Medical Association and one of Australia’s most respected authorities in digital health has been joined by Mr Steven Renouf, former rugby league star and dedicated advocate for Aboriginal health as Program Co-Sponsors.  Mr Neville Board will represent the Australian Commission on Safety and Quality on Health Care (ACSQHC).

Establishment of Medicines Safety Program January 2017

The Australian Digital Health Agency is pleased to announce the establishment of a new Medicines Safety Program.
Good medicines management can help to reduce the likelihood of medication errors and hence patient harm. The Program is designed to improve the access and quality of medicines information through the use of digital health, enabling consumers and healthcare providers to make safe, informed decisions and achieve better health outcomes.
The Program’s Executive Sponsor is Dr Monica Trujillo, the Agency’s Executive General Manager Clinical and Consumer Engagement and Clinical Governance, and Chief Clinical Information Officer.  The Agency welcomes the Programme Co-Sponsors Dr Steve Hambleton and Mr Steven Renouf who will advocate the interests of clinicians and consumers, and Mr Neville Board representing the Australian Commission on Safety and Quality in Health Care (ACSQHC).  

Let’s kill the Australian identity card zombie once and for all

January 17, 2017 11.33am AEDT

Author Bruce Baer Arnold

Assistant Professor, School of Law, University of Canberra
Some policies are like zombies – toxic, frightening, defiantly unkillable. They reappear, even though they aren’t useful and aren’t pretty. Pauline Hanson’s call for a national identity card is one of those zombies.
The One Nation leader has been calling for a networked biometric card for people who interact with the national government. Put simply, that is most citizens. The card will supposedly significantly reduce fraud by non-citizens who are resident in Australia.
Statements about the card are confusing. Presumably it is meant also to reduce entitlement fraud by citizens – a focus of the current Centrelink debacle – and provide definitive proof of identity in dealing with state or local government and the private sector.
Past enthusiasts for a national identity card, claiming “if you have done nothing wrong you have nothing to fear”, have suggested a “must carry” regime. People would be expected to take the card with them when they use public transport, walk the dog, visit granny, go shopping or otherwise step outside. The card would be the default proof of identity in private sector transactions, stronger than the easily forged driver licence photo cards that are the standard ID for most adults.

Landmark Australian ruling on what counts as 'personal information'

By Paris Cowan on Jan 19, 2017 12:06PM

Privacy Commissioner knocked back in metadata case.

A full bench of the Federal Court has today handed down a hotly awaited judgment on its interpretation of Australian privacy law, and what qualifies as personal information.
It has served a rebuff to Australian Privacy Commissioner Timothy Pilgrim, who has been fighting to secure a broad definition of personal information in the courts, to ensure that everything that could reasonably be used to identify an individual will fall under the protection of the Privacy Act.
But federal court judges today dismissed the commissioner's appeal, siding with Telstra and the Administrative Appeals Tribunal over whether the telco needs to hand a full suite of telecommunications metadata over to Telstra customer and former Fairfax journalist Ben Grubb, under the personal information access provisions of the Act.

Pharmacy must be integral in Health Care Homes

Pharmacy needs to be a key part of Health Care Homes if the initiative is to succeed

The Pharmacy Guild said today that it strongly supports the Federal Government’s Health Care Homes primary care reforms, but pharmacists must play a strong role.
Guild National President George Tambassis says the HCHs provide the opportunity to move towards a more integrated and coordinated approach to meeting the primary care needs of patients with complex, chronic health conditions.
But “in order for the HCHs to succeed in delivering better, more cost-effective health outcomes for patients with complex needs, it is imperative that their community pharmacy is an integral part of the primary care team,” Mr Tambassis said.
“More than any other healthcare professional, the community pharmacist is responsible for ensuring that patients are adherent with their medicines and that their medication-related needs are being met. 

Successful openEHR EHR implementation featured in WHO eHealth report

January 07, 2017  |  from: Heather Leslie
In Australia, the Northern Territory's My eHealth Record service has been featured as the only example of a successful electronic health record (EHR) implementation in a newly published WHO report on eHealth - a great win for the openEHR community as the EHR is underpinned by an openEHR platform.
The whole of  the report, 'Global diffusion of eHealth: making universal health coverage achievable - Report of the third global survey on eHealth' makes interesting reading, but focus on page 106 for the openEHR-related case study.
This  follows a very positive evaluation report, commissioned by NEHTA (now the Australian Digital Health Agency' and completed in August 2015, about the same My eHealth Record service. Importantly, the report stated:
"For the first time in Australia, we have strong evidence of the benefits of eHealth records in bridging the gaps in information that occur as patients move between different healthcare providers in the public and private sectors."

Case Studies

OceanEHR platform - NT Health, Australia

Published: 16 August 2016

Demonstrates: a secure way of sharing an individual’s healthcare information between care providers

My eHealth Record - a territory-wide shared electronic health record
The Northern Territory Department of Health provides health care to all territorians across the vast, remote geographical area of the northern Australia, including servicing the health needs of the indigenous community.
  1. To store structured atomic clinical data in a shared Electronic Health Record;
  2. To enable decision support;
  3. To enable advanced care planning;
  4. To consolidate health information using a common data structure; and
  5. To address identified inadequacies in security, access control and privacy management.

AMA defends its pharmacy trial

13 January, 2017 
AMA Victoria has defended its role in a controversial trial allowing pharmacists to change medication doses, issue repeat scripts and perform point-of-care tests.
The Victorian Government has opened applications for an 18-month pilot where pharmacists will monitor and refine the medication regimen of patients with asthma, hypertension and hypercholesterolaemia, as well as those on anticoagulation medications.
Before the trial begins, the government will train the pharmacists involved to perform blood pressure, spirometry, INR and lipid panel tests.
It is being stressed that the pharmacists will work according to a shared care plan drawn up by the patient’s GP who will also take an active role in the pilot.

Meet Qld Health's five new technology execs

By Allie Coyne on Jan 18, 2017 10:38AM

Still no fill for long-vacant CIO role.

Queensland's Health department has recruited five new executives into its eHealth Queensland technology arm to turn around the agency's IT fortunes and drive "digital transformation" into healthcare in the state.
The department has welcomed a new chief technology officer, chief digital strategy officer, chief customer experience officer, chief solution delivery officer, and executive director of corporate services.
All report into interim eHealth Queensland CEO and departmental CIO Mal Thatcher. The agency has been searching to recruit permanently into the position since July last year, following the departure of Colin McCririck to IBM in the US. It today was unable to give an indication of when that role will be filled.

Reducing medication errors in hospital discharge summaries: a randomised controlled trial

Erica Y Tong, Cristina P Roman, Biswadev Mitra, Gary S Yip, Harry Gibbs, Harvey H Newnham, De Villiers Smit, Kirsten Galbraith and Michael J Dooley
Med J Aust 2017; 206 (1): 36-39.
doi: 10.5694/mja16.00628
Objectives: To evaluate whether pharmacists completing the medication management plan in the medical discharge summary reduced the rate of medication errors in these summaries.
Design: Unblinded, cluster randomised, controlled investigation of medication management plans for patients discharged after an inpatient stay in a general medical unit.
Setting: The Alfred Hospital, an adult major referral hospital in metropolitan Melbourne, with an annual emergency department attendance of about 60000 patients.
Participants: The evaluation included patients’ discharge summaries for the period 16 March 2015 – 27 July 2015.

‘Precision medicine’ promises new hope for cancer sufferers

  • The Australian
  • 3:00AM January 17, 2017

John Ross

A shift from mass to personalised medicine promises new hope for cancer sufferers and health authorities, improving patients’ quality of life and saving health budgets billions of dollars by averting perilous and ultimately pointless operations.
A proof of concept study has given the tick of approval to “precision medicine”, which harnesses genomic “knowledge banks” to tailor individualised treatments based on the experiences of thousands of earlier patients.
Scientists reanalysed genetic data from more than 1500 leukaemia sufferers confronted with a harrowing choice: reduce the risk of relapse with a dangerous stem cell transplant or stick to safer but less effective chemotherapy.
It found a precision medicine approach would have changed treatment of about one-third of the patients, slightly boosting survival rates and cutting the number of transplants, while leaving survivors with fewer side-effects.

Christian Porter, Chris Bowen, Cory Bernardi are among victims of internet security breach

January 17, 201712:26pm
Staff writers News Corp Australia Network
PRIME Minister Malcolm Turnbull has ordered a report from his top cyber security adviser on a Yahoo data breach amid claims more than 3000 Australian government officials — including a federal minister — had private data stolen.
The Prime Minister confirmed he had not been a victim of the massive 2013 Yahoo data breach that has reportedly involved Australian diplomats, Defence officials and high-profile politicians.
Mr Turnbull said, based on what he had seen in news reports, it was unlikely there would be security issues with the politicians whose emails had been hacked.
Social Services Minister Christian Porter, Shadow Treasurer Chris Bowen, Victorian Premier Daniel Andrews, Liberal MP Andrew Hastie, Shadow Health Minister Catherine King and Liberal senator Cory Bernardi were among the victims of the hacking, ABC reports.

Malcolm Turnbull orders inquiry into theft of ministers’ data

  • The Australian
  • 12:00AM January 18, 2017

Kylar Loussikian

Malcolm Turnbull has ordered a review into data stolen from senior MPs and thousands of public servants as part of a wider leak ­revealed last month by Yahoo.
But the Prime Minister said the hacked accounts related to a time before the Coalition was elected and it was “very unlikely” there would be security issues.
“It begs the question as to ... what was in those accounts and clearly in terms of classified ­government information can only be transmitted or used on approved government communication ­systems,” Mr Turnbull said. “We don’t take any of this stuff lightly or complacently and I’ll be getting a report on this from my cyber adviser, Alastair MacGibbon.”

2017 should be the year of privacy – healthy paranoia obligatory

If one issue dominated the headlines last year it was Internet privacy – specifically the lack thereof. It was not just the tech giants collecting masses of information via telemetry, search, email, calendars, and document snooping but the massive data breaches of Yahoo! and others that shook our faith in using the Internet, trusting email, and trusting household technology names.
I don’t intend to go into the details – there are 851 million search articles that cover that all too well but I would like to help iTWire readers “walk softly and leave a smaller digital footprint".
The first thing to remember is that there is no inherent, inalienable concept of online privacy – the ability to separate and control sensitive information about yourself (privately identifiable information or PII). There are certain protections about what you do in the privacy of your home, but almost all countries have laws that limit online privacy. It seems that the overlap between privacy and secrecy (concealing information that others might use to their advantage) has led to a one-size-fits-all approach. So it's all up to you!
16 January 2017

Medadvisor - Quarterly Activities Report and Appendix 4C        

-       Record operating cash receipts for the quarter, totalling $1.32 million, an increase of 77% on the September quarter ($0.75 million)
-       Strong operational performance across all key metrics
o   Over 600,000 users on the MedAdvisor platform as at 31 December 2016, an increase of over 160% since September 2016
o   Over 45% of Australian pharmacies connected to the platform (30% in September quarter 2016)
o   Patient Engagement Programs (PEPs) experienced rapid traction, closing the quarter with 18 medications using the platform across 9 of Australia’s largest pharmaceutical companies including Pfizer, GSK, AstraZeneca, Novartis & Bristol-Myers Squibb
o   Increased the number of General Practitioners (GPs) benefiting from the platform to nearly 4,000 GPs
o   Tap-to-Refill script ordering function processing an average of $2.5 million in script refill value per week
-       Completion of $8 million oversubscribed capital raising receiving strong  participation from leading Australian financial institutions and pharmacy groups
-       Completion of Healthnotes acquisition, significantly enhancing the MedAdvisor offering and expanding market share
-       Key partnership agreements with Asthma Australia and Osteoporosis Australia, plus extended existing relationship with Bupa into certain Healthscope Hospitals

Pensioners and disabled next in line in Centrelink robo-debt campaign

Noel Towell
Published: January 17, 2017 - 10:10AM
The Coalition government is going to target more than 3 million of elderly and disabled Australians with its controversial Centrelink "robo-debt" campaign, Parliamentary documents show.
The mid-year economic forecast tables published last week shows the government has booked savings of $1.1 billion from data-matching the aged pension and another $400 million from the disability support pension.
The move will bring more than 3 million more Australians into the sights of the data-matching program, which uses an automated system to match information held by Centrelink and the Australian Taxation Office and calculate overpayments.

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