Monday, May 08, 2017

Weekly Australian Health IT Links – 8th May, 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

Well a really big week with all sorts of stuff happening on opt-out, the ADHA and the Budget coming tomorrow evening.
What fun! Enjoy the browse.
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Your private health information is online and you don’t even know it

Sue Dunlevy, National Health Reporter, News Corp Australia Network
May 5, 2017 10:00pm
IT’S the $2 billion online health record you don’t even know you have and it could be putting your health privacy at risk.
Millions of Australians are unaware they have an online My Health Record set up by the government that can reveal if they have a mental illness, sexually transmitted disease, an abortion or other embarrassing health problem.
It can be accessed by 650,000 health professionals including dentists, dietitians, optometrists, podiatrists as well as doctors.
The record has cost taxpayers $2 billion but is not routinely being used by doctors.
And Australians are unaware that under legislation even if you opt out of the record it is never deleted and can still be accessed by the government, it will be held for 130 years and can be revealed to law enforcement agencies and insurers.
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Make My Health Record mandatory for GPs, health department told

Antony Scholefield | 5 May, 2017 | 
All GPs would be forced to use the My Health Record system under a radical plan presented to the Department of Health.
The suggestion is found in an independent review of last year’s ‘opt-out’ trials in parts of NSW and Queensland, involving nearly one million patients.
In its 360-page report, health consultancy Siggins Miller tells the department it should consider making the use of My Health Record “compulsory for all healthcare providers” — but only once the system “is more developed”.
It does not delve into precisely how compulsory use might be enforced.
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Can you really spy on patients via the My Health Record?

4 May 2017
If you believe a recent media report, and some doctors, My Health Records are so badly secured that more than half a million people could potentially spy on individual patients’ medical records.
The News Corp article described the setup as a “bungle”.
But if you believe other doctors — or the Department of Health — this idea is ridiculous.
The argument is yet another controversy for the much-maligned national e-health records system, which has cost the government $2 billion and counting.
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Generics to become default as government tinkers with practice software

3 May 2017
Generic drugs would become the default setting on GP software under a Federal Government plan to cut prescribing costs.
The move is rumoured to form part of a $1.8 billion savings deal with the pharmaceutical industry that will be unveiled in next week’s Federal budget.
Pharmacists are embracing the idea, but AMA vice-president Dr Tony Bartone warns it will restrict doctors’ autonomy and independence.
“By changing the default option, the government is suggesting that they will interfere with clinical decision making."
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Health record ‘opt out’ trial a success

My Health Record should be opt out, says the Guild

The Pharmacy Guild of Australia has welcomed the success of the My Health Record trials which it says have confirmed the overwhelming benefits of the ‘opt out’ model involving automatic creation of patient records.
The formal evaluation of the trials, published today, has recommended that the Federal Government proceed to a national opt-out approach – a recommendation which the Guild says it fully supports.
The evaluation report says in part: “Taking all the data into consideration we can see no reason not to proceed with an opt-out approach in one national step rather than any progressive staged approach.”
The opt-out trials were conducted in the Northern Queensland PHN, and in the Nepean Blue Mountains PHN, with the final report on the trials completed in November last year. The opt-out trials included community pharmacists among the healthcare providers who took part.
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Opt-out for digital health record gets a tick

Evaluation of opt-out trials backs new approach
Rohan Pearce (Computerworld) 05 May, 2017 11:08
The national e-health record system looks set to shift to an opt-out model, after an evaluation of trials in Queensland and New South Wales concluded an “opt-out approach to increase both individual and healthcare provider participation and use is the preferred option,” with opt-in approaches “unsustainable”.
A 2013 government-commissioned review of the My Health Record system — then named the Personally Controlled Electronic Health Record (PCEHR) — recommended the system shift to an opt-out approach. Under the original design of the system, an e-health record was only created for an individual if they opted in to the system.
An opt-out approach was seen to be a way of boosting take-up of the e-health record.
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Guild welcomes big-bang proposal for My Health Record

4 May, 2017  
The Pharmacy Guild has welcomed a recommendation that the federal government proceed with a national implementation of an opt-out My Health Record.
This follows the publication of an independent evaluation that shows an opt-out model is more effective than an-opt in model.
The evaluation report recommends a big-bang approach to the roll-out rather than a staged approach.
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Evaluation of the My Health Record Participation Trials

Page last updated: 04 May 2017
In July 2012, My Health Record (then called Personally Controlled Electronic Health Record) was launched. This is a secure online summary of a person’s medications, diagnosed illnesses, treatments, allergies and tests. Each person can control what goes onto their My Health Record, and who is allowed to see it. For healthcare providers, knowing more about a patient’s medical history can lead to a better understanding of what is happening, and result in better treatment decisions.
In most parts of Australia individuals need to actively register for a My Health Record. From March to October 2016, trials of different participation arrangements were run. The trials were of opt out arrangements in Northern Queensland and the Nepean Blue Mountains of New South Wales area, and innovative approaches to opt in in Western Australia and Ballarat. The aim of the trials was to understand consumer reaction to different participation arrangements, as well as healthcare provider usage and upload of clinical information to the patients’ records, when most of their patients have a My Health Record.
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Rural GP goes digital to promote health nationally

Libby Hakim
Published: May 6 2017 - 12:00AM
Rural GP Mitchell Tanner is following the career path he plotted out back at school. After studying at the University of Newcastle, he completed his internship at Maitland Hospital and started practising, in 2011, in Singleton. "It's the town I've grown up in, the town that I always intended to work and live in," he says.
This may have been where his career story ends: a doctor experiencing the challenges and rewards of looking after many people he knew well before he started his medical career. But, thanks to the wonders of digital technology, he's added another strand to his career and taken his dedication to healthcare well beyond his Hunter Valley hometown.
Dr Tanner co-founded telehealth platform Stigma Health in December 2016. The platform allows people to be screened for sexually transmitted infections (STIs) — minus the awkward face-to-face consultation..
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The future is fast approaching, but are we ready? A LongRead on what AI might hold for rural health

Editor: Marie McInerney Author: Melissa Sweet on: May 03, 2017
The rapidly advancing field of Artificial Intelligence (AI) is set to shake up the health and healthcare of rural communities, the National Rural Health Conference was told last week.
The prediction and its accompanying warning – from a leading rural doctor and medical educator, Dr Jenny May – is underscored by a scan of recent medical publications, reports Melissa Sweet below.
For more of our Croakey Conference News Service reports from the #ruralhealthconf, see here.
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FHIR Product Priorities for Release 4

Posted on May 4, 2017 by Grahame Grieve
Now that we’ve published Release 3 of FHIR, it’s time for us to consider our main priorities for the next FHIR release. This is my draft list of product priorities that we’ll be discussing – and trying to execute – at the Madrid meeting next week:
  • Normative: push to normative for
    • Foundation / API / XML / JSON / Bundle / OperationOutcome
    • Terminology Service (ValueSet / CodeSystem / ExpansionProfile)
    • StructureDefinition / CapabilityStatement
    • Patient / RelatedPerson / Practitioner / Organization / ?Endpoint
  • Position a core set of clinical resources (‘health base’?) for normative in R5 (or Observation | AllergyIntolerance | MedicationStatement normative for R4?)
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Vic government eyes boost for health services’ cyber security

Invests in security monitoring for 29 health service networks
Rohan Pearce (Computerworld) 02 May, 2017 15:56
The Victorian government will seek to boost the security of networks employed by the state’s health services.
The state government budget, handed down today, includes FY18 spending of $11.9 million on increasing cyber security for 29 Victorian Health Services networks. The funding is to implement preventative cyber security controls and to monitor the security of systems across the network.
There is also $4.8 million over four years for the state’s Office of the Commissioner for Privacy and Data Protection to monitor data security across government agencies.
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1 May 2017

Medical records app adds two million patients

Posted byTMR Staff
A smartphone app that connects patients with GPs will be made available across 180 practices.
IPN Medical Centres group announced the roll out of Precedence Health Care’s MediTracker app to two million patients in April. It has been trialling the app in practices since the start of the year.
The app, which is endorsed by the RACGP, provides a real-time, mobile medical record that can be accessed by GPs, patients, family members and allied health professionals.
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Is new prescribing system an unusable clunker?

2 May, 2017  
The PBS online authority system is so bad that only 100 doctors have used it since its July launch.
The system is supposed to save doctors from having to call the authority script hotline to get the green light to prescribe certain drugs.
But the website has proved so difficult to navigate that only 100 prescribers have apparently managed to use the system.
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4 May 2017

Unfinished business – the Frank Pyefinch story

Posted byJeremy Knibbs
Dr Frank Pyefinch, the founder of both MedicalDirector and Best Practice, is the closest thing we have to a founder of Australian digital GP medicine. His story and ideas tell us a lot about how we should be embracing a rapidly unfolding digitally connected world in Australian medicine.
Only about three years ago, in a Telstra head office boardroom in George St, Sydney, the glitterati of Telstra Health had gathered to present their plans and visions to Lorraine and Frank Pyefinch, in an effort to get a not-insignificant cash offer for Best Practice, one of our two major patient management systems serving GPs, over the line.
Controlling Best Practice or MedicalDirector was, at the time, the centrepiece of a plan to pull together an eclectic collection of acquisitions in the e-health space. Having, at first, significantly underestimated the market share and power of the growing Best Practice business, the senior managers at Telstra Health were determined to impress and get this deal across the line.
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Northern Territory invests in digital government, data centre upgrades

Territory to establish an Office of Digital Government
Rohan Pearce (Computerworld) 03 May, 2017 06:30
The Northern Territory will spend $5 million to establish an Office of Digital Government.
The new agency was revealed in the NT budget, which was handed down yesterday. The Office of Digital Government will “advance government’s digital initiatives and address ICT strategy, design and direction at the enterprise level,” budget documents state.
The office will sit within the Department of Corporate and Information Services. The government's digital team has been shifted from the Department of the Chief Minister to DCIS as part of the creation of the agency.
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NT boosts budget of 'largest-ever' IT reform to $259m

By Allie Coyne on May 1, 2017 9:10AM

Adds $73 million to massive health systems overhaul.

The Northern Territory government has committed an extra $73 million to its massive healthcare systems reform as it prepares to announce the winning IT contractor for the core clinical systems renewal program (CCSRP).
The territory government has called the CCSRP the "largest ever" IT reform undertaken by the Northern Territory.
First announced last May, the CCSRP will completely overhaul the operational IT environment of the territory's healthcare system over five years.
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Automated pharmacy means more time for patient care

By Australian Hospital + Healthcare Bulletin Staff
Friday, 28 April, 2017
Western Australia’s Fiona Stanley Hospital (FSH) is enhancing the safety, efficiency and governance of its medications across the 783-bed major tertiary hospital through a sophisticated pharmacy automation system.
The automated inventory management system, the largest of its kind in the Southern Hemisphere, supports the hospital’s delivery of comprehensive care services through five key components. These include:
  • 3 robotic drug dispensary systems
  • 55 automated drug cabinets (ADCs) in clinical areas
  • 44 secured anaesthesia drug stations in operating theatres
  • 2 electronic controlled drug safes
  • 156 medication workstations on wheels.
At the heart of the system are drug dispensary robots that can precisely scan, move and store more than $200,000 worth of medicines each day.
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Telehealth could thrive under health care homes model

By Natasha Egan on May 3, 2017 in Government, Technology
The trial of a new approach to supporting people with chronic disease will encourage GPs to offer telehealth services, a member of the digital health agency says.
The Federal Government is funding a $21 million two-year trial starting later this year involving 200 general practices acting as the health care home for up to 65,000 Australians with chronic and complex conditions.
The providers will be funded through bundled monthly payments to coordinate care for patients, who will be supported to self-manage their chronic disease, and develop a shared care plan.
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  • Updated May 3 2017 at 8:00 PM

Open standards create opportunities

by Paul Wallbank
This content is produced by The Australian Financial Review in commercial partnership with the Commonwealth Bank
Standardised information offers a great opportunity for healthcare businesses, says Angela Ryan, the Australian Digital Health Agency's deputy chief clinical information officer.
Speaking at the recent Australian Healthcare Week at Sydney's International Convention Centre, Ms Ryan observed that getting digital right is not disruptive in itself – but applying technology to the healthcare industry can have disruptive effects and address soaring medical costs.
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  • Updated May 3 2017 at 8:00 PM

Technology delivers a healthy future

by Mike Gee
This content is produced by The Australian Financial Review in commercial partnership with the Commonwealth Bank
 Fifteen years ago it cost about $100 million to map one human genome. Now it costs $1000. Sometime in the next 10 years that will drop to just $100 according to Illumina, the largest maker of DNA sequencers.
This is good for all of us, theoretically. We are ultimately going to live longer as the tidal wave of technological advancement has an impact on all areas of healthcare – delivering new and better applications, treatments, cures, operative procedures and equipment.
According to figures released last year by the Australian Bureau of Statistics, in 2014 male life expectancy was 80.3 years, while female life expectancy was 84.4 years. But futurist Nick Abrahams says women are expected to live to 100 by 2055, while men will reach the expectancy "ton" by 2080. Imagine what that means to the life insurance industry.
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1 May 2017

Data holds the key to patient-centred care

Posted by Julie Lambert
A pioneer of the American “patient-centred” primary care model, which has inspired Australia’s Health Care Home trials, says better health outcomes were visible within a year.
Dr Kirsten Meisinger, of Boston’s Cambridge Health Alliance, was in Sydney last week advising general practices on how to make the transition to a data-rich, team-based care model with workflow designed around patients.
The key ingredients were multidisciplinary teamwork, a deep understanding of patients’ needs and making the most of high-quality data. These elements made healthcare access easier for patients and allowed doctors to focus on medicine, Dr Meisinger said.
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Digital security in the cloud for healthcare providers

By Andrew Tucker
Saturday, 29 April, 2017
In the Summer issue of AHHB we featured the article ‘Digital Disruption’ in response to the wave of new technologies bringing us closer to the fully digital hospital. E-health and telemedicine are taking centre stage and bringing patient data into the spotlight. In this issue, Andrew Tucker, CEO of ITonCloud, joins us to discuss patient record security and whether the answer is in the cloud.
What are the implications of data breaches for hospitals and aged-care facilities?
No-one wants a data breach to happen but unfortunately it does. The implications for hospitals or aged-care facilities would be devastating if they have not taken the correct steps to ensure the security and privacy of their clients’ data.
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Codeine solution a top priority: Guild

The Pharmacy Guild has reassured members it is doing its utmost in the lead-up to the upscheduling of codeine products

With the May budget looming, the AJP understands that the Guild is in “high-level” discussions with the government about implementing a different approach to deal with codeine access.
In a recent communication, Guild national president George Tambassis suggests a new approach that will allow certain prescription-only medicines to be supplied through community pharmacy without the need for a prescription.
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From unassuming GP to multimillionaire tycoon

3 May 2017

FEATURE

Don't talk to HealthEngine's Dr Marcus Tan about disrupting the healthcare sector. He'd just be happy to destroy the fax machine.
The list of GPs who become multimillionaire medical tycoons is not long.
There is Geoffrey Edelsten, the super clinic investor and buyer of football clubs, now deregistered following his conviction for attempting to solicit a hit-man to assault a former patient.
And there was Dr Ed Bateman, the media-shy founder of Primary Healthcare, who built a $2 billion empire out of universal bulk-billing, now deceased.
Then there is Dr Marcus Tan.
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Rapid advances linking brain with computer

Authored by Nicole MacKee
RAPID advancement in the field of neurobionics and brain–computer interface (BCI) may see the restoration of vision in people with acquired blindness or assistance for people with spinal cord injuries to walk, but many technical and ethical challenges lie ahead, say experts.
In a Narrative Review published in the MJA, Professor Jeffery Rosenfeld, director of the Monash Institute of Medical Engineering and senior neurosurgeon at Alfred Health, and Dr Yan Tat Wong, biomedical engineer and neuroscientist at the University of Melbourne, reviewed international research efforts in BCI applications over the past decade.
BCI technology involves linking the brain to computers through scalp, subdural or intracortical electrodes. These electrodes transmit computer-generated electrical signals to the brain; or receive, record and interpret electrical signals from the brain.
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Money given to GPs from ending the Medicare rebate freeze should target reform

May 1, 2017 6.03am AEST
General practice in Australia needs reform. 

Author Stephen Duckett

Director, Health Program, Grattan Institute
If the whispers are right, the Medicare rebate freeze will be partially lifted in next week’s federal budget, at a cost of half-a-billion dollars.
The previous Labor government introduced the freeze in 2013 as part of a A$664 million budget savings plan. The freeze, which the Coalition extended, effectively meant GPs and other medical specialists would be reimbursed the same amount for delivering health services in 2020 as they were in 2014, despite rising costs in other areas.
Many will welcome the move to lift some of the freeze because it will help reinforce bulk billing as a pillar of Australia’s health system. But it will be a wasted opportunity if the extra money that will go to GP clinics is not used to buy better general practice.
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Innovation is a team sport

Tuesday, 02 May 2017
Words like "disruption" and "transformation" get bandied about a lot these days, along with their more prosaic cousins "change" and "innovation". With Australians now spending more time in front of a screen each day than they do sleeping, we are seeing the shift as consumers choose "digital first" to manage both their personal and professional lives.
Organisations have seen the writing on the wall and are seeking new ways to adapt to this changing environment in pursuit of ever-greater efficiencies and operational effectiveness.
While there is a certain mythology about the lone visionary, the genius who sees the future and brings it into realisation through dogged persistence and sheer force of personality. We think of Albert Einstein, Thomas Edison or Gandhi. Apple famously eulogised on this myth, saying:
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Enjoy!
David.

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