Quote Of The Year

Quotes Of The Year - 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, December 11, 2017

Weekly Australian Health IT Links – 11th December, 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

A really big week with the regulations to enable myHR opt-out gazetted and now in operation with various start up dates and implications.
Otherwise the wind down to Christmas seems to be rapidly taking over!

Federal Government authorises itself to collect Australians’ health information

Lynne Minion | 05 Dec 2017
The Australian Digital Health Agency has been given the authority to collect the health information of Australians in the My Health Record system, including for those who have not signed up and prior to the availability of an opt-out function.
The Federal Health Minister has registered the legal instrument required to switch My Health Record to opt-out, allowing for all Australians to be signed up to the national repository for individuals’ medical information unless they choose to be excluded.
“Consumers support the concept of an opt-out model for the My Health Record system,” Minister Greg Hunt’s explanatory statement to the My Health Records (National Application) Rules 2017 says.

Online consults result in more work, not less

5 December 2017


What lessons can we draw from an experiment in the UK?
The idea of offering online consultations might be total anathema to some GPs. But if anything could persuade you that they really are the future, how about the idea they would save that most valuable commodity: time?
For example, what if the patient could fill out an online questionnaire with plenty of room to detail their complaint, which was then printed and delivered to you by your staff?
Voila, no face-to-face appointment required and time saved. Of course, there may be some medicolegal issues to contend with.
6 December 2017

Wild Health: Pay GPs to create health record

Posted by TMR Staff
My Health Record won’t take off without economic incentives for GPs to use the system, says Dr Tony Sara, the medical adviser at the South Eastern Sydney Local Health District.
“We all want it to work,” Dr Sara told The Medical Republic at the Wild Health Summit.
“Given that there is no fundamental economic model, then my sense is that there needs to be some sort of payment to incentivise GPs to create the record.”
8 December 2017

Wild Health: Is AI making headway in medicine?

Posted byTMR Staff
AI has crept into many areas of medicine already, says Professor Enrico Coiera, the director at the Centre for Health Informatics at Macquarie University’s Australian Insititute of Health Innovation.
“AI has been with us for 20 years or more,” Professor Coiera told The Medical Republic at the Wild Health Summit.
“We don’t even know that behind the scenes we’ve got intelligence algorithms doing everything from interpreting our blood tests [to] helping radiologists look at CT scans,” he said.

Pharmacy boost for My Health Record

Thursday, December 7, 2017 - 16:23
Every Australian pharmacy will be able to use My Health Record, with the final software provider about to connect to the system, reports industry newspaper Pharmacy News.
Corrum point of sale (POS) and script dispensing software, which is used by 1000 pharmacies nationally, will connect to the system next year.
Pharmacy uptake has also been boosted by Chemist Warehouse, which says it plans to roll out My Health Record in all of its pharmacies.
There are reportedly just over five million Australians with a My Health Record, and nearly 13 million prescriptions and dispensing records have been added to the system.

This suicide prevention app is a good idea, but needs work

5 December 2017


Product: My Coping Plan 
Price: Free 
Pros: Simple and easy to use, would remind some patients what to do when it becomes difficult to cope
Cons: Unlikely to garner enough interest to regularly use and therefore may be forgotten when needed 
Verdict: ★★★☆☆
1 December 2017

Mind the private and public procedures health gap

Posted by Jeremy Knibbs
The days of angry private health patients blaming their GP for sending them to hospital only to discover they have an out-of-pocket fee in the many thousands many be nearing an end.
If you’re a privately insured patient about to undergo a hospital procedure, one of three things can happen. Your specialist can be participating with one of the insurers in a “no gap” or a “known gap” scheme, or they can be non-participating.
Depending on the specialist you are directing a patient to, even the clinical aspects of your referral can be overridden by the financial settings if they are dire, which sometimes they can be.

CSIRO’s start-up accelerator selects AI, virtual reality and genomics health innovations

Lynne Minion | 08 Dec 2017
AI for gut disorders, virtual reality aids for carers, and genomics to develop drugs faster are among the emerging technologies selected for the latest intake of CSIRO’s sci-tech accelerator ON.
A fast-track to market, ON brings together researchers, entrepreneurs and mentors, and the new batch of innovators are tackling some of Australia's greatest challenges in energy, food and agriculture, water quality, wildlife conservation and health, according to CSIRO Chief Executive Dr Larry Marshall.
“Establishing ON was about bringing the Australian research sector closer to Australian industry – creating a pathway to help our scientists turn their excellent science into real-world solutions,” Marshall said.
  • Dec 6 2017 at 6:26 PM

Doctors asked to not include ‘grief reactions’ in medical records

Doctors say patients are asking them to exclude "ordinary grief reactions" from medical records because they don't want this information passed onto insurers as the insurance industry seeks to deal with what it describes as a 'tsunami' of mental health related claims.
The president of the peak body for general practitioners, Dr Bastien Seidel, said patients asking doctors to omit instances of grief, anxiety and other mental health information from their medical record is "not an issue for insurers" but is a significant problem for GPs.
With the banking royal commission likely to investigate cases relating to discriminatory practices in insurance cover, including the denial of cover and denial of claims, and a spike in mental health claims risking the sustainability of the sector, insurers are being forced to look at the quality of their risk profiling, as well as their underwriting and claims processes.
8 December 2017

Where are we at with real-time monitoring?

Posted by Julie Lambert
GPs will play a central role in the first serious attempt to stop doctor shopping and illicit use of pharmaceutical drugs on the Australian mainland.
Under legislation passed on October 19, Victoria will have the distinction of becoming the first state to impose a mandatory real-time prescription monitoring regime, giving doctors, pharmacists and nurse practitioners ready access to a patient’s prescription history.
The initiative rides on the back of Tasmania’s successful DORA monitoring system, which has been in place since 2011. But the challenge for Victoria is to cover a population 12 times larger, and an expanded list of medications. Not to mention the problem of bordering jurisdictions that have yet to get on board with real-time monitoring.

Depression and mental health apps: How to tell the good from the bad

Posted Wed at 11:12am
There are currently more than 10,000 depression and anxiety-related self-help apps available to download, the American Psychiatric Association estimates. But less than 1 per cent have been professionally evaluated.
Cause for concern? Well, yes. But not a cause for depression, says Harvard Medical School's John Torous, who leads the association's working group on smartphone app evaluation.
In fact, he sees great promise in digital mental health technologies.

GPs: Install the latest version of clinical information systems (CIS) to get the most of out of My Health Record

5 December, 2017
Dr John Aloizos AM shares his views on how digital health benefits him as a GP, plus how important it is to ensure clinical information systems (CIS) are updated to get the most out of My Health Record.
As a GP, I often find myself in conversation with colleagues who are in general practice about My Health Record and initiatives that the Australian Digital Health Agency is leading to connect other parts of the sector in the lead up to national opt-out.
One of the frequent comments I hear is:
I’ve tried using the My Health Record in my CIS but it’s too cumbersome to locate useful information. We were told usability improvements had been made – but I’m not seeing them! When will the My Health Record be fixed? When will the usability issues be fixed?’
In response, my question is: ‘When did you last upgrade your practice CIS?’

Ethics, regulation and the medical devices boom

Editor: Amy Coopes Author: Amy Coopes on: December 04, 2017
In an era of medical apps, remote-controlled biomedical devices and 3D printing, regulatory and quality-control challenges will enter unprecedented territory, the latest Consumers Health Forum journal explores.
In a special edition of Health Voices on medical devices, the ethical, practical and personal dimensions of this runaway industry’s frenetic expansion comes under the spotlight.
Australia has seen a number of scandals involving implants in recent years, including metal-on-metal hip replacements, breast inserts and, perhaps most famously of late, trans-vaginal mesh, which is the focus of a paper by Health Issues Centre chief Danny Vedasz.

Queensland research into hospital digital systems finds the benefits outweigh the risks

Lynne Minion | 04 Dec 2017
Ehealth technologies can improve patient care, lower costs, increase efficiency and prevent duplicated tests in Australian hospitals but they risk causing “alert fatigue” and prescription errors, according to new research published in Australian Health Review.
 Conducted by a team of authors involved in the digitisation of Brisbane’s Princess Alexandra Hospital, Going digital: a narrative overview of the clinical and organisational impacts of eHealth technologies in hospital practice claims ehealth systems can improve healthcare processes and patient outcomes but much is still to be learned about best practice design and use.
The study by PAH and Queensland’s Metro South Hospital and Health Service evaluated recently published research reviews of electronic medical records, electronic prescribing, computerised decision support systems and computerised physician order entry technologies, and found the benefits outweighed the risks.

Digital platform GoShare rolls out in NSW health service to help chronic patients help themselves

Lynne Minion | 05 Dec 2017
Reassuring patients they are not alone and providing resources for them to better manage their conditions are among the aims of the Western Sydney roll-out of a digital platform designed to help the chronically ill.
WentWest and Western Sydney Local Health District have signed up the patient education tool GoShare to provide multimedia guidance for people living with chronic disease, with the view to improving health outcomes, preventing complications and reducing avoidable hospitalisations.
Following a successful 12-month pilot with WentWest, this new agreement will allow all healthcare professionals across the continuum of care in the region to use GoShare with patients, including those requiring cardiac rehab.

It’s time to talk about who can access your digital genomic data

December 4, 2017 6.18am AEDT


  1. Caitlin Curtis  Honorary Research Fellow, The University of Queensland
  2. James Hereward  Post  Doc Ecological and Evolutionary Genetics, The University of Queensland
We are approaching a time when you might be too scared to have your genome sequenced.
Only last week, a US senator called for an investigation into the privacy policies of direct-to-consumer DNA companies. But this is only one piece of a puzzle that is about to get much more connected.
As with any kind of personal data there are a number of concerns regarding collection, transmission, storage and use. But unlike most other data, your genome reveals intimate information about not only you, but also the people to whom you are related.
It’s time to talk about who can access that data, how, when and why.

Avatars put a face to schizophrenic voices

Wednesday, 06 December, 2017
Therapy using avatars appears to help reduce auditory hallucinations for people with schizophrenia.
An experimental therapy which involves a face-to-face discussion between a person with schizophrenia and an avatar representing their auditory hallucination may help reduce symptoms when provided alongside usual treatment, according to a study published in The Lancet Psychiatry.
The randomised controlled trial compared the avatar therapy to a form of supportive counselling (adapted specifically for the study). It found that avatar therapy was more effective at reducing hallucinations at 12-week follow-up, and had a large effect size.

Consumer-centred digital health on the horizon

Thursday, 07 December, 2017
The Australian Digital Health Agency and Consumers Health Forum of Australia have signed a memorandum of understanding to ensure that digital health solutions are consumer centred.
It is hoped that the ongoing development of My Health Record will enable improved safety and quality of patient care.
“Our unique partnership with the Australian Digital Health Agency will ensure health consumers have a real voice in developing Australia’s digital health capability,” said CHF CEO Leanne Wells.
“Importantly, the MoU supports the national effort to promote increased use of the My Health Record system by consumers and carers.”

Consumers’ voice drives digital health

7 December 2017Media release
Health consumers are central to the design and delivery of a digital transformed health sector and the ongoing development of My Health Record, a digital system that enables improved safety and quality of patient care.
A Memorandum of Understanding signed between the Australian Digital Health Agency and the Consumers Health Forum of Australia (CHF) will ensure that digital health solutions are consumercentred and advance the efficiency, quality, and delivery of healthcare in Australia.
“Our unique partnership with the Australian Digital Health Agency will ensure health consumers have a real voice in developing Australia’s digital health capability. “Importantly, the MoU supports the national effort to promote increased use of the My Health Record system by consumers and carers,” CHF CEO Leanne Wells said.

Senior Telstra executive Cynthia Whelan to depart

  • The Australian
  • 12:47PM December 8, 2017

Supratim Adhikari

Telstra has lost another senior executive, with group executive of its new business division, Cynthia Whelan, leaving the telco.
Ms Whelan, who has headed Telstra’s new business portfolio since 2015, is also the chairman of Foxtel and a director on Telstra Ventures and Telstra Health.
At Telstra (TLS), Ms Whelan has had responsibility for driving growth initiatives into new markets.

Freedom of information: Australians are losing the battle against government secrecy

Richard Mulgan
Published: December 5 2017 - 12:15AM
The information commissioner survived abolition but FOI remains nobbled.
Government policy on freedom of information remains in limbo. In 2014-15, thanks to resistance from the Senate, prime minister Tony Abbott and his Attorney-General, George Brandis, failed in their initial aim of fully abolishing the Office of the Australian Information Commissioner. But they certainly succeeded in reducing its resources and public standing.
Though the office's statutory functions were later fully restored under the leadership of the privacy commissioner, Timothy Pilgrim, who took on the extra role of information commissioner, funds available for FOI functions remain well below former levels. Throughout this period, the office has kept a low profile on FOI issues while concentrating more on privacy and access to government data.

This GP isn't slowing down in his specialist fee crusade

7 December 2017


Earlier this year, we wrote about Dr Richard Zhu, the revolutionary Sydney GP on a mission to list the fees of every specialist in Australia.
His resulting website, SeekMedi.com.au, made national media headlines with praise from both GPs and patients for fighting for greater fee transparency.
What has happened since? Do doctors and patients use it? Is it making a difference? 

How much is too much information? The dose response curve of informed consent

Australia November 9 2017
“While the over-informed person is inconvenienced, the under-informed has his/her autonomy violated.” – United States Medical Ethicist, Robert Veatch.
“A patient may make an unbalanced judgment because he is deprived of adequate information. A patient may also make an unbalanced judgment if he is provided with too much information and is made aware of possibilities which he is not capable of assessing because of his lack of medical training, his prejudices or his personality.” - Lord Templeman in Sidaway[1] (1985)).
It has now been 25 years since the High Court of Australia[2] decided the case of Mrs Whitaker – the unfortunate lady who developed sympathetic ophthalmia in her left eye following an operation on her right eye. The High Court held that the surgeon, Dr Rogers, was liable for failing to warn Mrs Whitaker specifically about this rare, but devastating, risk of the procedure.

Google and others lead AI revolution in machine learning

  • The Australian
  • 12:00AM December 7, 2017

Chris Griffith

We’ve seen the beginnings of artificial intelligence in the world around us. But AI could also reside inside us. The idea ­exists that microscopic nano­machines could be injected into our bloodstream, scouting for ­disease and repairing cells through the use of artificial intelligence, within 20 years.
Senior inventor John McNamara discussed the idea at a British House of Lords AI committee meeting in October, so I was keen to hear the views of another of the world’s most eminent AI experts about the concept during an interview last week.
Jeff Dean is senior fellow at Google and last week was key speaker at Google’s AI conference in Tokyo. The conference revealed a plethora of AI projects that ­Google, Dean and the company’s engineers are involved with.

HFC network will need work to be fit for NBN: experts

Technical experts who have closely followed the rollout of the NBN say Telstra's HFC network will need considerable work done on it to meet the needs of NBN customers.
Last week, NBN Co, the company rolling out the national broadband network, said that network issues would mean a delay in HFC connections of anything from six to nine months.
Dermot Cox, an HFC expert and business consultant, told iTWire the HFC platform was fine, but "running out of capacity, yes. In need of field workforce training, yes; in need of robust NBN Co workforce craft practices, yes".

NBN Co will have to maintain HFC network no matter what

The NBN Co will have to continue maintaining the Telstra HFC cable network even if the condition of the cable network makes it impossible to be used for the national broadband network.
This is one of the conditions of the deal which NBN Co signed with Telstra for use of its HFC network, the Australian Financial Review reported.
NBN Co is paying Telstra $5 billion in infrastructure payments, $4 billion in disconnection payments and $2 billion in Commonwealth agreements for the HFC network.

Alan Kohler: how to fix the NBN

  • The Australian
  • 6:32AM December 4, 2017

Alan Kohler

Last week NBN Co took its first faltering step towards some kind of adulthood. There’s a long way to go.
The decision to delay HFC cable connections so the technology could be fixed was its first assertion of independence from the government, which is on the hook politically for a quick rollout of the network. That’s because speed of rollout was part of the reason given for downgrading it, the real reason being that it had to be different from the ALP’s idea.
Actually, the press release last Monday was a pretty phony piece of spin, and was rightly described as “glitter on a turd” by journalists the next day.


Bernard Robertson-Dunn said...

In Wild Health: Pay GPs to create health record, there is a quote:

Dr Sara told The Medical Republic at the Wild Health Summit... “Given that there is no fundamental economic model ...."

Is that code for "there is no financial benefit for patients and/or government in using MyHR"?

Many of us blog readers believe that but for Dr Tony Sara, the medical adviser at the South Eastern Sydney Local Health District to say the same thing, is quite something.

Anonymous said...

When something is so good you have to force people to subscribe to it and then pay people to use it? Sounds like a winner to me.

Dr Ian Colclough said...

The absence of a viable business model can only lead to failure.

Anonymous said...

9:27 PM Is it possible to create a viable business model around a project like the My Health Record when the government funds and controls the project? I don't think it's possible, do you?

Grahame Grieve said...

business model <> economic model. In general, if there's a business model for doing something, then the government probably shouldn't do it. But here, 'economic/business model' is some proxy for whether the idea of the MyHR is practical, for some combination of participants. But which ones? practical how?

Note that if we look into history, we have to realistic and say that the shape of the MyHR is not the national EHR that would have been designed in some theoretical perfect land; instead, it's what we got from a combination of different political constraints (e.g. "Australia card"). We can ask whether this is the right compromise, or what we might do to improve it. Also we can ask whether the right incentives are in place, or whether the whole endeavour is a value proposition - I'm not sure which is being asked here (and if it's the second, it's not clear to me that people are all discussing the same scope when they ask about the value proposition - the system we intended to create, the one we ended up with, or some future state we could build from here?)

Anonymous said...

I think the fundamental problem is the "fear of failure" obsession of government rather than political constraints that have shaped the path and disasters (such as myHR)that have manifested over the past few decades. If any bureaucrat reads this blog then at least understand that it is OK to fail ...as long as you lean from the mistakes and be prepared to engage much more broadly with the health community to pursue a range of different options ... it does not need to be just one stream of investment !!

Perpetually kicking the can down the road from fear of the political (and other) ramifications from pulling the plug is an insidious disease that is holding back investment in innovation that could really make a difference to the delivery of health care and patient quality of life / health outcomes.

Anonymous said...

..... which is why it is a waste of time engaging with the bureaucratically inept in the hope one might effect a change for the better. The bureaucracy will always retreat to a previous level where it felt secure and comfortable. It has been said many times previously progress will best be made without the stultifying impediments that are associated with government involvement. While government support is to be encouraged, involvement is to be discouraged. I'm from the government and I'm here to ......

Bernard Robertson-Dunn said...

In system architecture terms a business model is part of set of architectures that focus on what problem is to be solved and an analysis of the processes and data needed to solve that problem, independent of any technology.

The fact that this was never done explains why the question "what is myhr for?" keeps coming up and why other solutions are better alternatives.

myhr was a technology solution designed and implemented with no understanding of the health care problems it was supposed to address.

We are now suffering from the "sunk cost" problem. $2b has been spent, it would be embarrassing to admit that it has been a waste of money.

The old adage "if you have dug yourself into a hole, the last thing you should do is keep digging" applies in spades.