March 22, 2018 Edition.
It is really impossible to believe what is going on in the Trump Whitehouse at present. It is so bad that the Chief of Staff has had to reassure the staff that the “night of the long knives” is almost over and that most of their jobs are safe! Just amazing… With firings, tariffs(big time now with China announced on Friday) and increasing tension with Russia, China and NK it is hard to see what else will go wrong but I feel sure something will!!!
The only good news is that it seems that despite gerrymanders in many districts that the Republicans will lose their House Majority in November and that a real check on Trump will come into place.
In Australia it has been all about Mr Shorten tax grab and the furious reaction to it. He may just have overreached with this one as there are a fair few who are not fat cats who are hurt – some quite badly. The next Newspoll will be very, very interesting as will the election results in SA and Batman.
As it turns out Batman has been retained by Labor and The Liberals are forming a new Government in South Australia after 16 years of Labor rule.
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Here are a few other things I have noticed.
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Major Issues.
Conservatives leave door open to progressive change
- The Australian
- 12:00AM March 10, 2018
Noel Pearson
There is truth in conservatism. Not the narrow preservation of inherited wealth but the importance of inherited social, cultural and religious institutions and traditions.
Edmund Burke’s preference for the “small platoons” of society and our responsibilities to dead ancestors and unborn descendants is foundational. Conservatism speaks to our memory as peoples and cultures and lifts us out of our mundane material existence, offering answers to humankind’s great questions and life’s meaning.
Ever since, as a 14-year-old, I embarked on a political letter-writing campaign from my Brisbane boarding school against the decision of the Hope Vale show committee to turn our annual show day, with its wide variety of events and activities for non-cowboys into exclusively a rodeo, I realised the importance of conservatism. I had been a silent participant in the show committee’s Wednesday evening proceedings since I first accompanied my father as a small boy. I know small platoons. Alas, I lost the battle.
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How we could gang up against a Trump trade war
By Ross Gittins
11 March 2018 — 2:16pm
A possible trade war looms and, as always, an adverse overseas development has caught poor little Oz utterly unprepared. Well, actually, not this time.
Just as Treasury had been war-gaming the next big world recession well before the global financial crisis of late 2008, so the Productivity Commission began thinking about our best response to a trade war soon after the election of Donald Trump.
In July last year it published a research paper, Rising protectionism: challenges, threats and opportunities for Australia, to which Dr Shiro Armstrong, co-director of the Australia-Japan Research Centre, at the Australian National University, made a major contribution. (During a visit to ANU last week I also benefited from discussion with Professor Jenny Corbett.)
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Steel tariffs show Australia isn’t fair dinkum when it comes to fair trade
- The Australian
- 12:00AM March 12, 2018
Adam Creighton
It is said all is fair in love and war. It is, or should be, in trade too. The idea of fair trade, which motivates new US steel and aluminium tariffs, doesn’t stand up to scrutiny.
If countries can produce goods and services more cheaply, that’s not unfair — it’s just a fact of economic life. If others want to erect trade barriers, that’s their right too. They only hurt themselves. You won’t find any rich countries with high average tariffs.
“If they drop their horrific barriers & tariffs on U.S. products going in, we will likewise drop ours. Big Deficit. If not, we Tax Cars etc. FAIR!” President Donald Trump tweeted yesterday, capping a series of tweets that included demands for Japan to curb its $US100 billion trade surplus with the US — “not fair or sustainable”.
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Come on in! Australia's secret to avoiding recessions
By Jason Scott
13 March 2018 — 6:51am
Australia is standing firm amid growing calls for immigration curbs, even as the US and Europe succumb to rising populism. It has little choice if it's to continue its period of record economic expansion.
A flood of arrivals that's swelled the population by 50 per cent over the past three decades has underpinned economic growth and allowed a succession of governments to boast of avoiding recession since 1991. Populists are blaming immigrants for over-burdened infrastructure, soaring housing prices and low wage growth.
Former Prime Minister and now backbencher Tony Abbott is among those saying "enough." He wants to slash the annual allowance to 110,000 migrants from 190,000, a move the government says could shrink its coffers by as much as $5 billion over four years. Pauline Hanson's One Nation is calling for a complete halt to immigration.
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Who is to blame for the housing crisis and how to fix it
By Ross Gittins
Updated 14 March 2018 — 7:37am
There aren't many material aspirations Australians hold dearer than owning their own home - but dear is the word. There are few greater areas of policy failure.
The rate of home ownership, of which we were once so proud, has been falling slowly for decades. And as the last high home-owning generations start popping off, it will fall much faster.
Melbourne is growing faster than any capital city in Australia, but at what cost?
We've been debating this issue for years, while it's just got worse. Yet we have a better handle on the causes of the problem, and what needs to be done, than ever.
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Disillusioned voters not keen to go to the big party
- The Australian
- 12:00AM March 14, 2018
Paul Kelly
The malaise in our democracy is a malaise of party. This is a core truth too rarely stated. The major parties of government, Liberal and Labor, are ailing and face a loss of primary votes that, without correction, will mean a realignment to some degree in the party system.
If the main parties cannot check and reverse this trend then our democracy and our government will change in fundamental ways — almost certainly for the worse. In its report this week, A Crisis of Trust: The Rise of Protest Politics in Australia, the Grattan Institute warns the big parties face a choice: they can instigate radical improvements or prevaricate until voters “rebuild governments without them”. The report finds Senate votes for minor parties exceeded 26 per cent at the 2016 election, the highest level for 60 years and 15 percentage points above the 2004 figures — largely at the expense of the Coalition and Labor.
It says a minor party vote beyond 25 per cent “is prone to reshaping politics”. At the recent Queensland election the minor party vote reached 31 per cent and at the upcoming South Australian election Nick Xenophon, now fading, was involved in three-way debates over the next premiership.
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Pimco dumps Australian banks, property bonds as risks escalate
By Ruth Carson & Andreea Papuc
15 March 2018 — 8:46am
Pacific Investment Management Co., one of the world's largest bond managers, is cutting its investments in Australian bank debt because of lofty valuations. It's also trimming holdings of real estate and retailers' bonds.
The unwinding of some of its holdings in Australian lenders' debt is the first such move in about five years by the $US1.75 trillion ($2.2 trillion) money manager.
Pimco's reduction of its exposure to notes sold by real estate investment trusts and local retailers reflects concerns that surging personal debt will constrain consumption, according to Aaditya Thakur, senior vice president and portfolio manager in Sydney.
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Why Australia joining ASEAN is a great idea
By Peter Hartcher
16 March 2018 — 12:05am
Why are the leaders of south-east Asia holding their summit in Australia for the first time? Malcolm Turnbull invited them because Australia is feeling more insecure in the world than at any time since World War II.
With a mad king in the White House castle and with an unconstrained China breaking international rules, Australia is casting about for security. South-east Asia could be Australia's last best option.
And its leaders agreed to come because they are feeling every bit as edgy, and some of them much more so.
Vietnam, for instance, is in a state of high alert against Chinese maritime territory-grabbing. Last week it hosted a US aircraft carrier for the first time since the Vietnam War.
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Trade wars: a group exercise in self-destruction
By Ross Gittins
17 March 2018 — 12:15am
With The Donald now busy playing poker with Little Rocket Man, the threat of a trade war has receded. Good. Gives us time to get our thinking straight before the threat returns.
Everyone knows a trade war would be a terrible thing, but most people's reason for thinking so is wrong. This misunderstanding means such a war could happen, even though everyone knows it would be bad.
Global stocks and the dollar slumped on Wednesday after a strong White House advocate for free trade resigned, fanning fears that President Donald Trump will proceed with protectionist tariffs and risk a trade war.
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Royal commission bombshells - great to watch, painful to receive
By Jessica Irvine
17 March 2018 — 12:05am
AT 10am on the street outside the Commonwealth Law Courts Building in the heart of Melbourne’s CBD – home to several courts and, from Tuesday, the Turnbull government’s bank royal commission - the queue of people waiting to clear security snaked out the door, and around the corner.
Inside, the response from Commissioner, Justice Kenneth Hayne, was swift, delivered the next day.
“As I foreshadowed yesterday, unless somebody has good reason to the contrary, I propose to start sittings from tomorrow commencing at 9.45. Anybody game enough to suggest otherwise?” Hayne challenged the assembled packed courtroom of silks, solicitors and public relations experts acting for banks, along with media and the odd disgruntled bank customer – none of whom dared to dissent.
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Aussies who missed out on economic good times
- The Australian
- 12:00AM March 17, 2018
Adam Creighton
Rick Morton
Recall the proverb about the struggling Russian farmer Ivan who, granted a wish by God that he could have whatever he wanted on the irritating condition his neighbour would receive double, decided he wanted one eye plucked out. That’s a seriously warped case of envy, but pecking order matters greatly to many, perhaps even as much as their own standard of living.
Analysis revealed in The Weekend Australian today shows the dramatic improvement in real incomes across all income groups since 1988. Overall, our living standards are almost 70 per cent higher than they were then, adjusting for increases in the cost of living. Even the so-called poor are much better off — so-called because Australians today are, across whatever measure one chooses, among the richest people to have lived.
According to research by Peter Whiteford, a professor of public policy at the Australian National University, the median household income in Australia, adjusted for inflation, has increased more between 1995 and 2012 than in any of the 18 other major OECD countries, just pipping Norway.
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Marshall storms to win in SA election
Liberal leader Steven Marshall has claimed victory in the South Australian election, and thanked voters for electing them into a majority government.
Tim Dornin
Australian Associated Press March 17, 20188:50pm
Mr Marshall will take over from Labor's Jay Weatherill as premier with the Liberals likely to win at least 24 seats, enough to govern in their own right.
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I guess some are watching the Facebook-CambridgeAnalytica brouhaha.
ReplyDeleteFrom Adrien Chen at The New Yorker
On Wednesday afternoon, after remaining conspicuously silent since Friday night, Zuckerberg pledged to restrict third-party access to Facebook data in an effort to win back user trust. “We have a responsibility to protect your data, and if we can’t then we don’t deserve to serve you,” he wrote on Facebook.
In relation to that, and to health data, I reckon the operative word is your, as in what is theirs and what is it we can claim as "ours" when push comes to shove at the High Court.
HealthIT.gov (a USA government agency) says:
ReplyDelete"Personal health records (PHRs) contain the same types of information as EHRs (Electronic Health Record) — diagnoses, medications, immunizations, family medical histories, and provider contact information—but are designed to be set up, accessed, and managed by patients. Patients can use PHRs to maintain and manage their health information in a private, secure, and confidential environment. PHRs can include information from a variety of sources including clinicians, home monitoring devices, and patients themselves."
The important bits being "designed to be set up, accessed, and managed by patients" ... "in a private, secure, and confidential environment."
According to information on myhealthrecord.gov.au, you can’t delete or edit information, the only people who can edit data are those who created the document in the first place; any new documents are added to whatever was already there, you don’t get to see who has accessed your record, only the institution, you can’t control access on an individual health professional basis, once again, only the institution, you can’t cancel or delete your record, only suspend it. The government gets to see everything in it and keeps it, effectively, for ever.
IMHO, whatever else myhr may or may not be it isn't a Personal Health Record and doesn't deserve to be called "your". It's the government's.
With the way Peter Dutton is carrying on and with a former bank CEO running the DTA the interests of the citizens, residents and visitors of Australia will be at best secondary concerns over the opinions and greed of inderviduals in Government. I guess this is just another symptom of a broader global illness in Governments
ReplyDeletemYHR and private and confidential don't go together. Not when the ABS has made it quite clear it wants to link "your" health data with census data. And de-identification of health data has been proven to be an impossibility.
ReplyDeletePeter Dutton would be proud of the ADHA then, there are some nasty patterns emerging in some divisions.
ReplyDeleteHoping it is just a hiccup and not a sign the ADHA is falling apart. They have just notifies the the AMT Snomed CT AU release is delayed. A few of us were hoping to do some development this weekend in preparation for the connectathon. Thanks Tim owe you one.
ReplyDeleteAnother stuff up by their IT department management. Apparently they sacked the guy who ran the system and now they're scrambling to get it up and running!
ReplyDelete@9:19 AM. Those responsible do understand the importance of this terminology service don’t they? It is probably the only clinically useful output they have. There is seemingly an issue with their It management if they cannot hold onto staff. There is clear evidence going back to late 2017 that all is not well. Even if they did let someone go they surely could not be so arrogant as to not have in place an alternative. Maybe Tim is sacking the wrong people.
ReplyDeleteDisgraceful that this should happen to what is it has been a reliable release cycle. Tim has let the whole community down and those that work so hard to keep AMT and NCTS moving forward.
The conflict of interest problem is probably to hard to deal with. The GM of HR is supposedly best pals with the guy now running IT, who apparently appeared out of thin air into a role created especially for him and a role never advertised
ReplyDeleteA conflict of interest of the nature you mention is quite a serious matter in the public service. I wonder if the CEO knows if this as I cannot see him being that silly.
ReplyDeleteADHA seems quite dysfunctional, from many perspectives. I wonder if this is obvious from the political perspective?
ReplyDeleteSeems to me it would be hard to manage such a big operation like ADHA is your always out of office and on tour.
ReplyDeleteYes it would be hard, especially if your executive general managers are not doing their jobs and turning a blind eye to such behaviour and practices. Or perhaps ADHA at the top is dysfunctional which would be the CEO shortcoming.
ReplyDeleteFor the sake of the persons reputation. That person resigned. Why is for that person own reason, as I am sure it is with the many others resigned. The fact good people are resigning and some critical parts of ADHA are leaderless and run questionable ethics remains a major concern.
ReplyDeleteRegardless of the reason (although if true warrants a review) the impact is that I at least am concerned this is perhaps a sign, and not a good sign for the future. A lot of investment has been made by the whole community and significant progress has been made in driving the adoption of national standard coding systems such as SNOMED CT-AU and the Australian Medicines Terminology (AMT). The advent of the National Clinical Terminology Service (NCTS) has created a significantly improved distribution mechanism for code system distribution, lowering the barriers to adoption in Australian health IT systems. If some little short sighted IT manager is unable to grasp the importance then perhaps the manager is not the right fit. There are other support desks they could 'manage'
ReplyDeleteSort it out Tim this is just one more indicator that perhaps opt out is to big for ADHA.
Happy to see someone got AMT/SNOMED CT-AU released. Shame we have had a network outage all day. We are questioning if this IT mis-manager will keep the lights on long enough for ADHA to get to opt out. Certainly earning the rank of hero
ReplyDelete"Those responsible do understand the importance of this terminology service don’t they?"
ReplyDeleteOne must assume that the national MyEHR system itself uses the national NCTS terminology service? Otherwise, it would not be able to 'understand' a SNOMED or AMT code if that was included in an uploaded document from a hospital or pharmacy or GP practice. Nor would it be able to support clinically meaningful and safe use of data.
It would be too ironic if the MyEHR system did not use the terminology service that the ADHA is promoting to the ehealth community. Interoperability and all that jazz.
Surely they have or are acting on recommendations- https://www.safetyandquality.gov.au/wp-content/uploads/2017/08/Seventh-7.2-Medicines-view-Clinical-Safety-Review-of-the-My-Health-Record-System.pdf
ReplyDeleteBut then again having offices offline for a day in this age of IT system capabilities one would guess medicines terminology is a bit advanced for the CEO to grasp
Conscription is the aim at present. Once that is complete and the Government has no way out, then endless and most likely fruitless attempts will be made to enhance the system. The one guaranteed deliverable will be the massive bill we will be made to pay.
ReplyDeleteDoes anyone know if a report was ever commissioned on the use of AMT in the MyEHR?
There was a report commissioned a few year back on data quality in the MyHR. The report provided a table indicating terminology usage. I believe it was quickly buried. Where it might be I cannot assist as I was more than happy to move on.
ReplyDelete"One must assume that the national MyEHR system itself uses the national NCTS terminology service?" - no.
ReplyDeleteIt's a question of life cycles - the core of the MyHR was laid down a decade ago, while the NCTS was only introduced a few years ago. The MyHR runs an internal terminology service which is not publicly accessible, nor very strongly based on standards. That's what was available at the time. There was some discussion early on about exposing formal terminology services, but none of the things needed - appropriate specifications, architecture, budget, and time - were available.
Given that, there's as yet been no chance to make the kind of changes to get the MyHR to use the national terminology service. It's a very obvious and beneficial thing to do when we replatform the MyHR - and I've blogged that this will be discussed this year and acted on next year (well, that's the plan). So hopefully that will be part of the discussion
"Otherwise, it would not be able to 'understand' a SNOMED or AMT code" - it does, using the internal terminology service.
Further to my rant about the uselessness of myhr, and the future being connected health records, I suggest you read this:
ReplyDeletehttps://www.digitalcommerce360.com/2018/03/20/connected-health-records-start-where-electronic-records-end/
"A static, allegedly comprehensive health record misses the dynamics of an interactive, learning health system. Rather, patients, providers, population health agencies, registries, payers, researchers, social service agencies, community centers, and accountable care organizations all need interconnected systems and records."
And remember myhr isn't even a comprehensive health record, its a summary, at best.
It is a good job Digital Health is not a technology problem. This ADHA is a joke. We were promised new equipment, best breed, improved user experience. It's is beyond funny and the arrogance is unbelievable. COB today and pretty much it for myself at ADHA.
ReplyDeleteFollowing on from yesterday's unplanned power outage, most services have been restored in the Canberra office. The IT team is working to restore all services as our highest priority.
Network access is available through wired desk connections and Wi-Fi.
Print and scanning services are working normally on the multi-function devices.
Video conference services are operational in meeting roooms 6.112, 6.113 and 7.113.
Polycom desk phones and conference phones are now operational.
Staff using Windows 8.1 laptops can access shared folders and home drives hosted on the Canberra file server
The IT team is working to resolve issues for staff using Windows 10 laptops accessing shared drives and home drives on the Canberra file server.
Nobody knew IT could be so complicated.
ReplyDelete@9:13AM .... complicated? Just like Health Care Homes if Steve Hambleton's comments as reported in The Medical Observer and Australian Doctor.
ReplyDeleteOh yes I see what you mean "The architect of health care reform said implementation went wrong somewhere".
ReplyDeleteGosh, implementation can be complicated for the enthusiasts with little experience.
Steve Hambleton is a classic example of the Dunning-Kruger effect at work.
ReplyDeleteDr Hambleton must have same book of excuses as Bettina Kinti - Extract from Znet
ReplyDeleteAll our focus is on ensuring that we can complete the National Cancer Screening Register to support cervical screening, and for that reason we and Telstra Health have moved our resources into that in order to ensure that occurs. Once that is implemented and stable, the planning will recommence for bowel cancer transition," Konti told the committee.
"It's a shift in date."
However, while late 2019 is the goal, Konti admitted that "there isn't a target date" for the bowel cancer screening register, because the inefficient paper-based register can continue being used until then.
I think the government is doing well as prevent information falling into the wrong hands by preventing it from comming into existence. Tim would do well to rehearse with these two.