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, June 04, 2018

Weekly Australian Health IT Links – 4th June, 2018.

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

Senate Estimates happened and discussion of the opt-out plan continued. Good to see there is a reasonable about of discussion. Other fun things included for amusement.

'Better than nothing': A GP early adopter reflects on six years of My Health Record

Dr David Guest was there at the beginning
31st May 2018
Six years ago, Dr David Guest was one of only a handful of GPs uploading shared health summaries to My Health Record in the hope that it would improve communication and patient care.
This was in April 2012, when a man called Donald Trump was no more than the bizarrely quiffed host of a TV reality show called The Apprentice.
Fate has changed his life since then, but has My Health Record done the same thing for patients and GPs?
“It’s not the best system, but it’s marginally better than none,” he says.

Cover Story: Every Australian could have a digital health record by October 15. But critics question the value

On the 15th of October this year every Australian citizen will have a digital health record created for them under the government’s My Health Record system, unless they explicitly request otherwise. Those who do not wish to have a digital health record stored in a national database have three months from July 21st to opt out.
The ehealth initiative is similar to many other digital health record systems in developed nations and has sparked debate over the potential impact of data and digital technology on health systems.
Proponents of digital health records claim aggregating medical data improve cost and quality outcomes and lays the foundation for advanced use cases like artificial intelligence and machine learning. But critics argue the benefits are unproven and the privacy and security risks too great in some instances. And they argue that scope creep could create unexpected consequences for health consumers.

You have 3 months to opt out of electronic health record

Otherwise, the government will simply create one for you.

By David Braue on May 29 2018 11:16 AM
After years of trying carrots, the federal government is getting out the stick by controversially forcing all Australians to opt out of the My Health Record (MHR) program or have one automatically created for them by year’s end.
Some 5.7 million Australians have so far joined MHR, which was created in 2016 in a realignment of the Personally Controlled Electronic Health Record (PCEHR) project – which progressed in fits and starts after being favoured by government policy at the beginning of the decade.
The My Health Records Act 2012 laid out the goals of a voluntary electronic healthcare system that would overcome fragmentation; improve the availability and quality of health information; reduce the occurrence of adverse medical events and the duplication of treatment; and improve the coordination and quality of healthcare provided to healthcare recipients by different healthcare providers.

Surge in pharmacy registrations for My Health Record

Lots of interest ahead of opt-out period
1st June 2018
Pharmacies are increasingly embracing My Health Record, with 40% now registered on the system, according to the latest issue of Forefront.
Pharmacy Guild President George Tambassis says the organisation is working with the Australian Digital Health Agency (ADHA) to ensure dispensing and medicine-related services are fully integrated into the system.
New records for Australians who currently aren’t registered with My Health Record will be activated after the July-October opt-out period.
  • Updated Jun 1 2018 at 11:00 PM

Health insurers hopeful of My Health Record data access

Private health insurance companies remain hopeful the federal government will reconsider a ban on them accessing sensitive data contained in the new digital My Health Record system, arguing they should not be lumped in with life and general insurers. 
Health Insurers want access to anonymised data on a "secondary" basis, which would put them in the same group as parties conducting research, as opposed to primary users like doctors, who would access the records to inform health advice.
Nearly 6 million people already have a My Health Record, which can contain sensitive information on health conditions, pathology results and prescribed medication. This will extend to all Australians this year, unless they opt out.

eHealth Queensland plans tech support overhaul

By Ry Crozier on May 29, 2018 12:05PM

Cloud pilot uses chatbots to answer calls faster.

eHealth Queensland is turning to internal-facing chatbots and automation to cut the time the state’s 100,000 health employees spend on the phone seeking IT support.
The division of Queensland Health is driving the digital transformation of the state’s healthcare systems, as well as supporting workers like clinicians and nurses.
Chief customer experience officer Michael Berndt told the recent AWS Summit in Sydney that the agency is one of the first public sector organisations anywhere in the world to run a proof-of-concept on AWS Connect.
Connect is a year-old cloud-based contact centre service offered by AWS. As well as providing a platform for service automation, other AWS services such as Lex - used for chatbots - can also be plugged into it.

AI beats doctors at skin cancer diagnosis

By Matt Johnston on May 29, 2018 11:17AM

Won't replace dermatologists just yet.

Researchers in Europe and the US have shown that a deep learning convolutional neural network is capable of more accurate skin cancer diagnoses than experienced dermatologists.
The researchers from the University of Heidelberg in Germany trained the neural network - which is modelled on biological visual processing centres in the brain - by showing it more than 100,000 images of malignant melanomas and harmless moles.
Compared to 58 dermatologists from 17 countries, the AI missed fewer melanomas and was less likely to label benign moles as dangerous.

Artificial intelligence better than doctors at spotting skin cancers

  • Chris Smyth
  • The Times
  • 10:28AM May 29, 2018
Artificial intelligence is better than doctors at spotting skin cancer, a study has shown. A Google algorithm devised to recognise unusual moles not only picked up more cancers but also ruled out more benign lesions.
Experts are increasingly optimistic that within a few years machine learning will automate many diagnoses, helping doctors to become more efficient and reducing mistakes. Last week Theresa May said AI that harnessed genetic information and medical records to spot disease early was crucial to Britain’s future prosperity.
The latest study, led by Professor Holger Haenssle, of the University of Heidelberg, is one of the first in which AI convincingly comes out on top against specialists in spotting cancer.

Digital Baby Book Budget boost for parents

Investments in digital technologies and children’s health will have long term benefits for Australians.
29 May 2018
The 2018 Federal Budget, announced on 8 May, is notable for its emphasis on long--term investments in the health of Australians, particularly in children’s health and digital health technologies.

Better health from day one

New parents currently receive a hard copy “blue book” to record and track their children’s health and immunisation milestones, but this will be phased out in favour of a digital record next year. The Budget allocated $5 million to the development of a Digital Baby Book, which will let parents compile a complete medical history for their children from the very start of life, ensuring that their children need never be without the medical information they need to ensure optimal health.
$77.9 million has also been allocated to programs targeted at improving infant and maternal health, such as diet and exercise recommendations for expectant mothers, as well as free whooping cough vaccines. Together, these initiatives are expected to save money over the longer term by reducing reliance on the healthcare system in later life.

Digital health investments

$1.3 billion will be invested over 10 years in a new National Health and Medical Industry Growth Plan, which will cement Australia’s status as a global centre for medical research and innovation. This will include a $500 million investment in genomics research to develop the use of precision medicine.

Empower patients and harness technology to reduce medication mistakes, new research says

Lynne Minion | 31 May 2018
Improved integration of care between providers and the use of electronic records that “follow the patient” are needed to reduce serious medication errors in Australian healthcare, new research has found.
Patients are the “one constant” as they transition between GPs, hospitals, specialists, ancillary primary care services and private clinics, according to ‘Reducing medication errors at transitions of care is everyone’s business’ published in the Australian Prescriber journal, and they have the most to lose.
“As patients move between health providers and settings, discrepancies and miscommunication in clinical records are common and lead to serious medication errors. Hospital admissions and discharges, interdepartmental transfers, or care shared between a specialist and a GP are often dangerous times for patients, especially those with long-term conditions or taking multiple medicines.”
25 May 2018

ADHA defends strategy on MHR opt-out

Posted by Julie Lambert
Australian Digital Health Agency chief Tim Kelsey has batted away accusations that he is part of a conspiracy to keep Australians ignorant of their rights to opt out of the My Health Record.
After his televised National Press Club address in Canberra on Thursday, journalists demanded assurances from Mr Kelsey that a lack of public information about the launch of the electronic health record was not a deliberate strategy to muzzle dissent.
“There is no Big Brother, and people may be surprised that when opt-out comes and their record is created, there is literally nothing in it until it’s activated,” Mr Kelsey said.

Aussies know about Health Record opt-out

Nearly six million Australians already have their own My Health Record, ahead of a three-month opt-out period from mid-July.
May 29, 2018
The man overseeing the agency in charge of the new personal electronic health record is confident Australians know they can opt-out.
Nearly six million already have their own My Health Record.
But Australian Digital Health Agency chief Tim Kelsey insists patients can still cancel theirs even when a three-month opt-out period, from July 16 to October 15, wraps up.

Less than 2 percent of My Health Record trial users opted out

Perhaps more worryingly, the use of privacy controls is sitting under the 0.1 percent mark.
By Chris Duckett | May 29, 2018 -- 07:26 GMT (17:26 AEST) | Topic: Security
Rough calculations in Senate Estimates on Tuesday have seen the Department of Health and Australian Digital Health Agency (ADHA) agree that around 500,000 Australians will opt out of having a My Health Record if the same behaviour exhibited in a trial extends to the rest of the country.
Under questioning, an official from ADHA said in its trial involving 1 million people, only 1.9 percent opted out.
"We have had feedback from the two regions -- Nepean/Blue Mountains and Far North Queensland -- that there has actually been the opposite effect [of people opting out as time went on]," ADHA COO Bettina McMahon said. "Health care providers have had [opt-out] consumers come to them and say that they now want a record and they have actually chosen to opt in since then.

It's time to discuss My Health Record with your patients

31 May 2018


After a few months of quiet on the My Health Record front, the digital health agency put it firmly back on the agenda last week with two announcements.
The first was around the opt-out period when patients will be able to say ‘no thanks’ to being signed up to the scheme. The opt-out period will run from 16 July–15 October, and from year’s end, patients will be automatically ‘opted in’.
For practices and GPs, this means warning patients they need to make a decision about My Health Record within this period. 

The fight over patient data: What we can learn from the My Health Record fracas

Published on the 31/05/2018 | Written by Jonathan Cotton
Forget AI, Industry 4.0 and the chatbot hordes, data privacy is the tech issue of the moment. But when does the privacy imperative slip into paranoia?...
The latest storm in a teacup – producing much wringing of hands and political haymaking in Australia – is the federal government’s latest data-grab, the opt-out only (and AU$1.2 billion taxpayer funded) My Health Record service.
Simply put, the My Health Record initiative aims to put certain citizen medical data – allergies, medical conditions, treatments, medicines, and test reports – into a format which can be securely shared between clinicians and their patients.
“The current system of medical records means that we may have incomplete information on a patient – especially if the patient has recently seen another specialist or has been discharged from a hospital,” says Australian Medical Association president Dr Michael Gannon.

Health Care Homes, My Health Record to drive collaboration

Community pharmacies have an opportunity to position themselves as an integral part of the collaborative health care model, says the Pharmacy Guild

Pharmacists should prepare to get involved with two significant initiatives that will help improve collaboration with other health professionals, says Guild Executive Director David Quilty in his most recent editorial.
“The cost and complexity of modern health care mean it is no longer feasible or desirable for health professionals – be they doctors, pharmacists or allied health providers – to operate alone in a siloed system of care,” says Mr Quilty.

Senate Estimates: May 29, 2018

Link to Transcript – Community Affairs Committee.

RMIT creator of électronic skin’ nominee for APEC science award

A scientist at Victoria’s RMIT University - Associate Professor Madhu Bhaskaran – has been selected as Australia’s 2018 nominee for the prestigious APEC Science Prize for Innovation, Research and Education (ASPIRE) for her development of a form of “ëlectronic skin”.
The “electronic skin” monitors the environment and the human body and Associate Professor Bhaskaran’s work developing stretchable electronics and sensors has applications such as detecting dangerous gases in mines; reducing skin cancer with widespread use of UV sensors; or smart contact lenses that can analyse tears for biomarkers.
The award is valued at USD$25,000 and Associate Professor Bhaskaran has been nominated by the Australian Academy of Science.
30 May 2018

The patient management system dilemma for GPs

Posted by Jeremy Knibbs
A couple of weeks ago the announcement that patient cloud management system start-up MediRecords had won the contract to replace the patient management system used by medical officers employed by Queensland Health who also practise privately, seemed to pass with little fanfare. 
Pulse+IT, perhaps our most influential industry newsletter on health technology, subsequently wrote an opinion piece saying that most GPs weren’t ready for the cloud, and that the major primary care vendors, MedicalDirector and Best Practice, had made the decision that their client loyalty and the general market conditions meant they could take more time in developing their cloud offerings. 
I am on the board of MediRecords as a non-executive director and I’ve been involved or on the periphery of electronic patient management systems since the start of our original system, MedicalDirector, in 1995. And I think we might all be missing a trick here. A trick of how technology and timing work. And one that GPs, in particular, might need to be careful about in the coming few years.
(Useful info – but an advertorial for Medirecords!)

Resistance and pessimism cloud My Health Record uptake

Abstract: One of the more significant changes to our health system will occur in the next year when the national eHealth system, My Health Record, moves to an opt-out system for all Australians. To date, My Health Record has been, at best, a modest success with only a small number of Australians electing to participate and with very limited usage by medical professionals.

‘Wake-up call’ for real time monitoring

Pharmacy and medical bodies have written to the TGA, calling for national script monitoring to be implemented urgently

In its consultation paper on options for a regulatory response regarding prescription strong (Schedule 8) opioid use and misuse in Australia, the TGA highlights that apart from possible TGA regulatory action, consideration should be given to the wider control mechanisms available in the Australian health care system.
“The states and territories have an important regulatory function in the prescribing and supply of controlled drugs, and other medicines that have an abuse potential,” it says, pointing to the role of these governments play in implementing national real-time monitoring.

Federal Government successfully trials blockchain for researcher access to Australian patient records

Lynne Minion | 29 May 2018
The Australian Government has successfully trialled the use of blockchain technology to allow researchers to access medical information contained within platforms such as My Health Record, but the quality of MHR data remains a problem.
Australian companies Agile Digital, Vault Systems and Gulanga, together with the Federal Department of Health, achieved proof of concept for the technology, which avoided the need to distribute bulk data to health researchers, instead bringing researchers to the data.
The innovation has been awarded the Big Data Innovation of the Year at the Australian Information Industry Association’s 2018 ACT iAwards for the Secure Health Data Research and Analytics Platform.

More than 1.3 million GP appointments booked online

Monday, 28 May 2018  
eHealthNews editor Rebecca McBeth
More than 1.3 million GP appointments have been booked online via a patient portal in New Zealand.
More than 400,000 repeat prescriptions have also been ordered electronically, saving patients a phone call or visit to their GP.
Figures gathered by eHealthNews from New Zealand’s three main patient portal providers reveal that patients are increasingly using digital services to communicate with their GP practice.
Around 550,000 of New Zealand’s 4.5 million patients (12 per cent) are registered with a patient portal and 545 practices offer one. A patient portal is a secure online site where patients can access their health information and interact with their GP.

NSW signs with Sectra for state-wide enterprise imaging IT solution

HIMSS Insights | 28 May 2018
NSW Health has signed a proof of concept agreement with Swedish international medical imaging IT and cybersecurity firm Sectra, to supply a large-scale enterprise imaging IT solution following a competitive tender process.
The goal is to provide 10 local health districts and NSW Pathology with a consolidated imaging IT infrastructure and allow for increased efficiency by seamless sharing of images and information across departments and locations.
NSW Health, Australia’s largest public health system, has articulated the need for a consolidated medical image (PACS) and information (RIS) solution with the ability to collaborate around medical images and information state-wide.

Australian first: New e-health program for high conflict divorcing parents

A breakthrough e-therapy program offers parents who are going through stressful divorce settlements much-needed, affordable, online psychological support.
In an Australian first, RelationSpace Online aims to ease the chronic overburdening of the family law system while reducing the stress for couples involved in conflicted divorce settlements.
RelationSpace Online offers Australia’s first online cognitive behavioural therapy program for separating and divorcing parents.

Consumer data right boosts OAIC staff levels

By Justin Hendry on May 28, 2018 6:00AM

Highest level in over five years.

The impending consumer data right will see the biggest influx of staff into the Office of the Australian Information Commissioner in more than five years.
The office’s workforce is pitched to rise from 75 average staffing level (ASL) in 2017-18 to 92 over the next financial year, according to this month’s federal budget, in preparation to handle new workloads.
The recruitment drive will return the privacy and freedom of information authority to staffing levels last seen before the federal government's 2014 plan to dissolve the office, which it subsequently backed down from in 2016.

Bringing public health into the digital age

Authored by Eddie Cliff
RECENTLY, I had dinner with a friend who has type 1 diabetes and we discussed his Libre – a subcutaneous blood sugar sensor I had read about but never seen before, nor ever searched on my phone or computer. That night, I saw targeted advertisements for both the Libre and for Medtronic diabetes products in my Facebook newsfeed. Initially, I thought it was because Siri was listening to our conversation, but I suspect it is more likely that Facebook infers that my friend has diabetes, and knows we were together that evening.
As targeted advertising and messaging reach all new (perhaps creepy) levels, it reminded me how far behind we are in the world of health promotion and public health. It is no secret that the media landscape has changed dramatically over the past decade and continues to shift rapidly –and health organisations are lagging behind the big corporates in the degree, effectiveness and creativity with which we are engaging with people on these platforms.
As people increasingly receive health information via social media, public health organisations must increase and improve their presence on these platforms if they want to remain relevant and effective. As our attention span shortens, we must adapt to deliver health messages in formats that people are able and enthusiastic to digest.
  • Updated May 28 2018 at 2:29 PM

Health insurer HCF looks to start-ups, innovation to help retain members

Australia's third largest health insurer HCF is betting on its start-up accelerator Catalyst to help it retain and attract members, as the number of Australians abandoning their private health insurance has hit a five-year high, according to Roy Morgan.
A report released this month by Roy Morgan showed that in the year to March 2018, an estimated 256,000 people decided not to renew their private health insurance, up from the same period in 2017, amid rising costs and premium hikes.
HCF chief executive Sheena Jack told The Australian Financial Review the insurer was supporting new technologies to drive better, more cost-effective health outcomes.

Medibank launches WeChat channel to connect with Chinese market

Medibank has launched a WeChat channel in a move which it says is designed to better connect with the growing Australian-Chinese population.
A multi-functional Chinese messaging app claiming over a billion global monthly active users, the WeChat platform joins Medibank’s traditional channels as a way to discuss health insurance products with customers.
In particular, the channel is used to connect with overseas students and visitors who may need insurance.

This cap will one day warn people with epilepsy when seizures will strike

By Esther Han
29 May 2018 — 10:44pm

In numbers

·         Australians diagnosed with epilepsy. 250,000
·         Those with epilepsy who still don't know the cause. 50%
·         Those with epilepsy who will not gain full seizure control with medication. 30%
When Zoe Cartledge has an epileptic seizure, she doesn't fall to the ground or convulse. Instead, her body freezes up, her eyes glaze over and she begins to overheat.
She has had numerous seizures on Sydney's trains and buses, sometimes finding herself as far as two hours away from her destination once she regains control of her mind and body.

NBN CEO rejects suggestion he advocated dumping HFC, FTTN

Bill Morrow confirms that NBN prepared high-level cost analysis of dumping technologies in favour of FTTC
Rohan Pearce (Computerworld) 25 May, 2018 15:06
NBN CEO Bill Morrow has denied suggestions that he proposed that the company dump its use of fibre to the node (FTTN) and hybrid fibre-coaxial (HFC) in favour of fibre to the curb (FTTC).
A Senate Estimates yesterday hearing featured extensive probing of a presentation by the NBN chief executive to communications minister Senator Mitch Fifield more than two years ago. Morrow said that the presentation included a “high level” analysis of the costs of three options: The government switching its planned HFC rollout to FTTC, putting a cap the then-existing FTTN build and using FTTC instead, and dumping both HFC and FTTN in favour of the newer FTTC technology.
Morrow initially revealed details of the presentation last month at another Estimates hearing when he told senators that he had a discussion with the government “about if the government wanted to have more of a singular type of technology, a fibre to the curb type technology, here are the consequences. Here's how long people would have to wait longer than they would otherwise. Here’s how much more peak funding that we would need to be able to deliver that.”

NBN Co: the money is good, the results aren't

The NBN Co pays its staff handsomely, figures revealed ahead of Senate estimates hearings last week show, with 8% of its 6044 staff taking home more than $200,000.
The Australian reported that 2% of NBN Co employees pocket about $300,000 per annum, while the chief executive Bill Morrow has to make do on $3.56 million.
By comparison, Australia Post told Senate estimates that 0.8% of its employees were paid more than $200,000 per annum.

NBN Co accountability pledge by Labor if it regains power

The Australian Labor Party has pledged to make NBN Co, the company rolling out the national broadband network, more accountable to consumers if it gets back into power at the next federal election.
Labor Shadow Communications Minister Michelle Rowland said during a Sky News interview on Monday that she had spoken at many public forums around the country and when it came to the NBN, the main complaint she had encountered was the lack of accountability of the NBN Co.

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