Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Monday, October 15, 2018

Weekly Australian Health IT Links – 15th October, 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

There is a fair bit of general stuff going on so it is worth scanning the headlines to see if anything is of interest.
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Labor pushes for e-health system changes

The federal opposition wants changes to the My Health Record system to better ensure privacy of the data.
Australian Associated Press October 12, 20189:26am
Labor will push for further changes to the federal government's controversial online medical records system, in hopes of guaranteeing private health insurers can never get their hands on its data.
Opposition health spokeswoman Catherine King says Labor will also seek changes to the My Health Record system to better protect the privacy of employees and women fleeing domestic violence.
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8 October 2018

State gears up GPs for SafeScript launch

Posted by Julie Lambert
Specially trained GPs will be on hand to provide back-up for doctors managing patients on prescription drugs as Victoria’s real-time script monitoring system is rolled out. 
The SafeScript system went live in the Western Victoria PHN region last week, with the rest of the state to follow in April next year, making Victoria the first mainland state to crack down on doctor shopping and unsafe prescription-drug use with constant digital surveillance. 
Dr Keri Alexander, an addiction medicine specialist and former GP, said there had been huge interest from GPs wanting to train for the support service. 
“We are hoping that the roles of these GP Safescript Clinical Advisors will have a few different aspects, to try to build capacity among GPs in their areas,” Dr Alexander said. 
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AI to translate 700 Victorian medicos

By Simon Sharwood on Oct 8, 2018 10:02AM

Bendigo Health goes for cloudy integration and transcription.

Dust off your jokes about doctors’ handwriting, because 700 clinicians at Bendigo Health have just adopted cloud transcription services to turn their remarks about patients into written records.
The organisation has adopted the service as part of a wider IT refresh that Bendigo Health undertook to prepare for the opening of the regional Victorian city’s new hospital in early 2017.
As explained to iTnews by director of ICT architecture and applications Danny Lindrea, moving to the new facility gave Bendigo Health an impetus to develop new applications.
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Cloud, AI help Bendigo Health streamline mental health services

Bendigo Health Psychiatric Services in Victoria is using a cloud-based digital clinical system to streamline its operations, boost efficiency of its teams and enhance patient services.
To enhance patient services by streamlining operations and boosting the efficiency of its teams, BHPS has co-developed and deployed a cloud based digital clinical system to support staff in caring for consumers and patients accessing the service.
As well as connecting to Bendigo Health systems, a number of innovations were delivered in the release, including the use of Microsoft Cognitive Services, to enable speech to text conversion of clinician notes.
Connection to CSIRO's Ontoserver reference sets also enables the latest in Australian clinical terminologies to be used within the clinicians workflow, to ensure the right medication and allergy terms are used.
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Melbourne Uni to lead medical AI research centre

By Matt Johnston on Oct 10, 2018 5:01AM

To ponder mind-controlled prosthetic limbs and much more.

The University of Melbourne has become home to a new training and research centre seeking to develop artificial intelligence (AI) applications for medical technologies.
The Australian Research Council (ARC) Training Centre in Cognitive Computing for Medical Technologies was launched in Melbourne on Tuesday by federal senator Jane Hume.
The centre, which received $4.1 million in funding from the government, will be led by professor Timothy Baldwin from the university’s Department of Computing and Information Systems.
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  • 9 October 2018 11:50

eHealth Queensland CTO Warren Prentice to speak on Digital Transformation at AIIA Luncheon

How technology, business models and treatment regimes can help meet the needs of Australia’s growing population
Brisbane, Australia – 9 October -- The Australian Information Industry Association (AIIA), the nation’s peak representative body for the ICT sector, is delighted to announce that the AIIA Queensland Council will host an eHealth Luncheon on Friday, 19 October, with special guest speaker Mr Warren Prentice, Chief Technology Officer of eHealth Queensland.
With health currently consuming $16.6 billion of the State Budget, eHealth Queensland represents the largest use of government funds, and is coupled with expenditure that continues to rise annually to meet an ever increasing demand. In Warren’s address, he will identify how different technologies and the required ICT infrastructure foundations can support improved clinical outcomes, to meet the needs of Australia’s growing and ageing population.
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#FHIR and Cancer Patient Empowerment – Mike’s story

Posted on October 10, 2018 by Grahame Grieve
I’m very honoured to make a guest today from Mike Morris, who I met at the HL7 FHIR Applications Round Table in Washington DC a couple of weeks ago. Mike is a cancer patient who is using FHIR improve his own treatment.
Cancer Rears Its Ugly Head
October 18, 2014.  I’ll never forget that date.  We all have one of those.  For me it was waking up from a colonoscopy to find a doctor hovering over me.   “You have stage 4 colorectal cancer”.   I asked if I was going to die.  “It doesn’t look good” and then he walked away.  The doctors gave me six months to live.  I’m going to die?  Nobody wants to die.  I had a choice to make do I want to live or die?  I wanted to live.
They decided to put me in the chemo chair right away to try and reduce the tumors.  My cancer originated in my rectum and had aggressively metastasized to my liver and lungs.  After four chemo treatments they decided the tumors were too big and decided to operate on me.  February 13, 2015, Friday the 13th, and it was going to be my lucky day!  I went under the knife for 15 hours while they removed 2/3 of my liver, ¼ of my colon and the large tumor in my rectum.  I bled so much during the operation that I almost died.  But somehow, I survived.  I lost 30 pounds, had a bag coming out of stomach, and spent 2 weeks in the hospital trying to recover.  It took me a whole week before I could get out of the hospital bed and take a lap around the ward.  It was tough.  But so am I.  I had to keep fighting.
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Hunt flags cash for GP tele-consults

The 'blended-payment model' will build on Health Care Homes
11th October 2018
The Federal Government says it is looking at funding GP telehealth consultations to improve access to GP care.
Speaking at the RACGP annual conference on the Gold Coast, Minister for Health Greg Hunt said he had begun working with the college and the AMA on what he described as a “blended-payment model”, based on the Health Care Homes trial.
He flagged the possibility of introducing new Medicare items for GP telehealth consults, although he said details of the proposals were still being negotiated and were unlikely to be released until early next year.
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12 October 2018

Hunt wants blended funding model for GP telehealth

Posted by Felicity Nelson
The federal government has reassured GPs that the government is looking at Medicare funding for telehealth services.
In his address at GP18 in the Gold Coast yesterday, Federal Minister for Health Greg Hunt proposed a blended model of funding similar to the Health Care Homes trial.
In his speech, Mr Hunt agreed with the RACGP’s view that telehealth was the “future of general practice”.
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Emerging technologies will bring massive change to healthcare: Future Crunch

Doug Hendrie 11/10/2018 2:59:54 PM
Artificial intelligence and gene editing have been described as emerging technologies that will directly change how GPs work.
AI-driven technological upheaval is coming to healthcare – and fast.
That was the message from Dr Angus Hervey and Tané Hunter from Future Crunch, who gave the keynote address on ‘Disruptive Technologies and the Future of Healthcare’ at the RACGP’s GP18 conference this morning.
Technological change, they told a packed auditorium, does not have to make people feel fearful.
‘We know about IQ and EQ. Now we have AQ. Adaptability quotient is the ability to adapt and thrive in changing environments – and it’s beginning to be a necessary skill,’ Mr Hunter said.
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NT government plans $1m boost to IT industry

Territory government unveils new digital strategy
Rohan Pearce (Computerworld) 12 October, 2018 06:30
The Northern Territory government has announced a Digital Partnerships grant program as one of the key initiatives in the NT’s first-ever digital strategy.
The Digital Territory strategy was launched yesterday by the NT’s minister for corporate and information services, Lauren Moss.
The government last year foreshadowed the strategy’s launch, establishing an Office of Digital Government led by Sandie Matthews.
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Ups and downs of new Apple Watch heart monitor app

By Aaron E. Carroll
10 October 2018 — 2:42pm
The newest version of the Apple Watch will feature a heart monitor app that can do a form of an electrocardiogram. Many have greeted this announcement as a great leap forward for health. The president of the American Heart Association even took part in the product launch.
For a more measured response, it is worth looking at potential downsides, and it turns out there are a few.
The upside potential is twofold. First, doctors could monitor - at a distance - how patients with known heart problems are functioning outside the office.
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FHIR v openEHR – concreta

Posted on by wolandscat
Some readers may have read my previous post FHIR compared to openEHR. If not, I recommend you do, it is available in Spanish, Japanese and Chinese as well as English. Here I aim to clarify some of the concrete differences which are increasingly common sources of confusion, particularly with the FHIR hype wave preventing coherent thinking in many places. It seems that the human psychological pre-disposition for uncritical silver bullet thinking is as strong as ever, but I still hope (perhaps vainly) that in e-health we can soon get back to real science and engineering.

Design Intent

The design intent of FHIR is to enable applications to extract data from opaque systems for a) applications (so-called B2C), and b) other systems, i.e. messaging (aka B2B). Why ‘opaque’ systems? Firstly, nearly all commercial HIS and EMR systems today are proprietary and their vendors contractually control data access. Secondly, non-opaque systems – those containing data based on published standards and with open access to legitimate users – can export their data in their native form, via standard technology. Such systems don’t need another model imposed through the APIs or messages – indeed doing so creates risks for errors and patient safety. FHIR’s modelling approach is to create definitions called profiles, based on resources, which are fragment definitions. Obtaining a blood pressure in FHIR means designing a profile based on the use of the Observation resource, and then implementing a REST API that extracts that kind of data from each system you want to get it from (Cerner, Philips, InterSystems, Allscripts, VistA etc). The FHIR ecosystem looks as follows.
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Hi-tech gives lowdown on aged-care solutions

  • 11:00PM October 10, 2018
As the Morrison government’s aged-care royal commission gears up, technology experts are designing ways for the elderly to stay in their own homes longer and to use sensor devices to remotely monitor those already in nursing homes.
Terry Sweeney, IBM’s Asia Watson Health managing director, is today’s keynote speaker at the opening of the Global Centre for Modern Ageing in Adelaide.
The centre was established by the former South Australian government following the collapse of the automotive industry to generate new employment opportunities in the aged-care sector.
Dr Sweeney said he was excited by the opportunities the centre, run by an independent company with a non-government board, presented through an innovation hub that included a real-time test facility to allow businesses to invent and trial products and services in a simulated “real-life”environment.
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So many Americans have tested their DNA nation's privacy put at risk

By Deborah Netburn
13 October 2018 — 10:19am
Los Angeles: Everyone's DNA sequence is unique. But for those who wish to maintain their genetic privacy, it may not be unique enough.
A new study argues that more than half of Americans could be identified by name if all you had to start with was a sample of their DNA and a few basic facts, such as where they live and how about how old they might be.
It wouldn't be simple, and it wouldn't be cheap. But the fact that it has become doable will force all of us to rethink the meaning of privacy in the DNA age, experts said.
There is little time to waste. The researchers behind the new study say that once 3 million Americans have uploaded their genomes to public genealogy websites, nearly everyone in the US would be identifiable by their DNA alone and just a few additional clues.
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This is how much the WannaCry ransomware attack cost the NHS

Department of Health puts a figure on the financial cost of the incident, which disrupted patient care across the NHS.
By Danny Palmer | October 12, 2018 -- 09:59 GMT (20:59 AEDT) | Topic: Security
The WannaCry ransomware cyber attack cost the National Health Service almost £100m and led to the cancellation of 19,000 appointments, the Department of Health has revealed.
The NHS wasn't specifically targeted by the global ransomware attack, but a significant number of hospitals and GP surgeries fell victim to the outbreak which took advantage of a leaked NSA hacking tool to self spread itself across vulnerable Windows systems.
A patch to protect against the EternalBlue vulnerability was released prior to the WannaCry outbreak, but despite warnings, a number of NHS Trusts hadn't applied the update.
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Survey seeks to find how GPs use technology – and how it can be improved

Doug Hendrie 9/10/2018 2:29:17 PM
The fourth annual RACGP Technology Survey is now open, with calls for GPs and general practice registrars to have their say.
What priorities do GPs have for technology this year?
The RACGP is seeking opinions on how GPs and general practice registrars use technology.

The 
RACGP Technology Survey 2018 is part of an effort to help build an understanding of what systems are being used, where future investment is needed, and the key technology challenges being faced by general practice teams.

Incoming Chair of the RACGP Expert Committee – Practice Technology and Management (REC–PTM), Dr Rob Hosking, said the survey is a vital way to influence college priorities regarding technology and eHealth.
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Results of Australia’s health panel survey on recommendations and regulation of smartphone apps for health and wellness

2 Oct 2018
Consumers want support in finding accurate, effective smartphone apps for health and wellness, and they should be subject to an authoritative regulatory system that rates them for efficacy.
As consumers increasingly turn to health apps to aid and monitor their health and treatment, there’s clearly a need for people to know whether they can trust the apps, and whether they offer the best health option available and are worth the investment in time and money.
Our survey results highlight the growing public demand for credible and effective oversight of health apps given their accelerating reach into every aspect of health care.
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TGA to update regulation for health apps

By Simon Sharwood on Oct 11, 2018 10:48AM

Or as medicos call them, “software as a medical device”.

The Therapeutic Goods Administration (TGA) will update regulations for “software as a medical device” – including health apps - and embark on additional internal software development work in the coming year.
The Administration’s newly-published 2018/19 business plan (pdf) states that the agency will soon “Propose regulatory amendments for the emerging technologies of software as a medical device and the medical application of 3D printing”.
Software as a medical device is currently defined as “products that have a role in diagnosing or managing illness using software that analyses clinical data, such as the results of blood tests or ECGs”. Such packages are considered to be medical devices and therefore come under the TGA's purview.
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TGA to reform regulation for software as medical devices as apps, AI and 3D printing in healthcare boom

Lynne Minion | 11 Oct 2018
Health apps, diagnostic AI systems and the 3D printing of body parts are among the tech innovations that could soon be subject to strengthened oversight, with the Therapeutic Goods Administration planning to put forward regulatory amendments for the emerging technologies.
Within its new business plan for 2018-19, the TGA said software as a medical device – such as the recently announced Apple Watch 4, which includes an atrial fibrillation-detecting algorithm and an ECG – will soon need to jump through custom-fit hoops.
In response to the “complicated and dynamic” healthcare landscape, the TGA is chasing the health tech pioneers to put in place rules that manage risk and weed out the cowboys.
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Lack of funds hits digital health options for arthritis sufferers

The Australian Physiotherapy Association says a lack of funds is preventing arthritis sufferers in the country — whose treatment costs $23.9 billion every year — from being treated with digital health options which have been found to be effective.
In a statement to mark World Arthritis Day, Professor Kim Bennell, a member of the APA and Working Group chair of the National Osteoarthritis Strategy Project Group, said the care provided to many sufferers was fragmented and inappropriate.
“The reality is that people with these conditions often suffer chronic, persistent pain which affects their mental health, their ability to work and socialise, and can lead to overuse of pain killers," he said.
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This app provides a helping hand for military veterans

Its wordy instructions, however, may irritate users
Dr Rob Park
12th October 2018
PRODUCT REVIEW: The High Res app is designed for current and former Australian Defence Force personnel to help increase their resilience.
It offers self-management tools based on cognitive behavioural strategies to reduce stress and address unhelpful cognitions.
The app is freely available from app stores and is simple to access. It rapidly delves into content without requiring the user to input large amounts of initial data.
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Too much screen time bad for young minds

  • 12:00AM October 5, 2018
Remember the good old days when children would sit in front of the television for hours, then be forced to do something outside for a bit? But then the Atari games console came along and kids would sit in front of the TV with their dodgy paddles instead, looking as if they were at least getting some exercise and using their brains. TVs started getting bigger, the games consoles became more advanced, phones became mobile and then smart, and the internet hooked everyone up with an all-consuming digital fix.
Now, if children are sitting in front of a big screen, they may have one or two little screens with them and maybe another one nearby in case they need it. Adults are doing this too, of course, often leading by bad example on the pretext of getting work done or keeping up with friends and family. Devices are as alluring as a carnival, with all the bright lights, glamorous facades and promises of something better. Like everything, screen time should be in moderation — the online world has brought enormous changes to society, but overindulging on devices can be bad for your health. Screen-based devices not only are getting in the way of physical exercise and sleep but also disrupting brain function and development. As devices become embedded in our lifestyles, they also have more influence on our health and wellbeing.
Limiting screen time and improving sleep have the biggest positive impact on childhood cognition, according to a study published in The Lancet Child and Adolescent Health last week.
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Internet Australia asks Dutton to consult widely on encryption bill

Internet Australia, a not-for-profit that claims to represent Internet users in the country, has urged Home Affairs Minister Peter Dutton to intervene in what it characterises as "the inadequate consultation process" over the encryption bill that was presented to Parliament last month.
In a letter sent to Dutton on Monday, Internet Australia chairman Dr Paul Brooks said the period for public consultation had been too short and the bill had been rushed into Parliament just a week after the date for consultation ended.
The period for public comment on the bill, which is officially known as the Telecommunications and Other Legislation Amendment (Assistance and Access) Bill 2018, ended on 10 September after the draft was released on 14 August.
Dutton introduced the bill into Parliament on 20 September. One day has been set aside for a hearing before the Parliamentary Joint Committee on Intelligence and Security.
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Labor’s Rowland warns against rushing encryption bill

Proposed legislation needs to be “scrutinised rigorously,” shadow communications minister says
Rohan Pearce (Computerworld) 10 October, 2018 09:33
Shadow communications minister Michelle Rowland has called for the government to “engage directly” with industries and stakeholder bodies likely to be affected by its proposed encryption bill “regarding the significant concerns they have raised about the measures in this bill, with a view to developing workable solutions.”
That engagement “should include a series of industry workshops to develop scenarios and stress test them against the processes and mechanisms set out in the bill.”
“This will help to develop a better understanding of where legitimate objectives encounter technical barriers, or when there is an absence of limiting factors, or adequate accountability, in circumstances where requests can be issued,” Rowland said in remarks prepared for the CommsDay Congress in Melbourne.
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Encryption bill will hit family violence victims: claim

The South Eastern Centre against Sexual Assault and Family Violence (SECASA) has told the Federal Government that passage of its encryption bill would put those at risk of family violence in greater danger.
In a submission to the public consolation on the draft bill, Carolyn Worth, the manager of SECASA, said the broadening of the Telecommunications (Interception and Access) Act 1979 was unwarranted and would be detrimental to all citizens, especially those with a background of family violence and/or sexual assault.
The period for public comment on the bill, which is officially known as the Telecommunications and Other Legislation Amendment (Assistance and Access) Bill 2018, ended on 10 September after the draft was released on 14 August.
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Adopting encryption bill will endanger the online world

Will the adoption of the Federal Government's encryption bill make life online safer for the average citizen and guard against the growth of child pornography and terrorism? No. On the contrary, passing this bill into law will only help those who are involved in these activities to thrive.
The government appears to be talking about a 21st century situation and thinking of 1950s paradigms when it tries to rally support for this flawed piece of legislation. On Wednesday, Home Affairs Minister Peter Dutton was up on the podium at the National Press Club in Canberra, advancing the same tired arguments in support of the bill that he has put forward every time he has a chance to do so.
It looks like no government minister or supporter is willing to accept one fundamental truth: there is one form of encryption that we all use. Businesses, banks, private citizens, crooks, criminals, terrorists – this is basically a level playing field as far as encryption goes.
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MIT 'net policy wonks say decryption bill is unworkable

By Justin Hendry on Oct 12, 2018 9:50AM

Disputes feasibility of encryption access without security risks.

Researchers at the Massachusetts Institute of Technology (MIT) have called into question the ability of the Australian government to access encrypted communications without weakening security.
In a submission [pdf] to the Department of Home Affairs, MIT Internet Policy Research Initiative (IPRI) sought to address the technical drawbacks of proposed laws that will see service providers asked or compelled to assist law enforcement access encrypted communications.
The bill – which was first revealed in August and has now been altered to reflect some of the more than 14,000 submissions – indicates this could involve service providers building new tools, run government-built software, or facilitate access to targeted devices.
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NSW government's crackdown on price comparison websites

By Lisa Visentin
8 October 2018 — 12:05am
Businesses that operate price comparison websites will be forced to clearly disclose any commissions or referral fees or kickbacks they receive, under a new package of NSW consumer law reforms to be considered by State Parliament.
The NSW government's crackdown comes off the back of recent criticism by independent regulators against commercial comparison websites in the energy sector as Australians go online to look for relief from bill shock.
Better Regulation Minister Matt Kean, who will introduce the proposed laws to State Parliament this month, said consumers were increasingly relying on referrals by third parties when deciding what to buy.
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Microsoft halts Windows 10 update after users lose files

Microsoft has halted the rollout of its October update for Windows 10 after users reported problems, including the deletion of personal data residing in select directories.
The software giant said in a statement: "We have paused the rollout of the Windows 10 October 2018 Update (version 1809) for all users as we investigate isolated reports of users missing some files after updating."
Users have complained that they have lost files from the C:/Users/[username]/Documents/ folder. One user complained that he had lost 220 gigabytes of files which he had accumulated over 23 years.
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Telstra breaches priority assistance obligations

  • 9:54AM October 8, 2018
Telstra has been forced to commission an independent audit into how it manages the needs of customers with life-threatening medical conditions after the telco was found to be in breach of its priority assistance obligations.
The breaches relate to two incidents in 2017, where customers with serious, chronic health conditions were unable to use their Telstra landline.
Telstra currently provides a priority assistance service to 146,000 registered customers and is the only telco subject to a licence condition requiring it to offer such assistance. Under this licence condition, Telstra must provide information about eligibility and registration for priority assistance to customers who call and inquire.
It must also follow specific emergency medical request procedures for customers who have not registered for priority assistance but who have an urgent need for a working telephone service. Where customers are registered for priority assistance, Telstra must ensure that their telephone services are connected and repaired in priority (short) time frames or, if that is not possible, provide the customer with an interim service.
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3:27pm, Oct 8, 2018

Telstra faces audit for health call fail

Telstra has been ordered to audit its priority assistance systems after two seriously ill people died when their landlines failed.
It follows an investigation by the communications watchdog which revealed Telstra was aware both customers needed a working landline due to their life-threatening, chronic health conditions.
The Australian Communications and Media Authority says it is not clear if the communications giant could have changed the “tragic outcome” but priority assistance was “critical to ensure customers with life-threatening conditions are provided with swift assistance”.
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NBN gigabit connections will remain mostly a pipe dream

The CVC costs set by the NBN Co make it very difficult for ISPs to offer gigabit connections to more than a select band of customers who are willing to sign up in numbers and pay slightly more than other speed tiers, according to one ISP who caters to this type of consumer.
Damian Ivereigh, chief executive of Launtel, a Launceston-based ISP, said his was probably the only company which would sell a gigabit connection over the NBN at the moment – and only in Tasmania at the moment.
"I believe that we are one of the reasons why Tasmania has a higher than average number of FttP upgrades going on, because you can get gigabit here," Ivereigh told iTWire in response to queries.
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Enjoy!
David.

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