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"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Monday, September 12, 2022

Weekly Australian Health IT Links – 12 September, 2022.

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

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It is amazing how many senior roles at the ADHA are being advertised it seem. Some at $150,000 plus!

To keep busy we have vapourware interop plans being discussed and bullshit educational sessions being run for lesser salaries!

Otherwise it has been a pretty boring week I have to say!

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https://www.ama.com.au/gpnn/issue-22-number-35/articles/continuation-sms-reimbursement-and-electronic-prescription-fee

Continuation of SMS reimbursement and the Electronic Prescription Fee

Published 8 September 2022

The reimbursements of electronic prescription tokens sent via SMS will be extended until 31 March 2023, or until the outcomes of the tender process for the new provider of electronic prescribing services is completed, whichever comes first.

This is the official advice shared with the AMA by the Department of Health and the Australian Digital Health Agency. 

Reimbursements will be provided for both the original electronic prescription tokens through prescribing systems and the cost of repeat tokens generated through dispensing systems.  

In addition, image-based prescribing for public hospital arrangements will extend until 31 March 2023, allowing a prescription written for a hospital patient to be lawfully dispensed at a hospital pharmacy.  

Information on previous extensions of e-prescribing that expires on 30 September can be accessed here. 

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https://www.tga.gov.au/resources/resource/guidance/exemption-certain-clinical-decision-support-software?mc_cid=041e6d2130&mc_eid=caa143d459

Exemption for Certain Clinical Decision Support Software

Guidance on the exemption criteria

Last updated

17 August 2022

This guidance is for sponsors, manufacturers, suppliers, and software developers of Exempt Clinical Decision Support Software (CDSS) and provides detailed interpretation of the exemption criteria for certain CDSS. This document complements the general guidance on CDSS that was published by the TGA in February 2021.

Supporting documents

Exemption for Certain Clinical Decision Support Software: Guidance on the exemption criteria [PDF, 453.78 KB]

Exemption for Certain Clinical Decision Support Software: Guidance on the exemption criteria [Word, 2 MB]

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https://www.hinz.org.nz/news/615988/Patients-positive-about-remote-monitoring-trial-.htm

Patients positive about remote monitoring trial

Tuesday, 6 September 2022  

NEWS - eHealthNews.nz editor Rebecca McBeth

Early results from a South Canterbury remote patient monitoring trial are positive, with patients reporting less anxiety about their health and feeling well supported in the community.

Te Whatu Ora – Health New Zealand Counties Manukau and South Canterbury Districts have gone
live with trials of BioStickers to monitor patients in the community.

The wearable device sticks on a person’s chest and monitors a range of clinical parameters such as; heart rate, respiratory rate, skin temperature and activity level. It syncs with an app on a mobile phone, which securely transfers patient data to the remote monitoring team.

The South Canterbury project is looking at avoiding presentations at the Emergency Department and admissions to hospital for high-risk older people living in the community.
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https://www.hospitalhealth.com.au/content/technology/news/ai-to-detect-covid-19-infection-in-people-s-voices-903227323

AI to detect COVID-19 infection in people's voices

Wednesday, 07 September, 2022


Artificial intelligence (AI) can be used to detect COVID-19 infection in people’s voices by means of a mobile phone app, reveals a new paper presented at the European Respiratory Society International Congress in Barcelona, Spain.

Wafaa Aljbawi, a researcher at the Institute of Data Science, Maastricht University, The Netherlands, claimed that the AI model used in the research was accurate 89% of the time, whereas the accuracy of lateral flow tests varied widely depending on the brand. Also, lateral flow tests were considerably less accurate at detecting COVID-19 infection in people who showed no symptoms.

The results suggest that simple voice recordings and fine-tuned AI algorithms can potentially achieve high precision in determining which patients have COVID-19 infection, she said.

“Such tests can be provided at no cost and are simple to interpret. Moreover, they enable remote, virtual testing and have a turnaround time of less than a minute. They could be used, for example, at the entry points for large gatherings, enabling rapid screening of the population.”

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https://wildhealth.net.au/can-we-use-machine-learning-to-predict-childhood-asthma-risk/

5 September 2022

Can we use machine learning to predict childhood asthma risk?

Asthma Respiratory

By Dr Rachel Foong

Every time we browse the internet, ‘like’ a photo on social media, or look up directions on your phone, we are giving away personal data.  

Online platforms such as YouTube, Facebook and Google use this personal data and feed it to machine learning algorithms to train automated programs to learn about our spending habits for targeted advertising or improving facial recognition software through the photos we post online.  

We currently already use machine learning for common tasks such as junk email filtering, virtual assistants like Siri or Alexa, so why isn’t it used in healthcare more? Machine learning has the potential to revolutionize healthcare by aiding in disease prediction and diagnosis, however uptake by the medical community has been slow. Research into the use of machine learning in asthma prediction is limited, albeit increasing, but there are no currently validated machine learning models to predict asthma in children. 

Machine learning, as its name suggests, can be defined as giving “computers the ability to learn without being explicitly programmed”.1 While it might seem like a new technology, the concept of machine learning has been around as early as the 1950s with a paper by Alan Turing introducing “the Imitation Game”, a test to determine if machines could think.2 Turing used chess as an example of how machines could learn, and this was realized in 1996 when the supercomputer Deep Blue designed by IBM beat reigning chess world champion Garry Kasparov.  

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https://www.hinz.org.nz/news/616109/Covid-tech-enables-bedside-blood-testing.htm

Covid tech enables bedside blood testing

Wednesday, 7 September 2022  

NEWS - eHealthNews.nz editor Rebecca McBeth

Christchurch Hospital is starting a new quality improvement project assessing a fast bedside blood test that can show if a patient is having a heart attack.

Christchurch Hospital emergency medical specialist Martin Than says New Zealand is the first country in the world to have access to and test the next generation of bedside blood tests for heart attacks in the Emergency Department.

The bedside test measures a protein in people’s blood that is released from damaged heart muscle when they are having a heart attack and takes around eight minutes to produce a result, compared to one to two hours at a central laboratory.

The project team has been working with the Te Whatu Ora data and digital team to build on connectivity developed during the Covid-19 pandemic to receive and view results from the device.

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https://www.healthcareitnews.com/news/anz/sydney-study-evaluate-ais-impact-clinical-decision-making

Sydney study to evaluate AI's impact on clinical decision making

It will assess the impact of annalise.ai's chest x-ray platform on diagnostic accuracy and patient management.

By Adam Ang

September 06, 2022 10:32 PM

A new Digital Health Cooperative Research Centre project will study the impact of an AI-powered diagnostic support solution on clinicians' decision-making and patient management at the point of care.

Led by Macquarie University, Sydney Local Health District, and medtech startup annalise.ai, the project will specifically look into the use of the Annalise Enterprise CXR solution in helping clinicians deliver safe and effective interpretations of chest x-rays in emergency departments. It will assess its impact on diagnostic accuracy, patient management, and cognitive load in comparison to current practice. 

The Annalise chest x-ray interpretation tool can detect up to 124 findings and localise those suspected findings on chest x-ray images.

WHY IT MATTERS

While it is widely known that AI can assist doctors in clinical decision-making, its translated benefits to care quality and patient safety "remain largely unmeasured," said DHCRC. 

Given the short window of time for radiologists to review and render a formal report on chest x-rays, especially at times of high demand, the use of AI can offer doctors a "more timely clue on what to look" for until they can receive a full report, explained Professor Farah Magrabi of the Australian Institute of Health Innovation at Macquarie University.

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https://www.healthcareitnews.com/news/anz/te-whatu-ora-midcentral-adopts-new-solution-improve-clinical-documentation

Te Whatu Ora MidCentral adopts new solution to improve clinical documentation

iMedX's solution will replace the organisation's legacy, on-premise clinical documentation tool.

By Adam Ang

September 06, 2022 02:57 AM

The MidCentral District of Te Whatu Ora Health New Zealand is set to implement an enterprise digital dictation and clinical documentation workflow solution from healthcare solutions provider iMedX.

Following a competitive tender process, iMedX was chosen to deliver the said cloud-based SaaS which will replace the health organisation's legacy, on-premise system. The IT company will also provide associated transcription support services, according to a media release.

iMedX's clinical documentation offering runs on AI speech technology and features custom workflows for automation and smartphone dictation to drive mobility. 

WHY IT MATTERS

MidCentral was in the market for a digital technology that would improve the speed of its clinical communication, deliver efficiencies for its clinicians, as well as support its transition to digital outpatient communication strategies and platforms.

Adopting the iMedX digital solution will improve the organisation's process of creating and distributing clinical letters, which is essential in its communication with patients and health professionals.

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https://www.healthcareitnews.com/news/anz/roundup-victoria-wa-launch-initiatives-support-local-digital-health-innovation-and-more

Roundup: Victoria, WA launch initiatives to support local digital health innovation and more briefs

Also, Te Whatu Ora New Zealand is setting up a clinical and consumer council to advise on data and digital health projects in the country.

By Adam Ang

September 09, 2022 02:03 AM

Victoria invests in new centre supporting digital health innovators

The Victorian government has invested A$2.4 million ($1.6 million) to establish a centre for supporting digital health innovators.

The Victorian Connected Health Innovation and Commercialisation Centre will support up to 500 local companies each year by connecting them with healthcare professionals, investors, and other innovators who can assist in fast-tracking the development of their new digital health products.

It is funded through the state's Australian Medtech Manufacturing Centre and Biotechnology Fund and is being delivered by digital health accelerator ANDHealth. 

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https://www.smh.com.au/technology/refresh-mygov-gets-new-look-ahead-of-app-launch-20220905-p5bfj4.html

Refresh: myGov gets new look ahead of app launch

By Tim Biggs

September 5, 2022 — 3.35pm

The federal government has taken its first step towards overhauling the myGov online services portal, rolling out a refreshed website ahead of the launch of a new app later this year.

The new website, which is still at my.gov.au, has a new visual design with a modern logo and a blue colour scheme (replacing the green), but it also features a new navigational layout.

Government services minister Bill Shorten said the changes were designed to put inbox messages and linked services up front, with information on claims and payments organised according to particular life events.

“The initial topics include raising kids, changes in living arrangements, ageing, work, education and health and disability, with more topics and information to be added soon,” he said.

“The pandemic showed us the importance of having excellent connections with government services online, and these upgrades will immediately give Australians more options when using the site.”

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https://www.innovationaus.com/govt-launches-revamped-mygov-says-app-still-coming-soon/

Govt launches revamped myGov, says app still ‘coming soon’

Justin Hendry
Editor

5 September 2022

The federal government has launched its revamped myGov platform, as its full attention now turns to delivering a long-promised smartphone app for accessing government services online.

Services Australia flicked the switch on the new myGov on Monday, having revealed plans to permanently replace the legacy platform – which was last upgraded in 2017 – last month.

“From today, the myGov website has changed colour from green to blue, as part of a broader upgrade,” Government Services minister Bill Shorten said.

The changeover was followed by reports of issues in myGov accounts for some users on Monday, with the source of the problems now the subject of an investigation by the services agency.

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https://www.healthcareitnews.com/news/anz/virtual-reality-helps-train-defence-medics-australia

Virtual reality helps train Defence medics in Australia

It leverages live biometric data to dynamically change virtual scenarios.

By Adam Ang

September 07, 2022 10:53 PM

A new virtual reality software to augment the medical training of combat medics in Australia has been launched with support from the Department of Defence.

WHAT IT'S ABOUT

Developed by first responder training company Real Response, the Virtual Tactical Combat Care (VTC3) programme provides users with an immersive and personalised training experience to practice their medical skills in a range of scenarios, such as combat, humanitarian, and routine medical.  

Paired with a Garmin smartwatch, it uses live biometric data to dynamically change virtual scenarios. The data, alongside the VR training result, serves as a guide for debriefing sessions.

The VR programme is backed by the Defence Innovation Hub, which invests in new technologies that help grow the Australian defence industry. 

Moreover, this module adds to the list of VR projects offered by Real Response, which includes the MedEvac VR Simulator that trains military and civilian aeromedical retrieval specialists in critical medical and trauma scenarios.

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https://www.seek.com.au/job/58413267?type=standout

Director, Governance Services

Australian Digital Health Agency

Canberra ACT

Government (Government & Defence)

$149,194 - $176,637

Full time

08 September, 2022

About the Agency 

The Australian Digital Health Agency (the Agency) is responsible for national digital health services and systems, with a focus on engagement, innovation and clinical quality and safety. Our focus is on putting data and technology safely to work for patients, consumers and the healthcare professionals who look after them. 

About the Role 

The EL2 Director, Governance Services will support the Branch Manager, Governance and is accountable to perform very complex work that plays a critical role in managing a range of governance initiatives. This work ensures that the Australian Digital Health Agency (the Agency) has effective governance frameworks and the necessary policies and procedures to meet business objectives. 

Working with their team, the Director leads internal governance practices and manages Agency governance reporting requirements including policy, risk management, business continuity, assurance, corporate governance and plans.  The Director performs a business partnership role with key areas of the Agency to ensure governance and risk considerations are included throughout project lifecycles. 

Key skills required for the role will include: 

  • Extensive corporate governance knowledge and understanding of Commonwealth legislation and policies, especially the Public Governance, Performance and Accountability Act 2013 (PGPA Act) and associated Public Governance, Performance and Accountability Rule 2014 (PGPA Rule).
  • The ability to identify emerging risks and issues, consider implications and propose solutions. 
  • Dynamic leadership of teams and functions with the ability to consider and implement approaches that best achieve outcomes.  
  • Demonstrated success in governance and risk reform with the ability to lead key workstreams and provide regular updates on key deliverables.
  • Business partnership and representation skills and the ability to influence stakeholders through high-level communication skills, both written and verbal.
  • Skills in use of general office software applications.
  • Ability to undertake Fraud and Public Interest Disclosure investigation. 
  • Extensive knowledge and experience in efficient, cost effective, policy and procedure development, maintenance and assurance.

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https://www.seek.com.au/job/58405973?type=standout

APS5/APS6 Multiple Roles Technical Services Branch (Engineering Services)

Australian Digital Health Agency

Brisbane QLD

Government - Federal (Government & Defence)

Further details within

Full time

About the Role

The Australian Digital Health Agency is seeking candidates to fill six vacancies at an advanced core officer level (APS Level 5 and APS Level 6) within our Engineering Services Section of the Technical Services Branch: 

System and Network Administrator (3 positions) 

Full Stack Web Developer (1 positions)

Website Developer (1 position)

Data Engineer (1 position)

With a focus on the Agency’s corporate/enterprise information technology, the Engineering Services Section delivers: 

Web, Mobile, API, Integration Software Engineering​

Data and Analytics Software Engineering​

Network, Infrastructure, and Cloud Engineering

These roles are an excellent opportunity for technical business services professionals to gain experience and contribute meaningfully to a wide range of innovation and growth initiatives being delivered within the Agency over the next 18-24 months. 

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https://www.seek.com.au/job/58396358?type=standout

EL2 Directors – Technical Services Branch

Australian Digital Health Agency

Brisbane QLD

Government - Federal (Government & Defence)

$149,194 - $176,637

Full time

About the Role

The Australian Digital Health Agency is seeking immediate candidates for the Executive Level 2 role of Director, Engineering Services within our newly developed Technical Services Branch, and advising of a further two Executive Level 2 role: Director, Business Services and Director, Reliability Services, which will open thereafter.  Together, this Branch leadership team will be responsible for the: 

  • evolution and operation of Agency business applications/systems and information technology; 
  • engineering of external and internal-facing products and systems across web, mobile, application programming interface (API) networking; and
  • build and reliability processes and technologies to ensure the quality, trust, reliability and security in our products and systems. 

This is an exciting opportunity to be a leader in an Agency which is seeking to take a contemporary approach to designing and delivering programs and products, and delivering very on diverse technology needs, in a growing and vibrant business. 

We are seeking suitably qualified and experienced leaders to deliver influential and positive contributions which will drive the strategic direction and operational functions of their sections, and who work collaboratively within the Agency and with other stakeholder to achieve dynamic and innovative solutions. 

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https://www.digitalhealth.gov.au/careers/el1-engineering-services-managers-technical-services-branch

EL1 Engineering Services Managers - Technical Services Branch

EL1 ($125,047 - $142,618)
Technology Services Division > Data and Research
Brisbane, Canberra, Sydney

Closing - 3 Oct 2022

About the Role

The Australian Digital Health Agency is seeking candidates to fill two vacancies at an expert core officer level (Executive Level 1) within our Engineering Services Section of the Technical Services Branch: Manager, Data and Analytics Engineering and Manager, Network, Infrastructure, and Cloud Engineering.

With a focus on the Agency’s external-facing products and systems, as well as some internal corporate/enterprise information technologies, the Engineering Services Section delivers:

  • Web, mobile, API, integration software engineering.
  • Data and analytics software engineering.
  • Network, infrastructure, and cloud engineering.  

This is an exciting opportunity to join our team in a role which leads and influences our approach to technology. We are seeking detail-oriented engineers who are keen problem-solvers.  A growth mindset, excellent interpersonal skills, and the ability to manage your team and workloads concurrently are all essential skills for this role.   

As a EL1 Manager in the Engineering Services Section, you will also work with your team to ensure engineering standards are maintained and adhered to, as well as looking for ongoing improvement in both the processes, people, and technology within your scope of control.

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https://www.chandlermacleod.com/job/my-health-record-mhr-registration-support-officer?source=google.com

My Health Record (MHR) Registration Support Officer.

My Health Record (MHR) Registration Support Officer

As one of the Australia's largest providers of human resources solutions, Chandler Macleod has a proven track record of unleashing potential in people and companies. For over 40 years Chandler Macleod's recruitment business has connected leading-edge projects and employers with outstanding business professionals.

Our Federal Government client is seeking to engage an APS4 My Health Record (MHR) Registration Support Officer on a contract for 12 months with potential extension.

Duties & Responsibilities:

Leadership and Accountability

  • Have functional expertise in a specific area that contributes to team goals.
  • Provide sound advice and recommendations which influence the decisions made by others,
  • including supervisors and peers.
  • Have accountability for completion of allocated tasks, organising workflow, review of work and
  • development of less experienced employees.
  • Contribute positively to strategic planning and decision making within the work area.
  • Contribute new ideas and maximise the benefits of change, including the identification of
  • opportunities to improve the efficiency of business processes.

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https://www.eventbrite.com.au/e/introduction-to-my-health-record-port-adelaide-library-tickets-406662397177

Sep. 29 2022

Introduction to My Health Record - Port Adelaide Library

Learn how to download and use My Health Record with help from our Digital Team.

By City of PAE Libraries

When and where

Date and time

Thu., 29 September 2022, 5:00 pm – 6:00 pm ACST

Location

Port Adelaide Public Library 2-4 Church Street Port Adelaide, SA 5015

About this event

In this session, gain an overview of the platform as well as an opportunity to access and use a My Health Record.

Bookings Required.

Refreshments provided.

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https://swsphn.com.au/what-we-do/digital-health/telehealth-grants-for-racfs/

What we do

Telehealth grants for RACFs

South Western Sydney Primary Health Network (SWSPHN) is inviting feedback from Residential Aged Care Facilities (RACFs) across our region about what support they require to increase the availability and use of telehealth services for their residents. 

We have received funding from the Department of Health and Aged Care (DoHAC) to promote appropriate telehealth facilities and equipment in RACFs to facilitate increased capability and usage. 

We will also: 

  • Provide training to improve the capacity of RACF staff to assist residents with accessing telehealth consultations  
  • Encourage the use of My Health Record by RACFs to improve how information is shared between healthcare providers 
  • Assist RACFs to ensure appropriate after-hours plans are in place, and provide education on after-hours care options and processes  

 Understanding needs of RACFs in our region 

SWSPHN is conducting a needs assessment of all RACFs within south western Sydney to determine the level of support they require to increase the availability and use of telehealth services at their facility. 

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https://itwire.com/it-industry-news/deals/hills-to-supply-nurse-call-technology-in-new-footscray-hospital.html

Wednesday, 07 September 2022 11:13

Hills to supply Nurse Call technology to New Footscray Hospital

By Kenn Anthony Mendoza

Integrated technology solutions distributor Hills has secured a contract to supply its flagship Nurse Call “smart hospital room” technology for New Footscray Hospital.

Hills will form a part of the Plenary Health consortium—led by Multiplex including Honeywell and Compass—working in partnership with Appselec. The Hills supply and installation contract is estimated at $7 million.

“The team at Hills is proud to be trusted by the Victorian Government and consortium partners to deliver this critical element of the project. By selecting Hills and our Australian designed and manufactured Nurse Call technology, the Plenary Health consortium led by builder Multiplex has recognised our capability and reliability to deliver projects of this scale,” said Hills CEO David Clarke.

“These frontline tools support the delivery of quality care, improve safety, and introduce time savings processes to ease pressure on clinical and other staff members,” he said.

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ANDHealth - Special Announcement: 7 September 2022

 

ANDHealth, Australia’s leading digital health commercialisation organisation, in partnership with the Victorian Government, today announced it has received $2.4M from the Australian Medtech Manufacturing Centre and Biotechnology Fund to create the Victorian Connected Health Innovation & Commercialisation Centre (CHICC).

The CHICC has been established to drive the creation and commercialisation of digital and digitally enabled medical technology companies and raise Victoria’s profile as a leading centre for Australia’s fast growing connected health sector. 

ANDHealth CEO and Managing Director Bronwyn Le Grice said, “This investment by the Victorian Government represents a significant commitment to growing a strong connected health sector, comprising both digital and digitally enabled medical technologies. The CHICC will support the increase of medical technology manufacturing, create highly skilled jobs and ultimately deliver technologies that will result in better health outcomes for all Australians.” 

“Cutting edge medical technologies are increasingly leveraging the power of software to deliver improved patient outcomes. In many cases, medical technologies are powered by software which is instrumental in, or solely responsible for, the clinical benefit to patients. Software also makes these technologies more accessible and affordable for healthcare consumers and our healthcare system. The CHICC will act as a central resource to support accelerated commercialisation of these types of technologies in Victoria.” 

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https://itwire.com/government-tech-news/government-tech-policy/funding-boost-for-victorian-medtech-innovators.html

Wednesday, 07 September 2022 12:36

Funding boost for Victorian medtech innovators

By Staff Writer

The Victorian Government has contributed $2.4 million to support local medtech manufacturers and innovators compete in the booming global digital health products market.

The Victorian Minister for Industry Support and Recovery Ben Carroll today announced that the $2.4 million from the Government’s Australian Medtech Manufacturing Centre and Biotechnology Fund will go towards establishing the Victorian Connected Health Innovation and Commercialisation Centre in Melbourne’s CBD.

Delivered by ANDHealth, the Government says the new centre will support up to 500 local companies each year, connecting them with Atmo Biosciences, innovators and investors who can help them fast-track the development of new digital health products, such as local inventions like the Atmo Gas Capsule and PKG Watch.

Created by Box Hill-based Atmo Biosciences, the Atmo Gas Capsule electronically reports data about the gastrointestinal system when swallowed, allowing medical professionals to quickly identify and determine treatment for gut disorders including irritable bowel syndrome and inflammatory bowel disease.

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https://www.innovationaus.com/vic-gets-2-4m-digital-health-commercialisation-hub/

Vic gets $2.4m digital health commercialisation hub

Brandon How
Reporter

8 September 2022

Digital health commercialisation outfit ANDHealth has been given $2.4 million from the Victorian state government to establish a new health innovation and commercialisation hub.

Funded through the state’s $20 million Australian MedTech Manufacturing Centre (AMMC) and Biotechnology Fund, the hub will support up to 500 local companies every year. The businesses will be connected with healthcare professionals, innovators, and investors.

This includes “international expert in-residence program, targeted commercialisation workshops and access to collaborative and industry-led programs from across Australia”, according to ANDHealth.

The Victorian Connected Health Innovation and Commercialisation Centre (CHICC) aims to foster the creation and commercialisation of digital and digitally enabled medical technology companies.

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https://www.itnews.com.au/news/nbn-co-looks-to-build-a-digital-twin-584497

NBN Co looks to build a digital twin

By Kate Weber on Sep 5, 2022 6:40AM

Two people being hired to construct and maintain it.

NBN Co has given a strong indication that it intends to build a digital twin of its network, with two people being hired specifically for the effort.

iTnews can reveal that the company is in midst of hiring an "executive manager for digital twin and innovation environments" as well as an "innovation environment architect" as a direct report to that executive manager.

The function will sit within an NBN chief technology ofice "lab".

Digital twins, virtual replicas of the physical world, have become popular ways to simulate the production impact of new ideas or systems.

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Enjoy!

David.

 

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