I Know Government Moves Slowly, But This Lot Have Raised Taking Your Time To An Art Form!

This appeared last week

More privacy reforms urgently needed but not expected before election

Noah Yim and Alexi Demetriadi

12 August, 2024

The nation’s Privacy Commissioner says further reform in privacy legislation is “urgent” and “much needed” but those changes are unlikely to happen before the next election, due by May next year.

This comes after the Albanese government on Thursday introduced its first tranche of amendments to the Privacy Act.

The introduction of criminal penalties for doxxing – the malicious publication of personal information – has largely been welcomed by members of a WhatsApp group of 600 Jewish creatives who had been victim to doxxing earlier this year and prompted the new criminal ­penalties.

Privacy Commissioner Carly Kind welcomed the government’s first tranche of amendments but stressed the need for more reform.

“We are eagerly awaiting the second tranche of privacy reforms, dealing with much needed reforms including a new positive obligation that personal information handling is fair and reasonable,” Ms Kind said.

“The coverage of Australia’s privacy legislation lags behind the advancing skills of malicious cyber actors.

“Further reform of the Privacy Act is urgent, to ensure all Australian organisations build the highest levels of security into their operations and the community’s personal information is protected to the maximum extent possible.”

Attorney-General Mark Dreyfus has flagged the government will make more amendments. The Australian under­stands this is not expected before the next election.

Coalition legal affairs spokeswoman Michaelia Cash said the opposition would “closely examine” the bill.

She drew attention to a few areas: new costs for businesses, the role of class action law firms, and the bill’s interaction with anti-money laundering and counter-terrorism financing laws.

“The Coalition has only seen the bill for the first time today and we will now examine it in detail,” she said.

“We recognise the need for appropriate reform, but privacy is both highly technical and far-reaching.”

A spokeswoman for the WhatsApp group of 600 Jewish creatives welcomed the “positive” step taken by the government to stop “horrific Jew hatred” that had “swept” Australia. “These attacks against Jewish Australians have often been fanned by online agitators who have so far faced no consequences for their appalling actions,” she said.

In February, the names, mobile numbers, professions and photographs of creatives in the group were exported from the WhatsApp chat by a New York Times reporter who then passed the 900-page document to a person who was the “subject of a story”.

The proposed provisions would not be retrospective and therefore unable to address that incident.

“The lessons of history show that what starts with the Jews rarely ends with the Jews,” the group’s spokeswoman said.

Stuart Cohen, another of those doxxed, said the legislation’s enactment “could not come soon enough” and would protect not just Jewish people but all Australians.

“The impact of my name appearing on the list was limited but this doxxing has had a really terrible impact on many friends, family and associates who have been accused of all sorts of heinous crimes for which none are guilty,” he said.

Here is the link:

https://www.theaustralian.com.au/nation/more-privacy-reforms-urgently-needed-but-not-expected-before-election/news-story/d6a4328a46f07a2141dd80fecd53e89d

As best I can tell the ‘bad guys’ are inventing evil things to do to people faster that they can be legislated against!

A hopeless situation!

David.

Here We See More Signs Of The Stress The Private Health Care System Is Under.

This appeared last week:

Insurers deny caving in to Healthscope demands

Michael Smith Health editor

Sep 13, 2024 – 5.37pm

Private health insurers deny that they caved in to public pressure from hospital operator Healthscope to give it more money, accusing the private equity-owned group of launching an “unethical” advertising campaign that had been a “dismal failure”.

Medibank Private, NIB and HCF have agreed to out-of-cycle funding payments in the “tens of millions of dollars” in the past three weeks following intense lobbying from debt-laden Healthscope, which owns 38 private hospitals.

On Friday, the insurance lobby denied that the payments revealed in The Australian Financial Review were in response to Healthscope’s advertising campaign launched last week singling out three other insurers, including Bupa, which it accused of “bleeding it dry” by underfunding its hospitals.

Healthscope is owned by Canadian investment giant Brookfield.

“Out-of-contract payments have not occurred in response to Brookfield and Healthscope’s heavy-handed US-style campaign,” said Rachel David, the chief executive of Private Healthcare Australia, an industry body representing big insurance companies.

“The Brookfield campaign has been designed to pressure health funds into unsustainable, above-inflation contracts that would drive up the cost of health insurance for millions of Australians working hard to contribute to their own healthcare in a cost-of-living crisis.”

On Friday, Healthscope welcomed the funding injections but accused the insurance lobby of hyperbole and personal attacks.

‘Hyperbole and personal attacks’

“We’ve been in constructive dialogue with a number of health insurers, who have recognised the serious issues at hand for private hospitals and engaged with finding sensible solutions,” Healthscope chief executive Greg Horan said. “The insurers’ lobby group has offered no ideas or solutions, just hyperbole and personal attacks.”

Health funds said they had been making out-of-contract payments to private hospitals to help with financial difficulties for the past two years. Those payments are rarely disclosed, although Medibank said last month that it had contributed $63 million in additional funding across the sector.

On Friday, the insurers were keen to distance their latest payments from Healthscope’s campaign, although they did not say what specifically triggered the funding injection.

Sources said Healthscope had wanted insurers to tip in more than they agreed, demanding indexation gains that would have locked insurers into funding increases in the future. Insurers rejected that request, instead offering one-off payments as a consolation prize.

Even before it launched the campaign on September 4, Healthscope had been aggressively lobbying insurers to give it more money. In negotiations with them, it warned that it would be forced to close hospitals without financial help, something insurers want to avoid as well.

Dr David said the public campaign had caused distress for people planning treatment in Healthscope hospitals, including pregnant women booked to give birth, cancer patients, and people relying on mental health services. If a hospital operator goes out of contract with an insurer, patients often have to pay more for their treatment.

“It’s deeply unethical that they are threatening these vulnerable people with extra fees. There is no need to bring consumers into contract negotiations with health funds,” Dr David said.

“The Healthscope campaign has been a dismal failure, with minimal engagement from consumers. This is undoubtedly an embarrassment for Brookfield and its investors. This is not how we do business in Australia.”

Mr Horan hit back, saying Healthscope’s Protect Your Hospitals campaign focused on the insurers that were refusing to fund patient care fairly. He said thousands of health fund members participated in the campaign, which included advertisements radio and newspaper advertisements and on social media. He said nurses and hospital teams had also supported the campaign.

Bupa declined to comment on Friday, but sources said the insurer was still in talks with Healthscope and had previously made out-of-cycle payments. The Australian Health Service Alliance, which represents not-for-profit insurers being targeted in the Healthscope campaign, said it continued to work with Healthscope.

“The Australian Health Service Alliance (AHSA) and Healthscope entered into a new, two-year agreement earlier this year, which includes more than 20 of the nation’s not-for-profit health funds. The agreement is valid up until 2026,” AHSA chief executive Andrew Sando said.

Unexpected cost inflation

Ramsay Health Care, Australia’s biggest healthcare operator and one of the few profitable private hospital owners, declined to comment when asked if it was seeking similar payments. Although this was unlikely as it was in a better financial position, the company has previously brought health funds back to the table early or out of the normal contract cycle because of unexpected cost inflation.

Relations between hospital operators and insurers are more strained than usual because of cost inflation and a federal government review of the industry that has put the spotlight on the challenges facing the sector.

Last month, the country’s largest non-profit provider with 10 hospitals, St Vincent’s, reached a last-minute agreement with NIB after threatening to walk away and leave the insurer’s customers paying higher prices.

UnitingCare Queensland, which owns and operates four private hospitals, threatened to walk away this week from its contract with the Australian Health Service Alliance, a large buying group representing 22 not-for-profit insurers.

In 2022, Bupa and Ramsay hospitals failed to reach an agreement on how to cover costs. Bupa has more than 4 million customers.

Here is the link:

https://www.afr.com/companies/healthcare-and-fitness/insurers-deny-caving-in-to-healthscope-demands-20240913-p5kact

The bottom line here is that pretty much all health care costs are rising much more quickly than inflation and funding will become increasingly stretched! What this has to mean that both sides will have to give a little or get better and cheaper at what they do.

With the way healthcare is going the pressure can be assumed to be relentless!

David.

The Aged Care System Looks To Be About To Get A Fire-Cracker Up Its Backside To Start Meeting Patient Expectations!

I am afraid cold custard and a 2 hour wait to be taken to the toilet will not cut it anymore.

Aged care concessions cost $5b in revenue

Phillip Coorey Political editor

Sep 13, 2024 – 5.42pm

The Albanese government sacrificed about $5 billion in budget savings in return for securing the Coalition’s support for the aged care reforms announced this week, according to sources in both camps.

The reforms, which will require retirees to pay more for both home and residential care from July 1 next year, increase the use of means-testing and therefore have the greatest impact on part-pensioners and self-funded retirees.

These voters are key to the Coalition’s support base and, from the outset, Opposition Leader Peter Dutton and shadow health minister Anne Ruston told the government the package as originally proposed would never pass muster among Coalition MPs.

Consequently, Senator Ruston and Mr Dutton won a raft of demands, including exempting existing residents in aged care homes and those on the waiting list for home care, from the new fee structures.

Another key concession was to insist on a cumulative lifetime contributions cap for home and residential care of $130,000. The current cap is $79,900, but the initial proposal was to have no cap on home care and a $184,000 cap on residential care.

When the reforms were unveiled on Thursday, the government said the net saving to the aged care budget over the next 11 years would be $12.6 billion. But a government source familiar with the process said the figure would have been about $5 billion more had it not been for the concessions. A Coalition source said it was “billions”.

Nonetheless, over the longer term, the savings will start to increase as no one in the system will be exempt. The annual aged care bill is $36 billion and rising.

The exemptions differ between the two care modes. Anyone in a residential facility before the July 1, 2025 start date will be carved out, and anyone already on a home care waiting list on Thursday – the day the reforms were announced – will come under the old regime.

Under the new funding model, a full-pensioner will pay, at the most, $300 more a year for residential care, a part-pensioner $700 extra, while a self-funded retiree would be on the hook for up to $13,400.

As for home care, a full-pensioner will pay 5 per cent of their independence costs and 17.5 per cent of their everyday living costs.

Depending on their income and assets, part-pensioners and Commonwealth Seniors Health cardholders will pay between 5 per cent and 15 per cent of their independence costs, and between 17.5 per cent and 80 per cent of their everyday living costs.

Self-funded retirees will pay 50 per cent and 80 per cent of the respective costs. Everyday living services include cleaning and gardening. Independence supports could include help with showering, dressing and taking medications.

The reforms have been overwhelmingly welcomed by the aged care sector, but there has been some pushback from self-funded retirees.

Margaret Walsh, the acting national president of Australian Independent Retirees, who was on the aged care taskforce which advised on the reforms, told the ABC: “I felt I was pretty much the lone voice, particularly for independent retirees.

“We had other people representing pensioners. I think that I was the only one, and I was certainly overruled on most things.”

When Mr Dutton sought approval for the deal from his party room on Thursday, about 12 MPs who spoke in protest did so on behalf of self-funded retirees.

Aged Care Minister Anika Wells said asking people to pay a bit more was essentially for their own good.

“When a person arrives at residential aged care, let’s be honest, it’s not something that people look forward to ... in fact, over the past few years, people have been dreading it,” she said.

“Lots of people have said to me, ‘I’d be happy to pay a little bit more if I could get a higher standard of aged care’.

“What I hope is that when that moment comes ... they arrive to an aged care facility that has a new wing being built and that the room they have has an ensuite.”

Here is the link:

https://www.afr.com/politics/federal/aged-care-concessions-cost-5b-in-revenue-20240913-p5kaad

To me the problem with the aged care system has been that even if people were prepared to pay more for something better than cold custard such services were very hard to find and get access to.

The system seems to rely on all the patients being passive and uncomplaining and to be able to just lump them all together out of sight but with pretty pathetic services.

The ‘baby-boomers’ are hot going to wear this and are going to demand much better and more focused care I suspect (know) and will be willing to pay to get it. It will all cost a lot more than at present....

I suspect the next decade will be a period of dramatic change in aged care – see if I am not right!

David.

Interesting To See AI Actually Being Used In Some Clinical Situations. Just Amazing Stuff!

This appeared last week:

AI is just what the overworked, burnt-out doctor ordered

By Angus Delaney and Kayla Olaya

September 14, 2024 — 1.51pm

Shorter wait lists for surgery, more time with patients and reduced burnout for workers are some of the benefits that doctors believe are possible through the use of artificial intelligence in healthcare.

AI tools have been developed to record and document doctors’ consultations with patients, produce formal reports and slash clinicians’ paperwork, and advocates claim the technology could transform a healthcare system in crisis.

But some experts and industry bodies have urged caution when using AI, which remains largely untested.

Melbourne orthopaedic surgeon Ilan Freedman is an early adopter, using AI to save him an extra 90 minutes a day in his practice. Without the distraction of note-taking, he says he is more focused on his patients.

Freedman says the tech could have far-reaching benefits for the health system, by freeing time and effort that would allow more consultations and operations. It could also be transformative on the home front, as the Clayton-based medico spends more time with his family and is no longer stuck in the office after hours.

“Because I don’t need to allocate admin time, I can get the work done in less time,” said Freedman.

“For me, I’m not seeing more patients overall, but I’m seeing … the same number of patients in much less time.

“I think everyone [other surgeons] I showed it to basically has adopted using it.”

Joel Freiberg, the founder of Australian tech start-up Medow Health, was inspired to develop a medically specific AI scribe after watching his father, a respiratory physician, stay late at work completing paperwork.

Currently, Medow Health’s user base is increasing by 50 per cent every month, as word spreads in the medical profession of AI’s possibilities.

Freiberg said clinics commonly had months-long wait lists for patient consultations and his AI tool would help reduce those wait times.

“Doctors are spending 30 per cent of their time on data entry … if you cut that in half you can see three to four more patients a day and cut those wait times,” he said.

“We all sit in the doctor’s office waiting for an hour, many times they’re doing their reporting ’cause they don’t want to forget what they said.”

Freiberg’s AI is currently only used in private clinics, but the developer wants to take the technology into the public system, and believes it could reduce Victoria’s backlogged elective surgery wait list.

In June, 58,722 Victorians were on the waiting list for planned surgery, according to the Victorian Agency for Health Information, and the real figure is larger, as many patients were waiting for an initial consultation.

While advocates are not suggesting the technology replaces a real-person consultation, some in the health system urge caution with how widely AI is used.

“There’s very little research evidence around these scribes,” said Farah Magrabi, a professor of biomedical and health informatics at Macquarie University.

“There are issues where the scribe could be basically summarising it incorrectly.

“This AI has the potential to really solve a lot of problems for doctors, and other health professionals as well, who are burdened by documentation, but they need to clearly understand how it’s working.”

The Royal Australian College of General Practitioners in July released advice on AI scribes, and noted the potential benefits, such as reducing administrative burden, improving patient satisfaction and decreasing doctor burnout.

But the potential for errors in scribes and the risks of a data breach that would expose sensitive medical information are among the drawbacks. Also, there is limited data on how well the scribes work.

The Australian Medical Association’s guidelines on AI support the use of the technology only when there is appropriate ethical oversight and where it is “used to benefit patients’ health and wellbeing”. The association has also raised concerns about a patient’s rights and a doctor’s clinical independence.

Dr Michael Bonning, the association’s chair of public health, said AI that accelerated administration work could reduce surgery wait times, but “we still need more of these doctors available to our system ... and [to] fund our health system effectively”.

More immediately, Bonning said, the value lies in reducing doctor fatigue and staff turnover.

“The level of burnout we are seeing is significant, [AI] does something about that,” he said. “I think about it as being transformative … we are at a time where the demands on the system are overwhelming.”

Everything considered, Bonning is hopeful AI could make a big difference.

“I believe in the value of technology being rolled out … and to ensure it meets all of those practical and ethical standards and recognise this can make our lives easier,” he said.

Here is the link:

https://www.smh.com.au/national/victoria/the-doctor-will-see-you-sooner-ai-could-reduce-healthcare-burnout-20240911-p5k9pv.html

And here is the link to the AI-co-pilot.

https://www.medowhealth.ai/

I have to say I find it just amazing that these technologies have been integrated and packaged in such a way that they can now be made available to clinicians for routine use.

The web-site warrants a close review to see just how fast things are moving. I am reminded of Arthur C. Clarke’s comment about ‘any sufficiently advanced technology seeming like magic’. This sure comes close – and is worth a close review!

I am afraid my Luddite tendencies are beginning to emerge. This is plain scary!

David.

It Looks Like At Least One University Has Decided Packed Lectures Are Pretty Much A Waste Of Time!

This appeared last week -  and is simply a ‘beat-up’. No one is actually furious I am sure!

‘Furious’: Adelaide University becomes first major Aussie uni to ditch face-to-face lectures

Staff have been left outraged by the decision, which will see students having no face-to-face teaching at all.

Brielle Burns

September 14, 2024 - 10:21AM

Labor committed to growing number of Australian university students

Education Minister Jason Clare says the Albanese Labor government will provide extra funding to encourage more Australian students to go to university.

A major Australian university has ditched face-to-face lectures entirely in a move which has reportedly outraged staff.

Adelaide University, which will launch in 2026 as a multimillion-dollar merger between the University of Adelaide and the University of South Australia, announced “most students” will no longer attend face-to-face lectures, which will be gradually replaced “by rich digital learning activities”.

“These activities will deliver an equivalent learning volume to traditional lectures and will form a common baseline for digital learning across courses, providing a consistent experience for students,” a post on the University of Adelaide website reads.

“These asynchronous activities will be self-paced and self-directed, utilising high-quality digital resources that students can engage with anytime and anywhere.”

The university stated courses will have a “common digital baseline”, with the proportion of digital learning expected to increase by 2034.

Other activities such as tutorials and workshops “may be delivered on-campus to create a rich cohort experience, or in instances where digital delivery provides the best outcomes for students, through the online learning space”, it noted.

Dr Andrew Miller, division secretary of the National Tertiary Education Union’s (Nteu’s) South Australia branch demanded the university reverse the decision, revealing staff are “furious”.

“We were promised the new university would be co-created with staff, students and community stakeholders,” he told The Guardian.

“This decision sidestepped that commitment. Co-creation means giving agency and empowerment to collectively build the university.”

Dr Millier, who claimed the decision was made without the proper involvement of staff, said staff should have their own say in learning outcomes.

“Flexibility [between online and face-to-face] ordinarily works both ways – some learners benefit tremendously from face-to-face learning with a specialist academic present while there are other independent learners that benefit from more remote digital engagement.”

Dr Alison Barnes, the national president of the Nteu, further slammed the “outrageous” move, arguing the shift to an online model adds to the “death of campus life”.

“Having lectured most of my adult life … I think about how many students have approached me before or after lectures to raise academic issues, things they haven’t understood about material or want extra help with,” she told the publication.

A spokesperson for Adelaide University said the move away from face-to-face lectures is not new.

“Universities have been increasingly responding to student needs for flexible delivery over the years,” they said in a statement student newspaper Honi Soit.

“Lectures are passive learning activities that can be delivered online to maximise flexibility for students without impacting learning quality.”

News.com.au has contacted the University of Adelaide for comment.

Here is the link:

https://www.news.com.au/finance/work/careers/furious-adelaide-university-becomes-first-major-aussie-uni-to-ditch-facetoface-lectures/news-story/fa62e5dcad7006a2f980df5c5bf027e3

Large lectures are really a very inefficient way passing on knowledge, which has to be the fundamental purpose. Better to be talking with and discuss the information with small groups in interactive formats etc., maybe having watched some form of interactive A/V education prior. I am sure this is what is now actually happening!

This said – there are situations where the public lecture can be a very useful forum – especially when followed by questions and discussion – or when a speaker has a point of view to put, and wants to present an organized argument or set of ideas!

It would be hard to think that these plans are little more than a cost-cutting exercise! What do you reckon ‘flexible delivery’ really means?

All this said, I reckon the idea of ‘staff outrage’ is pretty confected!

Bottom line – there is a time and place for all sorts of pedagogy from one on one up!

David.

 

AusHealthIT Poll Number 764 – Results – 15 September 2024.

Here are the results of the poll.

Have You Seen Ward Based Use Of Computer Terminals For Clinical Information Recording At Your Local Hospital?

Yes                                                                                 21 (75%)

No                                                                                     4 (14%)

I Have No Idea                                                                 3 (11%)

Total No. Of Votes: 28

A very clear vote, many have seen terminals in use at the ward level in hospitals.

Any insights on the poll are welcome, as a comment, as usual!

A moderately disconnected voting turnout. 

3 of 28 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many special thanks to all those who voted! 

David.

I Have To Admit I Find Stonehenge A Fascinating Mystery.

This appeared last week:

Stonehenge

Stonehenge tale gets ‘weirder’ as Orkney is ruled out as altar stone origin

Weeks after revelation that megalith came from Scotland, researchers make surprise discovery

Esther Addley

Fri 6 Sep 2024 03.00 AESTLast modified on Fri 6 Sep 2024 11.31 AEST

The plot has thickened on the mystery of the altar stone of Stonehenge, weeks after geologists sensationally revealed that the huge neolithic rock had been transported hundreds of miles to Wiltshire from the very north of Scotland.

That discovery, described as “jaw-dropping” by one of the scientists involved, established definitively that the six-tonne megalith had not been brought from Wales, as had long been believed, but came from sandstone deposits in an area encompassing the isles of Orkney and Shetland and a coastal strip on the north-east Scottish mainland.

Many experts assumed that the most likely place of origin was Orkney, based on the islands’ rich neolithic culture and tradition of monument building.

But a separate academic study has now found that Orkney is not, in fact, the source of the altar stone, meaning the tantalising hunt for its place of origin goes on.

The new study, which was conducted separately from last month’s Australian-led paper but involved some of the same scientists, examined the chemical and mineralogical makeup of the stones in Orkney’s two great stone circles – the Stones of Stenness and the Ring of Brodgar – as well as field samples of rock deposits across Orkney’s islands.

When their key markers, identified in portable X-rays, were compared with those of the altar stone they were found to be strikingly different, leading the authors to conclude that Orkney could not be its source.

The report’s lead author, Richard Bevins, an honorary professor of geography and earth sciences at Aberystwyth University, said Orkney had seemed “the obvious place to look” once initial research some years ago had pointed away from Wales to an unknown location in northern Britain.

Extensive evidence exists of long-distance communication between Orkney and Stonehenge around 3000BC, and a number of key innovations in technology and culture are believed to have originated in the archipelago.

“Everybody and their dog would have said: ‘Let’s try Orkney first. It’s going to be Orkney,’” agreed co-author Dr Rob Ixer, an honorary senior research fellow at University College London, who, like Bevins, was involved in the Australian-led research. He added: “Life would have been far simpler had it turned out to be similar to the stones of Brodgar.

“The more we learn [about Stonehenge], the weirder it gets.”

Ruling out Orkney so quickly could help narrow the search in other areas of old red sandstone, said Bevins, adding that he was “optimistic” the specific source of the boulder would be identified one day. “The Orcadian basin [the area of old red sandstone from which the altar stone originated] is quite a big area, so I wouldn’t say it will be found quickly. What I would say it is, it is achievable.”

Ixer said he would be “astonished if there weren’t other people shoving little probes around suitable stones” in Aberdeenshire and Caithness.

Alison Sheridan, the former principal curator of prehistory at National Museums Scotland (NMS), who was not involved in the research, said the new findings were “an intriguing additional twist to the tale”. She added: “As with many things from Stonehenge, nothing is ever straightforward.”

Attention had understandably turned to Orkney because of what was known of the sophisticated society that built the Ness of Brodgar, said Sheridan, who is now a research associate at NMS.

“What we don’t know as much about is the social organisation of other parts of Britain at the time. There’s clearly scope that people were just as sophisticated and well connected geographically and socially [elsewhere].

“I think it would do no harm for us to reconsider what we already know about late neolithic communities in north-east Scotland.”

The study is published in Journal of Archaeological Science.

Here is the link:

https://www.theguardian.com/uk-news/article/2024/sep/05/stonehenge-tale-gets-weirder-as-orkney-is-ruled-out-as-altar-stone-origin

All this seems much to hard to me and I have no idea why the ancient Britons were carting these huge rocks all over the place. I look forward to a credible explanation as to what was going on and why? I fear I may never know!!!

David.

The Department Of Health Still Seems To Be Hoping The MyHealthRecord Will Become Widely Used. I Have No Idea Why!

This appeared last week:

Australia releases aged care CIS standards

It will underpin the interoperable connection between My Health Record and aged care digital care management systems.

By Adam Ang

September 05, 2024 09:21 PM

The Department of Health and Aged Care and the Australian Digital Health Agency have released a set of minimum software requirement standards for clinical information systems and electronic medication management systems used in residential aged care.

The Aged Care Clinical Information System (ACCIS) Standards set the foundation for information sharing and interoperability in residential aged care. 

According to Ryan Mavin, ADHA Connected Care branch manager, the standards provide a "clear and consistent direction for software developers and aged care providers on how to design and implement [CIS] that meet the needs and expectations of residents, their families and care teams, and ensure they will connect seamlessly with all national digital health infrastructure."

It is based on the following principles:

• Data is reliable, consistent, computable and contemporary. 
• Data can be seamlessly shared between systems, care settings and organisations. 
• Data is accessible and transparent and drives improved consumer choice and decision-making. 
• Data drives efficient and safe clinical decision-making and positively impacts the end-user experience. 
• Data is captured once, retains its original meaning, and can be used securely many times, as appropriate. 

WHY IT MATTERS

Sam Peascod, assistant secretary of Digital and Service Design at the Department of Health and Aged Care, said the ACCIS Standards are critical to support aged care reforms. 

One of the recommendations of the Royal Commission into Aged Care Quality and Safety in 2021 was the mandatory use of My Health Record-interoperable digital care management systems.

The standards are expected to drive the uptake of telehealth, remote monitoring, and data analytics in the aged care sector, according to Dr George Margelis, chief technology advisor of the Aged Care and Community Care Providers Association.

Moreover, ADHA's Mavin said that the ACCIS Standards will help enhance the continuity and coordination of care for older Australians, especially during transitions of care. 

THE LARGER TREND

The ADHA recently put up an offer to vendors of CIS and mobile CIS software in allied health to make more products that connect to My Health Record and electronic prescribing services. 

The offer comes as the ADHA recently introduced an upgrade to Provider Connect Australia (a portal for healthcare providers to update their business information) that allows CIS to connect via SMART on FHIR. 

As part of its National Infrastructure Modernisation programme, the ADHA is currently building a FHIR-based Health Information Gateway, which will be a scalable platform for exchanging and accessing health information, including vaccination records and aged care data. Its build contract was awarded to Deloitte in 2021.

Here is the link:

https://www.healthcareitnews.com/news/anz/australia-releases-aged-care-cis-standards

What to say – it again seems to be an instance of hope over experience in terms of getting traction of any form with the myHR!

The question still is – who needs and why do they need to use the billion dollar myHealthRecord? No good answer has yet emerged!

David.

Surely A GP Shortage Should Not See Pharmacists Treating Patients Over Their Clinical Capacity?

 \This appeared last week:

These illnesses once needed a trip to the GP. Now a pharmacist can treat you

By Alexandra Smith

September 6, 2024 — 5.00am

The worsening GP shortage in NSW will see the state government broaden the conditions that pharmacists can treat in local chemist shops, including ear infections, stomach bugs and joint pain.

NSW Health is working on expanding the scope of practice for pharmacists to allow them to treat more conditions including middle ear infections, acute minor wound management, acute nausea and vomiting and gastro-oesophageal reflux disease.

Pharmacists will also be able to prescribe treatment for moderate acne and mild acute musculoskeletal pain.

Expanding the conditions pharmacists can diagnose and provide medication for is part of the NSW government’s push to alleviate pressure on GPs, which results in many patients turning to hospital emergency departments.

The number of GPs in NSW has been declining since 2018. There were about 9550 GPs in NSW in the 2022–23 financial year, down from 10,062 the year before.

At the same time, emergency departments are being swamped with patients. There were 792,841 visits to NSW emergency departments in the first three months of this year, the most of any quarter since the Bureau of Health Information started counting in 2010.

More than 490 pharmacies across the state have already participated in the oral contraceptive pill trial since it began in September last year, delivering more than 1800 consultations to women.

That trial followed the successful completion of the first phase of an earlier pharmacy trial, which saw more than 3300 NSW pharmacists provide more than 18,000 consultations to women aged 18 to 65 with symptoms of uncomplicated urinary tract infection (UTI).

The UTI service transitioned to usual pharmacy care on June 1, 2024.

Trial under way

The third and final phase of the trial allowing pharmacists to manage common minor skin conditions such as school sores and shingles is under way and will be running until early 2025.

NSW Health is consulting universities on the development of suitable training and the Pharmaceutical Society of Australia on upskilling pharmacists in clinical assessment, diagnosis, management, and documentation.

The health department has also agreed to authorise individual pharmacists who have completed the Queensland pilot training to deliver selected services in NSW from January 2025 onwards.

The Queensland government has been trialling a pilot that allows pharmacists to diagnose and treat up to 17 conditions, including shingles, mild psoriasis, wound management, swimmer’s ear, travel health and hypertension.

NSW Minister for Health Ryan Park, who made the announcement at the Pharmacy Guild’s Pharmacy Connect Conference on Thursday, said people should be able to access “as and when they need it”.

“We know that it is becoming more difficult to access a GP than ever before, with people often waiting days or even weeks before they can find an appointment,” Park said.

“By empowering pharmacists to undertake consultations on more conditions, we can relieve the pressure on GPs and end the wait times.”

Subject to appropriate training and ongoing work in implementation, the expanded services delivery could start in NSW pharmacies from 2026.

Here is the link:

https://www.smh.com.au/politics/nsw/these-illnesses-once-needed-a-trip-to-the-gp-now-a-pharmacist-can-treat-you-20240905-p5k85n.html

The key issue is to ensure that a pharmacist knows when he/she are out of their depth and to ensure a medical referral follows. The experienced pharmacist will have little to no problems but those who are a bit greener may struggle. Simple rule – if in any doubt –  refer on to the GP – and save yourself lots of grief!

I wonder where we can see what the planned extra pharmacist training involves? Anyone got a link?

David.

In Case Anyone Thought We Could Relax Our Guard We Have This To Sober Us Up!

This appeared last week:

Victorian hospital blunders led to 167 patient deaths

By Henrietta Cook

September 6, 2024 — 5.30am

A record 245 patients have died or suffered serious harm due to errors that unfolded at Victorian hospitals within a year.

Three patients died or suffered serious harm after surgery on the wrong part of their body, while four patients had foreign objects such as surgical sponges and dressings left inside them following surgery and other invasive procedures.

In one case, a woman who was admitted to hospital with a sore leg after falling off a step, developed blood clots in her lungs after being prescribed an inappropriate medication which left her on life-support.

The incidents are detailed in a Safer Care Victoria report published online last week, which revealed that approximately 167 patients died as a result of errors in Victorian hospitals in 2022-23.

It also documented several cases of missed testicular torsion that seriously harmed adolescent and young boys. These boys had arrived at emergency departments with acute abdominal pain.

In another case, a woman died after gastrointestinal complications caused by an antipsychotic medicine she was prescribed in hospital.

There were 245 sentinel events recorded in the state’s public and private hospitals in 2022-23, slightly more than the 240 incidents recorded the year before.

A sentinel event is an unexpected incident that leads to death or serious harm of a patient due to deficiencies in systems and process. This serious harm might involve a patient requiring life-saving surgical or medical intervention, shortened life expectancy or permanent or long-term loss of function.

Safer Care Victoria chief executive Louise McKinlay said sentinel events were tragic for patients, their families and hospital staff.

“These are terrible, catastrophic events,” she said. “No one goes to work to do harm but sadly things do go wrong.”

She said the stabilisation of sentinel events, following a sharp rise in previous years, indicated that the majority of incidents were now being reported. She said the data also illustrated improvements to transparency and the reporting culture of health services.

“This is not about blame,” she said. “It’s about understanding why did something happen and how do we stop it from happening again.”

Australian Medical Association Victorian president Dr Jill Tomlinson said sentinel events were more likely to occur when doctors were under pressure.

“Doctor’s don’t have ratios like nurses,” she said. “There can be very high workloads and unfortunately the more under pressure clinical staff are the greater the likelihood of avoidable harm to patients.”

She highlighted the recent coronial inquest into the preventable death of 19-month-old Victorian toddler Noah Souvatzis, who died on December 30, 2021, from meningitis. The coroner found that the toddler was discharged from Wangaratta hospital after an inadequate review by an under-trained, junior locum doctor on his first shift at the understaffed regional health service.

About one-third of the 245 incidents recorded in 2022-23 were for failing to recognise or respond to deteriorating patients. Issues relating to clinical process or procedure made up 24 per cent of cases, while medication errors were involved in 9 per cent of the incidents.

There was a slight decline in the number of sentinel events involving children, with 35 incidents involving them in 2022-23, compared with 38 children the year before. Around half of the incidents involving children related to patient deterioration.

Related Article

Shadow health minister Georgie Crozier said the numbers were not heading in the right direction and “much more needed to be done”.

“Our overwhelmed hospital emergency departments and other areas are clearly not coping if these numbers are rising, not decreasing,” she said.

Victorian Health Minister Mary-Anne Thomas said every sentinel event was a tragedy we needed to learn from.

“We are making significant changes to the way our health services respond to patient deterioration because we know this has historically, and unacceptably, been a significant factor in paediatric sentinel events,” she said.

Thomas said these changes included a new urgent helpline to ensure patient and family concerns are heard, the roll-out of standardised monitoring across all hospitals and a new 24/7 virtual paediatric consultation system.

The helpline, which was launched by Thomas last week, was announced last year after an almost doubling of sentinel events involving children.

It also followed advocacy from the parents of eight-year-old Amrita Lanka, who died in 2022 after arriving at Monash Children’s Hospital with myocarditis, an inflammation of the heart muscle.

Her parents resorted to asking the cleaners for help while Amrita deteriorated. She was struggling to breathe, had chest pain and a high heart rate, but doctors ignored or misinterpreted signs she was critically unwell.

Here is the link:

https://www.smh.com.au/national/victoria/victorian-hospital-blunders-lead-to-167-patient-deaths-20240905-p5k81x.html

There are a lot of sad and unhappy stories here but the overall message I take from these sagas is that a mixture of actually seeing the patient and applying common sense to what you see will save much suffering. Clear-eyed assessment and recognition that all is not well is not hard and insisting on senior review of what is going on can save a lot of lives!!!!

The other message is that procedures and routines are developed for a reason and it is vital to follow them - counting swabs etc. - to maximise safety! Short cuts can kill!

It is the old story that any experienced clinician needs about 2 seconds with the patient to recognize all is not well – and if action follows much good can flow! Where trouble ensues is when the doctor does not actually see the patient and so is not exposed to see the subtle clues that reveal the serious trouble!

I reckon it only takes about a year of clinical experience to be able to quickly recognize all is not well and seek / initiate help / action. With many even less time is needed!

Basic lesson is to clamp eyes on the patient and you will seldom, if ever, not do the right thing in terms of what is needed next and how soon! No one should ever be embarrassed about asking for a senior review and the seniors should respond promptly!

David.

NSW Health May Be Making Some Forward Steps With Patient Information Sharing.

I spotted this a few days ago:

Collaboration sets the stage for next phase of Single Digital Patient Record (SDPR)

29 August 2024

Building a landing zone for technology to take flight

eHealth NSW in partnership with the Single Digital Patient Record Implementation Authority (SDPRIA), Epic Systems and Amazon Web Services (AWS), completed the build of the SDPR hosting environment, known as the AWS Landing zone.

The AWS Landing Zone is a secure, scalable and foundation for how the electronic Medical Record (eMR) will be managed and deployed for SDPR.

Configuration phase moves a step closer to reality

Cutting-edge cloud technologies were developed for the AWS landing zone to improve service delivery. This core foundation means the focus now turns to configuring the SDPR to ensure it meets the needs of NSW Health staff, patients and the people of NSW.

SDPRIA Chief Executive Dr Teresa Anderson AM shares how this milestone is a fantastic outcome and yet another example of excellence in partnering.

“The achievement is the result of tireless collaboration between AWS, eHealth NSW technical teams and Epic Systems and I couldn’t be prouder of the result,” Dr Anderson said.

“It truly demonstrates that our Single Digital Patient Record now has the infrastructure capabilities and readiness, in addition to enhanced security and compliance to ensure it is ready for this exciting next phase of configuration,” - Dr Teresa Anderson AM, (SDPRIA) Chief Executive

Focus now on data migration and integration

The team will focus on data migration and integration, to enable a seamless transition and integration with other systems and workflows as well as ongoing testing and validation said SDPR Associate Director, Service Delivery, Rodney Daly.

“This step signifies the transition from planning and preparation to actual deployment and implementation, ensuring that we have the right infrastructure in place to support the high performance and reliability required for the Epic Systems eMR" - Rodney Daly, SDPR Associate Director

“This milestone while very technical will provide a number of improvements and benefits, including the easy scaling of resources to meet growing demands, enhanced security and improved performance,” said Mr Daly.

Find out more about the Single Digital Patient Record program.

The link points to this screed:

Single Digital Patient Record (SDPR)

The Single Digital Patient Record (SDPR) will provide a secure, holistic and integrated view of the care a patient receives across the NSW Health system. Clinicians will be able to access a patient’s medical information in real-time from a single source.

The Challenge

Clinical information is captured in many different systems across NSW Health. Currently, healthcare teams must access several platforms to get a comprehensive patient history. These include various electronic medical record systems, patient administration systems and laboratory information management systems. This makes it difficult to quickly access comprehensive information about a patient.

Some of these systems are also not connected statewide. This means different care teams must manually request patient information from other local health districts if a patient is visiting multiple health services. Data is routinely collected but is often unable to be shared or integrated in real time. This can create data duplication or information gaps that could affect providing the best patient care possible.

To solve these challenges, a single source of clinical information is needed.

The Plan

The SDPR program will transform how people experience and deliver care across the state, providing benefits for the people of NSW and the NSW Health workforce regardless of their location and role.

It will bring the state healthcare system together, unifying access to patient clinical information in one view. This will help to provide connected, transparent and safe care for any person at any public healthcare setting statewide.

The SDPR program will achieve this by partnering with NSW Health pillars, public health services, staff, clinical leaders and community members who support or interact with the statewide health service. This will include a statewide integration of electronic medical records (eMR), laboratory information management system (LIMS) and patient administration system (PAS).

SDPR will be delivered under the leadership of the Single Digital Patient Record Implementation Authority (SDPRIA). The Single Digital Patient Record Implementation Authority (SDPRIA) has been established to work in partnership with Local Health Districts, Specialty Networks, eHealth NSW, NSW Health Pathology, shared services, Pillar agencies, the Ministry of Health and the EPIC teams to lead the implementation of the SDPR program.

SDPR will be first available in the Hunter New England LHD and Justice Health and Forensic Mental Health Network, followed by a phased roll out schedule across the state. The overall implementation timeline is expected to be completed by 2028. This includes the configuration of the system and roll out.

The Outcome

For the first time in NSW, healthcare teams will be able to use the same digital clinical system to access patient information, record the care they provide, order diagnostic tests and manage medications, no matter which public hospital or community healthcare facility they work in.

The key features of the SDPR will include:

• Holistic, real-time patient information accessible from a single system
• Continuity of information provided within a single system across all NSW Health services
• Improved integration with medical devices and other clinical systems
• Intuitive, user-friendly design that, for example, pre-fills records based on historic patient data
• Secure access to patient records and clinical workflows via mobile devices
• Simplified clinical workflows and streamlined technical support
• Robust privacy and security functionality
• Increased analytics, dashboards and reporting to support ongoing enhancement of health services and patient safety.

The Benefits

Having one statewide system will support consistency and continuity of care, particularly for patients receiving care across multiple NSW Health settings.

For patients visiting NSW Health services, it will mean:

• A reduced need to recall and repeat health information
• A consistent experience regardless of where they seek care
• More informed discussions with their health care providers, so they are better able to make decisions about their own health.

For NSW Health clinicians, the SDPR will mean:

• Easier, faster and more consistent access to comprehensive, up-to-date patient records in a single secure system
• Enhanced clinical safety and quality, with less duplication of care across sites and providers
• Less admin, with streamlined record-keeping.

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Here is the overall link:

https://www.ehealth.nsw.gov.au/news/2024/single-digital-patient-record-infrastructure-milestone

This all sounds wonderful, but I am curious to know how much of this is beyond the ‘vapour-ware” stage and is actually doing what is intended?

Reading the announcement one really wonders how much of this grand plan is real at present.

It would be good to hear from those on the ground as to how much has thus far been achieved.

I can report – after a very recent stay at Royal North Shore that – at a ward level – virtually all documentation is electronic and is very widely used. (No one goes anywhere without their mobile terminal)

So at a hospital level real progress appears to have been made! I am now wondering what the impact has been?

Anyone care to comment from the work - face?

David.

p.s. Put another way by Adam Ang:

SDPR foundation developed

The "landing zone" for the Single Digital Patient Record (SDPR) in New South Wales has been set. 

According to eHealth NSW, the landing zone, developed with Epic and Amazon Web Services, is the "secure, scalable foundation" for managing and deploying the SDPR. The single EMR project is set to replace nine EMR platforms, six PAS, five pathology LIMS, and other clinical support systems across NSW public health services. 

This step ensures that the right infrastructure is "in place to support the high performance and reliability required for the Epic Systems EMR," said SDPR project associate director Rodney Daly. 

Following this, the project now focuses on configuring the SDPR to meet user requirements, as well as data migration and integration with other systems and workflows, on top of ongoing testing and validation. 

Here is the link:

https://www.healthcareitnews.com/news/anz/sdpr-landing-zone-established-and-more-nsw-briefs

 Reports from the field encouraged!

 D.