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."

Friday, March 28, 2014

Now Here Is The Practicalities Of Just How Bad Health IT Can Actually Contribute To A Patient Death.

This awful story appeared a little while ago.

UK Coroner Fingers NHS Computer System in Toddler’s Death

By Robert N. Charette
Posted 10 Mar 2014 | 20:36 GMT
The number of IT-related errors, ooftas, and deficiencies reported last week reverted back towards the mean from the previous week's overabundance. We start off this edition of IT Hiccups with a sad case of a child’s death in the UK. The tragedy is being attributed in part to the past effort to fully computerize the UK’s National Health Service.
According to the Bristol Post, a coroner in charge of the inquest into the death of Samuel Starr, aged three, indicated in a narrative verdict that, “Due to the failure of the [Royal United] hospital's outpatient booking system, there was a five month delay in Samuel being seen and receiving necessary treatment.”  It is very rare for a coroner to criticize a hospital IT system so directly.
Samuel Starr was born with “complex congenital heart disease” in 2009. His parents were told at the time of his birth that Samuel would need several operations before he was five, and in fact, Samuel underwent an operation when he was nine months old. The Post reported that he made a good recovery, and was due to have regular checkups and further treatment at the Pediatric Cardiac Clinic at the Royal United Hospital (RUH) in Bath. Samuel received a checkup in October 2010 and one in April 2011, at which time his parents were told by his doctor to schedule another in about nine months for a more extensive examination of his heart.
However, a new electronic health record system, called Cerner Millennium, was being installed in 2011 at the hospital as part of the NHS’s National Program for IT (NPfIT), which was shortly thereafter cancelled. Though the main program was cancelled, certain elements, such as its national Choose and Book system for patient scheduling, remained. (Hospitals, like at Royal United, that were already installing electronic health record systems were given the go-ahead to proceed if they wished).
According to the Daily Mirror, “glitches” in the Royal United patient booking system caused Samuel not to receive his scheduled appointment with heart specialists as required, despite pleas for an appointment by his parents and a primary care specialist. The Mirror stated that medical secretary for Samuel's doctor insisted that she had taken down the appointment details and forwarded them on to a dedicated appointments team, but they were apparently not logged in. “While Samuel's medical records had been created on the new Millennium computer program, no appointments had been transferred across [from the old scheduling system],” the Mirror explained.
By the time Samuel was eventually seen, his heart condition had taken a turn for the worse, and he required immediate surgery. Unfortunately, the child died after enduring a series of cardiac arrests a few weeks after his surgery.
The rest of the story is found here - along with some other mess-ups.
This is a sad story which shows just how there can be consequences if great care is not taken to ensure IT that is involved in patient care is not looked at a whole and that seamless end to end operation is assured. Also important is to carefully ensure that issues that emerge with respect to use of systems and IT are appropriately escalated and remedied.
This really feels like a glitch that should have been caught and it is sad that it apparently was not.
David.

Thursday, March 27, 2014

Pre - Budget Review Of The Health Sector - 27th March 2014.

As we head towards the Budget in Early to Mid-May 2014 I thought It would be useful to keep a closer eye than usual on what was being said regarding what we might see coming out of the Budget.
According to the Australian Parliament web site Budget Night will be on Tuesday 13th May, 2014.
Here are some of the more interesting articles I have spotted this week.
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What do the polls tell us about bulkbilling co-payments?

Jennifer Doggett | Mar 19, 2014 11:24AM |
The opinion poll released on Monday in the Fairfax media is being interpreted by some commentators as supporting the proposal for a GP bulkbilling co-payment, reportedly under consideration by the Abbott Government.   
Around half of the people polled said that they supported charging a means-tested co-payment for bulkbilled GP services.  The same proportion of people also supported the Government taking action to ‘curb the cost of Medicare’.
Opinion polls have their uses but caution should be exercised when interpreting the results of this poll as a vote for shifting health care costs from Governments to consumers. 
In fact, polls on complex policy issues such as this should be seen as akin to horoscopes – ambiguous enough for all readers to find confirmation of their existing biases and to justify the course of action they were going to undertake anyway. 
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Poll results confirm change is afoot within the electorate

Comment
Laura Tingle Political editor
As politicians spent a hectic day trying to persuade us which messages we should take out of the Tasmanian and South Australian elections, more mundane factors that might have actually motivated voters were not getting all that much attention.
The most mundane of those factors goes to the Labor governments in Tasmania and South Australia being not so much ageing as geriatric. Voters wanted a change.
In Tasmania voters were also over the Greens and minority government. All the talk of the Greens becoming the major opposition party at Labor’s expense ended up looking very sick.
Yet the two state polls – and the latest Nielsen federal poll – do tell us some very big changes are taking place in the electorate.
…..

Voters show appetite for tough medicine

Yet the latest poll shows the case for tougher access to Medicare, rather than protecting universal access, in the ascendency.
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Medicare means test and co-payment have public support

17th Mar 2014
PROPOSALS to curb Medicare costs have earned the support of voters, with the latest Nielsen poll showing about half of those surveyed support measures such as the $6 co-payment and means-tested bulk-billing.
The Coalition leads Labor 51% to 49% in the poll published by Fairfax on Monday, down 1% from February, with Tony Abbott remaining as preferred prime minister with 48% support versus 43% for Opposition Leader Bill Shorten.
Despite the Labor campaign against the possible introduction of a $6 GP co-payment, the poll provided a boost for government indications of a tough budget in May, with 52% backing a means test for bulk-billing and 49% supporting the introduction of a $6 co-payment.
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Primary healthcare spending rises 50%

21st Mar 2014
GOVERNMENT spending on primary healthcare per person increased by 50% over the last decade.
A report from the Australian Institute of Health and Welfare shows expenditure increased in real terms from $30.8 billion to $50.6 billion for primary healthcare over the decade from 2001–02 to 2011–12.
Federal government spending per person on primary healthcare rose from $669 in 2001–02 to $1005 in 2011–12 after adjusting for inflation.
But Professor Jane Hall, a health economist at the University of Technology, Sydney, said this did not back an argument to introduce a $6 co-payment to cover these rising costs.
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Government healthcare spending figures may bolster case for a GP co-payment

Date March 21, 2014

Dan Harrison

Health and Indigenous Affairs Correspondent

Federal spending per person on primary healthcare services, including visits to GPs, grew by 50 per cent over the past decade, according to new figures that may bolster the case for new fees to visit the doctor.
The analysis from the Australian Institute of Health and Welfare to be released on Friday shows federal government spending per person on primary healthcare - a measure largely made up of visits to doctors - rose from $669 in 2001-02 to $1005 in 2011-12 after adjusting for inflation.
Federal spending per person on all health services - a measure that takes in spending in hospitals as well as visits to doctors - increased from $1892 to $2620.
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Price of 121 medicines to plunge

·         March 20, 2014 12:00AM
·         SUE DUNLEVY and LISA CORNISH
·           News Corp Australia
THE price of 121 medicines will crash by up to $12 a script for general consumers from April 1 as the government stops overpayments to chemists.
And drug companies are urging Health Minister Peter Dutton to put the $20 billion it will save from the cuts towards subsidies for expensive new medicines.
The government has been paying chemists up to 80 per cent above the market price for generic medicines in a policy that has cost the taxpayers billions of dollars a year.
The overpayments have also hit general consumers who have been paying up to 63 times more for commonly used medicines than consumers in New Zealand or Britain.
A new price disclosure policy is gradually forcing down prices however.
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News Ltd reports misrepresent pharmacy: Guild

20 March, 2014 Nick O'Donoghue
Reports in several News Limited papers, today, are misleading the public into believing that they are overpaying pharmacists for the medicines, the Pharmacy Guild of Australia says.
A Guild spokesperson hit out at claims that PBS price cuts were a result of the Federal Government stopping “overpayments” to pharmacies.
“This is an unfair slur on hard-working pharmacists who continue to provide PBS medicines at the best possible price to patients within a system in which they have no control over the PBS price – which is determined by Government,” the spokesperson said.
“The vast majority of prescriptions dispensed under the PBS are directly subsidised and therefore the price to the consumer – the co-payment – is identical no matter which PBS approved pharmacy supplies the prescription.”
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Private health priority treatment 'against spirit of Medicare', AMA official warns, as scheme expands

By Elise Worthington
March 20, 2014
A private health scheme that guarantees members priority bulk-billed care contravenes the "spirit" of Medicare laws designed to ensure equal access to health care, an Australian Medical Association (AMA) official warns.
Medibank Private began trialling the program last November at six north Brisbane medical practices and aims to expand it to 30 more sites in Queensland, as well as other states.
Medibank national medical director Dr Ian Boyd says many of the 4,500 patients who have tried the scheme have done so more than once, and the feedback is positive.
"The service allows them to have access to a GP within 24 hours for a standard daytime visit, and also allows them to have access to a GP in the metro areas in the after-hours period for home visits," he said.
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Secret Health Department plan to slash bulk billing

Joanna Heath
A plan to means test bulk-billed GP visits and charge an extra $5 for medicine was estimated to save the government nearly $2 billion but would upset doctors, who have threatened a mass walk-out if it is implemented.
The proposal from the Department of Health to reduce medical subsidies was rejected by the Labor government before last year’s budget. But it is likely to be reconsidered by Health Minister Peter Dutton, who believes Australians who can afford to, should pay more for their healthcare.
Under the plan, which was leaked to The Australian Financial Review, there would be a major change in how GPs are repaid by Medicare for treating patients. Bulk billing would be limited to concession card holders and ­children, saving $860 million over five years.
A spokesman for Mr Dutton would not rule out the changes, saying only the government would not comment on deliberations for the budget, which comes out May 13.
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Qld doctors reject govt pay deal

20th Mar 2014
MORE than a thousand senior doctors working in public hospitals across Queensland have voted to reject the state government's offer on individual contracts.
The unanimous vote of no confidence in the government's last-minute compromise came after Queensland Health Director-General Ian Maynard acknowledged their concerns at a crowded gathering in Brisbane on Wednesday night.
"The concerns that I've been told you had were consistent wherever you worked in the state," he told the crowd of about 1200 doctors, including one holding a placard, "Trust Gone, Goodwill Lost".
Senior medical officers (SMOs) had met with Mr Maynard and Health Minister Lawrence Springborg last week to express reservations about working conditions.
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Medicare offices to close on Saturdays, Human Services Minister Marise Payne says

March 20, 2014, 9:06 am
Medicare offices will close on Saturdays around the country, the Federal Government has confirmed.
Human Services Minister Marise Payne says there has been a 60 per cent reduction in walk-ins into Medicare shopfronts on Saturdays.
There are currently more than 90 Medicare offices which trade on Saturdays, mainly in regional and suburban areas.
Ms Payne says more people are making claims online or electronically.
"I think what we're seeing is a change in the way people are doing business," she said.
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Dutton supports Medibank funding proposal

Jessica Gardner
Health Minister Peter Dutton has backed a proposal from Medibank Private managing director George Savvides that would change the way doctors are paid to treat the chronically ill to a per year basis, instead of a payment per visit.
Writing in Monday’s The Australian Financial Review, Mr Savvides says the system now failed “high needs” patients because there was no structure that pays doctors to provide extra care.
In what would be a major reform of Medicare, Mr Savvides said Medibank wants to fund a “capitation” model of funding for GPs alongside the government. “We’re not asking government to be the only source of that funding,” he told the Financial Review.
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18 March 2014, 6.37am AEST

Want Medicare savings? Stop paying for private hospitals

TThe polls this week suggest half of Australians think the Abbott government should reduce the cost of Medicare. My solution? Claw back some of the A$9 billion the government pays to private hospitals…
Peter Sivey
Senior Lecturer, School of Economics at La Trobe University
The polls this week suggest half of Australians think the Abbott government should reduce the cost of Medicare. My solution? Claw back some of the A$9 billion the government pays to private hospitals.
Consider my experience … A few years ago I twisted my knee playing football. My GP, maybe after estimating my salary, suggested a private sports physician to diagnose my injury. The sports physician pulled and prodded at my knee before telling me:
It doesn’t seem like any ligaments are torn, but I can’t tell for sure. Why don’t we get you a scan – you’ll only pay $60. And Medicare will pay the rest.
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Super clinics not accountable for performance, govt says

17th Mar 2014
SUPER clinic operators have no responsibility to ensure performance quality even though the centres were built with multimillion-dollar government grants, Health Minister Peter Dutton has said.
Mr Dutton told MO that contracts entered into by the Labor government with super clinic operators only ensured that the centres would provide primary and allied care for a minimum of 20 years.
"Nothing was retained to ensure the companies performed over the 20 years. So the Commonwealth can’t really enforce performance," Mr Dutton said.
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Dutton ‘can’t enforce’ performance of ALP’s super clinics

THE federal government fears it could be powerless to enforce the performance of Labor’s $420 million GP Super Clinics program, a third of which have yet to be built or are not operating.
This is despite the super clinics being cornerstone Labor election promises in 2007 and 2010.
The latest update of the progress of the program obtained by The Australian, shows 10 of the 64 super clinics planned are yet to be started with another 14 still under construction.
Despite its $420m price tag, Health Minister Peter Dutton has confirmed that under the program the federal government owns none of the assets at the super clinics. Instead, the government holds 20-year contracts for service provision from the recipients of the grants.
But Mr Dutton is concerned the front-end loading of funding in the contracts could compromise the federal government’s ability to guarantee performance.
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Competing private health insurers push up costs, inquiry told

Date March 17, 2014

Inga Ting

Data journalist

Countries that rely heavily on private insurance to fund healthcare have more expensive health systems, the federal government's Commission of Audit has been told.
In an analysis of the health expenditure by Organisation for Economic Co-operation and Development countries submitted to the commission, researchers from the Centre for Policy Development say competing private health insurers were unable to keep costs down.
The government has hinted at cuts to health spending, warning that private funding needs to play a bigger role in containing rising healthcare costs.
It has appointed the commission to examine all federal spending and recommend budget cuts.
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Comment:
It seems even clearer there is a significant change coming on the basis of this week’s news as well.
What has been interesting this week has been the emergence of Medicare means testing and criticism of private health insurance. Additionally we have polls suggesting co-payments are fine and discussion on how these polls can mislead. All good fun and grist for the mill!
Importantly there is also a great deal of useful discussion here from The Conversation.
As usual - no real news on the PCEHR Review.
More next week.
David.

Wednesday, March 26, 2014

I Have Seen Rent Seeking Before But This Is A Really Great Example!

There was a white paper produced a little while ago.

One in Four Lives

The Future of Telehealth in Australia

March 2014
·         Lisa Altman
·         Shehaan Fernando
·         Samuel Holt
·         Anthony Maeder
·         George Margelis
·         Gary Morgan
·         Suzanne Roche
Here is the direct link.
Here is an article on the release of the white paper.

Calls for national telehealth strategy

By Australian Ageing Agenda on March 6, 2014 in Technology

One In Four Lives group speaker Dr George Margelis presenting the white paper to MP Steve Irons, chair of the House of Representatives Standing Committee on Health
The Federal Government is being urged to develop a national strategy for telehealth as an effective way to help rein in Australia’s ballooning health budget deficit.
A collaboration of health industry stakeholders, One In Four Lives, released a white paper in Canberra on Wednesday to promote the adoption of telehealth nationally.
The group, whose members include the Australian Information Industry Association (AIIC), BT, anywhere healthcare, Philips, and the University of Western Sydney, said telehealth could save $4 billion a year in avoidable hospital presentations related to chronic conditions.
The group said its name reflected the fact that almost six million, or one in four Australians, were affected by chronic health conditions. This accounted for 60 per cent of all hospital bed days and an estimated $17 billion annually in public health costs, it said.
The white paper said that the Australian health system was not sustainable in its current form. It cited Treasury modelling that predicted healthcare costs would consume more than 100 per cent of the entire revenue collected by the states by 2046.
Chair of the body, BT’s director of health Lisa Altman, said the aim was to encourage industry participation in the large-scale adoption of telehealth – providing faster, more efficient healthcare solutions without imposing an additional burden on the health budget.
Ms Altman said the evidence base for telehealth already existed, through large scale deployments such as the Department of Veterans Affairs in the US and the Whole System Demonstrator Program in the UK.

Lots more here:
There is also coverage here:

Telehealth could save "unsustainable" federal health budget, according to a white paper

A national strategy for Telehealth could save the federal government about $4 billion
A national strategy for Telehealth could save the federal government about $4 billion and help rein in an unsustainable health budget.
One In Four Lives, a group of industry stakeholders, has released a white paper in Canberra, to stimulate discussion and is urging the government to start a national scheme to take control of a ballooning health budget.
The One In Four Lives group estimates that Telehealth has the ability to slash Australia’s public hospital costs by about $4 billion a year in avoidable hospital presentations related to chronic conditions and improve access to healthcare for the thousands of Australians who wait months to see a doctor.
The name of the new body reflects the fact that almost six million, or one in four Australians, are affected by chronic health conditions.
This is a major burden on the health budget, accounting for 60 percent of all hospital bed days and an estimated $17 billion annually in public health costs.
The white paper recognises that the Australian health system is not sustainable in its current form.
Treasury modelling predicts that on current trends health care costs will consume more than 100 percent of the entire revenue collected by the states by 2046.
One In Four Lives is a collaboration of organisations representing a broad range of the health industry, including The Australian Information Industry Association, BT, anywhere healthcare, Philips and the University of Western Sydney.
Lots more here:
Disappointingly the white paper is really sad.
It is 8 pages long - rehearses all the information we know about rising health costs and - with very little evidence - suggests all sorts of additional MBS funding for the sector to make money for all the providers of bandwidth, equipment and the clinicians.
All these experts somehow want the Government to develop a National Telehealth Strategy rather than doing to work to propose one themselves!
The white paper has a total of seven references
1. Australian Bureau of Statistics,  Profiles of Health , Australia,  2011-13 [excluding Cancer, Arthritis and Osteoporosis]
2. Towards a National Strategy for Telehealth in Australia 2013- 2018, Australasian Telehealth Society, 2013
3. A National Telehealth Strategy for Australia, Australian National Consultative Committee for Electronic Health, 2012
4. Caring for the last 3%: Telehealth Potential and Broadband Implications for Rural Australia, CSIRO, Nov 2012.
5. National Digital Economy Strategy, Department of Broadband, Communications and the Digital Economy, 2012.
6. Supporting a Telehealth Strategy for Australia, Medical Technology Association of Australia, May 2012
(Also: Developing a comprehensive Telehealth Policy for Australia, Medical Technology Association of Australia, Dec 2012)
7. Telemedicine in the context of the National Broadband Network, National ICT Australia report for Department of Broadband, Communications and the Digital Economy, June 2010.
I list these to point out none appear to be literature / evidence reviews and are all older than 12 months - i.e. created under a different Federal health minister. I can't see the present Government lifting a finger without a really high quality business case at the least!
Interestingly  calling a report One In Four Lives seems to have some rather absurd assumption that every person with a chronic illness needs and will benefit from telehealth!
As they say - Nothing to see or going on here, move on!
David.

Tuesday, March 25, 2014

Weekly Australian Health IT Links – 25th March, 2014.

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

Social Media and the regulation of doctors communication with patients has been causing some consternation. Interesting to see how long it will be before AHPRA decides to properly fix the issue.
Other than that the non e-Health minister announces an e-health app and we have some other interesting positioning of various e-health infrastructure - some of which is very close to rent seeking.
Lastly we have two great articles on the major cosmological discovery which is likely to change our view of the very early universe. Worth reading.
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New mobile app an e-Health world first for people with bleeding disorders

The official launch of a new mobile application makes Australia a world leader in assisting people with bleeding disorders.
21 March 2014
The official launch of a new mobile application makes Australia a world leader in assisting people with bleeding disorders, the Assistant Minister for Health, Senator Fiona Nash, said today.
Launching the National Blood Authority’s new MyABDR app in Canberra, Minister Nash said the “globally-unique” smartphone app changes the way people with bleeding disorders, such as haemophilia, monitor and treat their condition.
“MyABDR enables people with bleeding disorders and their carers to record bleeds and their home treatments in real time,” Senator Nash said.
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7 March 2014, 6.35am AEST

Digital tools for a better, more sustainable health system

IIt seems that almost every politician, health economist, policy expert and health-care worker has a different take on the state of the nation’s health system and ways to make it more sustainable. But notably…
Sarah Dods
Research Theme Leader, Health Services at CSIRO
It seems that almost every politician, health economist, policy expert and health-care worker has a different take on the state of the nation’s health system and ways to make it more sustainable. But notably absent from the debate so far is the role of technology.
So, how can digital innovation improve the health system’s bottom line?
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Discharge letters fixed with 30 mins training

14 March, 2014 David Brill
GPs rejoice: hospital doctors have finally come up with a way to improve the quality of interns' discharge summaries.
The new scheme, being implemented in one of SA's biggest public hospitals, takes aim at the sloppy wording, irrelevant information and poor structure so often found in discharge summaries.
With just half an hour of extra training, interns dramatically raised their game — particularly on the clarity and presentation of their summaries, a pilot study has shown.
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Australian Electronic Health Records market set for growth

Australia’s Electronic Health Record (EHR) industry is tipped for growth next year as more organisations look to streamline their patient processes.
New Accenture research revealed the global market will be worth US$22.3 billion (AU$24.8 billion) by the end of 2015, with Australia set to contribute $700 million.
Australia’s national eHealth program, which received AU$447 million in investment, is thought to be a primary driver of the country’s 2.2 per cent EHR compound annual growth rate over the next two years.
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Compact breath sniffer could warn of diabetes

Toshiba's medical breath analyzer can check your fat metabolism
If you're worried about being out of shape, or suspect you might have a disease like diabetes, just breathe into this Toshiba tube.
It's part of a prototype medical breath analyzer that's small enough to be used in small clinics or gyms.
By detecting trace gases that are exhaled, it could be used to monitor health indicators such as fat metabolism and help diagnose disease, Toshiba said.
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IBM Watson has another go at helping solve brain cancer riddles

IBM has teamed with the New York Genome Center to find specific treatments for specific genetic mutations
IBM is using the powers of its Watson supercomputer service to help solve the mysteries of brain cancer by examining individual genetic mutations.
"When you do whole gene sequencing, you get a very complete picture of the mutations in a specific patient. It is critical to be able to translate that information into something an oncologist can understand and take actions around," said Raminderpal Singh, IBM Research business development executive for genomic medicine.
In a research study, IBM Watson will help New York Genome Center doctors by searching for their patients' mutations that may be referenced in genomic databases and in medical literature. It then can present any findings of interest to the patient's physician.
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Bad quality data costing Australia’s healthcare industry millions

Greater adoption of the global GS1 System of supply chain standards and the National Product Catalogue (NPC) has the potential to significantly improve data quality and bring about savings of anywhere between $30 million and $100 million a year for Australia’s healthcare industry, according to a newly published report.
The Australian Healthcare Industry Data Crunch Report reveals the impact of inaccurate and inconsistent data across the Australian healthcare industry and the effect on patient safety.
And, the report highlights what it says is unnecessary supply chain spending in the healthcare sector, including procurement, where it estimated $8.8million had been spent on resources to manually check unit of measure data in purchase orders, and an estimated $4.37 million was expended to ship emergency deliveries due to under supply.
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Creating nationally-consistent health information: engaging with the national health information committees

14 March 2014
This document provides guidance on engaging with the national processes responsible for health information and data standards. It has been developed to ensure data collected are consistent, accurate and useful for policy, planning and program management.
Summary
In a health system dispersed across the states and territories by the Australian Government, strong governance arrangements are needed to ensure that health information, collected under different health administrations, are consistent and therefore accurate and useful for policy, planning and program management.
The National Health Information Agreement, signed in 2011 by all jurisdictions and the national health agencies associated with health information, provides the overarching framework for the governance of national data collections.
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Getting e-health infrastructure right

RECENT advances in technology have seen a significant take-up and usage of telehealth in Australia.
From video conferencing applications for remote consultations, to the proliferation of e-health records and mobile devices that allow healthcare workers to access relevant patient data, technology is playing an important role in enhancing medical care for Australians.
As more healthcare providers rely on technology to deliver quality services to the community, a greater strain will be placed on the network infrastructure that connects hospitals to specialists, and doctors to their patients.
Now as the government, healthcare industries and service providers set about improving the network infrastructure and associated broadband services in these areas, we should ask: does Australia have the right infrastructure in place to allow healthcare providers to realise the true potential of telehealth solutions?
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One in Four Lives

The Future of Telehealth in Australia

March 2014
Lisa Altman
Shehaan Fernando
Samuel Holt
Anthony Maeder
George Margelis
Gary Morgan
Suzanne Roche
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Nurses’ tablets tame the tyranny of distance

TABLET computers with high-speed wireless broadband connectivity and video capabilities have been credited with saving time and money for healthcare provider Silver Chain.
The technology means specialist nurses don’t have to trek hundreds of kilometres to provide basic consultation or training programs to colleagues in far-flung locations. Nurses can view injuries, provide remote diagnosis, treatment and monitor medication adherence via video conferencing sessions with patients.
The technology, comprising Samsung tablets on Telstra 4G/3G links with Polycom video conferencing software, has been provided by Silver Chain, one of the largest not-for-profit health and community care providers.
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AMT v3 Pre-Production release is now available for download

Created on Tuesday, 18 March 2014
The AMT v3 Pre-Production release is now available for download from the NEHTA website.
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AHPRA UPDATES THE RULES: TESTIMONIALS AND SOCIAL MEDIA ARE IN THE REGULATOR’S SIGHTS

Newsflash - 13 March 2014
On Monday 17 March 2014, a series of updated guidelines drafted by the Australian Health Practitioner Regulation Agency (AHPRA) and the National Boards will come into effect. This includes a major overhaul of the guidelines for advertising health services and the introduction of a social media policy for registered health practitioners [1]. The guidelines for mandatory notifications and the Code of Conduct for Doctors in Australia have also been updated. This article examines the most significant changes in the updated guidelines and explores the potential focus areas for AHPRA and the National Boards.
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Doctors fight AHPRA's social media rules

17 March, 2014 Antonio Bradley
Doctors are petitioning AHPRA to clarify its confusing stance on whether doctors are responsible for patients' online comments about clinical care.
The petition, which has so far been backed by former AMA president Dr Mukesh Haikerwal among other social-media-savvy doctors, is also receiving growing support from medicolegal experts.
Revised advertising guidelines sparked outrage among the profession last month when it emerged comments about a doctor's clinical care on social media sites such as Facebook, and review sites such as RateMDs, were deemed to be testimonials, and as such would break advertising laws.
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AHPRA tries to clarify social media rules

18 March, 2014 Antonio Bradley
AHPRA has moved to explain its confusing guidelines on what doctors are expected to do if patients comment online about their clinical care.
The guidelines, which came into effect on Monday, have sparked outrage among the profession, as they appear to place a professional obligation on doctors to try and delete their patients' online comments about clinical care.
Previous attempts by the Medical Board of Australia to calm doctors' concerns have been unsuccessful, and have led doctors to circulate a petition that calls on AHPRA to change its guidelines.
Here, AHPRA has come up with the questions it believes doctors want answered, and explained how the controversial guidelines apply.
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Doctors still liable for online reviews

17th Mar 2014
PRESSURE is mounting on the Medical Board of Australia (MBA) to clarify guidelines about unsolicited online reviews of doctors’ services, with GPs and medical insurers worried that the door remains open for doctors to be unfairly fined.
Under the new rules, practitioners face a $5000 fine for not requesting the removal of patients’ online reviews of their clinical services.
Following an outcry that the rules placed an unreasonable burden on doctors, MBA chair Dr Joanna Flynn released a statement saying the guidelines were only intended to apply to testimonials intentionally used to advertise.
Medical defence organisations argue the clarification proves there is a need to modify the guidelines to ensure they reflect the board’s intentions.
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Doctors pressure AHPRA to axe social media guidelines

21st Mar 2014
THE doctor-led AHPRA Action campaign targeting controversial new advertising and social media guidelines is gaining momentum, with doctors and medical organisations supporting a petition calling for the rules to be axed.
A petition launched earlier this week by campaign organiser and Melbourne surgeon Dr Jill Tomlinson had attracted more than 100 signatures in just a few days.
Last night the petition and campaign was moved by Dr Tomlinson to the activist website change.org and is continuing to attract support.
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New AHPRA Action campaign kicked off on Change.org

The AHPRA Action campaign has stepped up a notch. Medical Observer is now media partner, the protest action has a new logo (see image) and a new public petition kicked off yesterday.
A Parliamentary Inquiry found that the National Registration and Accreditation Scheme, managed by AHPRA “remains a large and complex bureaucracy with potential confusion over lines of responsibility and accountability.”
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Doomsday approaches for Windows XP users

Date March 19, 2014

Ben Grubb, Tom Pullar-Strecker

Decision day is rapidly approaching for the owners of millions of computers, automated teller machines (ATMs) and cash registers still running the Windows XP operating system.
With less than 20 days to go before Microsoft ends support for the 13-year-old platform on April 8, millions of machines including 95 per cent of the world's ATMs are still running on it.
Microsoft first said it was planning to end support for Windows XP in 2007. It has since been warning consumers and businesses an upgrade is necessary to keep their computers from being run over by a train of malicious software, or malware. 
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Rolling out a new NBN strategy

Date March 19, 2014

Malcolm Maiden

Bill Morrow attended an NBN Co strategy meeting with key suppliers including Alcatel-Lucent on Monday, and sat in on an NBN board meeting on Tuesday. He flew out after it for some R&R in his home town of San Francisco, but will hit the ground running when he takes over as NBN Co chief executive in two weeks' time.
Job No. 1 is to accelerate the broadband rollout, and that part of the brief is in his DNA. Morrow is a corporate turnaround specialist, but he is also an engineer who started out down manholes in California, splicing cable for Pacific Bell.
As his rescue of Vodafone's mobile franchise in Australia showed, he reconstructs networks as part of his rehabilitation of troubled companies.
He will accelerate the NBN project by rapidly ramping up the fibre-to-the-node (FTTN) part of the Coalition's hybrid broadband network.
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NBN: Concern over medical alarms as copper switch-off approaches

NBN Co launches register to track personal medical alarms that may be affected
NBN Co this morning launched a register to track personal medical alarms that may be affected by the switch-off of the copper network in areas where the National Broadband Network has been rolled out.
In late May the initial wave of switch off will take place, affecting some of the first areas to receive NBN fibre, including Armidale and Kiama ion NSW, Brunswick and South Morang in Victoria, Townsville in Queensland, Willunga/Aldinga in South Australia, and George Town, Kingston Beach, Deloraine, Sorrell, St Helens and Triabunna in Tasmania.
NBN Co's medical alarm register will be used to identify households that might need help to transition to the NBN.
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Court approves first-of-its-kind data breach settlement

AvMed agrees to set aside $3 million for breach victims, whether they suffered direct harm or not

March 17, 2014 03:58 PM ET
Computerworld - Courts have generally tended to dismiss consumer class-action lawsuits filed against companies that suffer data breaches if victims can't show that the the breach directly caused a financial hit.
A federal court in Florida broke the mold by approving a $3 million settlement for victims of a data breach in which personal health information was exposed when multiple laptops containing the unencrypted data were stolen.
The Dec. 2009 theft of laptops belonging to AvMed, a Florida-based health insurer, exposed the patient records of tens of thousands of its customers. Several victimes later filed a putative class action lawsuit against AvMed.
The plaintiffs suffered no direct losses or identity theft from the breach but nevertheless accused AvMed of negligence, breach of contract, breach of fiduciary duty and unjust enrichment
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Discovery Bolsters Big-Bang Theory

Signals Reach Back to the Birth of the Universe

By Robert Lee Hotz and Gautam Naik
Updated March 17, 2014 8:43 p.m. ET
Scientists said Monday they have detected the earliest signals reaching back to the birth of the universe almost 14 billion years ago, buttressing the big-bang theory of how the cosmos was formed.
Using a radio telescope at the South Pole, a team of astronomers and astrophysicists said they found telltale patterns of gravity waves in the primordial microwave radiation that lingers in space today. Scientists consider this the faint afterglow of the big bang.
The discovery offers what scientists say is the first direct data on the creation of the universe. Until now, cosmologists had theories but few facts.
If the work proves correct, it demonstrates that gravitational waves, which squeeze and stretch the fabric of space, were created in abundance during the early expansion, or "inflation," of the universe, the instant when space grew from a pinpoint smaller than an atom to the entire observable universe seen today, several experts said. This theory is the keystone of modern cosmology.
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'Fingerprint of God': discovery cements Big Bang theory

Date March 19, 2014 - 2:49PM
A stunning discovery made at a research station in Antarctica indicates that Einstein was right about the nature of the universe. Michael Hanlon explains
The most epoch-making discoveries can be made in the unlikeliest of places. The smoking out of the elusive Higgs boson, perhaps the greatest recent milestone in fundamental physics, took place in 2012 under the serene and agreeable pastures of the Franco-Swiss border, home to Cern's muscular atom-smasher, the £8 billion ($14.6 billion) Large Hadron Collider.
Now another team of scientists, this time American and operating a £12 million telescope in the considerably less clement surroundings of the South Pole, has announced the discovery of what may figuratively be described as the fingerprint of God.
The importance of this finding, announced on Monday afternoon at an excited press conference at Harvard University, cannot be overestimated; one leading physicist has gone so far as to describe it as "one of the most important scientific discoveries of all time". The phrase "Holy Grail" is being bandied about, and there is talk of the most certain shoo-in for a Nobel Prize for decades. The researchers, headed by Professor John Kovac of the Harvard-Smithsonian Centre for Astrophysics, appear to have found the very echoes of creation.
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Enjoy!
David.