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."

Saturday, March 26, 2016

Weekly Overseas Health IT Links - 26th March, 2016.

Note: Each link is followed by a title and 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.
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Project uses EHR data to cut heart disease risks

Published March 17 2016, 2:58pm EDT
De-identified electronic health records data is being used in a small Minnesota town to monitor the heart health of its population and to reduce risk factors for cardiovascular disease.
In 2009, Minneapolis Heart Institute Foundation, along with Allina Health, New Ulm Medical Center and the community of New Ulm, began a 10-year population health research project to learn if heart attacks and heart disease risk factors could be decreased through collaborative efforts.
Called the Heart of New Ulm Project, it focuses on reducing factors known for increasing heart attack risk, including high cholesterol, high blood pressure, uncontrolled glucose, obesity, tobacco use, physical inactivity, low fruit and vegetable intake, as well as medication underutilization and non-adherence.
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HIT Think How to give physicians some relief from distracting alerts

Published March 17 2016, 3:05pm EDT
Clinical information systems now produce great quantities of data. That can be both blessing and curse.
Perhaps no one knows this better than physicians, who are looking for help in separating important information from that which is not. Systems that can’t help them with that process can impede their ability to provide effective care.
Alert notifications have been often cited as culprits in this gush of information. Intended to let physicians know when patient conditions merit their attention, the ability of systems to crank out alerts at a dizzying pace has had the opposite effect, at times.
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Epic round-up: seven stories worth another read

Rebecca McBeth
17 March 2016
Articles involving US software company Epic really seem to get our readers going and have been the most read on Digital Health over the past year. We’ve decided to recap our coverage for anyone who missed it, or who wants to jog their memory.
The EpicCare electronic patient record, which is in widespread use in the US, entered the UK market when it went live at Cambridge University Hospitals NHS Foundation Trust in 2014, following a high-profile and closely fought procurement. The implementation has since been revealed to have been problematic.
Only now are some of the details about where the deployment went wrong becoming clear. Our most recent coverage includes comments from the president of the Royal College of Surgeons Clare Marx.
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CIT: Ransomware will 'wreak havoc' in 2016; healthcare already 'relentlessly' targeted

March 18, 2016 | By Katie Dvorak
Ransomware in 2016 will "wreak havoc on America's critical infrastructure community," and the healthcare industry is already seeing an influx of such attacks, according to a recent Institute for Critical Infrastructure Technology report on the threat.
In addition to an increase of new ransomware attacks, older vulnerabilities that were exploited last year will allow malicious actors to "capitalize upon positions that they have previously laid claim," the authors write.
The report points to the healthcare industry, which has previously been off-limits, as one that now is "brutally" and "relentlessly" targeted. The authors say healthcare organizations may have escaped these attacks previously because shutting down systems could endanger the lives of patients, but that mentality is changing.
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Google, Harvard team up for better insights into health IT

March 18, 2016 | By Susan D. Hall
A new executive education program brings Google staff to Harvard Medical School in an attempt to help them better align technology with the needs of healthcare.
It's not about learning what the liver is and how it works--you can Google that; rather, the course's fundamental premise focuses on teaching how doctors think, according to an article.
The course looks at how diagnoses are made, how data drives healthcare and how healthcare delivery can vary geographically and demographically in the hope that Google tech experts can create better tools for the industry.
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University of Buffalo researchers develop necklace that tracks food intake by listening

March 17, 2016
Researchers at the University of Buffalo have developed a necklace that could help passively track nutrition by listening to the sound of the wearer chewing.
University at Buffalo computer scientist Wenyao Xu is developing the wearable, called AutoDietary, with a small microphone on the back that records the sound of people eating food. The sounds are sent to a smartphone via Bluetooth and compared against a database of chewing and swallowing sounds for different foods, including cookies, peanuts, and apples. 
“There is no shortage of wearable devices that tell us how many calories we burn, but creating a device that reliably measures caloric intake isn’t so easy,” Xu said in a statement.
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HIT Think In light of pervasive security threats, why not encrypt everything?

Published March 18 2016, 4:23pm EDT
In healthcare, we all know what a breach is. Generally, it’s an impermissible use or disclosure under the Privacy Rule that compromises the security or privacy of protected health information.
We all know what protected health information is, or at least we should, by this late date. The requirement has been around since 2009: it is personal health information that is not rendered unusable, unreadable or indecipherable.
Further, information released to unauthorized persons may be rendered unusable, unreadable or indecipherable through the use of a technology or methodology specified by the Secretary in guidance, such as encryption for electronic PHI.
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Parkland doctor hoping his Dallas health care software startup can ease other doctors’ headaches

Melissa Repko Email mrepko@dallasnews.com
Published: March 17, 2016 3:11 pm
A software platform for health care that began under Parkland Memorial Hospital has spun off into a Dallas-based tech startup and raised $21.6 million from venture capital firms, Dallas investors and hospital systems.
Dr. Ruben Amarasingham said he hopes his software brings joy back to the practice of medicine by eliminating some of the paperwork and giving doctors and nurses more time to build relationships with patients.
Pieces Technologies announced today that it has become a health information technology company. It raised millions in a Series A funding round to create a sales and marketing team, invest in cloud-based infrastructure and add more features to its software, said Dr. Ruben Amarasingham, its founder and CEO.
He hopes to see his company’s software used by hospitals and health care systems around the world.
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Report: Fewer docs using ambulatory EHRs than last year

March 14, 2016 | By Marla Durben Hirsch
Physician use of ambulatory electronic health records has dropped in the past 12 months, according to a report from SK&A.
The new market insights report of physician office usage of EHR software, based on telephone interviews with 290,155 medical offices, found that overall office adoption and use decreased from 62.8 percent in January 2015 to 59 percent in January 2016.
Usage also dropped from 54.5 percent to 50 percent for solo practitioners, from 73 percent to 70.5 percent for groups of three to five physicians, and from 77.2 percent to 75.6 percent for groups of 26 or more physicians.
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'Community' HIEs may need help to compete with 'enterprise' models

March 14, 2016 | By Marla Durben Hirsch
"Community" and "enterprise" health information exchanges (HIEs) have different priorities and goals, and while they could be complementary, currently they compete with each other, according to a new report in Milbank Quarterly.
HIEs are a major focus of data exchange and the Meaningful Use program. The researchers--from Indiana University School of Public Health and Texas A&M Health Sciences Center--wanted to determine why some health systems join community HIEs, which bring in a broad spectrum of participating providers, and why others create their own enterprise HIEs.
The authors conducted semi-structured interviews with 40 HIE leaders, policy makers and healthcare executives from 19 different organizations. They found that health systems that create enterprise HIEs of affiliated desired trading partners do so to as a "stepping stone" to leverage their own data and technology for their strategic goals, such as to participate in accountable care organizations and other payment reforms. 
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EHR notification overload costs doctors an hour a workday, JAMA says

Primary care doctors are subject to twice as many notifications as specialists, researchers found, but both are facing information overload.
March 17, 2016 08:37 AM
Primary care doctors now lose more than an hour a day to sorting through approximately 77 electronic health record notifications, researchers at Baylor University found.
“Information overload is of concern because new types of notifications and ‘FYI’ (for your information) messages can be easily created in the EHR (vs in a paper-based system),” the researchers wrote in the Journal of the American Medical Association  Internal Medicine.     
Making the workload harder to endure, reading and processing these messages is uncompensated in an environment of reduced reimbursements for office-based care, according to the study.
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PCAST touts telehealth, wearable sensors as key to keeping aging population connected

Report to President Obama claims remote monitoring technologies, robust Internet are essential as Americans live longer.
March 17, 2016 11:39 AM 
A new report from the President’s Council of Advisors on Science and Technology claims technologies such as telehealth and wearable sensors should be put to work to help more elderly Americans stay healthy and connected as they age.
The report by PCAST, an advisory group of scientists and engineers appointed by President Barack Obama to make policy recommendations related to technology and science, found these types of technologies can help elderly Americans face challenges tied to social connectivity, emotional health and cognitive and physical ability.
"With many Americans wishing to live in their homes and communities for as long as possible, technology such as prosthetics, wearable sensors, and other tools for daily living can make that possible," said PCAST members Christine Cassel and Ed Penhoet.
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Surrey and Sussex trust to use PKB with 3,200 IBD patients

Daloni Carlisle
16 March 2016
Surrey and Sussex Healthcare NHS Trust is to offer patient-controlled electronic records to more than 3,200 people with inflammatory bowel disease.
A pilot study funded by pharmaceutical company Janssen (part of Johnson and Johnson) has already seen more than 400 patients with IBD use the Patients Know Best system.
The solution is integrated with the hospital’s Cerner Millennium electronic patient record, allowing the patient record to augment the hospital record.
Dr Azhar Ansari, project lead and consultant gastroenterologist at Surrey and Sussex Healthcare said: “By using Patients Know Best, the patient can self manage their condition far more effectively and warn us before problems occur.
“In many cases we can avoid A&E visits and that’s good news for the patient – and for our hospital.”
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E-discharge: standard clinical headings required by Dec

Rebecca McBeth
14 March 2016
All NHS providers must send digital discharge summaries to GPs using standard clinical headings by December this year, the new draft NHS standard contract says.
The contract, which is out for consultation, also encourages providers to adopt structured messaging for discharge summaries, but this will not become a formal requirement until next year’s contract, NHS England head of enterprise architecture Inderjit Singh told Digital Health News.
The new General Medical Services contract will also make it a requirement for GPs to be able to receive discharges electronically from next month.
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HIT Think Breach notification planning should include the consumer angle

Published March 16 2016, 4:10pm EDT
Customer-facing breach notification and response should be a part of a healthcare organization’s incident response plan, but it’s often not top-of-mind when the worst happens for a healthcare organization.
Federal and state laws often dictate specific steps healthcare organizations need to take, particularly when they are victimized by large breaches. There are many steps to be taken, including public notification and release of information to the media in the event of large breaches.
However, that doesn’t replace the need to handle notifications to people whose information may have been compromised, communicate to employees and the public about what happened, and otherwise set the tone for recovery. It's more art than science, with different factors that influence what and how you do the notification and response.
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Hospital exec quits, compares $764M upgrade to Challenger disaster

A senior official was so worried a new $764 million medical records system for the municipal hospital system was launching too early that he resigned, comparing it to the disastrous space shuttle Challenger launch in 1986.
In a “resignation and thank-you” email last week, Dr. Charles Perry urged colleagues at NYC Health + Hospitals — formerly the Health and Hospitals Corp. — to sound the alarm and press for an “external review” to stop the system from going live next month.
Perry was chief medical information officer of Queens and Elmhurst Hospital Centers, the first scheduled to get the new electronic medical data system.
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HIE use sees 'considerable growth,' but only in a few states

March 16, 2016 | By Katie Dvorak
Health information exchange adoption and use continues to see "considerable growth," but is driven only by a small number of states, according to a new report from NORC at the University of Chicago researchers.
Examining the State HIE Cooperative Agreement Program, NORC found that from 2011 to 2013, directed transactions increased more than threefold and patient record queries increased more than fourfold. However, the authors note that those numbers do not reflect high participation from all states, but only from a select few.
For example, in the second quarter of 2012 Indiana, Colorado and New York accounted for more than 85 percent of transactions, while in Q3 of 2013, Michigan, Colorado, Indiana, New York and Vermont accounted for more than 85 percent of the total.
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Cyber threats multiply as foreign 'hacktivists' set sights on healthcare data

Jeff Rowe
Mar 15, 2016
Until recently, the idea of health data being the target of international cyber criminals would have been considered the stuff of science fiction, or at least the very distant future. 
But the future began back in 2012, writes our colleague Tom Sullivan over at HealthcareIT News, when organized criminals “found that stealing patient data enabled them to monetize that information in a number of ways. Since then attacks have grown increasingly sophisticated ever since. And attackers are launching attempts now than ever.”
He cites a study from the Ponemon Institute, which found that healthcare organizations have been hit by one hack per month during the last year. “Ponemon questioned 535 IT security professionals working at public, private and government healthcare organizations and found that the most common threat is attackers exploiting existing software vulnerabilities that are more than three months old. Newer vulnerabilities and spearphishing -- sending targets an email aiming to get them to click on an executable or other malicious code -- ranked second and third, respectively.”
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NQF identifies key health IT patient safety issues

Jeff Rowe
Mar 16, 2016
While issues surrounding cybersecurity may currently be top of mind for a majority of health IT stakeholders, concerns surrounding patient safety are bound to grow as EHRs and other IT systems continue to spread across the sector.
With that concern in mind, the National Quality Forum (NQF) has issued a report that identifies and addresses what the forum considers the key issues for stakeholders to understand.  To be sure, the report, "Identification and Prioritization of Health IT Patient Safety Measures," notes that with proper design, implementation and use, healthcare organizations can reduce medical errors and improve care quality, but it also discusses the potential for new hazards.
”HIT will fulfill its potential only if the risks associated with its use are identified and a coordinated effort is developed to mitigate those risks," the report argues. "Accordingly, there is a need for measures to help identify the nature, scope, and prevalence of HIT-related safety issues and to assess how well providers, vendors, and others are preventing or mitigating HIT-related safety concerns.”
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ONC Report on Health IT Details Barriers to Interoperability

HCPro Staff, March 16, 2016

Although some progress has been seen, a lack of health IT vendor transparency and cooperation have been named as barriers to interoperability in the ONC’s annual report.

A version of this article originally appeared on HCPro.com
The Office of the National Coordinator of Health IT has published its annual report to Congress detailing the ups and downs of health IT in 2015 and plans for 2016. The report summarizes actions taken by various government agencies to advance health IT, such as the Department of Health and Human Services’ Federal Health IT Strategic Plan, the ONC’s Interoperability Roadmap, and CMS’s EHR Incentive Programs, and touches on the pivotal role private-sector industry plays in realizing the goals outlined in the report. 
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Epic, InterSystems take top spots for HIE and interoperability in new KLAS rankings

A new report based on customer scores found that the two companies outperformed other EHR-dependent and EHR-independent vendors.
March 15, 2016 10:54 AM
Epic Systems and InterSystems earned the highest performance scores in the field of health information exchange and interoperability in the latest study from independent research firm KLAS.
A primary question KLAS asked providers was, “Will your vendor be able to meet your interoperability needs in the next few years?"
KLAS ranked Epic the highest customer score (91.3 out of 100) among electronic health records-dependent vendors – and among all vendors. InterSystems was given the highest customer score (87.1) in the EHR-independent category.
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How a hospital's analytics department helps clinical staff build data skills

March 15, 2016 | By Susan D. Hall
The homegrown data analytics department at Medical Center Health System (MCHS) in Odessa, Texas, aims to help clinicians drill down into data and answer the question of "why," according to an article at HealthData Management.
"Our goal is to supply them with the tools so they can answer those questions themselves," says Alan Snider, senior decision support data analyst in the department.
In setting up the department nearly three years ago, leaders at the 402-bed regional medical center combined decision support and analytics into one department because they believed implementing an electronic medical record and leaving analytics at the department level would have little effect on outcomes and wouldn't allow the organization to tie process metrics to outcomes.
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The 4 big trends of the information economy

Written by Carrie Pallardy | March 14, 2016
The information economy is comprised of "a community of digital citizens living in a global network, always connected with the world's information at our fingertips," according to a "The Information Generation Transforming the Future, Today" report from EMC.
The information economy is driven by using data to identify new opportunities, innovative products, transparency, desire for a personalized experience and 24/7 availability. The four big trends of this economy include:
1. Big data. In healthcare big data is being looked at to better understand populations and drive improvements in patient care.
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HIT Think New standard can ‘FHIR up’ precision medicine

Published March 15 2016, 2:29pm EDT
On February 25, President Obama at the White House celebrated the one year anniversary of his announcement of the Precision Medicine Initiative. The Initiative, first announced in the President’s State of the Union Address last year, initially invested $215 million in this research approach.
Most medical treatments are designed to treat the average patient. This broad approach fails to account for the differences in genetics, physiology, environments and lifestyles that greatly affect the effectiveness of therapies. Precision medicine works to overcome these shortcomings by conducting research into the efficacy of the available treatments in different patients using these and additional factors.
For example, Warfarin is a drug used in anticoagulation therapy for patients who need to prevent blood clots from forming (for example, patients with implanted heart valves or who recently suffered a stroke), and it showcases the value of precision medicine research.
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Dashboards Make Sense of Scattered EHR Data

Scott Mace, March 15, 2016

Savvy health IT customers understand that business intelligence tools are needed to leverage electronic health records data to the fullest.

Sometimes, we are at the mercy of technology.
Some years back, I was helping a nonprofit understand its customer relationship management system, as part of its intent to migrate from one CRM to another. In my naiveté, I sought to understand the underlying data structure of the CRM, which would help us figure out where the data lived, which data we had to move, and how best to arrange it after the move.
But the nonprofit's CRM, like the average CRM, and for that matter, like the average EHR, was populated with thousands of tables. Nine thousand tables.
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Can IT help better manage chronic pain?

Published March 14 2016, 7:34am EDT
New research starting at the Indiana University School of Public Health seeks to develop information technology tools to support the care of patients with chronic pain, as well as educate patients on the benefits of permitting their electronic health records data to be used for research purposes.
Researcher Christopher Harle has received a $1.1 million grant from the Agency for Healthcare Research and Quality to develop technology tools, and a $1.9 million grant from the National Institutes of Health to build software that helps patients through the process of sharing their data for research.
“It is fair to say the typical EHR doesn’t provide decision support content that fully recognizes the complexity of chronic pain and that patients often also have multiple other conditions,” Harle says.
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Enjoy!
David.

Friday, March 25, 2016

Happy Easter!

The blog is having a small rest for the Easter weekend.

Have a safe and happy Easter

David.

Thursday, March 24, 2016

The Macro View - General And Health News Relevant To E-Health And Health In General.

March 24 Edition
The macroeconomic stresses seem to have eased a little more with markets rising around the world. Indeed the stock market indices in the US are now up for the calendar year.
In Australia, things are also looking up for the present.
However we also are now see a set of ongoing bun-fights on pathology funding, health insurance costs as well as negative gearing and superannuation. Will be fun to watch. Mr Trunbull and Mr Morrison seem to have disappointed with the lack of a clear plan. At present it is not clear what will happen on Budget Night and indeed when the Budget will actually be!
There now seems to be very little tax reform coming - except in Superannuation and possibly company tax.
Here is a summary of interesting things up until the end of last week:
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General Budget Issues.

Scott Morrison brings ALP negative gearing policy under fire

  • The Australian
  • March 14, 2016 12:00AM

Sid Maher

Scott Morrison will intensify his attack today on Labor’s negative gearing policy, releasing 28 questions he says Labor needs to answer, including whether house prices would fall 4 per cent.
The Treasurer’s questions, part of a social media campaign, come as Bill Shorten will seize on the six-month anniversary of Malcolm Turnbull’s becoming Prime Minister to declare him “all talk and no action’’.
Labor has proposed limiting negative gearing to new homes as part of its tax policy, saying it will boost new home building.
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Wealthy primed for Turnbull’s superannuation tax hit

  • The Australian
  • March 16, 2016 12:00AM

Sid Maher

High-income earners face superannuation tax hikes in the ­Turnbull government’s tax package, with one proposal calling for the threshold beyond which contributions are taxed at 30 per cent, rather than the standard 15 per cent, to be lowered, possibly as far as $180,000.
Scott Morrison yesterday flagged that superannuation tax reforms would be announced in the May budget or earlier and would reflect the government’s view that superannuation should aim to reduce dependence on the Age Pension and should not be a vehicle for “estate planning”.
A proposal to reduce the threshold at which the contributions tax rises to 30 per cent from $300,000 to the top marginal tax rate of $180,000 could raise up to $1.5 billion a year and has support from elements in the superannuation industry.
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Treasurer Scott Morrison signals possibility of no tax cuts this budget

Date March 15, 2016 - 12:29PM

Gareth Hutchens

Federal Treasurer Scott Morrison says the government needs to be innovative when it comes to finding budget savings.
Treasurer Scott Morrison has given his clearest signal yet that personal and corporate tax cuts may be too difficult to deliver this budget, despite indicating for months that tax cuts would be his priority.
In an obvious indication of how difficult the Turnbull government is finding the budget repair task, Mr Morrison, when asked on Tuesday about the pressure that high tax rates were putting on the economy, said next year's scheduled removal of the deficit repair levy was an example of forthcoming tax relief.
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Expect great things from Malcolm Turnbull's first budget. No, seriously.

Date March 17, 2016 - 12:00AM

Peter Martin

Economics Editor, The Age

The Prime Minister is prepared to make the most of unusually low interest rates by spending up big on projects that will pay dividends.
The government is considering issuing long-term bonds to fund massive new infrastructure spending. Peter Martin explains the logic.
While the media has been obsessing about tax, Malcolm Turnbull has been focused on setting Australia up. To do it, he'll need to borrow big sums of money for exceptionally long periods at at extraordinarily low interest rates.
We should have done it sooner. Right now Australia can borrow for 10 years at 2.7 per cent, just a few points above the the Reserve Bank's inflation target of 2.5 per cent, meaning we are able to get money for close to nothing. But it's still unattractive for long-term projects because there's a risk that in a decade's time when the loans have to be refinanced, the new rates will be higher. So Turnbull's looking at borrowing for 30 years.
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Turnbull government's next target: limiting claims for work-related expenses at tax time

Date March 16, 2016 - 3:28PM

Alex Malley

It's time to shine a light on some dark political manoeuvring taking in place in Canberra at the moment. In the crosshairs is your right to claim full and legitimate work-related expenses in your annual income tax return.
As we head towards the May budget, the Prime Minister and Treasurer have made it clear that controlling expenditure is a priority. The retreat from holistic tax reform means the hunt for savings is well and truly on – it's why Treasurer Scott Morrison tasked a parliamentary committee with an urgent inquiry into tax deductibility.
We understand the committee's report has been finalised and is sitting with the government, its recommendations being fed into the budget process. We'll likely hear nothing about it until budget night (whenever that might be).
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Pressure on government to make budget repair levy permanent

Date March 17, 2016 - 12:15AM

Gareth Hutchens, Peter Martin, Mark Kenny

The opposition targets the government's abandonment of income tax reform as the government attacks Labor's fiscal record in question time on Thursday.
The Turnbull government is being called on to retain the temporary budget repair levy on high-income earners, which is due to expire next July, after conceding this week that tax cuts for individuals may be unaffordable in this budget due to lack of funds.
The temporary 2 per cent loading on the top tax bracket is scheduled to be removed in July 2017, giving high-income earners on more than $180,000 an effective tax cut.
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Backpacker tax: government to review controversial budget measure

  • The Australian
  • March 16, 2016 2:17PM

Rachel Baxendale

The federal government has announced a review of its controversial backpacker tax, admitting it could have an adverse effect on the agriculture and tourism industries.
The 2015 federal budget measure would see those on working holiday visas pay 32.5 cents tax for every dollar they earn, and forego the $18,299 tax-free threshold.
Speaking at the Tourism & Transport Forum Australia in Sydney this morning, Tourism Minister Richard Colbeck announced a cross-departmental review of the proposed tax to find a “revenue neutral” solution.
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Fitch warns Australia of ratings cut over deficit blowout

  • The Australian
  • March 17, 2016 12:00AM

Adam Creighton

Ratings agency Fitch has warned the Turnbull government against tolerating further debt blowouts, stressing Australia’s vulnerability to record foreign debt, fragile housing prices and a Chinese economic slowdown.
Fitch yesterday reaffirmed the Australian government’s AAA credit rating but said a “sustained widening of the fiscal deficit without remedial policy actions” could see it stripped of the coveted financial endorsement.
“Despite resilient GDP growth, a sharp fall in the terms of trade has weighed on nominal income growth, reducing tax revenues and slowing the expected pace of fiscal consolidation,” it said, noting total federal and state government debt had increased rapidly to 34.5 per cent of GDP or near the average level (43.6 per cent) of AAA-rated countries.
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  • Mar 17 2016 at 9:30 PM
  • Updated Mar 18 2016 at 10:23 AM

Morrison to cut company taxes; income taxes to wait years

by Staff reporters
Salary earners will have to wait some years for an income tax cut after Treasurer Scott Morrison confirmed on Thursday that company tax cuts will be his priority in the federal budget.
After indicating on Tuesday that the government had ditched plans for the income tax cuts it has been pledging for several months, Mr Morrison told Parliament the best way to fund income tax cuts was through economic growth. And the best way to drive economic growth was by reducing the 30 per cent company tax rate.
"We understand the burdens faced by people who are paying higher and higher rates of income tax. We understand that and we understand the best way to deal with that … [is to] grow the economy so you can grow revenues to support those changes," he said.
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Public may turn ‘hostile’ if govt messes with tax

Daniel Burdon | 18th Mar 2016 6:00 AM
A MAJOR accounting firm has urged the Turnbull government not to target people's work-related tax deductions, warning any changes will be "met with hostility".
The warning has come in a submission to a government-led inquiry into tax deductions that is understood to be "softening the ground" ahead of Treasurer Scott Morrison's first budget in May.
While the government has reportedly abandoned income tax cuts in favour of a company tax cut this budget, it is understood to be exploring potential savings by reining in work-related tax deductions.
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Samantha Maiden: Tax not adding up for Treasurer Scott Morrison

March 20, 2016 12:00am
SAMANTHA MAIDENThe Sunday Telegraph
BILLIONAIRE Oprah Winfrey once wrote a self-help book called What I Know For Sure.
Here’s what everyone in politics knows for sure about Scott Morrison.
If the Treasurer (pictured above) seriously thinks he can front up on Budget night without holding out the hope of income tax cuts for average earners he is in big trouble.
Time to hand in his police badge and his gun kind of trouble.
Burn the uniform, shave your head like Mark Latham. Nip down to Coles and buy a family tub of ice cream and a spoon and just go sit in a park. It’s over.
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Health Budget Issues.

Margaret Wenham
March 16, 2016 12:00am

Australia, we’re being ripped off

Here’s something for reform-spruiking Health Minister Sussan Ley to mull over: Australians are lumbered with an expensive, inefficient, bastard, hybrid health system that’s anything but a fair deal.
We are Medicare levy-paying taxpayers who are often unable to access, without unreasonable and distressing waiting periods, public treatment.
Most of us are also paying, under threat of punishing Medicare levy surcharges and savage “lifetime health cover” penalties, bloated health insurance premiums yet, when we require treatment, we are frequently expected to stump up supersized gap payments.
We are also forced to wait for 12 months even for private treatment if a condition develops requiring an insurance upgrade.
Think I’m overstating this diabolical shambles of a system? Well, last week I spoke with Julie. A former high school teacher, 20 years ago Julie set up her own business as a Qi gong instructor. She was super fit when she began having significant hip pain and was told a full hip replacement loomed.
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Prime Minister confirms children’s free dental health program faces axe

March 17, 2016

Shorten accuses Turnbull of caving in to the backbench

Kara Vickery News Corp Australia Network
PRIME Minister Malcolm Turnbull has confirmed he’s considering scrapping a dental health scheme, which has been used by around one million children since it was introduced.
Mr Turnbull told parliament on Thursday that the Labor scheme — which gives children $1000 worth of free dental care every two years — was failing to live up to expectations.
And the PM confirmed earlier reports the future of the program was under review.
Mr Turnbull said the scheme was “nowhere near meeting its targets”.
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Foreigners rack up millions in sick bills

  • The Australian
  • March 18, 2016 12:00AM

Sean Parnell

Foreign students and backpackers are adding to queues in public ­hospitals and leaving unpaid bills of tens of millions of dollars each year.
Most visa-holders are not ­eligible for Medicare and are ­required by the federal government to have health insurance in the expectation they will pay their own medical expenses as required.
Yet despite paying high premiums, thousands of foreign citizens are presenting to public hospitals for treatment and forcing administrators to chase payment later.
The trend raises questions over the value of such insurance ­policies and whether visa requirements are having the desired ­effect.
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Health Insurance Issues.

One Big Switch: health insurance hikes put pressure on households

March 13, 2016 11:45pm
John Rolfe Cost of Living Editor News Corp Australia Network
The campaign aims to use “people power” to extract cheaper cover from a leading provider.
EXCLUSIVE
THE latest health insurance hike is about to make the cost of cover a heftier hit than petrol for the first time on record.
For those households that don’t have childcare or private school fees to contend with, fuel has been entrenched as the third-biggest expense after the mortgage — or rent — and groceries.
However, analysis by News Corp Australia shows health insurance is set to displace it.
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Public patients ­persuaded to bill their private health fund

  • The Australian
  • March 16, 2016 12:00AM

Sean Parnell

Almost one in five emergency ­patients admitted to public hospitals for urgent operations, and one in 10 who have elective surgery in the public system, are ­persuaded to bill their health fund.
New data from the Australian Institute of Health and Welfare highlights the billion-dollar cost shift to insurers as state and territory governments seek to rely on alternative revenue streams to manage constrained budgets.
Under universal healthcare, Australians have a right to be treated without charge in the public system and taxpayers have traditionally funded such ser­vices. Public hospitals cannot force privately insured patients to bill their health fund, however hospital administrators now ­actively target such members, ­offering to pay their gap fees and even provide a private room.
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Public patients ­persuaded to bill their private health fund

  • The Australian
  • March 16, 2016 12:00AM

Sean Parnell

Almost one in five emergency ­patients admitted to public hospitals for urgent operations, and one in 10 who have elective surgery in the public system, are ­persuaded to bill their health fund.
New data from the Australian Institute of Health and Welfare highlights the billion-dollar cost shift to insurers as state and territory governments seek to rely on alternative revenue streams to manage constrained budgets.
Under universal healthcare, Australians have a right to be treated without charge in the public system and taxpayers have traditionally funded such ser­vices. Public hospitals cannot force privately insured patients to bill their health fund, however hospital administrators now ­actively target such members, ­offering to pay their gap fees and even provide a private room.
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Best and worst health insurers revealed in AMA report card

Date March 17, 2016 - 12:42PM

Julia Medew

Health Editor

The worst private health insurers have been revealed by a new analysis that shows some of the leading insurers, including Medibank and NIB, are not the most generous of all.
A new league table created by the Australian Medical Association has exposed what health insurers pay for 22 common procedures including cataract surgery, tonsil removals, colonoscopies and births.
It shows a large variation in payments for the same procedures, suggesting some policy holders are more likely to face out of pocket fees than others. For example, HBF pays $2150 for an uncomplicated delivery of a baby while GMHBA pays $832 - a difference of 158 per cent.
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Health is also clearly still under review as far as its budget is concerned with still a few reviews underway and some changes in key strategic directions. Lots to keep up with here with all the various pre-budget kites still being flown - although narrowing it seems to be largely focussed on Super! Enjoy.
David.

Wednesday, March 23, 2016

The AMA Has Yet Again Come Out To Say It Is Very Unhappy With The mHR. It Seems The DoH is in Denial Of The Scale Of the Issues.

This appeared a few days ago.

Government Ignores Flaws In E-Health Push.

15 Mar 2016


The Federal Government is pushing ahead with mass trials of its My Health Record e-health system despite concerns that fundamental shortcomings are yet to be addressed.
Health Minister Sussan Ley has announced that the personal health information of more than one million people will be automatically uploaded to the internet from July as part of a large-scale test of My Health Record prior to a nationwide roll-out of the scheme.
Under the plan, 700,000 people living in North Queensland Primary Health Network (PHN) and 360,000 covered by the Nepean Blue Mountains PHN in western Sydney, will have until the end of June to opt-out or have a digital health record containing details of their health status, medicines and allergies automatically created and uploaded to the system.
The trial is the latest development in the Government’s overhaul of Labor’s failed Personally Controlled Electronic Health Record (PCEHR) system, which failed to attract much support from health practitioners or patients despite the expenditure of more than $1 billion.
Ms Ley said it was important that patients be able to safely and securely share their medical records with health workers no matter where they were in the country.
“I consider this a landmark turning point in improving our health system and bringing it into the 21st century,” the Health Minister said. “Our new My Health Record means people will not have to remember the names of the medications prescribed, details of diagnosis and treatments, allergies, medical procedures and there will be no need to repeat the same information when they see another doctor or go to hospital.”
The move follows a heavy-handed attempt by the Health Department to boost the adoption of My Health Record by threatening to withdraw incentive payments from practices that fail to upload shared health summaries to the system in May – action condemned by the AMA as grossly premature, particularly given the trial did not start until July.
The AMA warned that the design of the My Health Record system meant it was unlikely to realise the Minister’s vision.
The clinical usefulness of the PCEHR was fatally compromised by the ability of patients to withhold or hide information, and the peak medical body said My Health Record was similarly flawed.
Patients can set controls on who has access to information in their My Health Record, and the AMA said that, whether or not such controls were used, doctors and other health providers had to be mindful of the possibility that the information that could view was incomplete.
“Unfortunately, My Health Record cannot be relied on as a trusted source of comprehensive information,” the AMA said. “This means that My Health Record can be a potentially useful additional source of clinical information, but it is not a replacement for existing clinical records maintained by doctors.”
The system incorporates a “break-glass option” to allow access to vital information in case of a medical emergency, but the AMA said there were many situations short of such a crisis where access to core clinical information would be valuable.
Other aspects of the system highlighted by the Minister are also likely to discourage the use of My Health Records by doctors.
Ms Ley emphasised that in designing the system the Government had paid particular attention to protecting sensitive medical information, and deliberate breaches of privacy could incur fines of up to $500,000 or even jail terms.
But the AMA said such heavy penalties were unjustified and were likely to prove counter-productive.
It said medical practitioners and practice staff already dealt with confidential information on a daily basis, and there was “nothing inherently different or unique” about the data contained in My Health Records.
Instead, it warned the complexity of the compliance rules for using My Health Records and the scale of the penalties for breaches would likely deter many practitioners from adopting them.
“While extreme penalties may appeal to those with very strong sensitivities and concerns on information access, they are counterproductive for encouraging participation by health care providers,” the AMA said. “They will be a very strong deterrent to participating in the My Health Record.”
The adoption of My Health Records is also being hampered by a failure to engage with specialists.
The AMA said medical specialists were a key group for creating and using information in electronic health records, but the Government was yet to consult with them.
AMA President Professor Brian Owler said this neglect was compounded by the fact most medical practice software was designed for GPs, not specialists.
“Until we engage with people as to how it might work, and the software vendors are on board, it’s never going to work,” Professor Owler told The Australian Financial Review.
Currently, around 2.6 million people have a digital health record, and about 8000 health providers are registered to use the system.
Adrian Rollins
Here is the link:
It really is hard to know just why the DoH is not working closely with the AMA and the College to come up with an agreed national approach to all this.
One can only hope the planned new Digital Health Agency will do what DoH has not done and found a way to proceed with e-Health that can gain public and clinical support.
Over to you guys and gals!
David.

Tuesday, March 22, 2016

Is It Really As Good In Queensland As This Seems To Imply? Seems Almost Too Good To Be True.

This appeared very late last week.

Minister for Health and Minister for Ambulance Services
The Honourable Cameron Dick

Friday, March 11, 2016

Australia’s digital revolution begins in Brisbane hospital

Brisbane’s Princess Alexandra Hospital has become Australia’s first public digital hospital, heralding a revolution in the way healthcare will be delivered in Queensland.
Minister for Health and Ambulance Services Cameron Dick today announced that implementation of the digital hospital project was successfully underway.
“This digital hospital project will transform healthcare delivery in Queensland and allow clinicians to focus on the patient, not paperwork,” he said.
“This means improved safety and quality of care for patients and faster treatment to get them home sooner.”
Deputy Premier and Member for South Brisbane Jackie Trad said the project also allowed for optimisation of world-class medical research through improved analysis of data and a reduction in inefficiency and wastage.
“This project is representative of what the Palaszczuk Government is all about – harnessing the potential of new technology and innovation to create a better Queensland,” she said.
Metro South Hospital and Health Service Chief Executive Dr Richard Ashby said Electronic Medical Records (EMR) were available instantly to healthcare staff across the hospital and, as other facilities follow suit, across Queensland.
“This project means the 2000 paper records that circulate in our hospital at any given time will now be replaced by real-time patient information being sent to a secure EMR,” he said.
“Given our proud history of clinical innovation, I’m delighted that the PA Hospital is leading this digital revolution,” he said.
Rollout of the project required training nearly 6000 staff and integrating more than 1600 new digital devices across the hospital, with extensive third-party support throughout implementation.
Care Delivery Lead Dr Clair Sullivan said hospital staff had enthusiastically risen to the challenge of going digital, with the benefits already starting to show.
“The scale of this change is unprecedented in an Australian hospital and by going digital, we will be able to provide patients with the best care possible,” she said.
The Queensland Government has invested $200 million over four years to establish the foundations of the digital hospital system, which will be implemented across the state.
Metro South Hospital and Health Service has contributed more than $30 million towards implementing the project at the Princess Alexandra Hospital.
The roll-out of the digital hospital system is part of the Palaszczuk Government’s $1.5 billion eHealth strategy, announced last year.
ENDS
Here is the link:
What confuses me in this release is the alternating use of the future tense and in the release. You read, for instance, that implementation is underway and at the same time 6000 staff HAVE been trained. We also hear that the benefits are “starting to show”.
What also makes me wonder just what is going on I see this in the 2014-15 Annual Report. (p 47)

Digital records–integrated electronic Medical Record (ieMR)

Princess Alexandra Hospital commenced scanning of inpatient notes into the ieMR in June 2014. Information is scanned within 48 hours of the notes arriving in the scanning unit and is then available for viewing in the ieMR. Quality and auditing processes have been implemented to ensure a high quality scanning service is provided at all times.
Numerous electronic and paper resources are available for all relevant staff to ensure the information in the ieMR is accurate and available as soon as possible.
Redland and QEII Jubilee hospitals currently manage a paper medical record system however Logan Hospital has had an electronic system since 2008 that supports the scanning of clinical information. It is anticipated that the ieMR will be available at each Metro South Health facility within the next few years.
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Knowing that Cerner is involved in the implementation of some state-wide systems it is not entirely clear just where all this scanning of paper records fit.
I look forward to a comment or two as to what is actually happening and what success is being achieved. With all we hear re SA and WA it would be nice to hear a good news story! The headline is certainly a big claim!!
David.