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."

Thursday, April 14, 2016

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

April 14  Edition
The macroeconomic stresses seem to have eased a little more with markets rising or stable around the world.
With Budget Night now May 3 we won’t have long to wait to see what is happening. The Budget now seems to now be very minimalist with any major reform seemingly off the table.
Given it is only 3-4 weeks away I guess we just wait and watch.
Here is a summary of interesting things up until the end of last week:
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General Budget Issues.

COAG: Turnbull warns states — don’t come to government for money

  • The Australian
  • April 3, 2016 3:03PM

Rachel Baxendale

The states must stop asking the commonwealth for more money and live within their means after rejecting the opportunity to take responsibility for raising the taxes to fund health and education, Malcolm Turnbull says.
The Prime Minister told Sky News the premiers’ “quick and clear ‘no’” to his proposal at last week’s Council of Australian Governments meeting that they levy their own income tax revealed that they have no credibility in demanding funding increases from his government.
“When they were offered the opportunity to be able to levy a portion of income tax themselves, and have the ability in due course to raise it or indeed lower it, they had no appetite for it,” Mr Turnbull said.
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Defining budget leaves Malcolm Turnbull with a deficit of time

  • The Australian
  • April 4, 2016 12:00AM

Phillip Hudson

At the weekend, Malcolm Turnbull reached 200 days as Prime Minister, but it is the next 100 days that will define his leadership.
There are just 29 days until Scott Morrison hands down the fast-tracked budget. It will be his first as Treasurer but must create the springboard for Turnbull to immediately contest his first election as leader. They will rise and fall together.
This week, the pressure will be intense as the expenditure review committee meets to make some of the big decisions about the May 3 budget.
Turnbull will attend and chair some of these sessions.
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3 Apr 2016 - 3:46pm

Key to surplus not higher taxes: Turnbull

Prime Minister Malcolm Turnbull insists that eliminating unjustified spending and growing the economy faster is the best way to return to a budget surplus.
Source: AAP  3 Apr 2016 - 3:46 PM 
Prime Minister Malcolm Turnbull insists returning the budget to surplus is a long-term project that will be achieved through growing the economy faster rather than raising taxes.
He says the government's approach is to eliminate unjustified spending, live within its means and maintain strong economic growth that boosts tax receipts.
"It's been very effective in other times and in other places, and is exactly how (New Zealand Prime Minister) John Key got back into balance," Mr Turnbull told Sky News on Sunday.
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Malcolm Turnbull and the Liberals are channelling the Tea Party

Date April 4, 2016 - 5:35AM

Jessica Irvine

Senior Writer

Malcolm Turnbull says the states' rejection of his income tax plan shows a weak commitment to reform. Vision courtesy ABC News 24.
It's a curious sort of person who joins an organisation with the sole purpose of diminishing it.
Most people are drawn to certain employers or professions through a core belief in what that profession seeks to do. Their desire is to participate in the purpose of that organisation and expand upon it, if possible.
Spending, is, in fact, the entire project of government.
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Morrison signals frugal election budget

April 4, 20161:50pm
Morrison aims to lift business tax burden
By Colin Brinsden, AAP Economics Correspondent AAP
Morrison signals frugal election budget
The Turnbull government has dusted off an old slogan a month out from the federal budget.
While "living-within-our-means" signals a frugal affair, Treasurer Scott Morrison is still leaning towards cutting business taxes as he prepares for his first and only budget ahead of an election.
"We want to see the tax burden moderated for Australians and particularly for businesses that are out there employing people and driving the growth that we need to drive jobs," Mr Morrison said on Monday.
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Tax changes will be in 2016 federal budget, Assistant Treasurer Kelly O'Dwyer says

By political reporter Stephanie Anderson and Louise Yaxley
Updated yesterday at 2:54pm
Assistant Treasurer Kelly O'Dwyer has insisted there will be tax changes in the federal budget, less than a week after the Prime Minister was forced to withdraw his proposed changes to income tax arrangements.

Key points:

  • Government is examining country's tax mix, rates and concessions, Kelly O'Dwyer says
  • Treasurer says he will not make "unfunded, fantasy promises"
  • Labor accuses the Government of trying to get states to put up income taxes
Premiers and chief ministers rejected Malcolm Turnbull's plan for states and territories to levy a percentage of income tax independently.
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Financial and political future of country all comes down to Super Tuesday

April 5, 2016 10:00pm
Terry McCrann Herald Sun
TUESDAY May 3 has become the day on which the entire financial and governing future of the country — Budget, interest rates and both politics and policies — will now pivot.
For the first time in the quarter century or so since the governor of the Reserve Bank ‘escaped’, so to speak, from then-treasurer Paul Keating’s pocket and took sole ownership — and so total responsibility — for interest rates, we will have an RBA rate meeting and the federal Budget on the same day.
Just to make it that much more ‘interesting’, both the RBA meeting and the Budget will be ‘live’, so to speak again. And the Budget will effectively ‘ring the bell’ to start the federal election campaign.
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Tax plan ‘bluff’ seen as spin to cover error

Treasurer Scott Morrison says Malcolm Turnbull was calling premiers’ “bluff” with his proposal to reinstate State income taxing rights.
There are also signs Labor will retreat from Julia Gillard’s $80 billion pledge for hospitals and schools.
Mr Morrison said the Prime Minister had exposed the States’ resistance to taking responsibility for their own budgets.
“What the Prime Minister did last Friday is call their bluff,” he told Sydney radio yesterday.
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Labor to appeal to women voters in stoush over superannuation

Date April 5, 2016 - 12:08PM

Sally Rose

Reporter

Labor superannuation spokesman Jim Chalmers has said gender equity will loom large in the election battle over super policies. Photo: Glenn Hunt
Labor has slammed the government's failure to reveal its plans for superannuation taxes and indicated it will seek to appeal to women in the the tussle over any changes announced in the May budget and in the lead-up to a federal election.
It comes as the latest Newpoll survey shows Labor ahead of the Coalition government for the first time since Malcolm Turnbull became Prime Minister.
By not announcing its plans for super taxes the government has left the opposition flat-footed in its ability to critique them.
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The budget deficit is at its lowest in two years

Chris Pash Apr 6, 2016, 3:48 PM
The underlying budget deficit has dropped to $36.1 billion, its lowest in almost two years, according to Department of Finance numbers.
The figures for February put the Federal Budget on track to meet forecasts, according to analysis by CommSec.
They are a result of lower spending more than making up a shortfall in revenue.
Total revenue was $1.22 billion weaker than the mid-year forecast mainly because tax collection didn’t meet expectations.
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Coalition has hard sell convincing voters of need for restraint

  • The Australian
  • April 7, 2016 12:00AM

David Uren

Scott Morrison’s strategy for ­repairing the budget deficit is to keep government spending growing more slowly than the economy overall and wait for economic growth to increase tax payments to a level that ­delivers a surplus.
It is, the Treasurer acknow­ledges, a slow and hard slog, with uncertain deadlines. There is the constant need to resist fresh government spending and find fresh savings when those efforts fail.
His goal is to get federal government spending down from 26 per cent of gross domestic product to 25 per cent, arguing that Australia has never achieved surpluses when spending is greater than that level.
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  • Apr 7 2016 at 11:45 PM

Government scraps plans to trade away tax deductions

The federal government has scrapped plans to trade away annual work-related deductions to find revenue to fund other tax cuts after concluding it would not stack up either economically or politically.
The decision to leave tax deductions unchanged, which is related to the earlier decision to leave the rate and base of the GST unchanged, has further limited options for what is a politically critical May 3 budget for the government which will contain tweaks to superannuation tax concessions and limited measures targeting small and medium business.
The Australian Financial Review understands that while it remains the government's intention to offer a company tax cut, the beginning of any phase down in the 30 per cent rate may be delayed.
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A wealth of unfulfilled budget reform opportunities

  • The Australian
  • April 9, 2016 12:00AM

Judith Sloan

I am one of a small number of people who found some merit in the 2014 budget. It did aim to restrict the growth of government spending and rein in the deficit. But, from a political point of view, it was a turning point. Seemingly unable to secure passage through the Senate of most of the key savings measures, the government quickly descended into chaos and mixed messaging.
Last year’s budget was a classic case of offending no one, although the previous budget’s $80 billion of savings in payments to the states for hospitals and schools were kept on the books.
In point of fact, the Abbott government had got off to a good start. The line was held on extending corporate welfare to the car industry and SPC Ardmona. A bunch of pointless and expensive agencies was abolished, with more to come. Arthur Sinodinos, then assistant treasurer, got on with the job of wading through the close to 100 tax measures left over from the Labor government that had never been legislated.
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Federal budget 2016: Scott Morrison signals tough approach focused on spending cuts

Date April 8, 2016 - 10:01AM

James Massola

There'll be no fantasy funding according to Scott Morrison who says we have to live within our means. Courtesy ABC News 24.
Treasurer Scott Morrison has given the clearest signal yet his election year budget will place spending restraint front and centre, with the prospect of "big bang" tax reform rapidly receding.
The Turnbull government is whittling down the number of tax changes that could be adopted in the May 3 budget, with a rise in the GST already off the table and a plan to offer simplified tax returns - which would have raised as much as $6 billion in revenue to pay for tax cuts - now apparently off the table.
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PM says looming budget won’t be about ‘a fist full of dollars’

  • AAP
  • April 9, 2016 5:58PM
The Turnbull government’s first federal budget will be prudent and responsible and won’t hand out a “fist full of dollars”.
The prime minister on Saturday began the task of managing public expectations ahead of the May budget, warning it would focus on living “within our means”.
However, he confirmed his first budget would contain “changes to our tax system” designed to promote investment, innovation and enterprise.
“This budget will not be about a fist full of dollars, it will be about prudence, fairness and responsibility to our future generations,” he told the Victorian Liberal Party conference in Melbourne on Saturday.
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Health Budget Issues.

Budget 2016: UBS analysts don’t expect health cuts in election year

  • The Australian
  • April 6, 2016 11:23AM

Sarah-Jane Tasker

UBS analyst Andrew Goodsall says despite his view that healthcare cuts are less likely in an election budget, the growing budget deficit remains a constraint on largesse.
The Turnbull government’s May budget could “showcase” new policies it plans to take to the election on innovation and research, according to healthcare analysts.
UBS analyst Andrew Goodsall also outlined that despite his view that healthcare cuts were less likely in an election budget, equally the growing budget deficit remained a constraint on largesse.
“Given major reform processes (in healthcare) underway, we generally expect a more subdued approach to further healthcare reform in budget 2016,” he said.
The respected healthcare analyst pointed out that federal funding represented more than 70 per cent of income for some of the major Australian-listed healthcare stocks.
The budget, he said, was likely to provide updated projections on recent policies, such as bulk-billing incentive cuts, updated forecast for pharmaceutical benefits scheme spending after existing pricing savings, along with the Medicare Benefits Schedule freeze.
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Claims health tests are in danger

April 7, 2016 9:55am
MATT SMITH State Political Editor Mercury
Hobart Pathology chief executive Lawrie Bott says a cut to bulk-billing incentives will force his company, which does the majority of pathology testing in Tasmania outside of the public hospitals, to introduce out-of-pocket charges.
TASMANIA’S largest pathology services provider has warned life-threatening diseases may not be detected after Federal Government cuts take effect on July 1.
Hobart Pathology chief executive Lawrie Bott says a cut to bulk-billing incentives will force his company, which does the majority of pathology testing in Tasmania outside of the public hospitals, to introduce out-of-pocket charges.
The Government wants to scrap bulk-billing incentive payments for pathology services (worth $1.40 to $3.40) which, along with changes to bulk-billing incentives for diagnostic imaging, would save $650 million over four years.
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The problem ingrained in our health system: patients don't come first

Date April 8, 2016 - 12:15AM

Vlado Perkovic and Leanne Wells

Over the past six months, companies such as Novartis Pharmaceuticals and Amgen Australia have spent millions sending health professionals on junkets all over the world.
Most aspects of health care have been designed with a focus on the needs of the doctor or other health care provider, rather than the consumer who uses the health services.
But health care is ripe for change.
This culture has not been deliberately created, and often frustrates doctors and other health providers as much as patients. But it is ingrained in our health care system.
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Fact check: Has the Coalition taken billions of dollars from hospitals and not put it back?

The claim

On April 1, 2016 following a Council of Australian Governments (COAG) meeting, the Governments of the Commonwealth, states and territories reached an agreement on hospital funding for the three-year period beginning July 1, 2017.
The Commonwealth is to provide up to $2.9 billion of additional funding to the states and territories over the three years, but some leaders have argued it is not enough.
"[H]undreds of millions of dollars today in extra funding for Victorian hospitals does not replace billions of dollars that have been taken away from Victorian hospitals...[M]any billions of dollars will not be flowing to hospitals in my state and hospitals right across the nation as a result of decisions made in the 2014 budget. They are not reversed today and that's a really important point for us all to acknowledge..."
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Pharmacy And Drug Issues.

Hundreds of prescription drugs will now be cheaper

April 3, 2016 8:48pm
Megan Palinnews.com.au
HUNDREDS of lifesaving prescription drugs will be cheaper as changes to the Pharmaceutical Benefits Scheme come into effect this weekend.
More than 400 prescription drugs have dropped up to $20 in price, including expensive cancer and cardiovascular disease pills.
Prices for some drugs will drop as much as 60 per cent from this weekend as annual changes to the Pharmaceutical Benefits Scheme take effect.
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Medicines sector reforms deliver consumer benefits and a sustainable PBS

Consumers, taxpayers and the national health system will benefit from the significant savings being delivered by medicine suppliers since 1 April, say Medicines Australia, the Generic and Biosimilar Medicines Association, the Pharmacy Guild and the National Pharmaceutical Services Association.

The direct contribution the medicine supply chain is making to these savings will ensure the PBS is sustainable into the future, enabling the reinvestment savings into the funding of new, breakthrough medicines for Australian consumers, they say.
The key players in the medicines supply sector said the consumer benefits of the latest round of PBS reforms—the costs of which are being borne across the sector—are helping to ensure that the PBS remains one element of Australia’s health system that is fiscally sustainable.
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PBS cuts skyrocket

Latest PBS cuts just the beginning, Minister believes

A “skyrocketing” number of medicines experiencing a reduction in their price in the April round of PBS cuts is only the beginning, Health Minister Sussan Ley says.
Over the weekend, Ms Ley announced that the price of around 400 medicines will fall as a result of the 1 April round of PBS reforms that are being funded by the medicines supply sector, and which took effect on 1 April.
“In an Australian first, the price of a large proportion of expensive combination medicines and patent-protected drugs listed on the Pharmaceutical Benefits Scheme will drop this weekend, in addition to the annual April changes,” she said.
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Patients could miss out on leading drugs: pharmaceutical firms

  • The Australian
  • April 5, 2016 12:00AM

Sarah-Jane Tasker

Pharmaceutical companies have warned Australian patients risk missing out on leading new drugs after the federal government cut the price of hundreds of medicines.
The government reduced by 5 per cent the price of branded medicines that have been on the Pharmaceutical Benefits Scheme for five years or more, and pharmaceutical companies say they will be forced to wear the discount.
Carlo Montagner, the chief executive of Specialised Therapeutics Australia, said if there were further price cuts, companies might remove drugs from the PBS because it would not be viable to keep them on the list.
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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. Only a few weeks to the Budget.
David.

Wednesday, April 13, 2016

Now This Is A Remarkably Good Question I Believe. Relying On Flawed Infrastructure Might Very Well Ruin The Trial.

This appeared last week:
April 4, 2016

Will Health Care Home fail on the back of MyHealthRecord’s fail?

Posted by Jeremy Knibbs
MyHealthRecord appears to be key to engaging with the ‘revolutionary’ Health Care Home Medicare reform, despite being plagued with problems and low GP uptake.
“One is tied to the other,” according to Dr Steve Hambleton, chair of the advisory group that helped shape the pilot and current NEHTA chair.
“I would think that a high-performing Health Care Home would want to opt in,” Dr Hambleton said. “And if you don’t want to be a Health Care Home then you won’t have access to the new funding model.”
While Dr Hambleton said creating the records was “dead easy” and took less than 90 seconds per patient, February saw fewer than 400 GPs updating a shared health summary with the program. 
The 65,000-person trial of the medical home model for chronic and complex conditions would shed light on doctors and patients opting out of the MHR and guide the national implementation of the reforms.
Between July 2017 and June 2019, up to 200 metro and rural general practices will be asked to sign up to the pilot, designed to inform the Health Care Home infrastructure rollout.
The federal government has promised to revolutionise healthcare for patients with chronic and complex conditions, and called it “one of the biggest health system reforms since the introduction of Medicare 30 years ago”. 
Health and consumer groups have come out in support of the move towards a medical home model of funding, with the RACGP calling it a “life-saver”.
However, Dr Bastian Seidel, current chair of RACGP Tasmania, cautioned against overstating the influence of the mere $21.2 million earmarked for the four-year project.
“It’s very easy to do something that underfunded and set it up to fail,” he said. “So you just over-promise and under-deliver, and if we have a look at the funding now we are talking about $100,000 per practice roughly.
“Now you could argue that’s a lot of money, but realistically it’s not that much.”
He pointed out this didn’t come near the $60 million given to hospitals to fix the elective surgery lists, or the $600 million extra money given as part of the Community Pharmacy Agreement to expand into “GP-lite” services.
Nevertheless, Dr Seidel was enthusiastic about the trial, and said that it was reasonable to hope the reform could reduce unnecessary hospital admissions and emergency hospital presentations. 
Lots more here:
With what we have learnt this week regarding the attitude of DoH to the current state of the myHR it is hard to know just why you would attempt to conduct such an important trial (and the trials are really important) using such inferior Health IT support and infrastructure.
It is made even more absurd when you realise there are already much better tools for managing co-ordinated care available in the Australian market place.
Pretty silly I reckon. Looks much like a solution in search of a problem and finding the wrong one to me!
David.

Tuesday, April 12, 2016

COAG Health Council Approves The Establishment Of The Australian Digital Health Agency.

At its meeting on the 8th of April the COAG Health Council agreed to found the ADHA.
Here is the relevant section of their Communique.
Inter-Governmental Agreement On Digital Health.
Ministers signed an Inter-Governmental Agreement (IGA) on Digital Health which establishes ongoing financial support and governance arrangements for the for the Australian Digital Health Agency.
The IGA has been developed jointly by the Commonwealth, states and territories through the intergovernmental E-Health Working Group. The Digital Health Agency will be responsible for the strategic management and governance responsibilities for the national digital health strategy and the design and operations of the national digital health systems, including the My Health Record. It will deliver a collaborative and innovative approach to using technology to improve health service delivery and health outcomes for all Australians.
The Australian Digital Health Agency, which will be fully operational from 1 July 2016, will be the single accountable organisation for all national digital health services in Australia.
----- End Extract.
I have to say, having had the experience of DoH, NEHTA, HealthCONNECT and so on this has to be an example of the triumph of hope over experience!
I look forward to Senate Estimates Committee sessions in the future where the questions are answered honestly and fully about where we are and what is actually going on.
I fear hell will freeze over before that actually happens! Time will tell.
David.

Monday, April 11, 2016

Weekly Australian Health IT Links – 11th April, 2016.

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

The biggest news this week was the draft Digital Health Strategy being disclosed for review. Thus far the comments are not all that positive and suggest there is still a good deal of work to do.
Otherwise all sorts of other stuff is happening - browse and click away!
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Health lifts game for chronically ill

The Department of Health is to improve digital heath records and data around health outcomes as part of a new commitment to Australians living with complex chronic illness.
In what the Prime Minister, Malcolm Turnbull termed the biggest health system reforms since the introduction of Medicare 30 years ago, eligible patients will receive coordinated healthcare packages tailored to their personal needs.
The Department said that in addition, Medicare would introduce a more modern payment system for doctors and service providers to allow them greater flexibility in the delivery of a broad range of healthcare services.
It said digital health measures including the new My Health Record, telehealth services, remote health monitoring and medication management technologies would be aimed at improving patients’ access to services and increasing the efficiency of the health system.
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April 4, 2016

Will Health Care Home fail on the back of MyHealthRecord’s fail?

Posted by Jeremy Knibbs
MyHealthRecord appears to be key to engaging with the ‘revolutionary’ Health Care Home Medicare reform, despite being plagued with problems and low GP uptake.
“One is tied to the other,” according to Dr Steve Hambleton, chair of the advisory group that helped shape the pilot and current NEHTA chair.
“I would think that a high-performing Health Care Home would want to opt in,” Dr Hambleton said. “And if you don’t want to be a Health Care Home then you won’t have access to the new funding model.”
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My health records project remains sick

The former Labor government introduced a personal electronic health record which despite enormous cost - "more than a billion dollars in cumulative funding" ("Health Band-aid", April 2) - is deemed to be flawed and has signed up a small fraction of the population. Now the Turnbull government is going to tip more money into the renamed My Health Record and make it apply to all citizens with the addition of an "opt-out" mechanism.
Meanwhile, frustrated private health providers are developing their own in-house app-based approaches to records. This is fine but what it means is that instead of thousands of paper-based record silos around the country we will end up with thousands of electronic silos with no interoperability. The government's controlling  "top-down" approach does not work and has failed to engage meaningfully with stakeholders including clinicians.
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  • Apr 5 2016 at 6:00 PM
  • Updated Apr 5 2016 at 6:00 PM

Health and education sectors the next to feel online disruption

by David Binning
Growing digital platforms, faster networks and smarter portable devices are driving massive changes in the way people work.
In today's globalised marketplaces, organisations are able to connect with and recruit workers from anywhere in the world. Likewise, workers are able to work for whomever they choose and from anywhere.
While the concept is relatively new, it's fast gaining acceptance as shown by the rapid success of online workplaces such as Australia's Freelancer.com and US-based rival Upwork.com.
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Real-time system needed, but not ‘silver bullet’

A Victorian coroner has called for a real-time prescription monitoring system to reduce pharmaceutical drug related harms and deaths following the death of a 47-year-old man who doctor shopped extensively to obtain a range of medicines including large amounts of diazepam.

Pharmacy Guild Victorian Branch president Anthony Tassone says such a system is needed, but it would be only part of a broader health solution.
Frank Frood, who suffered from severe asthma, died from bronchopneumonia on a background of methadone and benzodiazepine use.
The coroner noted that the PBS summary of PBS benefits paid for medicines dispensed to Frood in the two years before his death ran to 26 pages; he was going to great lengths to “prescription shop” to obtain diazepam.
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Reimburse online medicine and relieve logjams, says e-health boss

  • The Australian
  • April 8, 2016 12:00AM

Sarah-Jane Tasker

The founder of Australian digital health start-up CliniCloud has called on the Turnbull government to introduce a reimbursement for online services, arguing it is the way forward in healthcare in an ageing population.
Chief executive Andrew Lin said support for telemedicine played into Prime Minister Malcolm Turnbull’s innovation agenda and the recent launch of the Healthier Medicare package that was aimed at supporting ­patients with multiple chronic conditions.
Mr Lin said Australia had been slow to embrace consumer-facing digital health systems because of a lack of government incentives.
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http://www.crikey.com.au/2016/04/06/sure-you-can-opt-out-of-giving-govt-your-info-by-giving-govt-your-info/

The Department of Health does not seem to know a lot about online security.

Not super keen on the government storing all of your personal information in its e-health system? No problemo, 
just provide the government with all of your personal informationon an unencrypted website.
Or at least that was the plan, until those meddling kids on Twitter shamed the government into encrypting 
the sitebadly at first, and then finally up to proper standard.
Late last year, Health Minister Sussan Ley announced an overhaul of the e-health record system. Patients 
would be automatically signed up to the record system unless they specifically requested not to be included. 
At the start of this year, the Department of Health with the Department of Human Services began its trial 
in north Queensland and western Sydney for about 1 million patients, which would cost about $41 million.
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  • Apr 7 2016 at 11:45 PM

'Try before you buy' plan for doctors and hospitals

Consumers should be able to compare and review doctors, their performance and the price of procedures in the same way customers use online comparisons to buy banking and telecommunications products, according to a new blueprint for a consumer-led health industry.
As the federal government struggles to encourage GPs to join its e-health system in which patients' own health records are recorded online, a new report argues it is hospitals and health providers that need to open their books to patients so they can make informed decisions on medical procedures and choice of specialist.
The George Institute for Global Health, one of the world's largest health and medical research institutes, and the Consumer Health Forum of Australia, will release on Friday an eight-recommendation report that calls for the health industry to undertake the same sort of digital transformation seen in finance, telecommunications and e-commerce.
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MedsASSIST now rolling out

The Pharmacy Guild is now rolling out MedsASSIST, the codeine real-time monitoring system that it says will help pharmacists monitor consumer use of codeine containing products to ensure safe and effective use.

“Since the MedsASSIST pilot commenced in February in approximately 140 pharmacies in Newcastle, NSW and North Queensland regions, we have collected data on more than 50,000 transactions,” the Guild says.
“The system is demonstrating its effectiveness in identifying patients who may be at risk of developing codeine dependency. It is also demonstrating that the overwhelming majority of consumers are using these products safely.
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e-Health standards – beyond the message mentality

Posted on by wolandscat
I just spent a few days in Crete at an experts workshop of the European e-Standards project that aims to bridge well-known gaps in e-health standards and SDOs. I’ll comment on that effort in another post, for now I will just say thanks to Catherine Chronaki for the invitation, wonderful choice of venue and excellent workshop.
As is usual in these situations, being present in a beautiful place (Thalori village, southern Crete) with many interesting people (some old friends, others new acquaintances) and especially that vital ingredient: a world-class traditional band of musicians who played the paint off the walls of the Taverna until 3:30 am Saturday morning led to some new thoughts on standards (as well as a vastly improved appreciation of Cretan music).
In the e-health domain, the orthodox view in many standards organisations, is that ‘we can only standardise what is on the wire, because we have no control over what is in systems’. I would call this the ‘message mentality’, even if the physical communications have graduated over time from literal messages.
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Qld govt ordered to pay legal costs in IBM payroll stoush

Final failure in state’s bid for compensation.

By Paris Cowan
Apr 4 2016 2:27PM
The Queensland government has suffered another defeat in its legal fight with IBM, today being ordered to pay the IT giant's costs following its failed bid to sue the company for its role in the notorious Health payroll project.
State supreme court judge Glenn Martin today ordered the government to pay all of IBM’s costs incurred as part of Big Blue's appeal against the action, which commenced in February 2015.
He agreed with IBM that a legal waiver signed back in 2010 gave IBM the right to demand costs on an “indemnity basis” - or over and above the default “standard basis” that usually sees successful parties in a lawsuit claw back less than 100 percent for what they have spent defending a case.
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Now Qld Govt has to pay IBM’s costs in failed litigation

04/04/2016
blog Things are not going well for the Queensland Government in its lawsuit against IBM over the incredibly botched payroll systems upgrade project at Queensland Health.
First the judge in the case threw the case out of court in December last year, pointing out that the Government had signed a waiver of liability over the issue (a fact that even sites like Delimiter have been pointing out to the Queensland Government repeatedly), and now that same court will force the Queensland Government to pay Big Blue’s court costs on the issue. The Australian newspaper tells us (we recommend you click here for the full article):
“… the government argued IBM had misrepresented its credentials for delivering the system … But the claim was unsuccessful and Justice Glenn Martin on Monday ordered the State of Queensland pay IBM costs incurred by the proceedings on an indemnity basis.”
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Qld Health, IBM payroll court battle officially over

State to foot the bill for entire proceeding.

By Paris Cowan
Apr 7 2016 12:53PM
The Queensland government will face a mammoth legal bill for the full 2.5 year duration of a lawsuit it commenced against IT giant IBM in the state’s Supreme Court, following the official end of the case.
Today the state was ordered to pay the second round of costs in its failed attempt to sue its one-time IT partner over the $1.2 billion collapsed Queensland Health payroll replacement.
Supreme Court Justice Glenn Martin this morning formally dismissed Queensland’s original 2013 claim against IBM after the parties agreed to end the proceedings, officially shutting down the case.
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Data breaches: The first 24 hours are critical

The average cost of a significant Australian data breach is $2.82M – finding and remediating the breach quickly is the best start.
According to Rick Ferguson, country manager, Australia and New Zealand, Absolute, a persistent endpoint security and data risk management solutions provider, there is a direct correlation between how quickly an organisation identifies and contains a data breach and the resulting financial consequences.
With a global survey by the Ponemon Institute and IBM finding that the average cost of an Australian data breach is AUD$2.82m, it is imperative that companies be prepared in order to limit the damage from such an event.
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Driver health checks go digital in NSW

Taking paper out of the equation.

By Paris Cowan
Apr 5 2016 12:00PM
The NSW government will remove an inefficient, paper-based process used by truck drivers, the elderly and people with medical conditions to annually renew their driver’s licence with an integrated, electronic model.
Currently, heavy vehicle licence holders, drivers aged 75 and over, and people who suffer from illnesses that could affect them behind the wheel like epilepsy, sleeping disorders and diabetes have to visit a doctor once a year to certify that they are physically able to continue driving safely.
Motorists must then transmit the doctor’s certificate by mail or in person to their local motor registry to have their licence renewed.
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NSW Takes Another Step Towards Digital Driver's Licenses

Hayley Williams Today 2:00 PM
Following the government initiative to digitise drivers licenses (and other licenses) by the end of 2018, the process of driver health checks are due to go digital from the middle of the year.
The unnecessarily time-consuming, paper-based process is currently required by truck drivers, drivers over 75 and people with illnesses that have the potential to affect them while driving, such as epilepsy, sleeping disorders and diabetes. People who meet these categories are required to visit a doctor once a year in order to confirm that they are medically fit to keep driving safely.
Under the current system, affected parties have to deliver a doctor’s certificate either in person or by mail to have their licence renewed, a process that is soon to be replaced with an electronic system.
This process is being simplified into an electronic system that can be integrated into a GP’s practice software, allowing them to submit a form directly to the RMS licence review unit. The electronic form has been developed in partnership with e-health firm HealthLink, with an investment of $1.2 million from RMS. “This digital service developed by HealthLink means the 400,000 people who go through this process each year can now cross the visit into a registry or service centre off their to-do-list,” said Transport Minister Duncan Gay.
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Most Australian GP clinics aren't using e-health records

Battle still to be fought on adoption front.

By Paris Cowan
Apr 6 2016 10:06AM
Only 300 Australian GP clinics are using the federal government’s electronic health records system on a weekly basis, the Department of Health has revealed, highlighting the uphill battle Canberra faces getting doctors on board with its e-health drive.
In a response to questions on notice from the senate community affairs committee, the department shared the disappointing average, recorded between 22 October 2015 and 11 February 2016.
Australia is home to approximately 28,000 GP medical businesses, according to 2010 figures from the Bureau of Statistics.
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The new Australian Digital Health Agency (ADHA) is still without a chief executive and board just 3 months out from its official starting date of 1 July, according to a report in Pulse+IT. Labor has demanded that the government consult with it on senior economic positions but this is not thought to include the establishment of the ADHA, which will take over responsibility for the My Health Record and the role of the National E-Health Transition Authority, which will be dissolved. In other news from Pulse+IT, Australia's leading general practice software vendor MedicalDirector has been sold by owner Primary Health Care to a private equity firm for $155 million. MedicalDirector has reported healthy revenues of over $30 million annually for the past couple of years. In Primary Health Care's most recent financial results, it reported revenues of $21 million for the first half of the 2016 financial year, up by 12.3 per cent on the previous period, for earnings before tax of $6.8 million. The sale is expected to complete before the end of the financial year.
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All the bottom-line action

April 4, 2016
Tenable Network Security has announced that Healthdirect Australia, a public health care company providing a range of free services on behalf of the Australian national government, selected SecurityCenter Continuous View to improve security visibility and ensure compliance across its 100 percent Amazon Web Services (AWS) cloud environment. When the Australian Signals Directorate (ASD) passed a government mandate in 2012 requiring all federal services to comply with stringent security standards in the Australian Government Information Security Manual (ISM), the Healthdirect IT security team had to rethink its security approach. “As a business that conducts a majority of our work with the federal government, we knew that our bottom line would be directly impacted if we weren’t able to meet the demanding compliance requirements put in place by the ASD,” said Bruce Haefele, chief architect, Healthdirect Australia.
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Apps make gadgets less disruptive to sleep

  • Daniela Hernandez
  • The Wall Street Journal
  • April 5, 2016 2:00PM
As more people head to bed with smartphones and tablets, there’s increasing focus on the so-called “blue light” the devices emit.
Some research shows the light may disrupt the body’s biological rhythms, including a 2012 study that found reading an iPad for two hours caused a decrease in the hormone melatonin, which makes people feel sleepy.
Another study showed that reading on an iPad before bedtime could make it harder to fall asleep.
In recent years, consumer-tech companies have been developing free apps meant to minimise the amount of blue light consumers are exposed to while using their smartphones, tablets and laptops.
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Queensland Metro-North selects Orion Health

Medical referrals are still largely handled manually – go to a GP, get a referral to a specialist, post/fax the referral to make an appointment or bring it with you. It is not efficient.
New Zealand based Orion Health has developed a global healthcare platform that advances population health and precision medicine solutions for personalised care across the entire health community.
Brisbane based Metro North Hospital and Health Service serves over 900,000 people, and employs more than 16,000 staff in five hospitals and eight community health centres, along with oral and mental health facilities. It has selected Orion’s Referrals Management platform to enable healthcare professionals to submit, track and manage patient referrals as the individual moves from home to hospital to community care.
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Fujitsu wins $15m Tassie emergency dispatch deal

Work begins to replace 25-year-old CAD.

By Paris Cowan
Apr 7 2016 10:14AM
The Tasmanian government has chosen Fujitsu to complete the $15 million replacement of its 25-year-old emergency services dispatch system.
The government funded the project in last year’s state budget, addressing findings of the 2013 Tasmanian bushfire inquiry that the current systems used by Tasmania's police, fire fighters, and ambulance services are not up to the job.
Fujitsu will install a single integrated instance of the Capita Vision computer-aided dispatch (CAD) solution in place of the separate legacy solutions currently in use. The new CAD will also be used by the state emergency service, which currently relies on a manual pager-based process to assign volunteers to tasks.
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An app to help sift through medical literature

7 April 2016
WITH so many journals available it is impossible to sift through all that is floating around in the medical literature. Docphin is a free app which aims to collate and sort journal articles of relevance to the user.
After downloading the app, registration allows for tailoring available content. Those lucky enough to be affiliated with an institution can enter those details and have access through the app to the journals available to the institution.
To search, there are a number of options. Medstream provides a list of Docphin picks as well as new articles appearing in recently browsed journals.
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US Healthcare’s alarming lack of mobile security

More than 27 million Android devices with medical apps installed also potentially have at least one high-risk malware — yet 65% of doctors share patient data via SMS text message and 33% via Whatsapp.
According to the US Department of Health and Human Services, more than 260 major healthcare breaches occurred in 2015. Of those breaches, 9% involved a mobile device other than a laptop. The risk to patient and personal data in the healthcare industry only grows as more doctors and healthcare employees use mobile devices in their work.
Skycure,  a leader in mobile threat defense, has announced the results of its second healthcare focused Mobile Threat Intelligence report. It found that the number of doctors who use mobile devices to assist their day-to-day practice were exposed to network threats that significantly increase over time. In a single month, 22% of mobile devices are at risk of a network attack and reaches 39% after four months.
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4 April, 2016

Is Telstra Health a lame duck? Connect the dots

Posted by Jeremy Knibbs
Telstra Health has invested in 20 companies in two years and has been much feted as the company guiding our e-health future. It looks like it just ran aground on the isle of ‘strategic review’.
Last  week’s sale of Medical Director to a private equity group may have marked the beginning of the end of Telstra’s sometimes puzzling foray into e-health. According to industry insiders, Telstra Health had been in negotiations to buy 50% of Medical Director for $50 million and start a joint venture with Primary Health Care Ltd. 
Such a move would have benefited both Primary, which didn’t have the capital, know-how or assets to transform the business, and Telstra Health, whose assets to date are disparate and in dire need of something that might connect them into some semblance of a strategy.
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Why MedsASSIST is the answer for codeine

4 April, 2016 Sanofi Consumer 
Promoted Content
Pharmacists nationally will be monitoring codeine use as part of the real-time monitoring system MedsASSIST with the full roll out of the program expected to be Australia-wide this month. 
Developed by a consortium of organisations including the Pharmacy Guild and Pharmaceutical Society of Australia, MedsASSIST allows pharmacists to record codeine purchases and identify patients at risk of misuse.
The program was initiated after the proposal to reschedule codeine prompted intense debate, dividing doctors and pharmacists. According to a spokesperson for the Pharmacy Guild, MedsASSIST is the Guild’s long-term solution to address codeine misuse and will inform any further submission to the TGA, which is expected to make its scheduling decision by June.
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Enjoy!
David.

Your Taxes At Work - Courtesy Sean Parnell - Health Editor Of The OZ

Via Twitter!

"Fed Govt spent $1.5m rebranding PCEHR as My Health Record, plus indirect costs. Consultants advice on new agency to replace NEHTA cost $3.9m"

Amazing waste for what we all know is likely to be a  disaster in the ilk of NEHTA and HealthCONNECT!

David.

Sunday, April 10, 2016

Maybe, Just Maybe, There Is Some Reality On The myHR Emerging. Not Before Time But They Are Still Not Really Accepting The Scale Of The Mess!

As part of the recently released draft Commonwealth Digital Health Strategy we read the following:

9.1 My Health Record

The national My Health Record system was launched on 1 July 2012, as the Personally Controlled Electronic Health Record (PCEHR). The My Health Record system is a secure online summary of an individual’s health information.  The individual is able to control what goes into their My Health Record, and who is allowed to access it.  An individual’s My Health Record allows an individual and their healthcare providers to view and share the individual’s health information to provide the best possible care.
In order for the My Health Record system to be successful the following need to be addressed in the next three years:
·         A critical mass of consumers registered;
·         Active participation by healthcare providers, to both contribute clinical content and to use the information to inform clinical care;
·          Sufficient clinical information available to make accessing the content worthwhile;
·         Clinical information included of sufficient quality for healthcare providers to be able to confidently use the information for clinical care; and
·         The use of the My Health Record needs to be embedded within the clinical practice and workflow of healthcare providers.
Strategies to address these goals have been reflected within strategic initiatives throughout this document.
Following a recent architectural review of the My Health Record system, it has been recognised that changes are needed to the design of the underlying My Health Record system technical infrastructure in order to meet emerging and future clinical requirements.  These changes will be considered within this current planning period.
----- End Extract. (p39)
At the end of the same section we also read:
National Strategic Initiatives
S8.1 Design and implement changes to the My Health Record system technical infrastructure in order to meet emerging and future consumer and clinical requirements.

S8.2 Develop and make available a My Health Record system release and development roadmap.

S8.3 Implement changes to the authentication services for connectivity to digital health solutions, focusing on improving registration and renewal processes for healthcare providers and organisations and to rationalise the number of authentication certificates required.

S8.4 Establish better alignment of the roadmaps for the National Health Services Directory, including the National Endpoint Proxy Service, with the other strategic initiatives detailed within this strategy. 

(p40)
All this is just amazing. What we have is the Government out there compelling a million or so citizens to be allocated a myHR, while admitting, explicitly,  the present myHR product is simply not up to scratch.
Just what rationale can there be for not undertaking the re-design and re-implementation work - as well as, of course, addressing all the known issues (security, privacy, access controls, usability etc.) -before conducting the ‘opt-out trials’?
How on earth can the impact of opt-out be evaluated when the present mess is being trialled rather than a system that might actually be useful and clinically acceptable - assuming that the present myHR is reparable - which I very much doubt. No matter what is going on - the trials should not proceed until the myHR is shown to be fixable and then fixed and tested!
Seems someone is very keen to spend our money in a heck of a hurry for no good reason!
It is worth noting that points S8.3 and 4 highlight there is still a lot more work needed in the basic e-Health infrastructure as well.
David.
Note: For more information or to download the draft plan go here:
D.

AusHealthIT Poll Number 315 – Results – 10th April, 2016.

Here are the results of the poll.

Could The $450M Planned To Be Spent On The myHR Be Better Spent On Other E-Health Initiatives?

Yes 58% (83)

No 8% (11)

I Have No Idea 35% (50)

Total votes: 144

An interesting poll result with a majority seeing better possible uses for the funds in e-Health - or maybe spending on something other than e-Health preferred by some?

Only 8% think myHR spending is a great idea it seems.

Again Ms Ley should take careful notice!

Really great turnout of votes!

Again, many, many thanks to all those that voted!

David.