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."

Tuesday, May 10, 2016

Some Background On The 2016 Budget And The Australian Digital Health Authority. Some Useful Information.

This information appeared in the 2016 Budget Papers.
Here is the direct link:
The parts I found interesting were as follows:
Australian Digital Health Agency
Health Portfolio Entity
Section 1: Entity Overview and Resources
1.1     Strategic Direction Statement
The Australian Government is committed to the delivery of a national shared digital health record system to deliver safer, more efficient and effective quality health care.
In the 2015-16 Budget, $485 million was announced for the redevelopment and operation of the national digital healthcare system in Australia and delivery of the My Health Record program. A significant part of the program is the establishment of the Australian Digital Health Agency (Digital Health Agency) for the ongoing development and operation of the national digital healthcare systems. The Digital Health Agency will become operational from 1 July 2016.
The Digital Health Agency is the national body which will have responsibility for the strategic management and governance responsibilities for the national digital health strategy and the design, delivery and operations of the national digital healthcare system. The Digital Health Agency will provide the leadership, coordination and delivery of a collaborative and innovative approach to utilising technology to support and enhance a clinically safe and connected national health system to improve health service delivery and health outcomes for the Australian community.
The Digital Health Agency will perform the following functions:
·         coordinate and provide input into the ongoing development of the National Digital Health Strategy;
·         implement those aspects of the National Digital Health Strategy that are agreed or directed by the Council of Australian Governments (COAG) Health Council;
·         develop, implement, manage, operate, continuously innovate and iteratively improve specifications, standards, systems and services in relation to digital health, consistent with the National Digital Health Work Program;
·         develop, implement and operate comprehensive and effective clinical governance, using a whole of system approach, to ensure clinical safety in the delivery of the National Digital Health Work Program;
·         develop, monitor and manage specifications and standards to maximise effective operation between public and private sector digital healthcare systems;
·         develop and implement compliance approaches in relation to the adoption of agreed specifications and standards relating to digital health; and
·         liaise and cooperate with overseas and international bodies on matters relating to digital health.
The Digital Health Agency is a Corporate Commonwealth Entity under the Public Governance, Performance and Accountability Act 2013. The functions of the Digital Health Agency are set out in the Public Governance, Performance and Accountability (Establishing the Australian Digital Health Agency) Rule 2016.
1.2     Entity Resource Statement
Table 1.1 shows the total funding from all sources available to the entity for its operations and to deliver programs and services on behalf of the Government.
The table summarises how resources will be applied by Outcome (Government strategic policy objectives) and by Administered (on behalf of the Government or the public) and Departmental (for the entity’s operations) classification.
For more detailed information on special accounts and special appropriations, please refer to Budget Paper No. 4 – Agency Resourcing.
Information in this table is presented on a resourcing (i.e. appropriations/cash available) basis, whilst the ‘Budgeted expenses by Outcome’ tables in Section 2 and the financial statements in Section 3 are presented on an accrual basis.
Funds Available for 2016/17
Table 1.1: Digital Health Agency Resource Statement – Budget Estimates
for 2016-17 as at Budget May 2016

2015-16
Estimated
actual
$'000
2016-17
Estimate

$'000
Opening balance/cash reserves at 1 July
-
-
Funds from Government


Annual appropriations


Ordinary annual services1


Outcome 1
-
110,303
Other services2


Equity injection
-
10,589
Total annual appropriations
-
120,892
Amounts received from related entities3


Amounts from the Portfolio Department
-
-
Amounts from other entities
-
-
Total amounts received from related entities
-
-
Total funds from Government
-
120,892
Funds from other sources


Interest
-
1,200
Sale of goods and services
-
-
Other
-
34,400
Total funds from other sources
-
35,600
Total net resourcing for Digital Health Agency
-
156,492




2015-16
2016-17
Average staffing level (number)
-
51

-----
Budgeted Expenses for the Digital Health Agency
This table shows how much the entity intends to spend (on an accrual basis) on achieving the Outcome, broken down by program, as well as by Administered and Departmental funding sources.
Table 2.1.1: Budgeted Expenses for the Digital Health Agency

2015-16
Estimated actual
$'000
2016-17
Budget

$'000
2017-18
Forward
Year 1
$'000
2018-19
Forward Year 2
$'000
2019-20
Forward Year 3
$'000
Program 1.1: Digital Health





Revenue from Government





Ordinary annual services
-
110,303
114,124
4,159
-
Amounts from related entities
-
-
-
-
-
Revenues from independent





sources
-
35,600
35,600
-
-
Expenses not requiring appropriation




in the Budget year1
-
41,183
-
-
-
Operating deficit (surplus)
-
(18,730)
-
-
-
Total for Program 1.1
-
168,356
149,724
4,159
-
Total expenses for Outcome 1
-
168,356
149,724
4,159
-







2015-16
2016-17



Average staffing level (number)
-
51




3.2     Budgeted Financial Statements Tables
Table 3.1: Comprehensive Income Statement (showing net cost of services for the period ended 30 June)

2015-16 Estimated actual
$'000
2016-17
Budget

$'000
2017-18 Forward estimate
$'000
2018-19 Forward estimate
$'000
2019-20
Forward estimate
$'000
EXPENSES





Employee benefits
-
39,082
40,414
-
-
Supplier expenses
-
119,142
98,945
4,159
-
Depreciation and amortisation
-
10,132
10,365
-
-
Total expenses
-
168,356
149,724
4,159
-
LESS:





OWN-SOURCE INCOME





Own-source revenue





Sale of goods and rendering of





services
-
-
-
-
-
Interest
-
1,200
1,200
-
-
Other revenue
-
34,400
34,400
-
-
Total own-source revenue
-
35,600
35,600
-
-
Gains





Other
-
41,183
-
-
-
Total gains
-
41,183
-
-
-
Total own-source income
-
76,783
35,600
-
-
Net cost of (contribution by)





services
-
91,573
114,124
4,159
-
Revenue from Government
-
110,303
114,124
4,159
-
Surplus (deficit)
-
18,730
-
-
-
Surplus (deficit) attributable to





the Australian Government
-
18,730
-
-
-
OTHER COMPREHENSIVE INCOME




Changes in asset revaluation





reserves
-
-
-
-
-
Total other comprehensive





income (loss)
-
-
-
-
-
Total comprehensive income (loss)




attributable to the





Australian Government
-
18,730
-
-
-

Interesting points:
1. Outline of just what the ADHA is expected to do.
2. The staffing is planned to be 51 people - which is a lot less than NEHTA.
3. An majority of the outgoings are to suppliers (($100M p.a.)
4. It is not clear what has happened to the old NEHTA reserves and who is paying for all this - States / Commonwealth etc.
Other ideas on what is seen here are welcome.
David.

Monday, May 09, 2016

Weekly Australian Health IT Links – 9th May, 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

Well the election has been called and the fate of the Government is in the hands of the voters.
One can only hope there will be some recognition of and reframing of e-Heath policy - but for sure I am dreaming and given how gullible the pollies are about just how easy e-Health is I know there will be no change - no matter who wins. Pretty sad that.
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NSW govt to finish e-health records rollout within four years

Mobile, data analytics focus in 10-year strategy document.

By Andrew Sadauskas
May 3 2016 1:45PM
The NSW state government has committed to completing the rollout of electronic medical records within the next four years as part of its latest e-health policy. 
The e-health strategy for NSW Health 2016-2026 [pdf] was released by state Health Minister Jillian Skinner at the CeBIT conference in Sydney this morning. 
The core of the strategy is "maturing" NSW Health's core digital systems to create a consistent IT environment over the next four years. 
This includes completing the rollout of electronic medical records, which are currently implemented in 35 percent of facilities, across the state within the next four years. 
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NSW Government announces 10-year eHealth strategy at CeBIT

The NSW Government will finish the rollout of e-health records within four years and complete connections of its health facilities to the Health wide area network within three years.
These are just some highlights of its eHealth strategy announced by The Hon. Jillian Skinner MP, Minister for Health, NSW Government at CeBIT Australia today. If you are interested the 40-page document is a good read and outlines a huge range of initiatives.
The Minister promised a “Digitally enabled and integrated health system with a focus on delivering patient-centred health experiences with quality health outcomes; giving attendees an insight into the journey the NSW Government has taken as it builds on its existing blueprint and outlines the direction for NSW investment over the next decade.”
-----

eHealth NSW reveals how it is engaging clinicians

Health professionals play a pivotal role in system overhaul.

By Andrew Sadauskas
May 5 2016 10:16AM
The complexity of e-health programs lies as much in engaging stakeholders as it does with developing the technology itself, according to a senior manager in eHealth NSW’s electronic record for intensive care (eRIC) program.
The eRIC project aims to implement a statewide clinical information system designed to drive better patient outcomes in the intensive care units (ICUs) of NSW hospitals.
The system will eventually be hosted out of the NSW government’s GovDC data centre, and provide services to around 800 beds in 40 ICUs across the state.
Building the system has been a Herculean task that has involved implementing around 500 business and technical requirements, including things like medication management and decision support modules.
-----

OAIC saved from dissolution

Govt backs down on plans to abolish information agency.

By Paris Cowan
May 3 2016 7:32PM
The Office of the Australian Information Commissioner has been delivered a final-hour salvation after the government revealed it will ditch its plans to dissolve the privacy and FOI authority.
The OAIC was marked for dissolution in the Coalition's first budget in 2014 as part of its 'smaller government' agenda intended to return over $10 million back to the commonwealth purse.
The functions of the office, which include investigating privacy complaints, potential breaches of the Privacy Act and resolving freedom of information disputes, were to be broken up and merged into the Australian Human Rights Commission and the Attorney-General's Department.
But the plan was held up when enabling legislation lapsed in the Senate at the end of 2014 sittings.
-----

Revived OAIC to be "leaner"

Pilgrim warns agency won't return to pre-2014.

By Paris Cowan
May 4 2016
2:40PM
Information Commissioner Timothy Pilgrim has welcomed the news his office will be saved from dismantlement, but warns the agency will continue to be a much leaner organisation going forward.
Pilgrim was speaking to government lawyers in Canberra this morning following last night’s budget announcement that the government would no longer seek to abolish the Office of the Australian Information Commissioner.
"I of course welcome this decision," he said.
"Our organisation is uniquely placed to assist all agencies as they support the government’s innovation agenda."
-----

NSW launches 10-year eHealth strategy

Strategy builds on 2013’s Blueprint for eHealth in NSW
Rohan Pearce (Computerworld) 03 May, 2016 22:29
The New South Wales government has unveiled a strategy designed to map out the future of eHealth in the state from 2016 through to 2026.
The state’s health minister, Jillian Skinner, launched the strategy at a Cebit eHealth conference in Sydney.
"eHealth systems can help to foster access to information, personal healthcare management and targeted prevention to encourage participation in health decisions,” Skinner said in remarks prepared for the conference.
The strategy (PDF) has seven key focus areas: Core clinical systems (including the development of ‘paper-lite’ information systems); integrated care solutions (including support for remote monitoring of patients and telehealth); workforce and business management systems; data and analytics; ‘seamless’ information flow between core systems; infrastructure, security and intelligence; and innovation.
-----

Australia needs to link more healthcare data: MPs

Privacy law a stumbling block.

By Allie Coyne
May 5 2016 11:57AM
Linking de-identified datasets from the likes of Medicare, hospitals and the Pharmaceutical Benefits Scheme would add billions into Australia's economy and give doctors and policy makers a better understanding of how people use the healthcare system, Australian parliamentarians claim.
A committee of cross-party MPs tasked with reviewing the value of health datasets found Australia had "untapped potential" to use data generated by the healthcare system for financial and societal gain.
The Commonwealth spent more than $63 billion - or 25 percent of all government tax revenue - on the healthcare system in 2013-14, and health expenditure has grown at a rate of 5 percent above inflation for the last ten years.
In this climate, more effective and cost-efficient policies should be "vigorously pursued", the report argued, citing a Lateral Economics report that suggested health-specific data could inject as much as $5.9 billion each year into the economy.
-----

About the EMR

·         The Royal Children’s Hospital launched its Electronic Medical Record (EMR) on 30 April 2016. We are one of the first paediatric hospitals in Australia to replace paper-based medical records with a comprehensive state-of-the-art electronic record.
We've rolled out the EMR so that our health care professionals will have the most up-to-date and accurate information, all in one place, when they care for your child.
The new system will improve communication among doctors, nurses, allied health professionals and the rest of your care team, helping them deliver even safer care.
It will also help us communicate better with you through ‘My RCH Portal’, a new secure, online hub where you can access parts of your medical record through the internet.
-----

MBS and the My Health Record

LEVEL D
A Level D item will be used for a consultation lasting at least 40 minutes for cases in relation to one or more health related issues. The medical practitioner may undertake all or some of the tasks set out in the item descriptor as clinically relevant, and this should be reflected in the practitioner’s record. In the item descriptor singular also means plural and vice versa.
Creating and Updating a Personally Controlled Electronic Health Record (PCEHR)
The time spent by a medical practitioner on the following activities may be counted towards the total consultation time:
  • Reviewing a patient’s clinical history, in the patient’s file and/or the PCEHR, and preparing or updating a Shared Health Summary where it involves the exercise of clinical judgement about what aspects of the clinical history are relevant to inform ongoing management of the patient’s care by other providers; or
  • Preparing an Event Summary for the episode of care.
Preparing or updating a Shared Health Summary and preparing an Event Summary are clinically relevant activities. When either of these activities are undertaken with any form of patient history taking and/or the other clinically relevant activities that can form part of a consultation, the item that can be billed is the one with the time period that matches the total consultation time.
-----

Start-up Color Genomics democratises cancer testing

  • The Australian
  • May 3, 2016 12:00AM

David Swan

US-based genetic testing start-up Color Genomics has announced availability in Australia and New Zealand, as it moves to democratise access to genetic information and make testing for cancer predisposition available to tens of thousands of people who would have never had the chance.
The company is the brainchild of a group of former Google and Twitter executives who each had been personally affected by cancer and decided to use their expertise in business, technology and big data to build a solution.
Co-founder and president Othman Laraki told The Australian the cost of human genome sequencing had recently dropped at an exponential rate, going from tens of thousands of dollars to just hundreds in a couple of years.
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Pharmacies play pivotal role in new GP service

3 May, 2016 David Rowley 
A new telehealth trial to help patients in areas with limited access to GPS will allow them to have GP video consultations from within community pharmacies.
The new CP2GP system will handle the ReadyCare service, a result of a partnership between Telstra Health and the Pharmacy Guild.
According to Dr Amandeep Hansra (pictured), Chief Medical Officer of Telstra Health’s ReadyCare, the trial, which is already under way, will focus on pharmacies in areas where there is a priority need for better access to GP services.
“This includes areas where there is very limited or no local access to GP services generally or at particular times,” he says.
-----
5 May 2016

10 GPs and the ReadyCare pharmacy one said: “roll over”

Posted by Jeremy Knibbs
More than 40 community pharmacies will be receiving starter kits over the next two weeks to set up Telstra ReadyCare GP tele consult services within store so customers can talk to a GP on the spot
The move has prompted speculation that in some areas local GP practices may be bypassed for a pharmacy-based tele GP consult.
The program, called CP2GP, is being launched through the Pharmacy Guild. It follows closely on heels of the Pharmaceutical Society of Australia’s (PSA) Health Destination Pharmacy (HDP) initiative launched last year which has one of its aims as “transforming pharmacies into primary sources of healthcare advice and service in the community”.
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Medical apps: lifesavers or dangers to health?

Date May 5, 2016 - 11:20AM

Andrew Masterson

Researchers around the world are warning that none of the 165,000 available medical apps have been properly tested.
Black Dog has just tested 123 suicide prevention apps. It found none provided the appropriate level of support and some were potentially harmful.
Pretty much anyone who has expressed concerns about their own mental health, along with anyone diagnosed with a chronic non-communicable disease such as diabetes, knows that there is an app to help them manage their condition.
Actually, that's an understatement. Pick a health issue and you'll find scores. One study last month from the University of California, Davis, estimated that there are currently 165,000 healthcare apps on the market.
And for consumers, availability is king. They aren't waiting for a scientific stamp upon an app – they're using them anyway. 
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Playing this game could help unlock the secrets of dementia

Date May 5, 2016 - 1:34PM

Catherine Armitage

Senior Writer

In Sea Hero Quest, a father and son travel the oceans to find pieces of a missing map.
A smartphone game has achieved the seemingly impossible less than 24 hours after its launch. Thousands of people of all ages are participating in dementia research on their mobile phones, including youth who want to help their sick grandparents. The research data already collected would have taken 70 years to collect in a laboratory, the researchers say.
Sea Hero Quest is based on a simple idea: what could be achieved if some of the three billion hours people spend gaming each week was devoted to scientific research?
The researchers say every two minutes someone spends playing the game generates the same amount of data as it would take scientists five hours to collect in equivalent lab-based research.
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GP clinics urged to review privacy policies

Tessa Hoffman | 5 May, 2016 |
GP clinics are being urged to review privacy policies after an investigation suggests many may be in breach of privacy law.
Last year, the Office of the Australian Information Commissioner (OAIC) audited the privacy policies of 40 clinics against national privacy law requirements.
It found that many fell short across many areas, exposing clinics to the risk of prosecution.
One common fault was the absence of any statement telling patients how and why their information was being collected and protected.
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Privacy Foundation questions Govt’s e-health record motives

06/05/2016
news The Australian Privacy Foundation (APF) has said it is “concerned” about the Government’s eHealth plans for patients’ information.
In a statement, APF Health Committee Chair Dr Bernard Robertson-Dunn asked “What is the government really intending to do with our health data?”
In the recent Federal Budget, the Government allocated over $200 million in 2016-17 for the Digital Health Agency to run the My Health Record system (previously known as the Personally Controlled eHealth Record).
Active since 2012, the scheme will have cost “well over” $2 billion by the end of 2017, according to the statement.
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NSW Govt launches 10 year eHealth strategy

06/05/2016
news The New South Wales Government has launched a 10-year eHealth strategy, saying it will bring “smart, safe, sustainable and digitally-enabled care” to patients.
The state’s developing eHealth initiative includes a raft of measaures aimed to use digital technologies to transform the way healthcare is delivered.
“By harnessing technology, the NSW Government has made NSW Health the most advanced eHealth system in Australia,” Health Minister Jillian Skinner said when launching the 10-year scheme at the CeBIT Australia conference in Sydney.
According to Skinner, the new eHealth Strategy for NSW Health 2016–2026 builds on the 2013 Blueprint for eHealth and outlines the way forward for the state’s investment in the sector for the coming decade.
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Breaking down the barriers to scale in telehealth

By Natasha Egan on May 6, 2016 in Industry
Making telehealth so easy to use that it requires no training, is business as usual in institutions, and a diagnostic tool completely separate from health provision, are among approaches needed to ramp up its widespread availability, a recent health event has heard.
A panel of five experts discussed how to break down the barriers and bring telehealth to scale across the country at the Australian Telehealth Conference in Sydney last week.
The technology needs to be so simple that no training or change management is required, said Dr James Freeman, a GP and the founder of GP2U Telehealth.
“Think about Gmail. How did you learn Gmail? Were you change managed or did you just pick it up and start using it? It needs to be that easy,” Dr Freeman told delegates.
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Cyber attacks a growth industry: Guild

One of the most precious assets in any pharmacy is the confidential data held on patients, medicines and business operations… and protecting that data from attack is therefore a priority in the efficient and ethical operation of any pharmacy business, says the Guild.

Unfortunately cyber security attacks are a growth industry, with Australia leading the world.
A survey by PricewaterhouseCoopers released in October last year found Australia had the highest number of cyber security incidents in the previous 12 months with 9434 incidents reported, more than double the previous year.
The growth in the rest of the world was about 38%. This of course only accounts for known security attacks or breaches.
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What should a national digital health system look like?

May 1, 2016
What is the role of government in contributing to the nation digital health infrastructure? That is not an easy question to answer. Every nation has its own specific variant of a health system, with different emphases on the public or private, on central government intervention or laissez-faire commerce.  I have in earlier blogs made the point that, despite these differences in national systems, we now do have access to enough evidence that we cannot ignore the evidence when crafting national strategies.
Back in 2009, when I explored the implications of these structural differences for government, I came to the conclusion that digital health needed a ‘middle out’ governance model, rather than top-down or bottom-up approaches to strategy. One consequence of the thinking in that paper was that I formed a view that we did not need a centralised national summary care record – a view which left me with fewer friends in government than I used to have! I was only trying to be helpful …
With a new Australian Digital Health Agency, it is now a good time to revisit these questions, to learn from the past, and to come together as an informatics and e-health community, and give ourselves the best possible shot at getting digital health right.
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Lack of focus on family history is a missed opportunity for GPs

2 May 2016
THE ISSUE
FAMILY history is important because it influences the person’s risk of a range  of conditions and therefore the preventive care that is indicated.
Events in the family have  significant psychosocial effects on each person’s well being, knowledge of particular diseases and illnesses, and attitude to health and health care.
A study of people in the community found family history was a key component of a personal risk assessment that participants undertook and provided a critical motivator for preventive action and increased awareness of preventive activities.
Participants felt that GPs did not usually enquire about  family history.1
-----
5 May 2016

MHR privacy in jeopardy at call centres

Allowing call centres to access MyHealthRecord data is “a privacy disaster waiting to happen”, according to the Australian Privacy Foundation
Despite the federal health minister’s insistence that patients would have ultimate control over who accessed their information, the system’s reliance on call centres to help individuals manage their accounts exposes a privacy vulnerability, the foundation says.
This security flaw was identified in 2011 by the law firm Minter Ellison, who recommended the government develop regulations to control what system operators could view.
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6 top sources used by junior doctors for clinical queries

Michael Woodhead | 29 April, 2016 | 0 comments Read Later
The days when a junior doctor would consult a dog-eared copy of MIMS for clinical information are long gone, according to a survey of 142 junior staff at an SA hospital. 
In the digital age, junior doctors now turn first and foremost to online sources for answers to questions on drug doses and complex diagnostic problems.
6 sources to help with doses and diagnosis
  1. Eight out of 10 doctors said their first approach to a clinical query would be to go online for information sources.
  2. About half of junior doctors would seek help from a senior colleague, and 30% would ask a peer about a clinical query on a regular daily basis.
-----

Gumtree suffers security breach

Emails and other contact details of customers leaked
Rohan Pearce (Computerworld) 29 April, 2016 14:39
Online classifieds site Gumtree Australia has confirmed that customer information was compromised during a security incident.
The site notified customers of the attack by email. The attack took place last weekend.
“The attackers accessed the email addresses of some Gumtree users,” read a statement issued by Gumtree.
-----

Medical Error Is Third Leading Cause of Death in US

Marcia Frellick
May 03, 2016
Medical error is the third leading cause of death in the United States, after heart disease and cancer, according to findings published today in BMJ.
As such, medical errors should be a top priority for research and resources, say authors Martin Makary, MD, MPH, professor of surgery, and research fellow Michael Daniel, from Johns Hopkins University School of Medicine in Baltimore, Maryland.
But accurate, transparent information about errors is not captured on death certificates, which are the documents the Centers for Disease Control and Prevention (CDC) uses for ranking causes of death and setting health priorities. Death certificates depend on International Classification of Diseases (ICD) codes for cause of death, so causes such as human and system errors are not recorded on them.
-----

Budget 2016: NBN is running out of money

Date May 4, 2016 - 10:21AM

Hannah Francis

Technology Reporter

The Turnbull government's $29.5 billion cap on public funding for the national broadband network is set to run out by the end of the 2016-17 financial year, budget papers reveal.
The company rolling out the network has already begun tapping the private sector to make up the $16.5 billion and $26.5 billion shortfall, a year earlier than planned.
"NBN is currently undertaking the necessary preparatory work on the proposed debt raising," the budget's Statement of Risks says.
The final $8.8 billion tranche for fiscal 2016-17 includes $400 million initially allocated for the current financial year.
-----
Enjoy!
David.

Sunday, May 08, 2016

Parliamentarians Reveal Just How Little They Really Understand About E-Health. Magical Thinking In Spades!

Just before the election was called the House of Representatives released the results of an enquiry on Chronic Health Care.
Here is the full title and link:
Report on the Inquiry into Chronic Disease Prevention and Management in Primary Health Care
5 May 2016
The bits that seem relevant to e-Health and myHR seem to be as follows:
Telehealth and eHealth Support
4.1                   The importance of telehealth and eHealth initiatives, especially to rural, remote and low-mobility chronic disease patients, is a focus for many health care providers and commissioners.
4.2                   Programs such as the Royal Flying Doctor Service’s ‘Medical Chests’ program allow patients to access the services they would not normally be able to access easily. The Medical Chests program allows for pharmaceutical dispensing for inflammation, wound care or antibiotics via caches of supplies and specialised telehealth consultations to aid in dispensing these pharmaceuticals in specific circumstances.
4.3                   Innovative programs and services using telehealth and eHealth support, such as linking in multidisciplinary teams to rural cancer centres is essential to coordinating the chronic disease management of affected rural and remote populations.
4.4                   Simplified video or telephone consultations for disease management, such as ‘home monitoring, coaching, video consultation appointments and home medication management’ is a key benefit that can be realised in the delivery of health care via eHealth initiatives.
4.5                   eHealth support in the form of websites that allow for the convenient delivery of relevant information or secure messaging between providers of relevant records or patient information are essential to diversified health care delivery.
4.6                   eHealth records, such as the expanding ‘My Health Record’ initiative are also an important component of diversified and supported health care management.
Data Registries and eHealth Records
4.1                 Regardless of the expansion of the services and coordination of chronic disease care, without the appropriate data, records and patient information, both for care and evaluation and research needs, the fragmentation of chronic disease management in Australia will continue.
eHealth Records
4.2                   While primary health care, especially general practice, is a technologically advanced sector of society, the same cannot be said for allied health providers, specialists and surgeons. In 2012 only approximately 37 per cent of specialists and 22 per cent of surgeons relied on computerised patient records.
4.3                   Similarly, even though general practice do generally use electronic patient records, there are still multiple proprietary systems used and on the market. It is for this reason that the Australian Government and state and territory governments established the National Electronic Health Transition Authority (NeHTA) in 2005 to help promote eHealth initiatives and create standards for the health care sector to adopt.
4.4                   These standards and their application to patient records aid in the connectivity required for multidisciplinary and coordinated care. The Health Network Northern Territory highlighted the importance of eHealth in a diverse community:
Given the large geographical size of the Northern Territory, increased access to eHealth technology will greatly improve the prevention and management of chronic disease. The use of eHealth has been demonstrated internationally to decrease the administration burden of health care service delivery, improve the quality of care, increase efficiencies and encourage patient self- management. Best practice includes an electronic patient record, electronic prescribing and medication administration, telehealth services and secure message services for health professionals.
4.5                   The establishment of the Personally Controlled Electronic Health Record (PCEHR) in July 2012, now the My Health Record, has enabled a universal platform for the storage and management of health information about patients in Australia and placed the control of that information with the patient themselves. The review of the PCEHR released in May 2014 establishes a firm foundation for the My Health Record to become the central repository of patient information, for both general health and chronic disease management.
4.7                   NeHTA will transition into the Australian Digital Health Agency as of 1 July 2016, continuing its work in the electronic health standards space, as well as taking responsibility for the continued management of the My Health Record.
4.8                   Access to the My Health Record is currently limited to the patient and any ‘nominated healthcare provider’ that is granted access by the patient’s consent; however access to the health information stored within can be accessed by certain parties in the case of an emergency.
4.9                   The patient data stored within the My Health Record, as well as in the wider electronic patient and other health record systems across Australia, can form the datasets and data registries that many identify as being crucial to coordinated chronic disease care, as well as evidence-based research and policy development.
Datasets and Registries
4.10                The creation of a unified national health dataset, by combining the information from federal government data (Medicare, Pharmaceutical Benefits Scheme (PBS) and aged care) along with private and public hospital data, is an ideal outcome that could help drive health outcomes and reform.
4.11                However, the reality of multiple sources, formats, quality and access to the health care data existing in Australia’s systems places barriers on accessing a centrally consistent dataset or data registry for use in chronic disease prevention or management.
Currently there are multiple datasets of patient information within the health care sector, as well as potentially replicated data held by private health insurers related to their members. The potential to access that de- identified or secure member data, to supplement any consolidated government patient data, is a compelling reason to investigate sharing and
Recommendation 10
The Committee recommends that the Australian Government examine the feasibility of linking relevant Medicare Benefits Schedule, Pharmaceutical Benefits Scheme and Repatriation Pharmaceutical Benefits Scheme data, with applicable hospital patient data, to create a unified patient dataset, or to consider this link when developing the National Minimum Data Set for Healthier Medicare purposes.
Moving into the Future
5.112  Supported by well-funded and coordinated eHealth systems – expansion of the My Health Record to become the central repository of patient data, augmented by practice data and de-identified central government treatment data, that can be used for performance measurement, as well as research and outcomes-based improvement.
5.117  Additionally, the Committee recommends that the Australian Government continue to fund the evolution and expansion of the My Health Record, managed by the Australian Digital Health Agency from 1 July 2016. The importance of patient-managed care information, as well as the resultant data that can be used to measure successes, failures and outcomes, as identified in Chapter 4, is essential to moving the primary health care system into the future.
Recommendation 13
5.120    The Committee recommends that the Australian Government continue to prioritise funding of the evolution and expansion of the My Health Record to support improvements in the prevention and management of chronic disease, as well as the wellness of all Australians.
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Overall what we see here is:
1. There seems to be a total failure to recognise the myHR is a secondary system and not a primary data source. The GP, Specialist and Diagnostic systems are where the trustworthy information is.
2. The myHR is not well designed to support co-ordinated care as opposed to other much better designed private sector systems to support these requirements.
3. The politicians seem to want to create huge databases of personal health information that they can just troll at whim - while the really don’t understand just how reliable and trustworthy the base information is and how wrong conclusions may be derived. Of course all this ignores the security and privacy implications…
4. Yet again we have just a bucket load of assertions as to benefit on the scantiest, if indeed, any evidence.
The bottom line is that the pollies are victims of the magical thinking of the bureaucrats who think they can produce a wonderful data and information driven future without having a clue just how hard it will be.
David.

AusHealthIT Poll Number 319 – Results – 8th May, 2016.

Here are the results of the poll.

Does The Victorian Government's Investment In Real Time Drug Monitoring Suggest They Lack Confidence In myHR Ever Delivering Effective Medication Management?

Yes 86% (138)

No 4% (7)

I Have No Idea 9% (15)

Total votes: 160

Pretty clear outcome and another vote of no-confidence in the capabilities of the myHR.

Great turnout of votes as well!

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

David.