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, May 19, 2016

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

May 19  Edition
With the Budget on the Third of May what we have seen is as follows in the articles below. In broad terms there seem to have been some pretty tough stuff in the sectors such as health and education. Comments welcome on what you thought of the Budget.
Note: A hell of a lot of all this has not been legislated - and now we are in an election mode they may or may not come about depending on the election outcome.
With the Election now formally announced for July 2 we will need to keep a close eye out for any health and e-Health impacts.
As we move further into the campaign I am sure it will become more interesting - with the polls as tight as they are at present.

General Budget Impacts.

  • May 8 2016 at 11:45 PM
  • Updated May 9 2016 at 5:09 AM

Election 2016: Voters gives thumbs down to Turnbull budget

The Turnbull government's first federal budget has received a generally negative reception from the voting public, but it is nothing like the politically disastrous 2014 offering which sent Tony Abbott and his government into freefall.
The latest Fairfax/Ipsos poll finds that the budget, a critical document given it was released less than a week before the federal election campaign, was perceived as fair by 37 per cent of voters while 43 per cent disagreed. Another 20 per cent had no view either way.
In the 14 budgets polled by Fairfax since the tough 1996 Howard/Costello budget, last week's budget is second only to 2014 in terms of perceived unfairness.
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Updated May 10 2016 at 12:27 AM

Election 2016: Labor promises quick mini-budget

A federal Labor government would release a mini-budget within three months to calm concerns among the ratings agencies that Australia is not doing enough to preserve its AAA credit rating.
With the economy dominating the start of the election campaign, shadow treasurer Chris Bowen will use his reply to last week's budget to claim the government's path back to surplus was a risk to the rating because it was based more on hope and unrealistic assumptions, such as a high iron ore price, than concrete action.
"None of it can be relied upon," he will tell the National Press Club on Tuesday.
Mr Bowen will say a Labor government needed to be brave enough to raise taxes and cut spending to make an impact on the deficit and assuage the ratings agencies.
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Is this really a disgusting Budget?

Is this really a “disgusting Budget?” That’s how my barista described it to me on the day after Scott Morrison’s first fiscal effort, so I promised Andre that I’d evaluate his assessments.
So let’s start with why a generally well-balanced barista would be disgusted by this Budget.
If he was planning to retire soon and had plans in place, he could be disgusted with the super changes. For the first time ever, I threw the phone lines open on my TV show last night, as I’d received an avalanche of emails about how many of my viewers, readers and listeners have been affected by these proposed super changes.
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Signs of a problem for Malcolm Turnbull in post-budget sentiment

Date May 14, 2016 - 12:15AM

Malcolm Maiden

Columnist

My prediction a week ago that Scott Morrison's Budget was unlikely to be a election liability is not looking good. Wednesday's consumer sentiment result and other feedback suggests that the budget isn't helping, and might be doing harm. The fact that it was actually even-handed is being lost in the election ruckus.
People began being contacted for the May edition of the Westpac Melbourne Institute consumer sentiment survey on Monday, May 2, the day before Scott Morrison unveiled his first budget, and the Reserve Bank met and cut its cash rate. The survey of 1200 people was completed on Saturday, May 7, so both events are in the weave of the results.
Compared with April, sentiment improved by a solid 8.5 per cent, to 103.2 points, comfortably above the 100 point plimsoll line that divides a positive mood and a negative one. By way of comparison, the index sank from 99.7 points to 92.9 points in May 2014 after Joe Hockey's heavy-handed first budget.
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Health Budget Issues.

1:31pm May 8, 2016

GPs to launch targeted Medicare campaign

By  AAP
Doctors will ask patients to join their fight against the government's freeze on Medicare rebates in a widespread campaign planned to coincide with the election.
From Monday, GPs will move to warn patients about the budget measure and encourage them to lobby against it.
Last week's budget extended by two years to 2020 a four-year indexation freeze on the Medicare rebate the federal government pays for services like GP visits.
The government expects the move will save almost $1 billion, but the Royal Australian College of General Practitioners says it will leave patients worse off, especially the disadvantaged.
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Election 2016: Doctors launch campaign against extended freeze on Medicare rebates

Date May 8, 2016 - 2:40PM

Jane Lee

Legal affairs, health and science reporter

EXCLUSIVE
The federal Coalition is facing an early election headache with thousands of GPs set to urge their patients to lobby against the extended freeze on Medicare rebates.
The Royal Australian College of General Practitioners will launch its campaign against the government's decision to continue to freeze current rebates until 2019/20, which it says will force more doctors to start charging their patients a co-payment. The government expects the move will save it about $925.3 million.
From Monday, the 32,000 members will hang posters in their waiting rooms that warn: "Danger. You and your family's health is being targeted. The extended freeze on Medicare rebates means you will pay more!"
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Robbing sick Peter to pay healthy Paul

Lesley Russell
Monday, 9 May, 2016
THE 2016-17 Budget is described by the Prime Minister as a national economic plan focused on the long term. That does not ring true for the health budget, which presents more as a statement of politics and short-term fixes.
The subtext is that there is no vision or commitment to necessary health care reforms in primary care, clinician payments, mental health and Closing the Gap on Indigenous disadvantage.
The big spending commitments were already known. The additional $2.9 billion over 3 years to public hospitals and the commitment to activity-based funding is welcome, although this represents less than half the funding cut in the 2014-15 Budget. There are references to associated initiatives to improve quality and safety and to tackle avoidable hospital admissions and readmissions, but there is no further information in either the Council of Australian Governments communiqué or the Budget papers.
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Tunneling for Budget health nuggets

Cate Swannell
Monday, 9 May, 2016
TUNNEL down deep enough into the 2016-17 Budget papers and a couple of health care nuggets emerge, buried under the increases to the tobacco excise, the Health Care Homes trial and the Healthier Medicare package.
One such shiny morsel is the $20.4 million to be poured into improving the regulation of therapeutic goods in Australia, which will be spent via the Therapeutic Goods Administration (TGA) from 2016–2017 to 2019–2020.
The measure is a response to the Sansom review (Expert panel review of medicines and medical devices regulation) which reported to the government back in July 2015 with a list of 58 recommendations.
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Getup maps $57bn in Abbott-era health cuts hospital by hospital

Cuts budgeted since 2014 will cost big hospitals like Royal Melbourne more than $1.3bn over 10 years, lobby group says
Voters more concerned with hip replacements than the hip pocket might want to look at a new map launched by GetUp that offers a projection of what $57bn of health cuts would do to hospitals in their local area.
According to the progressive campaign group, the Coalition government’s policies amount to a $57bn cut over 10 years, equivalent to 37,000 hospital beds that can’t be funded, or 68,000 nurses or 33,000 doctors that can’t be paid.
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Federal election 2016: funding tweaks shear $1.2bn

  • The Australian
  • May 10, 2016 12:00AM

Rick Morton

The federal government’s decision to shave $1.2 billion from care funding for the aged-care sector was prompted by an astonishing over-classification of complex ­resident needs in most states, particularly in Queensland, South Australia and Tasmania.
While the overall aged-care budget jumped $17.8bn — almost 8 per cent — the government will build on Labor efforts to restrict the Aged Care Funding ­Instru­ment which has, intentionally or not, been improperly applied.
The ACFI governs funding for the care needs of residents in homes but is only one element of the sector’s overall funding.
Data obtained by The Australian shows almost 18 per cent of ACFI reviews in Queensland aged-care homes for the nine months to the end of March led to a downgrade in funding — because of over-egging of complex care needs — and almost 22 per cent in Tasmania and 22 per cent in South Australia.
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Election 2016: Where the parties stand on the big issues

Here's what you need to know about how the parties' policies stack up.

Health

The Coalition went into the 2013 election "on a unity ticket" with Labor, to neutralise a campaign that Tony Abbott would begin cutting health funding once elected.
However the 2014 budget saw the ticket torn up, with hospital funding agreements the states and territories made under former Labor prime minister Kevin Rudd to be wound back from 2017, saving a massive $50 billion over eight years.
Also announced was a $7 co-payment to visit the GP, which became one of the least popular measures in Joe Hockey's 2014 budget, and was eventually scrapped.
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Aged care investment will stall due to funding cuts

Date May 13, 2016 - 12:15AM

Tim Binsted

Reporter

Funding cuts to the aged-care sector threaten to kill much needed investment in new beds and push sick and frail residents into hospitals, industry players warn.
There are also private mutterings that the redesigned funding formula for complex healthcare  – in some cases cutting funding from $46 a day per resident to just $16 a day from July 1 2017 – could drive some businesses out of the aged care industry altogether.
In the May budget Treasurer Scott Morrison unveiled $1.2 billion of cuts to aged care. The latest cuts came after $600 million was stripped in the mid-year update last December.
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Bulk-billing rates have continued to rise under the Coalition

  • The Australian
  • May 13, 2016 8:33AM

Sean Parnell

Bulk-billing rates have continued to rise, undermining a campaign by Labor and health groups concerned a prolonged freeze on Medicare rebates will force more patients to pay to see a doctor.
The Coalition government extended the freeze in the recent budget, meaning doctors and other practitioners will have no change in government income for at least seven years.
While Labor initiated the freeze when last in government, the Opposition has made Medicare a key election issue, aided by doctors putting up posters and writing prescriptions on pads warning patients they will pay more under the Coalition.
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  • May 13 2016 at 8:56 PM
  • Updated May 13 2016 at 8:58 PM

Election 2016: Turnbull backpedals on health cuts but Shorten wins debate

Malcolm Turnbull has moved to take the sting out of Labor's attacks over health funding by announcing a partial reversal of a contentious policy that would have seen pathology costs rise.
During Friday's leaders' debate, the first of the election campaign,  Mr Turnbull partly reversed a $650 million savings measure announced in last year's mid-year budget update which removed bulk billing for pathology tests.
The debate, a close and civil affair, was held in front of an audience of 100 undecided voters in the Liberal-held marginal seat of Macquarie, in western Sydney. Despite Mr Turnbull's policy olive branch, the audience awarded the contest to Mr Shorten by 42 votes to 29 while another 29 were undecided..
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Medical groups still concerned about bulk billing amid Turnbull pathology deal

By political reporter Francis Keany
Doctors' groups say they have concerns about the Prime Minister's pathology deal because the proposed cuts to bulk-billing incentives are still on the table.

Key points:

  • PM declares breakthrough in bulk-billing dispute
  • Government gets to keep proposed cuts, pathologists to absorb costs
  • AMA concerned about future changes
  • Changes would save budget $650 million over four years
Yesterday Malcolm Turnbull used a leaders' debate in western Sydney to declare a breakthrough in the stoush over bulk-billing incentives for blood tests — a deal which had been a source of long-running funding dispute.
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6:10am May 14, 2016

Bulk-billing for pathology to continue after government makes deal with practitioners

By AAP
May 14, 2016: In a bid to win the hearts and minds of Australian voters, Prime Minister Malcolm Turnbull and opposition leader Bill Shorten have taken to a People’s Forum in western Sydney.
The federal government has brokered a peace deal with angry pathologists in a major win for patients who will continue to access bulk billed medical tests.
Changes to bulk-billing incentive payments due to come into force from July 1 will save the budget $650 million over four years.
Pathologists were up in arms when the announcement was made in the budget review last December, warning they were unable to absorb the costs and would have to pass them on to patients.
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14 May 2016 - 4:08pm

Win on medical tests but not scans

The federal government will postpone making changes to bulk-billing incentive payments for pathology services for three months.
Source: AAP 14 May 2016 - 4:08 PM  UPDATED 28 MINS AGO
While patients will continue to be bulk-billed for pathology tests people could still be left hundreds of dollars out of pocket for x-rays and scans.
Prime Minister Malcolm Turnbull has called a truce with pathologists over changes to bulk-billing incentive payments which were due to come into force from July 1.
They were slated to save the budget $650 million over four years.
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AMA slams bulk-billing deal

Updated: 9:09 pm, Saturday, 14 May 2016
The Australian Medical Association (AMA) is on the attack over a peace deal between the federal government and Pathology Australia.
The government has delayed changes to a bulk-billing incentives, which were slated to save the budget $650 million over four years, until after the election.
The AMA has warned the deal would still mean cuts to bulk-billing incentives for pathology services.

Health Insurance Issues.

Complaints up as health fund members struggle: Ombudsman

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

Sean Parnell

Complaints about private health insurance have risen 24 per cent as the office of the Ombudsman, Colin Neave, joins calls for the federal government to provide more support to members struggling with rising costs.
The Ombudsman’s latest report on the industry, quietly published on Friday, noted that there were 4265 formal complaints last year as more members found themselves caught without cover when they needed it most.
Premiums rose by an average 5.9 per cent last month, a trend exacerbated by erosion of the insurance­ rebate because of changes made by Labor and ­Coalition governments.
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Boom in after-hours GPs raises concerns about Medicare cost blowout

Date May 12, 2016 - 9:54AM

Harriet Alexander and Julia Medew

EXCLUSIVE

How to make the most of your health cover

SMH's Harriet Alexander's hot tips to save you money and optimise your private health insurance in 2016.
Home visits by mobile GPs are booming in Australia, causing some doctors to question whether the "Uberisation" of medicine is ripping off Medicare.
New data shows the growth in private companies offering "free", bulk-billed home doctor consultations in people's homes out of business hours has cost Medicare $662.1 million since 2010, challenging traditional "family doctor" GP clinics.
The services have been a boon for people who want a doctor to visit them at home between 4pm and 8am during the week and on weekends and public holidays. In some cases, the doctors will provide pharmaceutical treatments such as anti-nausea drugs, saving people a visit to a pharmacy.   
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Canberra warns health funds on clinical decisions

  • Sean Parnell Health Editor
  • The Australian
  • May 12, 2016 1:41PM
Health Minister Sussan Ley has told a doctors’ group her department warned health funds not to interfere in clinical decision-making when trying to keep costs down.
The Australian revealed in February that Australia’s two largest health funds, Medibank and Bupa, were requiring eye surgeons to sign declarations that procedures they had booked in for members were clinically necessary and not purely cosmetic.
The Australian Society of Ophthalmologists alerted Ms Ley who recently informed them “senior officers” of the department had held meetings with major health insurers and written to other funds on the issue. The department advised the industry that there was no requirement for any pre-approval process where members were due to receive hospital treatment attracting a Medicare rebate and covered under their policy.
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Pharmacy Issues.

Employing naturopaths in chemists akin to McDonalds style ‘do you want fries with that?’ marketing

May 8, 2016 5:00pm
JANE HANSEN News Limited
PHARMACISTS have blasted attempts by the vitamin and supplement industry to employ naturopaths in chemists as a sales gimmick and fear it will diminish the credibility of their profession.
Ian Carr, a Taree-based pharmacist, said he was dismayed by the trend of naturopaths employed by supplement companies and pharmacists to work as in-store ­consultants. He said many supplements were not evidenced-based and didn’t do what they claimed.
“I’m going to campaign against the placement of naturopaths in store because its message is contrary to the dispensing side and I don’t want to mislead clients with nonsense like naturopathy.
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Naturopathy: ‘If it wasn’t so serious it would be funny.’

Taree pharmacist and Friends of Science in Medicine member Ian Carr is stepping up a campaign against naturopathy in pharmacy, the Daily Telegraph reports.

Reporter Jane Hansen spoke to Carr, who has written in the past for the AJP criticising homoeopathy, as well as Blackmores’ Lesley Braun and the Pharmacy Guild’s Greg Turnbull, after Blackmores advertised last week for naturopaths to work in Sydney pharmacies as part of an “in-store health and wellbeing team”.
Carr told Hansen that he plans to campaign against the placement of naturopaths in pharmacies because “its message is contrary to the dispensing side”.
“I think there’s a real undercurrent, a lot of consumers out there who want to be dealt with in an honest and science-based manner,” Carr told the AJP today.
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Superannuation Issues.

Turnbull and Morrison risk losing the federal election if they proceed with changes to superannuation

Rowan Dean The Courier-Mail
PRIME Minister Malcolm Turnbull and Treasurer Scott Morrison have 54 days to scrap their superannuation changes or risk losing the election.
It’s an ominous figure – it’s the same number of Liberal MPs who overthrew Tony Abbott to install a man who treats the Coalition’s most loyal supporters with contempt.
It also happens to be the age of many Liberal voters who may well vote Labor on July 2 unless the Coalition’s disgraceful superannuation caps are ditched.
In fact, anyone a decade either side of 54 who has worked all their life to save for their own and their family’s future will think twice about voting Liberal if the super rules, sprung like a booby-trap on Budget night, are still there on election eve.
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In Scott Morrison’s 1 per cent? Too bad for you

  • The Australian
  • May 10, 2016 12:00AM

Judith Sloan

One of the most idiotic and ill-judged statements in Scott Morrison’s budget speech was this: “The transfer balance cap, the lifetime non-concessional cap and the 30 per cent contributions tax will each affect less than 1 per cent of superannuation fund members.”
Doubling down on this mistake, the Treasurer went on to tell us that “a concessional contributions cap of $25,000 per annum will affect just 3 per cent of superannuation fund members, particularly those who pay the top rate of income tax”.
Now I’m not sure how these figures should be added up: is it 4 per cent in total? Of course, the Treasurer couldn’t be less interested in the answer because all he wants to do is get away with announcing bad policy that can be dressed up as “fair”, even if it’s nothing of the sort.
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Can Australia afford Morrison's super changes?

Analysis

The Federal Government's proposed changes to superannuation reduce incentives for people for fund their own retirements - and that could cost the country dearly, argues Andrea Michaels.
Andrea Michaels
Tuesday, May 10
For middle-income earners in their 50s and 60s, waking up last Wednesday morning to read about the budget – specifically the raft of superannuation changes – probably caused some indigestion over breakfast.
Between the usual headlines of ‘winners and losers’ (something the Treasurer had been at pains to avoid), it must have become clear that any plans to save for a comfortable retirement were looking shaky.
Tax experts wondered how much some of these super changes might actually cost the country in the longer term. Financial Services Council chief executive Sally Loane was quoted in The Australian Financial Review last week saying the test will be if we create more pensioners or more self-funded retirees. At this stage, it doesn’t seem like the last group will be the winners.
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Institute of Public Affairs plans aggressive superannuation campaign

Conservative think tank says its members are furious about 2016 budget changes limiting contributions and tax-free income.
Treasurer Scott Morrison and finance minister Mathias Cormann with the 2016 budget papers, which included new limits on tax-free income from superannuation. Photograph: Stefan Postles/Getty Images
The Institute of Public Affairs is preparing to run an aggressive public campaign against the Turnbull government’s superannuation changes similar in style to its anti-18C and climate change campaigns.
IPA executives held a meeting on Tuesday morning to plan their campaign, saying their members were furious at the raft of super reforms revealed in Scott Morrison’s budget.
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Federal Budget 2016: super tax hit seemed good idea at the time

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

Terry McCrann

Tinkering with superannuation pre-election was bad timing
The government’s — rather importantly, proposed — changes to superannuation are not retrospective. To claim they are requires a suspension of reason or a simple failure to understand the meaning of the word.
The proposed changes are certainly a direct breach of multiple promises by this government not to increase the taxation of superannuation. And worse, they are a major stupidity nestling within an even broader stupidity.
They are, quite simply, a total trainwreck. They have become Treasurer Scott Morrison’s deficit levy — a measure aimed only at the top end of town but stoking fear and loathing across Middle Australia.
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Super changes set to hit more than government suggests

  • James Kirby
  • The Australian
  • May 14, 2016 12:00AM
Scott Morrison has managed to pull off that rarest of political acts … he’s managed to upset just about everyone with his superannuation changes. But what really matters is that the Treasurer has not just upset, but embarrassed the nation’s wealth advisers and for that sin he will not be easily forgiven.
Investment is after all a matter of making plans and sticking to them, but now many plans are off … or at the very least in jeopardy.
As Will Hamilton of Hamilton Wealth Management puts it: “A blanket rule has been introduced which has produced extreme anger and an erosion of trust.”
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I look forward to comments on all this!
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David.

Wednesday, May 18, 2016

This Looks Like A Pretty Reasonable Suggestion To Me. The Issue Is Would Consumers Use A Register Like This.

The following appeared last week:

Online pharmacy “safe list” needed

Charlotte Mitchell
Monday, 9 May, 2016
WITH only a minority of online pharmacies considered legitimate, experts are now debating how to address the growing problem of substandard and counterfeit medications.
Dr Conor Hensey from the Department of General Medicine at the Royal Children’s Hospital in Melbourne told MJA InSight that Australia must set up a safe list of online pharmacies to help protect consumers from the dangers of counterfeit drugs.
“This way, consumers would have easy, reliable access to a list of authorised websites and be able to refer to this resource prior to purchasing medications online.”
“Globally, there are about 36 000 active internet pharmacies, of which less than 5% are estimated to be legitimate,” the authors wrote.
In Australia, the drugs bought online are often lifestyle medications targeted at weight loss, hair growth or erectile dysfunction.
“There have been recent reports in Australia of these medications being contaminated with sulfonylureas and sibutramine with significant adverse effects,” Dr Hensey and his coauthors wrote.
The authors urged Australians to be vigilant to the risk of unregulated online pharmacies, and to develop clear guidelines for monitoring, regulation and education.
A spokesperson for the Pharmacy Guild of Australia (PGA) told MJA InSight that they acknowledged the seriousness of the problem of counterfeit and substandard medicines at home and internationally.
“The World Health Organization estimates that up to 1% of medicines available in the developed world, and 10% globally, are likely to be counterfeit.
“The globalisation of markets has made the distribution of medicines easier, with people having direct access to medicines via the internet without the need for consultation with a health professional.”
More here:
There is some coverage from a pharmacy perspective here:

Online pharmacies: Australia needs ‘safe list’

Substandard and counterfeit medicines, and online pharmacies which aren’t legitimate, are a serious and growing problem, say experts.

Australia needs to set up a “safe list” of online pharmacies in a bid to protect consumers from potentially dangerous medicines, says Dr Conor Hensey from the Department of General Medicines at the Royal Children’s Hospital in Melbourne, in MJA InSight.
Dr Hensey says that this would allow consumers easy, reliable access to a list of authorised online pharmacies, which they could refer to before buying medicines online.
Dr Hensey co-authored a report published this week in the MJA, examining the Australian perspective on counterfeit drugs.
“In countries with stringent legislation, governance and customs, such as Australia, the prevalence of counterfeit medications is low and estimated by the World Health Organization to be less than 1% of market value,” he and co-author Amanda Gwee write.
“Substandard medications are a greater issue globally, with reduced efficacy and potential for contamination. All may have serious and unpredictable risks.”
Less than 5% of the world’s 36,000 active internet pharmacies are considered to be legitimate, they write.
In the US and European Union, consumers can access lists of authorised websites, such as LegitScript and the EU common logo. However, in Australia, there are no such protections.
Australia needs to take several steps to protect consumers, they write.
  • “All Australian online pharmacies should be accredited through the Quality Care Pharmacy Program. From this, the TGA in conjunction with the Pharmacy Guild of Australia should release a safe list of Australian online pharmacies.
  • Public awareness campaigns should utilise NPS MedicineWise and Australian “Prescriber — resources widely accessed by consumers, pharmacists and prescribers.
  • “The Australian Customs and Border Protection Service should continue to work with global agencies to optimise the identification of counterfeit medications.”
More here:
I have to say my feeling is that most people who are going online overseas for medicines (other than those seeking treatments for things like cancer which are not available in Australia) should really be discouraged from doing so as the risks of getting fakes etc. are just too high. You can see just how many fake suppliers there are simply by looking at the e-mails caught by your spam filter.
In Australia there are some reputable suppliers of licenced medicines and there is no reason the Therapeutic Good Administration (TGA) should not maintain an on-line list.
I find it just too silly that the TGA says it is a State problem and that they can’t regulate or help. Grow up guys!
David.

Tuesday, May 17, 2016

This Is A Rather Ominous Report With The Same Story Also Happening Globally.

This appeared last week:

Australian health sector an easy target for cyber criminals, says IBM

A push to encourage greater adoption of electronic health records has raised the spectre of online record theft

According to IBM’s 2016 Cyber Security Intelligence Index, there has been a clear shift recently in online targets, essentially away from credit cards and toward health-related data.
IBM has worked with small suburban medical and dental centres in Australia, which have become a particular target for ransomware.
Glen Gooding, an executive from IBM’s Security Services (ANZ), said health records were “an important way to extract money by taking on the persona of someone else”.
He added health-focused organisations were often an easier target than financial sector businesses, many of which have implemented more robust information protection systems.
“In the local medical clinic there’s usually not a large IT component, and there’s a lack of skills. They are an easy target,” said Gooding.
Moreover, there’s going to be a whole lot more such targets as both federal and state authorities ramp up initiatives to encourage the creation of online health records.
The federal scheme, originally dubbed the Personally Controlled Electronic Health Record, has been renamed MyHealth. Currently an opt-in regime, 2.7 million people now have a MyHealth record, but the federal government expects its opt-out trials now underway will net another one million.
Australia’s May budget earmarked A$156m for the Australian Digital Health Agency, which starts operations in July and is charged with encouraging the uptake and use of online health records, and also for managing their security.
While the central database may be locked down, the access points are widespread, and security education will be essential to ensure health records aren’t leaked from the 8,400 connected healthcare entities now using the system, including GPs, hospitals, pharmacies and residential services for the elderly.

Read more about cyber security in Australia:

More here:
In the same week we see this from the US:

Ponemon Institute: Poor state of healthcare cybersecurity causing industry finger pointing

May 12, 2016 | By Susan D. Hall
Criminal attacks continue to be the leading cause of data breaches in healthcare, with ransomware the latest threat, according to a new privacy and security survey conducted by the Ponemon Institute.
The study estimates the cost of breaches for the healthcare industry to be $6.2 billion, with the average cost to an individual organization at $2.2 million. For business associates the cost is more than $1 million. Nearly 90 percent of responding organizations said they experienced a data breach in the past two years, and 45 percent had more than five, though many of those were small incidents.
Ransomware, malware, and denial-of-service (DOS) attacks are the top cyberthreats that healthcare organizations face, the report notes, though they're also concerned about employee negligence, mobile device insecurity and use of public cloud services.
At the same time, organizations don't feel adequately prepared to deal with breaches.
FierceHealthIT spoke with Larry Ponemon, chairman and founder of the Ponemon Institute, and Rick Kam, president and cofounder of ID Experts, which sponsored the report, about the implications of the survey.
FierceHealthIT: These results sounds like what we've been hearing over and over. Is there anything new or surprising?
Kam : It's more of the same. Last year criminal attacks were on the rise. Healthcare data has high value. The thing I find surprising is that Larry has been doing this study for six years now, and we've got the same problems cropping up. Why is that?
One of the nuances that came out of this study is that it seems there's some finger-pointing on among players in the healthcare ecosystem. Healthcare entities are pointing fingers at business associates and business associates are doing the same thing back to covered entities.
In my mind, it boils down to the issue of accountability. Someone has to take responsibility to make sure risk assessments are done and there has to be follow-through on the appropriate investments to make sure data is secure. Organizations are making investments, but they seem not to be making them in a way that's reducing the problem. So there's a problem somewhere.
Lots more here:
I have to say, realistically, it is really a matter of time rather than if, information in the myHR is compromised. It is a great pity the system is not much more distributed to avoid the large single database risk.
Time will tell, but we all need to be careful in the area of patient sensitive information.
David.

Monday, May 16, 2016

Weekly Australian Health IT Links – 16th 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

A very quiet week indeed with possibly the biggest news being the formal announcement of the ADHA start date and the WA budget finding a little funding for e-Health in a very tough Budget.
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Cash-strapped WA govt finds $60m for e-health

Revenue drop devastates in the west.

By Paris Cowan
May 13 2016 6:31AM
The WA government has managed to scrape together roughly $60 million for e-health projects and another $13.7 million to upgrade its licensing and registration database in a budget described as the toughest the state has ever seen.
The state government has seen its revenue fall 22 percent since 2014-15 due to the drop in commodity prices coupled with reductions in GST income.
It is facing a debt balance close to $40 billion and no prospect of a return to surplus until 2019-20.
But it has still managed to gather together some modest funding for its struggling IT functions.
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Australian health sector an easy target for cyber criminals, says IBM

A push to encourage greater adoption of electronic health records has raised the spectre of online record theft

According to IBM’s 2016 Cyber Security Intelligence Index, there has been a clear shift recently in online targets, essentially away from credit cards and toward health-related data.
IBM has worked with small suburban medical and dental centres in Australia, which have become a particular target for ransomware.
Glen Gooding, an executive from IBM’s Security Services (ANZ), said health records were “an important way to extract money by taking on the persona of someone else”.
He added health-focused organisations were often an easier target than financial sector businesses, many of which have implemented more robust information protection systems.
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Online pharmacy “safe list” needed

Charlotte Mitchell
Monday, 9 May, 2016
WITH only a minority of online pharmacies considered legitimate, experts are now debating how to address the growing problem of substandard and counterfeit medications.
Dr Conor Hensey from the Department of General Medicine at the Royal Children’s Hospital in Melbourne told MJA InSight that Australia must set up a safe list of online pharmacies to help protect consumers from the dangers of counterfeit drugs.
“This way, consumers would have easy, reliable access to a list of authorised websites and be able to refer to this resource prior to purchasing medications online.”
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Online pharmacies: Australia needs ‘safe list’

Substandard and counterfeit medicines, and online pharmacies which aren’t legitimate, are a serious and growing problem, say experts.

Australia needs to set up a “safe list” of online pharmacies in a bid to protect consumers from potentially dangerous medicines, says Dr Conor Hensey from the Department of General Medicines at the Royal Children’s Hospital in Melbourne, in MJA InSight.
Dr Hensey says that this would allow consumers easy, reliable access to a list of authorised online pharmacies, which they could refer to before buying medicines online.
Dr Hensey co-authored a report published this week in the MJA, examining the Australian perspective on counterfeit drugs.
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Public Governance, Performance and Accountability (Establishing the Australian Digital Health Agency) Transfer Day Notice 2016

I, Sussan Ley, Minister for Health, specify that, under subsection 73(1) of the Public Governance, Performance and Accountability (Establishing the Australian Digital Health Agency) Rule 2016 (the Rule), the day to be the transfer day for the purposes of Part 11 of the Rule is 1 July 2016.
Dated   5 May    2016
SUSSAN LEY
Health Minister
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Vic govt's new strategy hopes to end IT project woes

Will it be enough?

By Paris Cowan
May 12 2016 12:32PM
The Victorian government is hoping a transparent IT projects dashboard, a technology education program for executives, and an army of independent auditors will protect it from future embarrassing and expensive technology catastrophes.
Special Minister for State Gavin Jennings today unveiled the Victorian Labor government’s first whole-of-government IT strategy, focused on open data, shared solutions and rebuilding the state’s internal technology skills.
Implicit in the plan is an infamous track record of IT failures in a particularly disaster-prone public service.
Most recently, former officials of the Department of Education have been dragged to the state’s corruption watchdog over serious allegations of mismanagement and conflicts of interest behind the $180 million Ultranet schools intranet scheme.
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GuildCare announces new Telehealth Module

Pharmacy Telemedicine has arrived: in a joint initiative by the Pharmacy Guild of Australia and Telstra Health, pharmacy customers can now access a GP conveniently from their local community pharmacy.

ReadyCare is a purpose-built telemedicine service where pharmacy customers can talk to a doctor in Australia by phone or video 24/7.
ReadyCare is not about a pharmacy competing with local GP services – it is about community pharmacies facilitating access to a quality telemedicine service at times and in areas where a patient’s access to local GP services are limited or not available.
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Report suspected fraud, misconduct or non-compliance

Fraud against government programmes and business disadvantages Australians who rely on the effective and efficient delivery of services.
Page last updated: 28 January 2016
The Australian Government Department of Health is committed to preventing the occurrence of fraud in all areas of business administered by the Department. A robust fraud control environment supports the aim of the Department in creating better health and wellbeing for all Australians.
The following section provides information on raising concerns with the Department about our programmes, with links to the appropriate resources for submitting your tip-off information.
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News in brief

Monday, 9 May, 2016
The role of the doctor as an expensive problem-solver may become redundant in the future, according to health experts commenting in the New Zealand Medical Journal. The authors believe that over the coming years, artificial intelligence (AI) will diagnose most health problems and even decide what treatment the patient should have. The health experts say that humans would continue to be an important part of health care delivery, but in many situations they would only be trained to fill the gaps where artificial intelligence is less capable. “Human doctors make errors simply because they are human, with an estimated 400 000 deaths associated with preventable harm in the US per year,” the authors wrote. “Furthermore, the relentless growth of first world health care demands in an economically-constrained environment necessitates a new solution. Therefore, for a safe, sustainable health care system, we need to look beyond human potential towards innovative solutions such as AI. Initially, this will involve using task-specific AI as adjuncts to improve human performance, with the role of the doctor remaining largely unchanged. However, in the longer term, AI should consistently outperform doctors in most cognitive tasks. Humans will still be an important part of health care delivery, but in many situations less expensive, fit-for-purpose clinicians will assume this role, leaving the majority of doctors without employment in the role that they were trained to undertake.”
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Latest technology news across the sector

In this wrap:
  • NSW Government announces eHealth strategy
  • South Australia’s Clevertar begins diabetes trials in the US
  • Australian startup CliniCloud partners with American telehealth provider

NSW Government announces eHealth strategy

At last week’s CeBIT Australia conference NSW Minister for Health Jillian Skinner announced the state’s eHealth strategy for the next decade.
The strategy will see a digitally enabled and integrated health system, with a focus on delivering patient-centred health experiences with quality health outcomes, and builds on the government’s existing blueprint.
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A go-to app for kidney disease

9 May 2016
CKD-Go! was created by Dr Priyanka Sagar and Dr Angus Ritchie of Concord Repatri­ation General Hospital, Sydney, and draws information from the handbook Chronic Kidney Disease Management in General Practice, produced by Kidney Health Australia. 
Opening the app, the user sees a home menu offering a ‘CKD calculator’ or ‘more information’. The calculator allows development of a personalised action plan based on a patient’s eGFR and urine albumin:creatinine ratio. Entering these details stratifies risk and includes prompts for absolute cardiac risk calculation, lifestyle modification, blood pressure monitoring, etc. 
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MEDIA RELEASE
For immediate release

Red Cross releases new app to protect its life-saving emblems

A new phone app has been released to help protect the life-saving red cross emblem from illegal use.
“Red Cross is releasing The Emblem App on World Red Cross Red Crescent Day to remind people that a red cross on a white background means ‘don’t shoot’ in war and armed conflicts. It shows that impartial help is available for anyone who needs it,” said Judy Slatyer, CEO of Australian Red Cross.
“This app gives the Australian community the ability to safeguard the red cross emblem by reporting misuse. Every time the red cross is misused, even by mistake, its real meaning is diluted and this can cost lives.
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Making sense of consent and health records in the digital age

May 8, 2016
There are few more potent touchstones for the public than the protection of their privacy, and this is especially true with our health records. Within these documents lies information that may affect your loved ones, your social standing, employability, and the way insurance companies rate your risk.
We now live in a world where our medical records are digitised. In many nations that information is also moving away from the clinician who captured the record to regional repositories, or even government run national repositories.
The more widely accessible our records are the more likely it is that someone who needs to care for us can access them – which is good. It is also more likely that the information will might seen by individuals whom we do not know, and for purposes we would not agree with – which is the bad side of the story.
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Claims budget cuts undermine effectiveness of Privacy Commissioner

Savage funding cuts to the Office of the Australian Information Commissioner (OAIC) have undermined the ability for the Privacy Commissioner do his job effectively, according to the Australian Privacy Foundation (APF).
The APF warns that the “long delays” in the handling of privacy complaints, and the large backlog of unresolved matters, have earned the OAIC a poor reputation – “and now it will get worse”.
Under the Federal Government’s Budget announced on Tuesday, the APF says funding for the OAIC had been slashed and “resources that should be spent on privacy will now be burnt on FOI matters”.
As the APF points out, the cuts in the OAIC’s budget come despite the fact that when the OAIC was created in 2010, it was given less funding than had been originally indicated.
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Privacy concerns in the healthcare sector

Australia May 4 2016
The past few years have seen multiple “privacy insurance” policies come on to the Australian market, with policies tailored to the needs of both SMEs and large corporates. The healthcare sector is at particular risk of privacy breaches and resultant regulatory action and claims, but it is not clear that this has led to an increased uptake of privacy insurance policies in the sector.
Insureds operating in the health sector tend to hold highly-sensitive personal information. They are also subject to onerous regulation.
Their employees, however, fear that their privacy protections are not up to the task. A 2010 US benchmark study on patient privacy and data security by Ponemon Institute found the three key causes for privacy breaches were:
  • Unintentional employee action;
  • Lost or stolen computing devices; and
  • Third-party errors.
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GPs to take their privacy medicine

Australia’s family doctors are to improve their privacy practices following an assessment by the Office of the Australian Information Commissioner (OAIC) that found that many practices could be improved.
According to Acting Australian Information Commissioner, Timothy Pilgrim, the nation’s peak medical groups have lined up to support OAIC in improving the privacy practices in general practitioner (GP) clinics.
Mr Pilgrim said he appreciated that many GP practices were small to medium-sized businesses and so practical, industry-relevant support was an effective way to improve privacy outcomes for practices and patients.
“I welcome the fact that the Australian Medical Association (AMA), the Royal Australian College of General Practitioners (RACGP), the Australian College of Rural and Remote Medicine and the Australian Association of Practice Management have come together with the OAIC to provide practical support to their members to deliver open and transparent privacy policy.
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Here's how to stop Google seeing your private medical history

May 4, 2016, 7:22 PM
Last week, New Scientist reported that the NHS has given Google access to approximately 1.6 million patient records in order to help the internet giant develop an app to monitor possible kidney failure.
The data includes the names and medical histories of every patient who has stayed in Royal Free, Barnet and Chase Farm hospitals in London overnight or attended A&E in the last five years.
If you’re one of those people and you’re not comfortable with Google having access to your patient records then by law you have the option to opt out.
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Enjoy!
David.

This Might Be A Wild Guess But I Suspect ADHA Has An Interim CEO.

From this it rather looks like Mr Richard Royle is in place until 30/11/2016.

Australian Digital Health Agency 




The Australian Digital Health Agency is part of the Health portfolio, and functions in an executive management capacity. 
 
The Australian Digital Health Agency (the Agency) is governed by a skills-based Board which will be responsible for deciding the Agency’s objectives, policies and strategies, and for ensuring the proper and efficient performance of the Agency’s functions. The Agency is the single accountable organisation for national digital health systems in Australia.
Location: 
ACT
Email: 

Current board appointments


Position
Appointee
Gender
Start date
End date
Chairperson
Mr James Birch
Male
20/04/2016
20/04/2019
Member
Mr Robert Bransby
Male
20/04/2016
20/04/2019
Member
Prof Johanna Westbrook
Female
20/04/2016
20/04/2019
Member
Mr Michael Walsh
Male
20/04/2016
20/04/2017
Member
Dr Bennie Ng
Female
20/04/2016
20/04/2019
Member
Ms Stephanie Newell
Female
20/04/2016
20/04/2019
Member
Mr Stephen Moo
Male
20/04/2016
20/04/2017
Member
Ms Lyn McGrath
Female
20/04/2016
20/04/2019
Member
Mr Paul Madden
Male
20/04/2016
20/04/2019
Member
Dr Elizabeth Deveny
Female
20/04/2016
20/04/2019
Member
Dr Eleanor Chew
Female
20/04/2016
20/04/2019
CEO/Executive Director/Managing Director
Mr Richard Royle
Male
04/05/2016
30/11/2016
Here is the link:
The dates for the apparent CEO role seem to run from just before the Caretaker Convention took hold and runs for about six months. I wonder what Mr Moo and Mr Walsh did to only get one year appointments?
Looks like they (the Board) struggled to find a full-time CEO. Maybe no one really wanted to take it on with the smell of death around the myHR?
Any other clever explanatory  ideas welcome!
David.

Sunday, May 15, 2016

Enrico Coiera Discusses The Consent Models In The Era Of Digital Health Records.

This appeared as a blog last week:

Making sense of consent and health records in the digital age

May 8, 2016
There are few more potent touchstones for the public than the protection of their privacy, and this is especially true with our health records. Within these documents lies information that may affect your loved ones, your social standing, employability, and the way insurance companies rate your risk.
We now live in a world where our medical records are digitised. In many nations that information is also moving away from the clinician who captured the record to regional repositories, or even government run national repositories.
The more widely accessible our records are the more likely it is that someone who needs to care for us can access them – which is good. It is also more likely that the information will might seen by individuals whom we do not know, and for purposes we would not agree with – which is the bad side of the story.
It appears that there is no easy way to balance privacy with access – any record system represents a series of compromises in design and operation that leave the privacy wishes of some unmet, and the clinical needs of others ignored.
Core to this trade-off is the choice of consent model. Patients typically need to provide their consent for their health records to be seen by others, and this legal obligation continues in the digital world.
Patient consent for others to access their digital clinical records, or e-consent, can take a number of forms. Back 2004, working with colleagues who had expertise in privacy and security, we first described the continuum of choices between patients opting in or out of consent to view their health records, as well as the trade-offs that were associated with either choice [1].
Three broad approaches to e-consent are employed.
  1. “Opt Out” systems; in which a population is informed that unless individuals request otherwise, their records will be made available to be shared.
  2. “Opt in” systems; in which patients are asked to confirm that they are happy for their records to be made available when clinicians wish to view them.
  3. Hybrid consent models that combine an implied consent for records to be made available and an explicit consent to view.
Opt in models assume that only those who specifically give consent will allow their health records to be visible to others, and opt out models assume that record accessibility is the default, and will only be removed if a patient actively opts-out of the process. The opt-out models maximises ease of access to, and benefit from, electronic records for clinical decision making, at the possible expense of patient privacy protections. Opt-in models have the reverse benefit, maximising consumer choice and privacy, but at the possible expense of record availability and usefulness in support of making decisions (Figure 1).
There is much more to be read here:
The last two paragraphs seems to cover a lot of ground. To quote:
“So, whilst we need to be clear about the risks opt in versus opt out, we should also recognise that it is only half of the debate. It is the mechanism of governance around the consent model that counts at least as much.
For consumer advocates, “winning the war” to go opt-in is actually just the first part of the battle. Indeed, it might even be the wrong battle to be fighting. It might be even more important to ensure that there is stringent governance around record access, and that it is very clear who is reading a record, and why.”
In reading the article I think the thing that is missing is the recognition of the importance of individual attitudes and history in all this and in the debate about what consent model is appropriate.
Many individuals have widely divergent life stories and these stories and their life experience can have a major impact on their comfort with a consent model and their preferences.
Individuals also vary greatly in their attitudes to disclosure of, and trust with, their personal information with some adopting a highly disclosive approach and others the reverse - often related to their individual experiences and illnesses.
Taken overall, and recognising the critical importance of governance and technical security, I think it unlikely agreement is ever likely to be reached unless we can properly response in the individual’s level of trust, personality and the risk of discrimination, shaming and embarrassment should their information be disclosed.
Given the importance of the proper protection of information the individual wants to keep to themselves, we need to develop systems that meet these needs.
David.

AusHealthIT Poll Number 320 – Results – 15th May, 2016.

Here are the results of the poll.

How Satisfied Are You With The Recent Federal Budget As Far As Health Funding Is Concerned?

Very Satisfied 1% (1)

Neutral 25% (29)

Not Satisfied At All 63% (72)

I Have No Idea 11% (13)

Total votes: 115

Pretty clear outcome and a vote of no-confidence in the Budget as far as health is concerned.

Great turnout of votes as well!

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

David.