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, June 09, 2016

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

June 09  Edition
With the Budget on May 3 now almost forgotten we are now off and rolling in the election campaign. We are seeing a lot of promises with Health from Labor with Medicare well and truly in focus. Also the traditional divide in areas of concern are being emphasised
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 - and seemingly getting tighter, with some recent ones even suggesting Labor might win.
I also note concerns on economic growth,  the changes to superannuation as well as continuing cuts in other areas. It will be a while yet before it is clear just what the final outcomes of policy in both parties will be.
In the middle of the election campaign it is inevitable there is more commentary on the issue.
Globally there seems to be increasing worry  about the global economy.

Bill Gross: Get ready for an 'entirely different' market

Thursday, 2 Jun 2016 | 5:30 PM ET
Gross: Stellar returns of last 40 years won’t repeat - Janus portfolio manager Bill Gross discusses his investment playbook and outlook for the markets
Bill Gross has some bad news for investors.
In his June investment outlook released Thursday, the widely followed bond fund manager contended that bond and stock returns realized in the last 40 years are "a grey if not black swan event that cannot be repeated." Investors should not expect 7 percent returns on bonds or returns in the high single digits or double digits on stocks, Gross told CNBC on Thursday.
"The markets are entirely different and it would pay to travel to Mars as opposed to stay on Earth, because the returns here are very, very low," the manager of the Janus Capital Unconstrained Bond Fund, said on CNBC's "Power Lunch".
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Not sounding all that good…..

General Budget Issues.

Election 2016: Scott Morrison moves to head off economic growth fears

Date May 30, 2016 - 6:00PM

James Massola

Chief Political Reporter

Treasurer Scott Morrison has moved to pre-empt concerns about a potential slow-down in economic growth figures that will be released in Wednesday's national accounts.
And he has lashed Opposition Leader Bill Shorten's class warfare attack on a tax cut for big banks and big business in the Sunday night's election debate, describing it as a "retro ideological frolic" and cynical politics designed to play to the Labor base.
The Treasurer stressed he was not "commentating on the markets" but pointed out market expectations were that as the March 2015 growth figure of 0.9 per cent dropped out, it would be replaced by a figure of about 0.6 per cent growth for the March 2016 quarter and GDP growth of 2.7 per cent for the year to March, down from 3 per cent.
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  • May 30 2016 at 11:45 PM
  • Updated May 31 2016 at 7:45 AM

Election 2016: Scott Morrison says economy too fragile for Labor return

Treasurer Scott Morrison is ramping up attacks on Labor's opposition to corporate tax cuts in anticipation figures this week will show economic growth slowed last quarter.
Speaking after profits from mining to manufacturing and property services tanked by almost 5 per cent in the March quarter - escalating concerns about the sustainability of share investor dividend expectations - Mr Morrison indicated Wednesday' s national accounts were likely to underscore the economy's fragility.
"This is a very sensitive time for the Australian economy," he said in an interview. "Wherever the figures land, the policy objective doesn't change - and that's about securing growth in this economy. You can't increase investment by taxing it more."
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Federal election 2016: Scott Morrison steps up company tax pitch

  • The Australian
  • 12:00AM May 31, 2016

David Uren

David Crowe

Treasurer Scott Morrison says he believed people were ‘very alive’ to the global challenges.
Scott Morrison has redoubled his argument for $48.2 billion in ­company tax cuts to ward off a business slowdown, as the ­government braces for weaker growth in tomorrow’s national ­accounts, intensifying the election fight with Labor over economic management.
The Treasurer expressed concern at a fall in company profits just as Labor stepped up its attack on the ambitious tax cuts for generating an economic gain that was too small and took too long to create more jobs. Labor Treasury spokesman Chris Bowen is blaming the Coalition for a 26 per cent fall in private investment since the last election and dismissing the company tax cut for adding “a tiny 0.1 per cent” to the nation’s economic output every year.
Mr Morrison took on critics of the tax cut by insisting the government would fight for “every inch of growth” and voters should not trust Labor or others who rejected a proven option to expand the economy. “I think we’re being very honest with people, I think we’re being incredibly honest,” he told The Australian. “We’re saying it’s a tough economy out there.”
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The reality of post-China resources boom is good, bad and ugly

May 31, 2016 10:00pm
Terry McCrann Herald Sun
THE trade and current account deficit figures yesterday and the GDP ones today will combine to lay out with brutal clarity our post-China resources boom reality. The good, the bad and the ugly.
They will also serve to emphatically reinforce the two-tier message that Treasurer Scott Morrison has been trying to get across since budget night — an effort, which he has stepped up this week in anticipation of these critical figures.
The first and in a broad sense the overlaying element of the message is the absolutely fundamental need to encourage business — small, big and wicked multinational all — to invest and keep investing in Australia. Not just for one year or even one decade, but for decades.
Business — again, whether big or small, local or foreign — needs two things fundamentally, to embark on such long-term financial commitments. The first is a welcoming investment environment; the second is some confidence in sustained stability of both government policy and political governance.
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  • Jun 1 2016 at 11:45 PM

Election 2016: Company tax cuts will struggle to pass Senate

The federal government's 10-year plan to cut the company tax rate to 25 per cent will struggle to pass the Senate if the Coalition wins the election, with all those likely to hold the balance of power opposed to some or all of the package.
As the government used better-than-expected economic growth numbers to argue the tax cuts were needed to shore up an underlying weakness in the domestic economy, the Greens confirmed their opposition to the entirety of the tax cuts with the release of costings by the Parliamentary Budget Office which estimated the cost of the cuts over a decade would be $51 billion.
While just $3 billion different from the $48.2 billion Treasury estimated for the government, Greens treasury spokesman Adam Bandt, who commissioned the PBO modelling, called it "a death blow to the argument that company tax cuts are affordable".
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Higher Australian household debt mounts to ‘unsustainable’ levels

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

Adam Creighton

“If something cannot go on forever, it will stop,” said Herbert Stein, economic adviser to presidents Nixon and Ford. Stein was mocking concerns about the ­“unsustainable” US current ­account and budget deficits in the late 1980s. He had a point, both grew much larger.
Calling things unsustainable is often a cover for expressing disapproval for other reasons. The federal budget has been in surplus in fewer than 20 of the 116 years since Federation, so deficits are clearly sustainable. What isn’t sustainable is a rising stock of public debt (and interest payments) as a share of national income.
Both main political parties are rightly and routinely admonished for doing little to stem the rising tide of federal and state government debt, which has tripled to about 34 per cent of GDP over the past 10 years. But the spectacular ascent of private debt, which has doubled to about 160 per cent of GDP over the past 20 years, hasn’t rated a mention by either side of politics in this election.
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Health Budget Issues.

Dr Michael Gannon named new Australian Medical Association president

Date May 29, 2016 - 2:41PM

Jane Lee

Legal affairs, health and science reporter

The Australian Medical Association's new president has vowed to repair the group's relationship with government, which he says has been partly damaged by speaking out on asylum seekers.
Western Australian obstetrician and gynaecologist Dr Michael Gannon -  who counts Coalition MPs among his friends - pledged to work "constructively" with whichever party formed government, shortly after he won the association's election at its national conference in Canberra on Sunday. 
The doctors' union has lobbied against a range of Coalition policies under outgoing president Associate Professor Brian Owler, including its failed $7 GP co-payment and abandoned hospital funding formula. It recently launched a public campaign against the Turnbull government's extended freeze on Medicare rebates to 2020, warning patients this could lead to GPs charging a co-payment of up to $20.
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AMA seeks to close political wounds with election of Michael Gannon as president

May 29, 2016 12:54pm
Sue Dunlevy National Health Reporter News Corp Australia Network
IT’S precisely the medical relief the Prime Minister needed — the doctors’ lobby has elected a new president who says he wants to work more closely with the Federal Government.
As the Royal Australian College of General Practitioners today launches television ads against the six-year freeze on Medicare rebates, its sister organisation the Australian Medical Association has elected a new president who has boasted of his close relationship with Coalition ministers.
West Australian obstetrician Michael Gannon told News Corp Australia earlier this year he wants to the AMA to work more closely with the government and said he thought the previous AMA leadership was too lefty.
Dr Gannon is a personal friend of Assistant Minister for Health Ken Wyatt and says he knows Finance Minister Mathias Cormann socially and he wants the AMA needs to rebuild its relationship with the Coalition Government.
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'GPs are at breaking point': new AMA president vows to fight Medicare freeze

Michael Gannon, who had previously said the AMA was becoming too left wing, says the six-year freeze is ‘unfair’ and ‘wrong’
The new AMA president, Dr Michael Gannon, says the freeze on indexation for Medicare rebates until 2019-20, announced in the budget, reflects ‘continued under-investment in general practice’. Photograph: Mick Tsikas/EPA
The new head of the Australian Medical Association has said fighting the Coalition’s “unfair” and “wrong” six-year Medicare freeze is his highest priority in his new post.
West Australian obstetrician Dr Michael Gannon, appointed to a two-year term as AMA president at the organisation’s national conference on Sunday, said general practitioners could not endure more restrictions imposed upon their working conditions.
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Labor prescribes healthcare reform

The Opposition Labor Party has promised to establish an Australian Healthcare Reform Commission to guide the continuous improvement of the nation’s healthcare system if elected at the 2 July Federal poll.
Opposition Spokesperson on Health, Catherine King announced the plan, saying a new Centre for Medicare and Healthcare System Innovation would also be established to develop, trial, evaluate and implement new payment and service delivery models to reduce health expenditure while improving the quality and safety of care.
“Much like the successful National Health and Hospitals Commission, the new Commission will have a key advisory role,” Ms King said.
“It will investigate, develop and evaluate proposed changes to Australia’s health system, and advise Governments — including State and Territory governments — on these changes.”
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Federal election 2016: doctor glut to blow out Medicare costs

  • The Australian
  • 12:00AM June 1, 2016

Adam Creighton

Growth in GP numbers of ­almost 50 per cent over the past decade — 2.5 times population growth — has undermined doctors’ ability to charge fees above the Medicare Benefits Schedule.
A growing glut of doctors has forced GPs to “chase patients” and pushed bulk-billing rates to record highs, leaving Medicare vulnerable to overuse that will add to its projected cost blowout of more than $35 billion within a decade.
Growth in GP numbers of ­almost 50 per cent over the past decade — 2.5 times population growth — has undermined doctors’ ability to charge fees above the Medicare Benefits Schedule, according to Australian Population Research Institute analysis.
The findings cast doubt on Labor’s and doctors’ claims that the Coalition’s plan to freeze the MBS for a further two years until 2020, to save $925 million, would hit bulk-billing rates. “There are so many GPs seeking patients that few could risk charging a co-payment because patients would go around the corner to a competitor who bulk bills,” said report author Bob Birrell. “Oversupply is the cause of escalation of GP costs that the Coalition is trying to curtail. But freezing the rebate is just a Band-Aid.”
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Soaring demand for after-hours GPs ‘open to abuse’

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

Sean Parnell

Growth in “urgent” after-hours home doctor visits has prompted a leading provider to call for greater monitoring to prevent operators ripping off Medicare or allowing patients to abuse the ­system.
The number of services — funded through higher than normal Medicare rebates and usually bulk-billed — has doubled in just four years, from 733,685 in 2010-2011 to 1,475,547 last financial year, when it cost Medicare about $200 million.
Non-urgent after-hours visits increased in the same period, ­albeit only to 310,948, whereas standard-hours home visits declined, from 1,288,377 to 1,176,724, continuing a downward trend.
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Superannuation Issues.

Federal election 2016: Turnbull takes sting out of super

  • The Australian
  • 12:00AM May 30, 2016

David Crowe

Sid Maher

A clash over superannuation sharpened the election fight last night as Malcolm Turnbull promised voters there would be no further changes to the system after the controversial reforms in this month’s budget while Bill Shorten attacked the “poison” of retrospective tax laws.
Mr Turnbull used a televised debate with Mr Shorten to assure Australians that a Coalition government would not go beyond the super tax increases now before the public, while attempting to highlight sweeteners in the package that help women and those on low incomes.
In a debate that lacked fireworks and showed both men relying on prepared lines, the two leaders refused to accept that the other would have a mandate in power — highlighting the risk of a deadlock in the Senate under a Coalition or a Labor election ­victory.
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Coalition blind to superannuation debacle

  • The Australian
  • 12:00AM June 1, 2016

Glenda Korporaal

Watching Foreign Minister Julie Bishop’s grilling on Neil Mitchell’s program on radio 3AW yesterday on the Coalition’s proposed superannuation changes was painful.
It was patently clear that one of the government’s most senior and experienced members did not know what the transition to retirement scheme was and did not understand the impact of the proposed $1.6 million cap on
tax-free super.
Challenged on the fact that many more people would be affected by the sweeping super changes proposed on budget night than the 4 per cent the Treasurer declared, Bishop could only answer that this was the number given to her by the Treasury in a “briefing”.
Several weeks after the budget it is clear that senior members of the government either don’t know or don’t want to know the true impact of the changes on super.
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Super stoush could cost Coalition the election

  • The Australian
  • 10:57AM June 1, 2016

Robert Gottliebsen

One of the great dangers that governments in Australia face is that many in Treasury hate superannuation and don’t have a deep understanding of how it works in the lives of ordinary Australians.
Accordingly, the department led Treasurer Scott Morrison into claiming that only 4 per cent of Australians would be affected by the superannuation changes proposed in the budget.
The first person who can loosely be described as being ‘on the government’s side’ to raise the alarm was Tony Abbott’s former chief of staff Peta Credlin. She emphatically told Andrew Bolt that once the public understood the superannuation changes, the government would be forced to modify them as the election approached.
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Federal election 2016: Kelly O’Dwyer explains superannuation

  • The Australian
  • 9:57AM June 1, 2016

Rachel Baxendale

Assistant Treasurer and Minister for Small Business Kelly O'Dwyer is delighted to explain the Coalition’s superannuation policy.
Assistant Treasurer Kelly O’Dwyer has declined to directly comment on Peta Credlin’s declaration that she has been “completely absent from the campaign” and has not articulated the government’s superannuation policy sufficiently.
Ms O’Dwyer said she was not going to “commentate on a commentator”, but that she was delighted to be on ABC RN Breakfast radio earlier this morning.
“This is the first invitation I’ve received to be on your show to talk about superannuation, and I’ve actually been spending a lot of time travelling around the country talking to people about our small business tax cuts and superannuation policy,” Ms O’Dwyer told host Fran Kelly.
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  • Jun 1 2016 at 5:42 PM

Election 2016: Super tangle ensnares the government

Malcolm Turnbull won't be happy his enthusiasm about an economy in transition is being overwhelmed by arguments about "transition to retirement" and the government's other changes to superannuation.
So instead of being able to celebrate better than expected growth figures as confirming its "economic plan", Coalition messaging keeps being diverted by the antagonism, mainly from its own supporters, to its plan for super.
That leaves the Treasurer and the Prime Minister belatedly trying to refine their big super sell to emphasise such changes will help pay for those who will supposedly benefit from making the system "fairer".  
According to the government's list, that includes women with more flexible arrangements, lower income earners who get a tax credit and people over 65 who can now keep contributing.
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  • Jun 1 2016 at 6:36 PM

Not just wealthy hit by pension crackdown, say super experts

Superannuation experts warn a planned crackdown on transition-to-retirement pensions will hurt middle-income savers and burden the industry. 
Transition-to-retirement pensions are in the spotlight after Foreign Minister Julie Bishop was unable to explain incoming changes to the scheme during a radio interview with 3AW's Neil Mitchell his week. 
The scheme was designed to allow individuals aged 56-65 to wind back their work hours while maintaining their income levels. Under the current system transition-to-retirement pensions are tax free, but the government has said it will levy a 15 per cent tax on the earnings from July 1, 2017.
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Superannuation changes 'confusing seniors'

June 2, 20168:28am
AAP
Seniors are confused - and some are outraged - at the federal government's superannuation changes.
The issue has been put in the spotlight with some coalition MPs admitting they are receiving concerns from voters and will be seeking further consultation on the budget measures should they win the July 2 election.
"We accept that there is a need for some reform ... but I don't think it has been well sold and that's really fed into this whole area of people now resisting, I suspect, the importance of reform," National Seniors Australia chief executive Michael O'Neill told ABC radio.
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A fix for the Coalition’s super mess

  • The Australian
  • 9:38AM June 2, 2016

Robert Gottliebsen

From what I am hearing, the protests from Coalition members over changes to superannuation are far more vicious and widespread than what is being described in the media.
And so they should be.
The Coalition is still telling half-truths and untruths about some of the changes it proposes to make to super.
Indeed, almost every time a minister speaks on the subject the government digs a deeper superannuation hole.
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Impacts of the 2016 Budget superannuation measures

2 June 2016 Industry Expert |
Catherine Chivers looks at the key changes and potential Budget 2016 impacts on superannuation and taxation of small businesses.
On Tuesday 3 May 2016, Treasurer Morrison handed down his inaugural Federal Budget plan which was focussed on "growing jobs and supporting small business sustainably".
From a financial planning perspective, key measures involve changes to superannuation and taxation of small businesses. As expected, there will be a mixed series of impacts for clients, especially within the superannuation space.
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I look forward to comments on all this!
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David.

Oh Dear! It Seems Another State Health System Is Running Into Implementation Problems.

This appeared last week:

Doctors warn of budget blowout due to dodgy software program at Cairns Hospital

May 29, 2016 5:00am
Daniel Bateman The Cairns Post
SENIOR doctors have warned of a budget crisis developing at Cairns Hospital, with health bosses asking them to no longer use pens, and to switch off lights in unused rooms.
The Cairns and Hinterland Hospital and Health Service has confirmed it is facing a “modest” deficit by the end of the financial year, forecasting a shortfall of about $6 million.
However the Far North Queensland Senior Medical Staff Association has warned unless the health service’s new electronic medical records system is fixed – claiming it is a major contributor to the hospital’s financial woes – then a much larger budget blackhole could emerge.
Cairns has been one of two pilot sites in Queensland for the rollout of the software program, Digital Hospital, an Integrated Electronic Medical Record (iEMR) system.
The program removes the need for paper records and charts, allowing staff to see patient information across a number of wards and facilities.
Dr Sean McManus, vice- president of the medical staff association, said Digital Hospital was too unreliable, and therefore creating a lot of stress for clinical staff, distracting them from patient care.
He said hospital funding was dependent on accurate reporting of clinical activity like surgery and clinical visits, which was being jeopardised by the new software program.
“The effect it is having on work, ward rounds and clinics is it now takes significantly longer,’’ he said.
“Medical records are not readily available under the new system. Yes, it is accessible from multiple locations, but you can’t always access it.
“The ability to report on the work that is done in order to get more funding has been problematic.”
More here:
This all sounds rather like what we have already seen in Victoria, SA and to some extent in NSW.
As Mark Twain allegedly said - History seldom repeats but it does rhyme!
David.

Wednesday, June 08, 2016

The UK Finds That Personal Health Records Are Pretty Much Useless. What A Surprise!

This appeared last week:

PHRs struggling to gain traction and show benefits - review

Ben Heather
2 June 2016
Attempts to create a personal health records suffer from a “lack of quantifiable benefits” and some schemes face an uncertain future if new funding is not found.
A wide ranging review of PHRs, carried out by the Royal College of Physicians’ Health Informatics Unit and funded by NHS England, found that attempts to put more health information in the hands of patients remain at a “relatively low level of maturity.”
It also found that while organisations that had set up PHR projects claimed they had led to meaningful improvements - from fewer hospitalisations to cost savings – these were mostly “assumptions or anecdotal.”
“Many of the case study sites had invested in PHRs on the basis that they are ‘a good thing’, but with little evidence of quantified benefits,” a report released this week says. “The lack of a viable business case could slow further developments and make existing PHRs unsustainable.”
Professor Jeremy Wyatt, who leads the Health Informatics Unit, said there was a clear desire from the public to get more involved in managing their health; but not yet the capacity for providers to deliver.
“Personal health records are a tool that can facilitate this, but at present are only available to restricted groups of patients,” he said. “The evidence shows that more work is required to develop and improve the user experience.”
The report defines personal health records as “a digital tool that helps people to maintain their health and manage their care”; most often by enabling them to access their health record, carry out transactional services, and communicate with medical staff.
Rolling out PHRs across the country is part of the National Information Board’s ‘Personalised Health and Care 2020’ framework to drive improved use of digital technology in healthcare; and some large acute and mental health trusts have invested in developing them.
Lots more here:
Here is the link to the report:
Here are the summary recommendations:

Key recommendations

  • There is little information available on the usage of PHRs in the UK, but it appears that the number of both individual users and organisational users is low.
  • Although it seems self-evident that patients and service users should have access to their electronic records, how they can do that is currently unclear, as are what data they want to see or which functions they are able to carry out using their PHR.
  • At best, there is only anecdotal information on PHR benefits, with little concrete evidence, and funding tends to be short term.
  • Where a PHR is used, it tends to be for a very specific purpose with a very specific user base.
  • Commonly identified success factors in the adoption of PHRs were: health/care professionals encouraging patients; good communications through multiple channels; support for users at the start (e.g. demonstrating use of PHR).
  • It is vital that patients and health/social care professionals are active participants in the design, implementation and appraisal of PHRs.
  • The implementation of PHRs has tended to focus on enhancing information sharing and communication. The failure to fully utilise PHRs for health service improvement projects may mean that potential improvements in cost-efficiency and effectiveness are not being realised.
  • Further research should seek to understand what patients require from PHRs, along with exploring and piloting projects that utilise the features available within a PHR to deliver health or social care in innovative ways.
  • With the anticipated greater use, functionality and complexity of PHRs, sufficient attention must be paid to the design and user interface of these systems to ensure ease of use by, and benefits for, all sectors of the community.
-----  End Summary.
There is little reason to think that things are any different in Australia and this all goes to show just how evidence free the PCEHR / myHR is!
David.

Tuesday, June 07, 2016

It Is Interesting That It Seems To Have Taken So Long To Resolve These Privacy Breaches.

These two reports appeared last week.
First we have:

SA Health workers sacked for breaching privacy

Department takes zero tolerance approach.

By Paris Cowan
Jun 1 2016 4:50PM
Three SA Health employees have lost their jobs for breaking privacy rules protecting patient records.
Department boss David Swan announced today that all three had their employment terminated for “inappropriately accessing” information in patient databases.
Swan had pledged in February to provide full transparency about any staff caught snooping in the state’s health information systems without a good reason, in the wake of revelations that 13 workers had been disciplined for accessing the records of Cy Walsh after he was charged with the murder of his AFL coach father Phil Walsh.
“I made it clear in February of this year that staff inappropriately and deliberately accessing confidential patient information would not be tolerated," Swan said in a statement today.
“Regrettably, since then we have terminated the employment of three staff for deliberate, inappropriate access of patient information."
Swan said in a press conference he would not provide any more details on who the patients were that have been caught up in the latest breaches.
He did, however, reveal the access took place in the latter half of 2015.
More here:
Second we have this:

More SA Health staff sacked for snooping

1 June, 2016 0 comments Read Later
Three more SA Health staff have been sacked over inappropriately accessing patient records.
The sackings were made over the past three months and come on top of two dismissals earlier this year for the same issue.
In February, SA Health revealed that clinicians, including doctors and nurses, were found to have inappropriately accessed medical records, with some snooping on the details of Cy Walsh after the stabbing death of his father last year, former Adelaide Crows coach Phil Walsh.
Thirteen staff were disciplined for accessing Walsh's records after he was taken to the Flinders Medical Centre in Adelaide for tests before he was charged with murder.
Six clinicians were also disciplined and two sacked for snooping on other patients.
At the time the government pledged to report on any further action taken against staff every three months.
More here:
Here is the press release:

Privacy Breach Update

1 June 2016
Over the past three months, three SA Health staff have had their employment terminated for inappropriately accessing patient records according to information published by SA Health today.
On 29 February 2016, SA Health Chief Executive David Swan warned that if it is proven staff have inappropriately accessed patient records it is highly likely their employment would be terminated.

Background

SA Health committed to report quarterly how many staff have been disciplined for inappropriately accessing patient medical records during the previous three months.

Quotes attributable to SA Health Chief Executive, David Swan

The trust between our patients and staff is the bedrock of our high quality health system and we take any breach of patient confidentiality or privacy extremely seriously.
As I have said many times, the vast majority of our staff do the right thing, acting professionally and with high ethical standards as they carry out their role.
I made it clear in February of this year that staff inappropriately and deliberately accessing confidential patient information would not be tolerated.
Regrettably, since then we have terminated the employment of three staff for deliberate, inappropriate access of patient information.
These actions and other important strategies we have put in place reinforce our commitment to the highest standards of patient privacy and confidentiality and ensure the South Australian community can continue to have the highest level of confidence in our health system.

Here is the link:
Three Comments:
First, what was the fate of the other 10 snoopers identified in February?
Second why don’t we have an proper enquiry to identify exactly what happened with this breach and to formulate a publicly disclosed plan (for the staff and public) as to how such issues will be prevented going further?
Third why disclose issues every three months rather than at the end of the week the breach was detected or staff dismissed. A delay like this is nonsense.
David.

Monday, June 06, 2016

Weekly Australian Health IT Links – 6th June, 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 as the election campaign rolls on. E-Health etc not apparently an issue - as expected.
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SA Health workers sacked for breaching privacy

Department takes zero tolerance approach.

By Paris Cowan
Jun 1 2016 4:50PM
Three SA Health employees have lost their jobs for breaking privacy rules protecting patient records.
Department boss David Swan announced today that all three had their employment terminated for “inappropriately accessing” information in patient databases.
Swan had pledged in February to provide full transparency about any staff caught snooping in the state’s health information systems without a good reason, in the wake of revelations that 13 workers had been disciplined for accessing the records of Cy Walsh after he was charged with the murder of his AFL coach father Phil Walsh.
“I made it clear in February of this year that staff inappropriately and deliberately accessing confidential patient information would not be tolerated," Swan said in a statement today.
-----

More SA Health staff sacked for snooping

1 June, 2016
Three more SA Health staff have been sacked over inappropriately accessing patient records.
The sackings were made over the past three months and come on top of two dismissals earlier this year for the same issue.
In February, SA Health revealed that clinicians, including doctors and nurses, were found to have inappropriately accessed medical records, with some snooping on the details of Cy Walsh after the stabbing death of his father last year, former Adelaide Crows coach Phil Walsh.
Thirteen staff were disciplined for accessing Walsh's records after he was taken to the Flinders Medical Centre in Adelaide for tests before he was charged with murder.
-----

Aussies on the verge of bionics ‘Holy Grail’ ahead of human trials of brain machine interface technology

June 2, 20167:54am
Australian researchers are leading the way with brain machine interface technology.
Nick Whigham news.com.au
IMAGINE being able to communicate with a machine using nothing but your thoughts.
That is the goal currently being pursued by a team of researchers and engineers at Melbourne University who are leading the way in the hugely significant field of developing brain machine interfaces.
In an effort to accomplish what has been likened to machine telepathy, they have developed a tiny biocompatible implant called a stentrode which gets implanted into a blood vessel next to the brain. The tiny implant records electric activity from a specific part of the brain and the information is then fed into a decoding algorithm which interprets the electric activity, or thoughts.
Dr Tom Oxley is leading the research and perhaps the only thing more impressive than the science involved is the story behind how he secured funding to embark on the project.
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Doctors warn of budget blowout due to dodgy software program at Cairns Hospital

May 29, 2016 5:00am
Daniel Bateman The Cairns Post
SENIOR doctors have warned of a budget crisis developing at Cairns Hospital, with health bosses asking them to no longer use pens, and to switch off lights in unused rooms.
The Cairns and Hinterland Hospital and Health Service has confirmed it is facing a “modest” deficit by the end of the financial year, forecasting a shortfall of about $6 million.
However the Far North Queensland Senior Medical Staff Association has warned unless the health service’s new electronic medical records system is fixed – claiming it is a major contributor to the hospital’s financial woes – then a much larger budget blackhole could emerge.
Cairns has been one of two pilot sites in Queensland for the rollout of the software program, Digital Hospital, an Integrated Electronic Medical Record (iEMR) system.
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Integrated accounting for Medical practices to become a reality with MedicalDirector and Surgical Partners

Australia’s leading clinical software provider, MedicalDirector and Surgical Partners, the leading provider of financial management systems for medical practices, have finalised an agreement to deliver integrated accounting automation for their customers. MedicalDirector PracSoft and Blue Chip customers will soon be able to integrate their financial transactions with popular accounting packages Xero, MYOB AccountRight Live, and Quickbooks Online, via the Surgical Partners Integration platform. Surgical Partners was the first to offer cloud integration solutions dedicated to the financial management problems faced by Medical practices. The solution set includes partnerships with the accounting packages as well as with market-leading solutions in the management of staff, accounts payable, and quality/accreditation processes – all of which will now be available to MedicalDirector clients.
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27 May, 2016

Telstra ‘screening contract’ critics might want to join the flat earth society

Posted by Jeremy Knibbs
When it comes to digital transformation in healthcare, Australia is all creep and no leap, lots of show and no go.
The amount of hoo-haa generated last week after Telstra Health won a $180 million contract to manage a national cancer screening register over the next few years demonstrates how unwilling and unprepared many of us are to embrace the sort of massive efficiencies that transformative digital technologies and the private sector can bring.
Telstra Health hasn’t covered itself in glory since its inception a couple of years back and conceivably the Telstra brand isn’t the country’s most trusted. But how do we expect to seriously create the sort of efficiencies we are going to need in the next few years to continue providing a decent standard of care and not go broke if we don’t take the odd jump? And get someone other than the government to share the risk? Currently it’s all creep and no leap.
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Telstra Health will hold Australians' cancer details, so we need to ensure their privacy is protected

May 30, 2016 8.00pm AEST
Telstra Health has won the contract to manage the National Bowel Cancer and Cervical Screening Program registries. from shutterstock.com

Author

Stephen Duckett
Director, Health Program, Grattan Institute
Telstra Health – the company’s health arm – will aggregate and manage data currently held by various state registries into one national database. There is potential that other cancer screening registries, such as breast screening, might also be contracted to Telstra Health in the future.
The registries not only contain personally identifying information, such as names and addresses, but also the results of pap smears that allow inferences about a person’s sexual status.
When Telstra Health’s venture into the market place was first foreshadowed in late October 2014, commentators highlighted potential issues around the privacy of Australians' personal information. So it was no surprise that this first Australian outsourcing provoked consumer advocates to highlight similar concerns.
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Health data a national asset: Can Telstra Health deliver on cancer registries?

Editor: Jennifer Doggett Author: Alison Verhoeven on: June 01, 2016
The proposal to consolidate Australia’s existing cancer registries and link them with electronic health records was one of the few Budget 2016-17 announcements that received widespread support from the health sector.
However, the decision by the Commonwealth Government to allow Telstra Health to develop and operate the new national cancer screening register from 2017 has raised questions which need satisfactory answers if the Australian public and health sector are to trust and support it according to Alison Verhoeven, Australian Healthcare and Hospitals Association Chief Executive.

Alison Verhoeven writes:

We welcomed the announcement in the 2016–17 Budget that the government would invest in modernising and integrating cancer screening registries, including proposed connections with the My Health Record. Integrating the smaller registries into a single entity has the potential to greatly reduce inefficiencies and support one of the key objectives of Primary Health Networks, which is to increase cancer screening in their communities.
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Question: where did the v2 messages and events go in FHIR?

Posted on May 30, 2016 by Grahame Grieve
Question:
I’m relatively new to the HL7 scene having implemented a few V2 messaging solutions (A08 , A19, ORU) and the V3/CDA work on PCEHR.  I am trying to get my head around FHIR.  So far I am stumped in how I would go about for example implementing the various trigger/messages I have done in V2.  Is there any guidance?  I cant find much.  Is that because the objective of FHIR is implementers are free to do it anyway they like?  If you could send me some links that would be a good starting point that would be great
Answer:
Most implementers of FHIR use the RESTful interface. In this approach, there’s no messaging events: you just post the Patient, Encounter etc resources directly to the server. The resources contain the new state of the Patient/Encounter etc, and the server (or any system subscribed to the server) infers the events as needed.
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My health record - Anyone use it?

Questionable 30/05/2016
I was just in the my.gov.au account and remembered I had signed up for the My Health Record.
While looking through, I noticed that nothing comes up - no pathology results, no health outcome results, absolutely nothing. I'm pretty healthy but currently pregnant with my second bub and I'd assume if Dr's were on board with this tool then they would be utilising it. My permissions are open to anyone who is involved in my medical care.
It got me thinking:
Do you ever sign in to the My Health Record?
Do you have any medical specialists who use it?
Do you think it’s a good idea to have, or another development that will fizzle??
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8 go-to sources of drug information

1 June, 2016 0 comments Read Later
Not all information sources are reliable, so it’s useful to ask yourself some simple questions to help you appraise them.
Is it evidence-based, is it current and is it relevant to your patient?
Sources of medicines information: a quick guide:
  • Australian Medicines Handbook, Therapeutic Guidelines and NPS MedicineWise cover most commonly prescribed medicines and conditions and should be among the first resources consulted. This information is evidence-based, current and reflects Australian best practice. The layout of AMH and Therapeutic Guidelines also allows rapid access to the information needed to prescribe safely.
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Medical apps prove tricky to regulate

Carmel Sparke | 31 May, 2016 |
Most of us have smartphones jammed with apps that promise to improve our lives by tracking our sleep, finding the best coffee spots or, more annoyingly, reminding us it’s time to go for a run. 
Many are fun and entertaining, but some are for more serious medical purposes.
An estimated 165,000 medical apps are on offer that range from measuring blood pressure to helping manage conditions such as diabetes, asthma and mental health. 
While some are helpful, for the most part, this field of mobile personalised healthcare is untested, unregulated, possibly ungovernable and occasionally dangerous. 
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How to pick the good from the bad smartphone health apps

May 31, 2016 6.21am AEST

Author

Carol Maher
National Heart Foundation Senior Research Fellow in Physical Activity, Sedentary Behaviour and Sleep, University of South Australia
With an estimated 100,000 health and fitness apps available on the two leading smartphone platforms, iOS and Android, it seems there is an app for everything – from tracking your bowel movements, to practising your pimple-popping technique.
However, a number of apps are starting to raise the ire of government regulators. Brain-training juggernaut Lumosity was recently fined US$2 million (A$2.7 million) for making unfounded claims that its app could improve work performance and delay the onset of Alzheimer’s.
“Ultimeyes”, a vision-training app touted to “turn back the clock on your vision” and reduce the need for glasses and contact lenses, was fined US$150,000 for misrepresenting scientific research and ordered to stop making deceptive marketing claims.
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Ambos' union disputes completion of NSW Health payroll

Department touting completion of rollout.

By Paris Cowan
Jun 1 2016 6:30AM
The NSW health system’s IT arm claims to have successfully reached the finish line in the statewide rollout of its Stafflink payroll system, onboarding all 140,000 health workers, Health staff and ambos.
But the union representing paramedics claims ambos were bolted on to the system as an afterthought, and are suffering from late and bungled payments as a result.
eHealth NSW last week announced that the successful migration of 4500 NSW Ambulance workers marked the final phase of the project, which it described as “one of the largest ever Oracle payroll implementations”.
The department has managed to keep the upgrade more or less out of the headlines, keen not to repeat the horror-story implementation of the equivelent system in Queensland.
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Is it goodbye to fingerpricks for diabetes patients?

Jo Hartley | 1 June, 2016 | 
Do you have an insulin-dependent diabetes patient who hates needles? 
A new, TGA-approved blood glucose monitoring device, which doesn’t require finger-prick tests, is being touted as something that could help in their management. 
The catchily named FreeStyle Libre Flash Glucose Monitoring System is made by Abbott and from Wednesday will be available in Australia. 
It reads blood glucose levels through a sensor inserted just under the skin, usually on the back of the upper arm, that remains in place for up to 14 days.  
A handheld scanner is used to read the sensor, which produces real-time results, historical trend data and the direction the glucose is heading.  
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Inside the tech supporting the bleeding edge of neuroscience

Queenslanders map living brains in real time.

By Andrew Sadauskas
May 30 2016 9:48AM
Each time researchers at the Queensland Brain Institute build a 3D map of a living organism they create another 30 gigabytes or so of data.
As real-time brain imagery gets better, faster, and bigger, the QBI is being forced to invest in some pretty serious IT kit to keep up.
QBI’s microscopy facility manager Luke Hammond took iTnews inside the fast moving research enterprise.
He said recent advancements in both the speed and sensitivity of imaging equipment meant that researchers can see far more of the brain than ever before, and at far greater speed. They can now visualise the brains of animals, observing their neural activity at a cellular resolution while they are still alive.
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Universal cancer vaccine ‘on track’, say researchers

  • The Australian
  • 3:00AM June 2, 2016

John Ross

Scientists say they are on track to produce a universal cancer ­vaccine, capable of eliminating any type of the disease, after they found a new way to convince “killer” immune cells to attack ­tumours.
In a revolutionary approach, charged nanoparticles simulate invading viruses and coax the immune system’s support cells to investigate. The nanoparticles then manipulate the support cells to produce “antigens”, or markers of cancer, triggering a full-blown response from the ­immune system.
The technique, described this morning in the journal Nature, has drawn encouraging results in mice and a handful of advanced melanoma patients. The team plans wider human trials in 12 months, when the full results of the melanoma trial are known.
Lead researcher Ugur Sahin said he anticipated approval of the treatment in about five years. It would be a “therapeutic ­vaccine” used to cure people who have already contracted cancer, unlike preventive vaccines such as the Australian-developed ­cervical cancer vaccine, which stop the disease taking root in the first place.
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Prescription pain pills swapped for heroin causing addiction epidemic in the United States

June 2, 20163:49pm
Nick Whigham news.com.au
THE United States is experiencing a heroin epidemic of unprecedented proportions and much of the blame falls at the feet of a once renegade pharmaceutical industry.
Opiate based pain killers became widely available in the US, particularly in the state of Florida in the late ‘90s after the drug OxyContin, known as “hillbilly heroin”, hit the market.
At roughly the same time, medical authorities urged doctors to pay greater attention to pain alleviation. As a result increasingly lax regulations around the drug meant it became readily and widely accessible, resulting in widespread abuse.
The award-winning 2009 documentary OxyContin Express showed the depths of the misuse and provided the impetus for a government crackdown on the trade and sale of the prescription drug. But the crackdown has resulted in what was apparently an unforeseen catastrophe by US policy makers.
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Enjoy!
David.

Sunday, June 05, 2016

The Election Campaign Is Going Into The Final Phase - Time To See What The E-Health Policies Are.

First I had a look at the Liberal web site.
Here is the link:
Sadly there was not a word on Health IT to be spotted.
Also checked the 2013 Liberal  policy document - again just not mentioned.
Of course we know the Liberals have funded the myHR for a couple of years in the recent budget - but they don’t seem to think that is worth mentioning.
Next to the Labor web-site:
The main web-site is found here:
Here is the policy document:
Again can’t find any references - but given the myHR as a Labor idea we can assume they support it.
Next to the Greens.
Their main national website is found here:
Interestingly the Victorian Greens do mention e-Health.
Health Services
“Hospitals with fully electronic medical records, that can be edited in real time and improved co-ordination and integration between all state, federal and private  health services, using shared health records such as the Personally Controlled Electronic Health Record.”
Here is the link:
The Queensland Greens also have a policy point:
7. Fund e-health records and improving information management and client access to personal medical information.
See here:
From these references I think we can assume that Health IT is something that the Greens are keen on!
So - overall I suspect the pollies could not care less about what is going on in the e-Health space.
If you have any additional in information please let us all know.
Pity that!
David

AusHealthIT Poll Number 323 – Results – 5th June, 2016.

Here are the results of the poll.

Are There Valid Reasons For Concern With The Involvement Of For-Profit Entities (e.g. Telstra, Cerner, Accenture etc.) In Government E-Health Projects?

Yes 33% (41)

No 63% (79)

I Have No Idea 5% (6)

Total votes: 126

A clear majority seem to think the worries regarding private sector involvement are overdone.

Good turnout of votes as well!

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

David.