HIC 09 – Australia’s Peak E-Health Conference – Alert Number 2

The HIC 09 Conference is being held in Canberra between August 19 and 21, 2009.

The conference web site is found here:

http://www.hisa.org.au/hic09

In a series of posts over the next two weeks I want to highlight some of the goodies on offer, and encourage you to attend if you possibly can.

All the details and registration is available on the link above.

Alert 2.

Personal Health Records and the NHHRC

With all the talk of Personal Health Records following the NHHRC report why not hear from a real expert in the area at HIC 09.

Here we have one:

Mr Omid Moghadam is one of the key note speakers

Mr Omid not only is a genomics expert but is also highly relevant to the NHHRC report emphasis on personal health records. Omid started the DOSSIA initiative, which is still one of the largest PHR projects in the US with Walmart employees amongst others using it. He was also on the original Robert Wood Johnson Foundation PHR group which developed the standards.

Here is a brief CV

“Omid Moghadam is a member of staff at Harvard Medical School's Center for Biomedical Informatics, focusing on applications of next generation sequencing and personal genomics. He is also the Chair of National Development Board for the Ignite Institute for the Individual Health (www.ignitehealth.org), a newly formed research institute in personalized medicine.

Previously, he was the Global Director for Intel Genomics, an Intel division focused on providing services to the Genomics market. Prior to joining Intel Genomics, he founded Dossia Corporation (www.dossia.org), a corporation that has created a national network for storing life long consumer owned health records. Mr. Moghadam served as Dossia Chief Executive for three years. Before Dossia, Mr. Moghadam was the head of product strategy at Intel, where he led the transition of the corporation from single to multiple core processors.

Prior to joining Intel, Mr. Moghadam was a Principal of the American Management Systems, a management consultancy based in Washington, D.C. At AMS, he focused his efforts on serving clients strategy needs in healthcare, finance and government.

Before AMS, Mr. Moghadam spent seven years with Eastman Kodak Company in various technical and general management roles. His assignments ranged from creation of the Digital Angiography business, to managing regional sales and marketing for the newly created Digital Imaging business and leading mergers and acquisition deals in the printing and semiconductor sectors.

An expert in medical imaging, Mr. Moghadam holds bachelors and masters degrees in electrical and computer engineering, with concentration in biophysics. He also holds an MBA in finance.

Mr. Moghadam is an Entrepreneur in Residence at the Lally School of Management at Rensselaer Polytechnic Institute, and also serves on the advisory boards of Markle Foundation's Personal Health Technology, Children Hospital Boston's Gene Partnership Program, CITL Personal Health Records, and Robert Wood Johnson's Project Health Design. A prolific inventor, he holds 32 patents, and has received the honor of being named an Eastman distinguished inventor.”

A must not miss speaker!

David.

HIC 09 – Australia’s Peak E-Health Conference – Alert Number 1

The HIC 09 Conference is being held in Canberra between August 19 and 21, 2009.

The conference web site is found here:

http://www.hisa.org.au/hic09

In a series of posts over the next two weeks I want to highlight some of the goodies on offer, and encourage you to attend if you possibly can.

All the details and registration is available on the link above.

Alert 1.

The $60 million Funding Opportunity

Senator Conroy's Digital Region Initiative

With submissions to Senator Conroy's $60 million Digital Regions Initiative due later this year, HIC'09 will be an ideal opportunity to hear Senator Conroy speak on health and communications, one of the program's key funding areas.

For those who have not heard of the program, the Digital Regions Initiative will deliver innovative and sustainable projects that:

• boost innovation in healthcare by enabling services such as remote consultation, diagnosis and treatment in areas where there are specialist skills shortages
• increase the use of digital technologies to improve emergency and disaster response both within and across state and territory borders, and
• improve and extend digital education services so that regional, rural and remote communities have the same access to educational opportunities as other Australians.

Come along to HIC'09, hear about the technology and real world application opportunities that will underpin programs such as this. HIC'09 is the place to learn and network, to establish how best to engage with this and other government programs.

HIC'09 is capturing the imagination of e-health leaders and influencers from all over Australia, covering issues from national broadband through bioinformatics to electronic health records, it addresses the topics that are critical to our nation's e-health. The conferences merges the latest research with its practical application.

Be there or be square!

David.

Sometimes I Just Want to Scream!

The following appeared on the Croakey blog site a day or so ago. (Croakey is the Health Sector Interest blog of www.crikey.com.au and is accessible from the web front page.)

The big bang lies with e-health proposals

July 28, 2009 – 11:19 am, by Croakey

Philip Davies, Professor of Health Systems & Policy at the University of Queensland’s School of Population Health, is encouraged by the National Health and Hospitals Reform Commission proposals around e-health. He writes:

“Much of the debate following the release of the National Health & Hospital Reform Commission’s (NHHRC) report A Healthier Future For All Australians will inevitably, and rightly, focus on issues of health care governance, funding and models of service delivery. Some of the Commission’s most far-reaching recommendations could, however, be those relating to e-health.

The Commission is to be commended for providing one of the clearest, most powerful and potentially most effective statements of how to move the national e-health agenda forward. Its key recommendation is that every Australian should be offered the opportunity to have a person-controlled electronic health record (PEHR) – a comprehensive electronic repository of health-related information generated by, and accessible to, themselves and their health care providers.

There’s not much new in that idea. The concept of electronic health records has been around for a very long time; but the Commission’s approach has two distinctive, new features.

First, it suggests quite categorically, that Governments should play no part in “designing, buying or operating IT systems” to support PEHR. That’s a job which, according to the Commission, can safely be left to the private sector. Governments, in turn, should focus on the essential tasks of defining standards for those PEHR systems and regulating their use. State and Territory Governments will also need to continue developing ‘in-house’ patient administration, communication and other IT applications to enable their public hospitals to interface with PEHR systems.

Second, the Commission proposes a series of deadlines for public and private sector health care providers to become e-enabled and able to write to, and read from, individual patients’ PEHR.

To reinforce the point, the Commission goes on to recommend that Government funding in the form of Medicare subsidies or direct payment for public hospital services should be withdrawn from any provider who fails to meet the relevant deadline.

Lots more here:

http://blogs.crikey.com.au/croakey/2009/07/28/the-big-bang-lies-with-e-health-proposals/?source=cmailer

Now we all have to be a bit careful here.

Consider this recent article from the NY Times I cited the other day.

Op-Ed Contributor

Lost in the Cloud

By JONATHAN ZITTRAIN

Cambridge, Mass.

EARLIER this month Google announced a new operating system called Chrome. It’s meant to transform personal computers and handheld devices into single-purpose windows to the Web. This is part of a larger trend: Chrome moves us further away from running code and storing our information on our own PCs toward doing everything online — also known as in “the cloud” — using whatever device is at hand.

Many people consider this development to be as sensible and inevitable as the move from answering machines to voicemail. With your stuff in the cloud, it’s not a catastrophe to lose your laptop, any more than losing your glasses would permanently destroy your vision. In addition, as more and more of our information is gathered from and shared with others — through Facebook, MySpace or Twitter — having it all online can make a lot of sense.

The cloud, however, comes with real dangers.

Some are in plain view. If you entrust your data to others, they can let you down or outright betray you. For example, if your favorite music is rented or authorized from an online subscription service rather than freely in your custody as a compact disc or an MP3 file on your hard drive, you can lose your music if you fall behind on your payments — or if the vendor goes bankrupt or loses interest in the service. Last week Amazon apparently conveyed a publisher’s change-of-heart to owners of its Kindle e-book reader: some purchasers of Orwell’s “1984” found it removed from their devices, with nothing to show for their purchase other than a refund. (Orwell would be amused.)

Much more here:

http://www.nytimes.com/2009/07/20/opinion/20zittrain.html?_r=1

It also seems I am not the only one who cautions a bit of care.

Davis: privatising records 'dangerous'

28 Jul 2009

Former Conservative home secretary David Davis has slammed his own party’s reported plans to hand health records to commercial IT companies as “naïve” and “dangerous.”

Writing in The Times yesterday, the MP for Haltemprice and Howden said the first time he read about the policy his “heart sank.”

“The policy described was so naïve, I could only hope that it was an unapproved kite-flying exercise by a young researcher in Conservative HQ,” he wrote.

“If not, what was proposed was both dangerous in its own right, and hazardous to the public acceptability of necessary reforms to the state’s handling of our private information.”

A number of papers reported at the start of July that the Conservatives might give patients the option of transferring their health records to personal health record platforms such as those run by Microsoft and Google.

The reports followed a Centre for Policy Studies paper that recommended such a move, alongside a wider use of cloud computing and decentralised IT systems.

Much more here:

http://www.ehiprimarycare.com/news/5066/davis:_privatising_records_%27dangerous%27

Before we go rushing in to signing up the public to PEHRs we would want to be certain the information was not going into some nebulous cloud – but that it is in a secure, inaccessible, un-data-minable environment where the terms of service were such that the public would be entirely comfortable to have their information stored by whoever provided the service.

I suspect that may mean that only local, well established and technically very sophisticated providers will want to be involved and that if we want long term reliability and security there are going to be real costs! I think most would also like to be sure their information is actually held in Australia.

I am as keen as the next man to have patients be able to keep track of their health information and to have ownership of that information but this is not as simple as it is made out and as I have discussed in previous blogs, while be case for provider used EHRs / EMRs is robust, the same simply is not the case for PEHRs.

Commentators who do not grasp the difference, and the implications of those differences, really should not be leaping into print.

I also think it will be very important to think through the various interfacing and communications issues as well as ensuring that clinician workflow is not made problematic during information transmission etc. Timing of just when information is sent from the EHR to the PEHR may need careful thought.

Additionally, I think that any penalty regime to foster information sharing is likely to simply be counter-productive. The architects of a final plan need to think much more ‘outside the box’ to come up with an approach that works and the clinicians are comfortable with.

Can I also suggest that the economic fundamentalist approach of this commentator may not be the best way to move e-Health forward.

The idea of the PEHR is possibly a very good one but we do need to think carefully about how we go about it for the benefit of all. This needs to be fully thought through and all the wrinkles identified and resolved.

Hasten slowly.

David.

Now We Have the NHHRC Report - What Has to Happen Next?

Well it has been a big 24 hours for e-Health in OZ and I suspect many of us are now asking the question “what next?”.

There has been a lot of press coverage of yesterday’s release. Typical of the e-Health coverage have been the following:

NHHRC reboots e-health plan

Karen Dearne | July 28, 2009

AUSTRALIA'S e-health strategy has been endorsed by the National Health and Hospitals Reform Commission, which also puts the federal government back in the driver's seat after disastrous delays through the Council of Australian Governments process.

"We want our future health system to be powered by the smart use of data and enabled by the electronic flow of essential information between individuals and health professionals," the commission says.

"Data should enhance decision-making, drive improvements in clinical practice, guide how resources are deployed and provide feedback to promote improvements across all health settings.

"Key to this is a structured, robust communication matrix that connects all participants with relevant, accurate and secure information, in real time."

The commission says it concurs with the direction of the National E-Health Strategy -- produced by Deloitte and adopted by the nation's health ministers at COAG late last year. The strategy is yet to be publicly released.

A copy obtained by The Australian shows the commission has backed Deloitte's recommendations and costings in full.

"There is a critical need to strengthen the leadership, governance and resources committed by governments to giving effect to the (Deloitte) action plan," the commission says.

"This includes providing support to public health organisations and incentives to private providers to augment takeup and successful implementation of compliant e-health systems.

"It should not require government involvement with designing, buying or operating IT systems."

The current lack of interoperability standards, and the inability to send and receive high-quality data -- even within healthcare settings -- should be addressed as a matter of urgency.

The commission estimates an extra $1.2 billion to $1.9bn is needed to fund an e-health system, including between $600 million and $900m for national e-health standards; $500-$800 million for training and support for medical practitioners; $35m-$65m for consumer education, and up to $100m for new research, performance monitoring and governance programs.

These priorities and costs mirror Deloitte's estimated costs of $1.5bn over the next five years for foundation standards, awareness campaigns and a new e-health governing body to replace the sometimes troubled National E-Health Transition Authority.

Lots more here:

http://www.australianit.news.com.au/story/0,27574,25843275-15306,00.html

and here:

Electronic health records to save lives

Clancy Yeates

July 28, 2009

BY 2012, every Australian should have an electronic health record, a Federal Government report advises.

As the health system braces for the greying population, moving the system away from paper-based records should be a key priority, the National Health and Hospitals Reform Commission said yesterday.

The move is part of broader growth in ‘‘e-health’’ measures, which could radically change the experience some patients have with their doctors, eventually leading to activities such as electronic prescribing.

Meanwhile, electronic health records will speed up the time it takes for doctors to obtain details about their patients.

Although critics have raised privacy concerns, supporters of the proposal argue that moving medical records into the digital age will save not only money but also lives.

More here:

http://www.theage.com.au/national/electronic-health-records-to-save-lives-20090727-dysd.html

and here:

Australia must spend $1.2 to $1.9b on e-health

Suzanne Tindal, ZDNet.com.au

27 July 2009 05:34 PM

Prime Minister Kevin Rudd and Health Minister Nicola Roxon released a report on the nation's hospitals today by the National Health and Hospitals Reform Commission (NHHRC) which recommends a $1.2 to 1.9 billion spend on e-health.

The report endorsed the recommendations of the National e-health strategy completed by Deloitte last year. Its figure for rolling out a National e-health agenda of $1185 to $1865 million roughly mirrored the consultant's original reported amount for implementing its national strategy.

In addition to Deloitte's recommendations, the NHHRC put out a plea for better leadership on e-health. "We urge the Commonwealth Government to take responsibility for accelerating and adequately resourcing implementation of a National e-health Action Plan which incorporates strengthened national leadership to direct and revitalise implementation and which values and actively seeks the expert guidance of key stakeholders," it said.

The report acknowledged that the work had been already completed but pointed out how far Australia had to go. "There is increasing frustration and mounting cynicism with the pace of action on implementing a national e-health platform. The lack of visible utility at the point of care has resulted in calls to stop the 'talkfest' and get on with setting a dedicated budget and definite delivery date with clear responsive and responsible governance for electronically enabling the health system: e-health."

There was still a "small window of opportunity" to capitalise on the money the nation had already spent on a national e-health system, it said. If that window were missed, the cost would be much higher.

Lots more here:

http://www.zdnet.com.au/news/software/soa/Australia-must-spend-1-2-to-1-9b-on-e-health/0,130061733,339297606,00.htm

Overall the coverage seems to be quite positive and supportive and it is good that there is recognition of the importance of the work done in 2007 by Deloittes that has now been extended and built on by the NHHRC.

In broad terms what would I like to see next?

First I would like to see, before any final decisions are made, an implementation planning group established within DoHA, but possibly externally resourced given the scale of the work involved.

This group would have the brief to consult widely within the health sector, in the light of the directions set by the other components of the NHHRC report to develop what I would term an Opportunity and Benefits Driven Implementation Plan and Business Case. (This is a small extension of the idea of a National E-Health Action Plan as provided by the NHHRC)

The idea is that all the proposals from Deloittes and the NHHRC would be considered carefully in the light of where we presently are, where the most bang for the buck can be found, what will work for both the public and providers and to then develop a real, pragmatic plan for implementation of these solutions and technologies.

My view is that this plan should draw the best from the NHHRC, NEHTA and Deloittes and put it together in a way that will most quickly and effectively achieve the ends of coherent e-Health support for the health system. The time for coming up with ideas is over – the time for getting going with a clear, well articulated and well funded direction has now arrived.

Most especially the timeframes, costs, and benefits need to be carefully considered to make sure expectations of all the stakeholders can reasonably be met.

I would envisage that once the plan was developed that a focussed group within DoHA would manage the development of the business case for implementation, have that approved and then move on to actual implementation of the agreed plan – using NEHTA and external resources as required – having been endorsed by COAG..

This group will need to be very aware of the various successes and failures (relative and total) that have been seen around the world and apply world’s best practice both to the planning and implementation tasks.

It might be that a group such as the Coalition for E-Health could assist in providing the breadth and scope of input needed to get this planning process right.

See here:

http://www.ceh.net.au/

This implementation task force group will require the co-operation of all the e-Health community as well as the broader health community and the public in general. For that reason it will need to be exceptionally well led and resourced appropriately – as well as given a clear mandate for action from both DoHA and COAG.

If there is not a coherent plan developed soon to leverage the momentum that has been provided by the report release then there is a real risk of the whole thing sinking into some terrible bureaucratic mire – and that would be very sad indeed having got this far!

Second, once this work is done – and it will take all of the six months Mr Rudd has allocated for the other systemic decisions, I would like to see the final Opportunity and Benefits Driven Implementation Plan and Business Case approved and funded as part of the overall reform process.

Anything less will be a betrayal of one of the key directions provided by the NHHRC.

David.

The National Health and Hospitals Commission Reboots Australian E-Health.

I believe this is a very good day for e-Health in Australia.

Today the National Health and Hospitals Commission (NHHRC) released its Final Report after some sixteen months work.

The report is found here:

http://www.nhhrc.org.au/internet/nhhrc/publishing.nsf/Content/nhhrc-report

E-Health and the Use of ICT within the sector runs through the entire document and is really an embedded part of what is recommended.

The most important parts related to e-Health are found in the following spots:

1. The Executive Summary.

2. Section 5 of the Main Report.

3. Appendix G – Implementing Reforms.

4. Appendix H – Investing in Reform.

The Executive Summary (on E-Health) I posted earlier and it can be seen here:

http://aushealthit.blogspot.com/2009/07/core-recommendations-from-nhhrc-on-e.html

What is very interesting about the report is as you go through the detail – and there is lots in Section 5 and the Appendices – the balance moves, as I read it, further and further away from the almost total focus on the Person Controlled Health Record in the Executive Summary to a much more balanced holistic view of e-Health by the end.

By the time we reach the section on Funding (Appendix H) we have the following:

RECOMMENDATION 123

With respect to the broader e-health agenda in Australia, we concur with, and endorse the directions of the National E-Health Strategy Summary (December 2008), and would add that: There is a critical need to strengthen the leadership, governance and level of resources committed by governments to giving effect to the planned National E-Health Action Plan. This Action Plan must include provision of support to public health organisations and incentives to private providers to augment uptake and successful implementation of compliant e-health systems. It should not require government involvement with designing, buying or operating IT systems. In accordance with the outcome of the 2020 Summit and our direction to encourage greater patient involvement in their own health care, that governments collaborate to resource a national health knowledge web portal (comprising e-tools for self-help) for the public as well as for providers. The National Health Call Centre Network (healthdirect) may provide the logical platform for delivery of this initiative. Electronic prescribing and medication management capability should be prioritised and coordinated nationally, perhaps by development of existing applications (such as PBS online), to reduce medication incidents and facilitate consumer amenity.

Additional cost $1,185–$1,865 million

Costing Assumptions 1. $600–$900 million implementation and adoption of national standards including:

investment in bringing existing public and private systems to a level that will allow them to operate with a broader electronic health care system, including interfaces;

encouragement of the development and implementation of new e-health solutions that apply these standards and implement the interfaces necessary to allow broad integration. This would include solutions to allow consumers access to and use of their own personal health information.

Implementation of additional enablers of national information exchange, such as national indexing, strong privacy management and authentication services.

Investment in the industry infrastructure required to test and accredit the adoption of e-Health.

2. $500–$800 million e-health teaching, training, change management and support to health care practitioners targeting:

encouragement of the active use of high priority e-Health solutions prior to the mandated use of these solutions to provide data that can be integrated into a person-controlled electronic health record (such investment does not replace investments by the private and public sector in the development of their internal e-health solutions, but helps ensure that they can contribute to the national system);

health information training for clinicians, including in universities, continuing education and in specialist health contexts (such as hospital emergency departments);

workplace change, enabling new workplace practices that can only be adopted with e-health solutions in-place;

delivery of new tools and capabilities that leverage e-health information to deliver provider efficiencies (e.g. new electronic clinical registries) and enhanced health monitoring (such as bio-surveillance capabilities).

3. $35–$65 million consumer marketing program

4. $50–$100 million research, performance monitoring and governance

These costs are in addition to developments to date funded by COAG commitments of $318m and industry and individual practitioner investment and do not include hospital information system infrastructure.

---- End Quote.

When one compares what I asked for a few weeks ago as far as e-Health is concerned from the Final Report I must say what we have looks pretty good.

See here for my wish list:

http://aushealthit.blogspot.com/2009/07/nhhrc-final-report-will-be-released.html

It is also worth comparing the funding cited here with what the Deloittes work suggested.

See here:

http://aushealthit.blogspot.com/2009/05/what-should-be-in-budget-for-e-health.html

Overall the NHHRC is saying to Government get on an fund what is essentially the National E-Health Strategy – and interestingly does not seem to be asking for funds for the Personal Records – just the funds to make the possible. Do you think it is possible someone else will provide those records (Google or Microsoft perhaps?)

In section 5.0 there is also lots of mentions of some of my favourite topics (governance, leadership, education, workforce, knowledge portals and so on) which I can only be happy about.

Additionally it is clear the issues of privacy and security have received pretty comprehensive coverage. As always it will only if public trust is developed will any e-Health initiative succeed!

Appendix G seems to me to make it clear – as I have long suggested – that NEHTA is to become an implementation arm of DoHA under the Accord and to come back much more under Government control – what a good thing!

All in all my only concern is that we have to wait to see if Government will support these recommendations, fund them and get on with it.

The only two serious issues I might have are

1. I would still like to see an e-Health Australia entity established to be responsible and accountable for doing all this.

2. I really think trying to force clinicians to contribute data to personal EHRs is just a bad, bad idea.

There is so much that is good in this I am almost prepared to let these points pass!

Well done team. 9.7/10. I only hope Mr Rudd will now implement.

David.

Core Recommendations from the NHHRC on E-Health.

On page 8 of the Executive Summary of the NHHRC Final report we have the Key e-Health Recommendations.

The full report is found here:

http://www.nhhrc.org.au/internet/nhhrc/publishing.nsf/Content/nhhrc-report

The relevant parts are these – so far!

Smart use of data, information and communication

Our third lever to support an agile, self improving system is the smart use of data, information and communication.

We are recommending a transforming e-health agenda to drive improved quality, safety and efficiency of health care.

The introduction of a person-controlled electronic health record for each Australian is one of the most important systemic opportunities to improve the quality and safety of health care, reduce waste and inefficiency, and improve continuity and health outcomes for patients. Giving people better access to their own health information through a person-controlled electronic health record is also essential to promoting consumer participation, and supporting self-management and informed decision-making. We want the Commonwealth Government to legislate to ensure the privacy and security of a person’s electronic health data.

Making the patient the locus around which health information flows is critical and will require a major investment in the broader e-health environment. Electronic health information and health care advice will increasingly be delivered over the internet. Broadband and telecommunication networks must be available for all Australians if we are to fulfil the real promise of e-health.

We are also recommending that clinicians and health care providers are supported to ‘get out of paper’ and adopt electronic information storage, exchange and decision support software. The Commonwealth Government must set open technical standards which can be met by the vendor industry while ensuring the confidentiality and security of patient information. Most importantly, we urge governments to expedite agreement on a strengthened national leadership structure for implementing a National Action Plan on E-health, with defined actions to be achieved by specified dates.

Access to good information is also vital to measuring and monitoring the health of our population. We are recommending the development of Healthy Australia Goals 2020 – the first in a rolling series of ten-year goals. We want all Australians to participate in setting these goals and working towards improvements in health outcomes at local, regional and national levels.

End Quote.

Comments on all this will follow after details digested.

David.

Update on NHHRC Report Release on July 27, 2009.

The following appeared in the Sunday Telegraph this morning.

PM to Unveil Health Plan.

Prime Minister Kevin Rudd is set to unveil his long awaited plans to fix state hospitals tomorrow, plans that are expected to fall well short of his election promise of a federal takeover.

Instead, Mr Rudd is tipped to reveal pared down recommendations from the NHHRC for a limited takeover of hospital outpatient services.

A spokesman for Mr Rudd would not confirm tomorrows launch, except to say the Prime Minister was scheduled to make a speech concerning health.

But invitations to the event – described by some participants as “looking like a wedding invitation” – have already been sent out to key health sector players,

The event, at the Australian National University, is billed as a prime ministerial speech, followed by a discussion with participants.

----- End Quote.

This sounds pretty well sourced to me so we can all plan a busy day tomorrow!

Thanks to ABC Insiders for the vision of the press report.

David.

PM Speech Alert on Future of the Health System.

Listening to Insiders on ABC TV today I noticed one of the guests mentioned that the Prime Minister is giving a speech on the future of the Health System tomorrow – Monday 27, July 2009.

It was suggested that the speech was going to announce the takeover of the non-hospital health sector. We shall see!

It would be nice if e-Health were to get a mention if this is a major directions speech. I notice that in the 6000+ words on policy published in the Herald and Age on Saturday 25 July there was mention of the need for reform but no mention of e-Health.

See here:

http://business.smh.com.au/business/the-road-to-recovery-20090725-dwg5.html?page=-1

I can’t find any confirmation on the web as yet – but the timing is what we were expecting for the timing of the release of the NHHRC Final Report. We were told a week or so ago the report was at the printers.

As they say – ‘Stay Tuned’.

David.