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."

Wednesday, March 12, 2014

Pre - Budget Review Of The Health Sector - 12th March 2014.

As we head towards the Budget in Early to Mid May 2014 I thought It would be useful to keep a closer eye than usual on what was being said regarding what we might see coming out of the Budget.
According to the Australian Parliament web site Budget Night will be on Tuesday 13th May, 2014.
Here are some of the more interesting articles I have spotted this week.
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Doctor visit co-payments are a healthy price signal, not a tax

March 3, 2014
Kelly O’Dwyer
Consistent inane attempts to brand the proposal by the Australian Centre for Health Research for a $6 co-payment for GP visits a “GP tax” distort the debate about the very real need to rein in growth in health spending.
On the plus side, the ALP has clearly worked out that Australians think tax is a dirty word. On the downside, they misunderstand the difference between a service fee and a tax, and signal a wrecking ball approach to attempts to set the Australian budget on a sustainable footing.
If a co-payment for GP visits is a “GP tax”, then what are the existing payments to a pharmacist for prescriptions? Are they a “medication tax”? What about payments for stamps? Or connection and usage fees for the national broadband network – are they “communications taxes”?
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Posted: Mar 4, 2014

AMA calls on food industry to stop "undermining" star rating system

The vice-president of the Australian Medical Association (AMA) has called on the food industry to stop “undermining” the new star rating system.
Dr Steve Hambleton says the Australian Food and Grocery Council (AFGC) was lobbying against the system on the same day that the website was shut down by the Assistant Minister for Health’s office.
“Even though they worked closely with the public health sector on the development of the new system, the AFGC has lobbied against the consumer-friendly food labels since they were agreed by the federal and state governments last year,” Dr Hambleton said.
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Government abolishes pharmaceutical pricing body

Joanna Heath and Jessica Gardner
The government will abolish the independent body responsible for recommending prices for new medicines on the Pharmaceutical Benefits Scheme, in a bid to speed up the listing process for subsidised drugs.
The Department of Health made a surprise announcement late on Friday that the Pharmaceutical Benefits Pricing Authority would stop operating. The announcement was made without consultation with major stakeholders, according to sources.
“This measure will further streamline the PBS listing process and reduce the time taken to list medicines,” a spokesman for Health Minister Peter Dutton said.
“The PBPA has served government well in formalising processes for PBS pricing, but those processes are now well entrenched and will be subsumed into the PBAC and the Department of Health where most of the work is already undertaken.”
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Final report of the Pharmaceutical Patents Review will not be released or actioned

This week in the Australian parliament, the Pharmaceutical Patent Review quietly disappeared off the radar. The Minister for Industry, Ian Macfarlane, stated in response to a question from the Opposition that ‘the government has no plans to release the final report at this stage’, and further: ‘the government is not considering the recommendations made by the panel’.
On the 15 October 2012, the then Parliament Secretary for Innovation, Mark Dreyfus, announced a review of pharmaceutical patents in Australia. The report was initiated to evaluate Australia’s current system for pharmaceutical patents and its ability to ‘effectively balance the objectives of securing timely access to competitively priced pharmaceuticals, fostering innovation, and supporting employment in research and industry’. Central to the review was an investigation of the patent extension of term provisions available under section 70 of the Patents Act 1990, specifically the impact of these extensions upon the market entry of new generic pharmaceuticals.
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NIB CEO says private health penalises young customers

Jessica Gardner
The chief executive of NIB, Mark Fitzgibbon, has written to Health Minister Peter Dutton claiming a policy that forces health funds to subsidise the costs of other insurers’ most expensive members drives up prices and discourages young people from signing up.
Mr Fitzgibbon wants a “sensible ­discussion” on risk equalisation, which partially compensates health funds for the hospital costs of high risk patients. It supports “community rating”, which means funds can’t price their policies based on risks such as age and pre-existing conditions. Equalisation shares a proportion of costs for members aged 55 years and older on a sliding scale with the industry. Funds pay a share based on the size of their membership.
NIB would be significantly more profitable without risk equalisation. In the first half of 2013-14 it paid ­$101 million to the shared pool. It had net profit of $40 million in the half. The reason NIB has a high liability, and doesn’t receive money back, is a result of its younger membership. NIB customers are aged an average 37 years, compared to 40.5 years across the industry, Mr Fitzgibbon said.
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Consumers Health Forum slams GP fee proposal

Date March 4, 2014

Dan Harrison

Health and Indigenous Affairs Correspondent

The introduction of a fee to see the doctor would hit the poor and chronically ill hardest and would be unlikely to generate savings, according to a report to be released on Tuesday by consumer advocates.
The Consumers Health Forum prepared the report in response to a proposal by a former adviser to Tony Abbott, Terry Barnes, for a $6 fee for GP visits, and a call by Health Minister Peter Dutton for a national conversation about the sustainability of the health system.
"CHF wants to ensure any changes are evidence-based and are not at the expense of those most in need of care," said chief executive Adam Stankevicius.
In a submission to the government's Commission of Audit on behalf of the Australian Centre for Health Research, Mr Barnes predicted his plan would save $750 million over four years by reducing avoidable demand for GP services.
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Keynote Address to the General Practice Registrars Australia Conference 2014

Minister for Health Peter Dutton presented the Keynote Address to the General Practice Registrars Australia Conference 2014 on 6 March 2014.

Page last updated: 06 March 2014
6 March 2014
Check Against Delivery
Good morning ladies and gentlemen and thank you for welcoming me here this morning to open the Future of General Practice 2014 (#fgp14) conference.
For the past four years I have spoken at the GPRA’s annual conference while in Opposition, so I’m pleased to have the opportunity to address this event as the Minister for Health.
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GPs may be given lump sum payments to treat patients

Joanna Heath

Key points

  • Lump sum payments
    to doctors may replace the fee-for-service model.
  • Major overhaul of Medicare expected in the May budget based on the first report from the Commission of Audit.
Doctors may be given a lump sum payment to treat individual patients rather than be paid by the number of consultations they provide, under plans being considered by the government.
Health Minister Peter Dutton said the government was “open to a conversation” about scrapping the fee-for-service model which has been in existence since Medicare was established. He said the government would look at a greater role for lump sum payments as an incentive for doctors to improve a patient’s health quickly and prevent repeat visits.
Mr Dutton is softening the ground for a major overhaul of Medicare in the May budget based on the first report from the Commission of Audit, according to sources. In a speech delivered a fortnight ago, he described Medicare as “unsustainable” and canvassed the introduction of mandatory GP co-payments and the means-testing of bulk billing in other areas.
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Medicare costs must be reined in: Dutton

  • 10 hours ago March 05, 2014 1:16AM
  • AAP
HEALTH Minister Peter Dutton says the Medicare system needs to modernised to be affordable, but he won't say if GP co-payments will be part of the mix.
The Consumers Health Forum on Tuesday reignited debate on GP co-payments, when it released research showing that not only would they hit the needy, but they would fail to provide any overall budget savings.
Co-payments of up to $6 have been flagged as one way to tackle health spending as the government grapples with the budget deficit.
Prime Minister Tony Abbott has downplayed the likelihood of a co-payment being introduced, saying he wants the government to be "the best friend that Medicare has ever had".
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Tackling avoidable cost has to be at the heart of how the hospital system works

PUBLIC hospitals are wasting up to $1 billion a year and should be held to account for inefficient and substandard medical care, the Grattan Institute has warned.
In a report released last night, the think tank headed by long-time reform advocate Stephen Duckett has called for activity-based funding to be accompanied by measures that would reduce costs and rein in health inflation.
Health Minister Peter Dutton is awaiting the findings of the budget Commission of Audit, along with reviews of Medicare Locals and electronic health records, to decide the future of the health system.
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Activity-based hospital funding healthy way to go

SIX Australian public hospitals do more than 200 hip replacements a year. In one, the cost of a hip replacement is $9700 a patient. In another it is $23,400, nearly 2 1/2 times higher.
Similarly, the cost of a common treatment for gallstones - laparoscopic cholecystectomy - ranges from $4100 to $7900 a patient, depending on the hospital.
Grattan Institute’s new report, Controlling Costly Care: A Billion-Dollar Hospital Opportunity, reveals substantial differences in costs among Australia’s public hospitals. Much of this cost can be avoided. If it is, nearly $1 billion will be freed up to address other needs every year.
When state finances are tight, such large differences cry out for attention. There is also a moral imperative: it is unethical to ration services or shift costs to consumers when there is inefficiency in the system that, with better management, could be reduced and the savings used to address unmet needs or future cost pressures.
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Health system could save a billion a year

Date March 5, 2014 - 5:54AM

Dan Harrison

Health and Indigenous Affairs Correspondent

Governments could save a billion dollars a year by cutting waste in public hospitals, according to a former top health bureaucrat.
A report by the Grattan Institute think tank found a high level of unexplained variation in the average cost of comparable procedures between hospitals. For example, among the five hospitals nationally that perform the most gall bladder removals, median costs range from $4200 to $8000. In NSW hospitals, the average cost of the procedure varies from $3500 to $8000.
Grattan Institute researchers led by Stephen Duckett, a former head of the federal health department, analysed public hospital cost data to identify differences that could not be explained by patient or hospital characteristics. It finds in some cases the cost of providing the same kind of care to the same kind of patient was two or three times more than in other hospitals in the same state. The researchers calculate these unexplained costs amount to at least $928 million a year across the nation.
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Better hospital management needed to improve patient care

Date March 5, 2014

Peter Breadon

In one NSW public hospital, removing a gall bladder - a common treatment for gallstones - costs $3500. In another, it costs $7300.
The story is similar for hip replacements, which cost $15,000 in one hospital and more than $20,000 in another. Such big differences are not inevitable. States could easily reduce them, saving taxpayers nearly $1 billion a year.
A new Grattan Institute report, Controlling Costly Care, shows such gaps don't come from treating patients with more severe problems. They can't be explained by the cost of running different types of hospitals, or hospitals in different kinds of places - both the hospitals mentioned above are in Sydney.
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Senate censures Fiona Nash over conflict of interest concerns

Date March 5, 2014 - 9:58PM

Amy Corderoy, Dan Harrison

Parliament has censured Assistant Health Minister Fiona Nash for misleading the Senate and refusing to produce documentation about her employment of a junk food industry lobbyist in her office.
Labor says Senator Nash’s position is no longer tenable and has called on her to resign after the censure motion passed 37 to 31 votes.
Only three such censure motions have passed in the past 10 years.
Senator Nash had until early Wednesday afternoon to produce a document that she claimed outlined the measures she put in place to address the fact her chief of staff, Alastair Furnival, co-owned a lobbying firm that did extensive work for soft drink and confectionery companies.
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6 Mar 2014 - 7:05pm

Labor on WA hustings, slams Medicare idea

Opposition health spokeswoman Catherine King says a co-payment to see a GP is only going to add to cost of living woes in WA.
Source
AAP
As West Australians prepare to return to the polls, Labor has appealed to their hip pockets, saying the Abbott government's planned changes to the Medicare system will only increase their high cost of living.
The government has flagged the possibility of co-payments of up to $6 for GP visits as one way to tackle health spending.
Opposition health spokeswoman Catherine King said on Thursday WA already had some of the nation's highest out-of-pocket expenses for attending a GP, with some Karratha doctors charging a gap payment of $85.
"Imagine what will happen to that if you add a co-payment, a tax from the Abbott government, on top of that," Ms King told reporters in Perth.
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Comment:
It seems even clearer there is a significant change coming on the basis of this week’s news.
Was very interesting to see the variability in the costs of delivery of common hospital treatment from the Grattan Institute and the speeches and comments from Mr Dutton.
Also very interesting was exploration of the possibilities of moving from fee- for service GP visits.
As usual - no real news on the PCEHR Review.
More next week.
David.

AusHealthIT Blog Service Update

Being quite fond of round numbers I thought I would, rather shamelessly, report the following statistics for the blog:

Total Site Visits - Now over 500,000 (Site Meter)

Total Page Views - Now 1,806,977 (Google Stats)

Average Readers Per Week - 1450+

Total Posts -  3236

Total Comments - 8869

I am sure Ms Halton will be less than pleased at how many are reading all this subversive material!

Big thanks to all who have made it so! 

David.



Tuesday, March 11, 2014

Now Would It Not Be Wonderful To Have The Same Sort Of Audit Of The PCEHR Program?

This appeared a few days ago:

Turnbull asks how the NBN got that way

Former Telstra official to lead audit of NBN policy process under Labor
The Coalition will deepen its probe of the National Broadband Network, with the government announcing the appointment of a former Telstra official to investigate the public policy process behind Labor’s NBN.
Communications Minister Malcolm Turnbull announced the appointment of Bill Scales to perform the audit. Scales was previously in charge of regulatory matters at Telstra as group managing director for regulatory and corporate affairs.
Scales also served as chairman of the Industry Commission and secretary of Victoria’s department of premier and cabinet.
“The independent audit will investigate the advice, decisions and policy processes that led to the National Broadband Network policy and establishment of NBN Co,” Turnbull announced today.
More here:
There is also coverage here:

Coalition on hunt for Labor’s NBN secrets

THE federal government has commissioned its fifth audit of the National Broadband Network and appointed the former head of the Productivity Commission, Bill Scales, to oversee an independent investigation into the process that led to the formation of Labor’s NBN policy.
The genesis of the policy has been steeped in controversy since it was originally devised in March 2007 by then opposition leader Kevin Rudd as a $4.7 billion publicly funded subsidy to build a fibre-to-the-node network.
In 2008, as the world’s economy was rocked by the global financial crisis, the original proposal was scrapped and replaced with a $43bn proposal for the government to go it alone and build a fibre-to-the-premise network. At the time the official reason given by an expert panel overseeing bids for the $4.7bn subsidy was that none of the bids presented “value for money”.
But sources say the real reason the process collapsed was that the nation’s dominant telco, Telstra, submitted a noncompliant bid.
It has been rumoured for years that the complex decision to approve the shift to a fibre-to-the-premise NBN was done on the fly when former communications minister Stephen Conroy caught a VIP plane with Mr Rudd to brief him on the shift to the new policy.
Now the Coalition wants to get to the bottom of exactly what led to that process and has appointed Mr Scales, a former Telstra executive, to investigate the advice, decisions and policy processes that led to the NBN policy and establishment of NBN Co.
The audit will cover the period from April 2008 (when the government issued a request for proposals for a national broadband network solution) to May 2010 (when the $25 million implementation study for the NBN was released).
The government has asked Mr Scales to investigate the reasons why NBN Co was given a mandate to create a network using the fibre-to-the-premise technology and why the network was expanded to cover 93 per cent of premises with the technology.
More here:
What a great idea if we had a similar Audit for the PCEHR Program. As far as I know the PCEHR appeared out of a ‘clear blue sky’ with neither NEHTA or DoHA having ever talked of it, or similar, until it appeared - almost fully formed - from the NHHR Commission in 2009.
Similarly would be fun to get some of the other audits Mr Turnbull is conducting on the NBN for the PCEHR like a real and credible cost-benefit study!
Sadly all we have is a PCEHR Review which, if it had actually a robust plan, would have been trumpeted by the Minister. I suspect no release = no idea what to do!
David.

Monday, March 10, 2014

Weekly Australian Health IT Links – 10th March, 2014.

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 - other than the comments from Mr Dutton outlined below.
Other than this we have an eclectic mix of items which are relevant to e-Health - most especially the outcomes and consequences that are now flowing from the data breach at the Immigration Department.
Of most fun to me was the Medicare Locals - facing oblivion - talking their own book and pointing how wonderfully effective and useful the Medicare Locals are. Oh how true I am sure that is!
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PIP payments for teaching set to double

6th Mar 2014
A DOUBLING in PIP payments for GP teaching promised by the Coalition before the election last year looks likely to be included in the upcoming federal budget.
Health Minister Peter Dutton told the Future of General Practice Conference, held by General Practice Registrars Australia (GPRA) in Canberra today, that the government was “implementing that promise”.
…..
And while there remained some “serious flaws” in the personally controlled electronic health record (PCEHR) system, Mr Dutton remained optimistic about its potential.
He told the conference he was considering the findings of a review he commissioned into the billion-dollar system but said problems relating to the availability of reliable medication and allergy information needed to be made a priority.
By improving these areas and allowing greater uploading of patient discharge summaries, GP and hospital clinician engagement could be significantly increased, Mr Dutton said.
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Orion Health Wins Frost & Sullivan 2014 Growth Excellence Award for Healthcare IT

The Australia Healthcare Awards honour companies that have demonstrated best practices and exemplary levels of excellence.
Sydney, 3 March 2014 - Orion Health, a global e-health technology leader, has now been recognised as a leader in the Australian healthcare IT market by Frost & Sullivan Australia. The company was awarded the prestigious Frost & Sullivan Growth Excellence Award for Healthcare IT for 2014.
The Australia Healthcare Awards are part of the Frost & Sullivan Australia Excellence Awards which were founded in 2006, and honour companies that have demonstrated best practices and exemplary levels of excellence. Market participants were judged according to research conducted for Frost & Sullivan’s latest research on the Australian and global healthcare market.
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Global PC shipments fall 10%

Date March 6, 2014 - 10:40AM

Brandon Carte

Global shipments of personal computers fell 9.8 per cent last year and are likely to decline by 6.1 per cent in 2014 due to lacklustre demand in developing countries, according to market research firm IDC.
The results in the fourth quarter of 2013 were slightly better than expected. IDC predicted a 10.1 per cent decline, but last year's 9.8 per cent decline has been the largest drop since IDC began tracking the data in 1994.
Unit volume of PCs is predicted to slip from 315.1 million units worldwide in 2013, to 291.7 million in 2018. IDC defines PCs as: "desktops, portables, mini notebooks and workstations." This means the figures include netbooks but exclude tablets with detachable keyboards.
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Ineroperability and Safety: Testing your healthcare integration

Posted on March 3, 2014 by Grahame Grieve
Testing is is critical both early and often. Please learn from others failures. The Apple “goto fail”provides a chance to learn testing governance lesson. It is just one in a long line of failures that one can learn the following governance lesson from. Learning these lessons is more than just knowing the right thing to do, but also putting it into practice.
Starting with the Apple Goto Fail: I was personally astounded that this bug existed for so long. John notes that this is an open-source library, though I think of this as “published source” not “open source”. And btw, NSA, thanks for letting Apple know about the bug when you found out about it – I’d hate to think that you preferred for us all to be insecure…
Anyway, the key thing for me is, why isn’t this tested? Surely such a key library on which so much depends, it’s surely tested every which way until it’s guaranteed to be correct?  Well, no, and it’s not the only security library that has problems - even very similar ones. Though it’s probably properly tested properly by Apple now – or soon anyway (in fact, I figure that’s probably how they found the issue).
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Medicare Local myths busted

4th Mar 2014
IT BEGGARS belief that Australia’s primary healthcare system stirs up misleading myths about its performance and purpose.
Sean Rooney 
Chief Executive Officer, AML Alliance
For a system that is actively organising primary healthcare, reducing bureaucracy and improving service access and equity, the naysayers are starting to look like they are crying wolf.
So let’s look at some of the myths surrounding Medicare Locals (MLs) and set the record straight.
Myth #1 — GPs not happy: Recent press reports that assert an “overwhelming majority of doctors think their ML has done nothing to improve healthcare” are just plain wrong. The facts are that the survey quoted was not exclusive to GPs. It attracted just over 1200 respondents, of whom 75% provided the negative feedback. Of approximately 30,000 GPs Australia-wide, 900 is not the majority of doctors. Spot the myth. Furthermore, MLs that have surveyed GP satisfaction levels are reporting positive responses.
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Researchers testing tiny ear computer

Date March 3, 2014

Miwa Suzuki

A tiny personal computer that is worn on the ear and can be controlled with the blink of an eye or the click of a tongue is being tested in Japan.
The 17-gram wireless device has Bluetooth capability and is equipped with a GPS, compass, gyro-sensor, battery, barometer, speaker and microphone.
Wearable computing is thought by many commentators to be the next big thing in technology, with products such as Google Glass at the forefront.
The device, known at the moment as the "Earclip-type Wearable PC" has a microchip and data storage, enabling users to load software, said engineer Kazuhiro Taniguchi of Hiroshima City University.
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Asylum seekers across Australia launch legal appeals following data breach

Government faces slew of federal court appeals after details of every asylum seeker on the mainland was accidentally published
Asylum seekers across Australia are lodging court appeals following the inadvertent disclosure of almost 10,000 asylum seekers’ personal details, claiming the breach has exposed them to persecution from authorities in their home countries and therefore they are entitled to automatic protection.
Guardian Australia revealed in February that the names, dates of birth, countries of origin, arrival date and location of every asylum seeker in a mainland detention facility was accidentally published on the department’s website.
A letter, which detainees say has been signed by more than 50 asylum seekers in Villawood detention centre in western Sydney, also claims Immigration Department staff have intimidated asylum seekers who have indicated they will lodge claims, and are inviting “vulnerable” detainees to waive their privacy rights.
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Medical board’s online fine backflip

7th Mar 2014
THE Medical Board of Australia has made a swift U-turn on threats to fine doctors for failing to police online reviews of their services.
Under the recent directive, due to come into effect on 17 March, practitioners faced a $5000 fine for not requesting the removal of unsolicited online reviews of their clinical services. 
GPs reacted angrily to the move, claiming it amounted to censorship of freedom of speech.
But MBA chair, Dr Joanna Flynn, has now said the policy was only ever intended to apply to proactive advertising or promotion of a regulated health service.
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AHPRA’s guidelines: Can someone tell me what just happened?

For those who haven’t followed the lively debate about the revised advertising guidelines for Australian health professionals, this post from last week explains it all. In summary, the Australian Health Practitioner Regulation Agency now says in its new guidelines that practitioners can be fined if patients post online testimonials praising the clinical care they received.
Last Friday, it seemed as if AHPRA had backed down on the harsh regulation. But is this really the case?
What does AHPRA say?
First of all, here’s a quote from the current guidelines:
a review (…) that states ‘Practitioner was quick to diagnose my illness and gave excellent treatment’, is a testimonial which references clinical care and is considered in breach of the National Law.
The guidelines also state that health practitioners must take steps to remove unsolicited testimonials appearing on any (social media) website not under their control. However, last Friday the medical board put out a media statement on the AHPRA website saying this:
The advertising guidelines apply to testimonials in the context of advertising (…) there is a clear difference between advertising - which requires an intent to promote the health services - and unsolicited online comment over which practitioners do not usually have control (…). The Board recognises that practitioners are unable to control what is written about them in a public forum.
The full statement can be found here.
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Are we raising a generation with digital dementia?

Date March 7, 2014 - 5:33PM

Mary Ann Roser

The obsession with all things digital, from smartphones to online games, has some health experts worried about kids today - especially their brains.
The two-year-old who can nimbly use an iPad or kill a gazillion monsters playing a video game isn't necessarily a genius, says Manfred Spitzer, a neuroscientist and psychiatrist. That child could be en route to trouble with memory and thinking, a condition Spitzer and others call "digital dementia".
"When you use the computer, you outsource your mental activity," Spitzer said. While computers can be fine tools for adults who are using their minds all day long, they're poison for kids, he said.
Spitzer is author of the 2012 book Digital Dementia: What We and Our Children are Doing to our Minds.
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Pro anorexia, bulimia social media posts on the rise

Date March 6, 2014

Katie Cincotta

The young girl's collarbone juts forward, her ribcage taut and exposed like the withered bones of a sunken vessel, more threatening than sensual in this body display known as the ''bikini selfie''.
Social networks have acted to try to minimise harmful behaviours by their users, but comb sites such as Instagram, Pinterest and Tumblr for hashtags such as #thinspo and #thinspiration and you'll find thousands of gaunt, underweight victims documenting their quest to achieve their version of beauty.
Social media, with their global proliferation and instant provision of validation in the form of a ''like'', have drawn dramatic new focus on ''skinny'', acting as an intimate tabernacle of gaudy body shots where the anorexic come to worship.
According to an Internet Trends study, the number of pro anorexia and pro bulimia - or ''pro mia'' - sites increased 470 per cent between 2006 and 2008.
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Coalition on hunt for Labor’s NBN secrets

THE federal government has commissioned its fifth audit of the National Broadband Network and appointed the former head of the Productivity Commission, Bill Scales, to oversee an independent investigation into the process that led to the formation of Labor’s NBN policy.
The genesis of the policy has been steeped in controversy since it was originally devised in March 2007 by then opposition leader Kevin Rudd as a $4.7 billion publicly funded subsidy to build a fibre-to-the-node network.
In 2008, as the world’s economy was rocked by the global financial crisis, the original proposal was scrapped and replaced with a $43bn proposal for the government to go it alone and build a fibre-to-the-premise network. At the time the official reason given by an expert panel overseeing bids for the $4.7bn subsidy was that none of the bids presented “value for money”.
-----

Turnbull asks how the NBN got that way

Former Telstra official to lead audit of NBN policy process under Labor
The Coalition will deepen its probe of the National Broadband Network, with the government announcing the appointment of a former Telstra official to investigate the public policy process behind Labor’s NBN.
Communications Minister Malcolm Turnbull announced the appointment of Bill Scales to perform the audit. Scales was previously in charge of regulatory matters at Telstra as group managing director for regulatory and corporate affairs.
Scales also served as chairman of the Industry Commission and secretary of Victoria’s department of premier and cabinet.
“The independent audit will investigate the advice, decisions and policy processes that led to the National Broadband Network policy and establishment of NBN Co,” Turnbull announced today.
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NBN should be made a monopoly

  • ALAN KOHLER
  • Business Spectator
  • March 04, 2014 12:00AM
THE government must either legislate for the National Broadband Network to be a monopoly or ditch it. There's no other alternative.
To allow Telstra and TPG, and perhaps others, to compete against it would turn a marginal infrastructure proposition into a financial disaster, and Malcolm Turnbull couldn't blame Stephen Conroy either: Conroy's NBN was going to be a monopoly.
Turnbull is the one who, in opposition, talked airily about allowing competition against the NBN, and now both TPG and Telstra are taking him up on it. TPG has announced plans to lay the fibre to the basements of apartment buildings, and last week David Thodey of Telstra said, in effect, that if TPG is allowed to do that, then so will Telstra.
Here is what Thodey is reported to have said a few days ago: "If they (the government) are going to continue with what was the original intent, to have no infrastructure-based competition, then they need to plug the hole.
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ANU astronomers want to fire lasers at space junk

Date March 7, 2014

Henry Belot

Reporter

Astronomers at the Australian National University want to fire lasers at space junk orbiting Earth in an effort to avoid scenes depicted in the Oscar-winning movie Gravity.
The astronomers will be based at the $20 million Cooperative Research Centre at Mount Stromlo.
Cooperative Research Centre chief executive Ben Green said scientists estimated more than 300,000 pieces of space junk were orbiting the Earth and they posed serious risks to satellites and space exploration.
"There is now so much debris that it is colliding with itself, making an already big problem even bigger. A catastrophic avalanche of collisions that would quickly destroy all satellites is now possible," he said.
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Enjoy!
David.

Sunday, March 09, 2014

Does This Sound To You Like A Man With A Plan - It Really Doesn’t to Me!

Mr Dutton gave a major speech last week.

Keynote Address to the General Practice Registrars Australia Conference 2014

Minister for Health Peter Dutton presented the Keynote Address to the General Practice Registrars Australia Conference 2014 on 6 March 2014.

Page last updated: 06 March 2014
6 March 2014
Check Against Delivery
Good morning ladies and gentlemen and thank you for welcoming me here this morning to open the Future of General Practice 2014 (#fgp14) conference.
For the past four years I have spoken at the GPRA’s annual conference while in Opposition, so I’m pleased to have the opportunity to address this event as the Minister for Health.
I would like to acknowledge:
  • GPRA Chair, Dr David Chessor, and Board members,
  • General Practice Students Network (GPSN) Chair, Joseph Monteith,
  • GPRA Patron Professor, John Murtagh,
  • medical students and registrars, and
  • other important members of the medical community.
Firstly thank you to the GPRA for continuing to look for innovative ways to further improve the quality of Australia’s health care through higher standards of education and training.
These conferences play an important role in the future of the health care sector, providing an opportunity for leaders in the field to share ideas and investigate ways we can support the next generation of GPs to provide the standards of care that Australians need and deserve.
Thank you also for your important work representing the nation’s future GPs - and I note the importance of the theme you have chosen for this conference – transforming communities – and your focus on the role of technology in the future of general practice.
New technology and social media have been transformative forces in modern Australia, touching virtually every aspect of our daily lives. I suspect your experience with Twitter is a little different to mine.
The many new young registrars we have coming through today, many of whom will be tomorrow’s GP in communities throughout Australia, are high users of online tech both personally and professionally.
You are part of a new generation of physicians for whom new online technology and social media tools will greatly influence their professional life. This opens up new opportunities – both for GPs as well as the communities and patients they support.
A large part of the challenge we face today is the need to think about how we can better utilise those tools to better support you – to help you do your job more efficiently and effectively, and to achieve better outcomes for patients.
The full speech is here:
There was commentary on the speech here with some e-Health comments at the bottom of the article:

PIP payments for teaching set to double

6th Mar 2014
A DOUBLING in PIP payments for GP teaching promised by the Coalition before the election last year looks likely to be included in the upcoming federal budget.
Health Minister Peter Dutton told the Future of General Practice Conference, held by General Practice Registrars Australia (GPRA) in Canberra today, that the government was “implementing that promise”.
The $119 million commitment would result in existing maximum practice payments for teaching sessions with medical students rise from $100 to $200, with a maximum of two sessions able to be claimed by a practice per calendar day. Eligible sessions must last at least three hours, while the maximum payment of $200 would remain, regardless of whether multiple students are taking part in the session.
----- Lots omitted
And while there remained some “serious flaws” in the personally controlled electronic health record (PCEHR) system, Mr Dutton remained optimistic about its potential.
He told the conference he was considering the findings of a review he commissioned into the billion-dollar system but said problems relating to the availability of reliable medication and allergy information needed to be made a priority.
By improving these areas and allowing greater uploading of patient discharge summaries, GP and hospital clinician engagement could be significantly increased, Mr Dutton said.
Full article here:
What we have here is that the Minister thinks the PCEHR has ‘serious flaws’- unspecified  - but that it has potential. He then goes on the say he is still considering the review. It is interesting that the speech transcript did not mention e-Health that I could see.
On the basis that the report represents Mr Dutton’s views we are forced to conclude that, having had the Review for 2-3 months, really does not know what to do - or he would have done it - or possibly he is wanting to get more input.
What I suspect is going on is that Minister is under lobbying pressure from the vendors supporting the PCHER and NEHTA that this can all be fixed and that if he is patient it will all turn out to be a great success.
My view is that if he falls for this line he will regret it, big time, 2-3 years from now. Anyone who knows anything about e-Health know the PCEHR is a deeply conceptually flawed concept that does not know what its purpose is and who it is meant for.
Doing anything other than essentially starting again with a more workable model or scrubbing the whole thing are the only viable options. I suspect the final outcome will depend on the dollars needed and the quality of the lobbying. Do you reckon it is possible the increased PIP Payments will be funded by a cut to the e-Health PIP incentive? Overall this my not be an ideal way to set public policy and meet health needs.

Another possibility is that they have a plan and that it has real Budget impact and so is under review by Finance etc before being agreed. It is worth remembering the PCEHR funding ends Jume 30.

Maybe the Health IT industry could develop a recovery plan?

Look forward to other insights!
David.

AusHealthIT Poll Number 208 – Results – 9th March, 2014.

Here are the results of the poll.

How Would You Rate The Performance Of Federal Health Minister Dutton In The Area Of E-Health Over The Last Six Months?


Just Fabulous 4% (2)

Pretty Good 4% (2)

Neutral 22% (12)

Pretty Bad 38% (21)

Just Awful 27% (15)

I Have No Idea 5% (3)

Total votes: 55

It seems there is a slight majority (65%) who are less than pleased with Minister Dutton’s performance so far!

Again, many thanks to all those that voted!

David.