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."

Saturday, April 19, 2014

Weekly Overseas Health IT Links - 19th April, 2014.

Note: Each link is followed by a title and 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.
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Eight (No, Nine!) Problems With Big Data

BIG data is suddenly everywhere. Everyone seems to be collecting it, analyzing it, making money from it and celebrating (or fearing) its powers. Whether we’re talking about analyzing zillions of Google search queries to predict flu outbreaks, or zillions of phone records to detect signs of terrorist activity, or zillions of airline stats to find the best time to buy plane tickets, big data is on the case. By combining the power of modern computing with the plentiful data of the digital era, it promises to solve virtually any problem — crime, public health, the evolution of grammar, the perils of dating — just by crunching the numbers.
Or so its champions allege. “In the next two decades,” the journalist Patrick Tucker writes in the latest big data manifesto, “The Naked Future,” “we will be able to predict huge areas of the future with far greater accuracy than ever before in human history, including events long thought to be beyond the realm of human inference.” Statistical correlations have never sounded so good.
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5 ways Google Glass will innovate healthcare

April 11, 2014 | By Ashley Gold
Google Glass--no longer just a hopeful idea or cool trend--is slowly but surely disrupting healthcare for the better as various innovators come up with creative ways to use the technology and get results.
Most notably, as reported earlier this week, in the latest post to his Life As a Healthcare CIO blog, John Halamka, CIO at Beth Israel Deaconess Medical Center in Boston and a FierceHealthIT Advisory Board member, discusses how Google Glass improves the lives of patients at BIDMC.
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Heartbleed: What is the impact on health IT?

April 11, 2014 | By Dan Bowman
When it comes to maintaining the safety of health information technology and patient data, encryption is almost always one of the first recommendations made by security experts. That's why news this week about the "Heartbleed"computer bug--which compromised Web encryption program OpenSSL, opening "hundreds of thousands of websites to data theft," according to Reuters--is so disturbing for the industry.
Even health entities that don't rely on the version of OpenSSL compromised by the bug should be worried about the ramifications, according to Boston-based health attorney and FierceHealthIT Editorial Advisory Board member David Harlow.
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Doctors Going Mobile, But Still Skeptical of Connected Health

Gregory T. Huang 4/8/14
At least two-thirds of American doctors surveyed use mobile-health apps on the job. But about two-thirds also think a truly connected healthcare system in the U.S. is more than five years away—or won’t happen at all.
That’s according to a new report by MedData Group, a healthcare marketing firm based in Topsfield, MA. The report surveyed 532 doctors around the U.S., across specialties and practice sizes, between December and March.
As health IT booms with startups, investors, and tech giants getting into the game, the MedData findings provide a snapshot of which mobile technologies physicians are using—and what they want to be using.
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Fast, easy tech matters to physicians

Posted on Apr 10, 2014
By Carl Shulman, MD
For physicians on the combat field, making technology easy to use is nothing short of critical. I am the director of the William Lehman Injury Research Center, where we developed MobileCare, a web-based software that integrates documentation, education and telemedicine. MobileCare was originally designed for Army physicians in the field. We are now applying these lessons to the civilian healthcare sector.
One of the most important things we had to take under consideration when creating MobileCare, which was developed in partnership with the Department of Defense, was the actual design of the app and the related user experience. The biggest lesson I’ve learned as a result of this experience is this: If a certain technology or app is not something physicians like, actually want to use and feel like they can easily integrate into their workflow, they simply won’t use it.
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DeSalvo charts new course for ONC

Posted on Apr 10, 2014
By Diana Manos, Senior Editor
Karen DeSalvo, MD, the national coordinator for health information technology has proposed that ONC become “more forward-thinking.”
At a Health Information Policy Committee on Tuesday, of which she is the chair, she urged the committee to consider what needs to change.
DeSalvo suggested the ONC dissolve its current workgroups and form new ones, in an effort to make ONC’s work into a “less siloed approach.” She envisions consumer and privacy advocates participating across all the groups. The proposed workgroups are:
  • HIT strategic planning
  • Advanced health models and meaningful use
  • HIT implementation, usability and safety
  • Interoperability and health information exchange
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Lorenzo 'winning business on merit'

10 April 2014   Lis Evenstad
Lorenzo is “probably more perfect” than other patient administration systems in the UK market, CSC’s UK healthcare lead, Philippe Houssiau, has said.
Speaking to EHI about managing three successful go-lives of the electronic patient record system in a couple of months, Houssiau said that Lorenzo has been “lifted out of the box”, and the company is now “deploying the system on the merit of the system itself.”
“To me, Lorenzo is one of the most robust and homegrown PASs in the UK market. It is by no means perfect, but it’s probably more perfect than other systems that are around,” said Houssiau.
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Millions of dollars spent on big data, but where are the results?

April 10, 2014 | By Ashley Gold
Many organizations--including those in the healthcare industry--have invested millions of dollars in big data analytics over the past few years. But where are the results?
A recent post in Harvard Business Review details some CIOs' frustrations with what they thought would be more impactful returns from big data analytics. The author, Michael Schrage--a research fellow at MIT--argues that a "data heuristic" has emerged--companies with mediocre outcomes use big data for decision support, while companies that have successful return on analytics (ROA) use it for effecting and supporting behavior change. 
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Cost remains a barrier to e-prescribing, despite benefits

April 10, 2014 | By Susan D. Hall
While e-prescribing has the potential to increase patient safety and medication adherence while save money, implementation costs remain one of the biggest barriers to adoption in ambulatory practices, according to research published at Perspectives in Health Information Management.
Sending prescriptions electronically to pharmacists has the potential to save the U.S. healthcare system an estimated $27 billion a year, the article points out. It potentially can help prevent more than two million adverse drug events a year, 130,000 of them life-threatening.
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Innovation showcase brings 'wow' factor

Posted on Apr 09, 2014
By Erin McCann, Associate Editor
Boston has long proven itself a mecca for healthcare innovation, a hub of some of the best minds and most prestigious hospitals in the nation. And the 2014 Boston Children's Hospital Innovators' Showcase proved no exception.
Featuring some 35 innovations developed by engineers, researchers and clinicians at Boston Children's, the exhibit boasted an array of cutting-edge technologies and problem-solving platforms. Amid the bustling showcase floor were, among others, robotic implants, phototargeted nanoparticles, drug delivery devices and clinical IT platforms that could signify big things for patient care. 
One of them, the Integrated Clinical Information Sharing System, or ICISS, is all about bridging the communication gap between provider and patient, and bringing healthcare connectivity out of the Dark Ages. And, from what developers have seen anecdotally, it's already beginning to do so. 
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IOM: Put social, behavioral data in EHRs

April 9, 2014 | By Susan D. Hall
Social and behavioral health information should be included in electronic health records to give care providers the most complete patient data about the patient, the Institute of Medicine says in a new report.
A 13-member committee compiled a proposed list of 17 social and behavioral "domains" to be included as a guide for federal officials developing criteria for Meaningful Use Stage 3, reports Family Practice News.
The domains include sociodemographic, psychological and behavioral factors as well as information about a patient's relationships, neighborhoods and communities.
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Google Glass to Assist Parkinson's Patients

Google Glass is being trialled in an effort to find new ways in which the smartglasses can be used to support people with long-term conditions such as Parkinson's disease and dementia.
Researchers at Newcastle University have been working with Parkinson's patients to investigate ways the wearable technology can be used as an assistive aid for people suffering from the condition.
Currently only available to developers and Glass Explorers, five pairs of the smartglasses were donated by Google to the university to assist in the research.
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Beth Israel Deaconess Deploying Google Glass in ED

APR 9, 2014
Google Glass technology developed by San Francisco- and New York-based startup Wearable Intelligence (WI) has been deployed in the emergency department at Beth Israel Deaconess Medical Center, Boston after a successful pilot.
In an April 9 entry in his "Life As A Healthcare CIO" blog, BIDMC CIO John Halamka, M.D., wrote the hospital had been piloting the technology for four months.
"After several months of testing, we have deployed the product to clinical providers in the ED and are completing the first IRB approved study (to our knowledge) of the technology’s impact on clinical medicine," Halamka wrote.
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Study: Using Laptops or Tablets Saves Physicians an Hour a Day

Written by Ayla Ellison (Twitter | Google+)  | April 08, 2014
Researchers from Birmingham Women's Hospital in the United Kingdom have found swapping traditional methods of filling out forms on paper for tablets or laptops saves physicians an hour a day during rounds.
The researchers found physicians spend approximately 56 percent of ward round time filling out paperwork, but this could be reduced to 41 percent if physicians made use of technology.
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OpenNotes Expands Regional EHR Adoption

Scott Mace, for HealthLeaders Media , April 8, 2014

Kaiser Permanente Northwest is one of several healthcare providers participating in an effort to roll out open access to clinician notes as a standard of care throughout the Pacific Northwest.

A consortium of nine healthcare provider systems is targeting more than one million residents of Oregon and southwest Washington State in 2014 to provide open access to their physicians' notes in electronic medical records.
The announcement this week marks the first time that OpenNotes, a national movement that urges health-related organizations to adopt open access to clinician notes as a standard of care, has been embraced simultaneously throughout an entire region.  
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But Seriously Now, Why Do Doctors Still Make You Fill Out Forms on Clipboards?

"Meditative practices emphasize returning to one’s breath. The clinical equivalent of this is to return to one’s patient. "
James Fallows  Apr 8 2014, 12:34 PM ET
We'll get back to St. Marys, Georgia, later today. For now, let's dip back into the mailbag for the latest array of views -- most from doctors or other medical professionals, some from technologists, some from "ordinary" patients -- on the pluses and minuses of the shift to electronic medical records. For background: my original Q&A with Dr. David Blumenthal, who directed the electronic-records program at the start of the Obama administration. That article also has links to four previous rounds of discussion -- and, why not, here they are again. One, two, three, and four. Now, eight more ways of looking at electronic medical records.
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How Not To Do Big Data

APR 7, 2014 9:37am ET
I got a letter from my health insurer last week. It looked like junk to me at first, but my wife opened it up and left it at my place on the dining room table, so I eventually got around to reading it.
According to my health plan, I would benefit from taking part in their disease management program. They have nurses who serve as personal "health coaches," who could help me to "reach my best health," or "understand treatment plans or medications from my doctor," and "discuss the online resources available for me to live a healthier life."
There's just one problem with their thoughtful offer: I don't have a disease. I didn't even catch a cold this winter.
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Feds release FDASIA workgroup report on health IT governance

By Diana Manos, Senior Editor and Eric Wicklund, Contributing Editor
A widely anticipated report from the U.S. Food and Drug Administration and other agencies may finally clear the air on how healthcare IT – and mHealth in particular – will be regulated.
The Department of Health and Human Services' Office of the National Coordinator for Health IT and the Federal Communications Commission joined the FDA in drafting the report, which was mandated under the Food and Drug Administration Safety Innovation Act (FDASIA) of 2012. The report now goes on to Congress.
Dan Haley, vice president of government and regulatory affairs and assistant general counsel at athenahealth, said he sees “a lot of good language,” in the report. That language was taken from an industry collaboration of 100 or more experts, including athenahealth, led by the Bipartisan Policy Center (BPC). 
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Google Glass gets wearable neuro app

Posted on Apr 08, 2014
By Mike Miliard, Managing Editor
In a development that could help providers with remote patient monitoring and other telehealth applications, one developer has created a neuroimaging app designed to work with Google Glass.
Created by Personal Neuro Devices, a Canadian application developer staffed with neuroscientists and biochemical engineers, the technology, called Introspect: the PND Wearable, is designed to enable Google Glass to give neuro-feedback to clinicians and caregivers.
The head-mounted, voice-activated tool could help passively monitor brain activity, relaying data to physicians to help diagnose and treat conditions such as depression, say PND officials.
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Plans for £230m GP IT spend released

3 April 2014   Rebecca Todd
NHS England has released its plans for how more than £230m in GP IT funding will be spent over the next year to ensure all practices across England have high-quality IT systems.
An updated operating model for 2014-16, ‘Securing Excellence in GP IT Services,’ aims to "improve the quality of GP care by enhancing patients’ experience of services, supporting and encouraging greater integration of care and providing efficiency benefits for practices by reducing paperwork, freeing up more time for patient care", a statement from NHS England says.
The new document confirms what EHI exclusively revealed last month; that GP IT funding will now be paid to clinical commissioning groups on a per-head-of-population basis, with some funding kept back to form a 'transitional fund' to which CCGs can apply if they need it.
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What's keeping telemedicine from reaching its potential?

April 8, 2014 | By Ashley Gold
Payment procedures must be figured out and more doctors and hospitals must be persuaded to offer telemedicine before telemedicine's potential can truly be met, Robin Farmanfarmaian, a founder of Silicon Valley's technology and humanities-focused Singularity University, writes in a recent MedGadget post.
Some of the benefits of telemedicine technology, according to Farmanfarmaian, include:
  • Cost reductions: When patients stay home, healthcare facilities and patients save money and doctors and hospitals can process more patients overall, Farmanfarmaian says.
  • Greater patient engagement: Adds Farmanfarmaian, "Going to the doctor" is less of a drag with telemedicine--no taking time off work or traveling. Consultations are easier, so compliance will increase.
  • Reduction in diseases transmission: Waiting rooms and hospitals are "hotbeds" for germs and viruses and hospital-acquired infections like sepsis, Farmanfarmaian says.
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Quest for a Unique Patient Identifier Stalled

by Bonnie Darves, iHealthBeat Contributing Reporter Tuesday, April 8, 2014
It's been almost 17 years since HHS, in a report, issued this bold statement:
"The need for unique patient identifiers has become urgent and critical. The widespread implementation of information technology and the emergence of computer-based patient records have paved the way for its potential success." (November 24, 1997)
The short, now old story is this: The original HIPAA legislation called for a unique patient identifier. Congress, citing privacy concerns, prohibited HHS from spending any money on developing standards and each annual appropriations bill since has continued the prohibition. 
The urgency, however, now has renewed impetus with the proliferation of health information exchanges, as cross-organizational patient-data sharing increases the patient mismatch potential.
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Colleagues In Cuffs: When Employees Steal Patient Records

4/7/2014 09:06 AM
The Queens County DA recently arrested two Jamaica Hospital employees for stealing patient data, a lucrative crime occurring at hospitals across the nation.
The Queens, N.Y., district attorney recently charged two employees of Jamaica Hospital Medical Center with illegally accessing emergency room patients' medical records and personal identification information, and selling that data to individuals who then solicited services such as outpatient care or legal assistance -- sometimes while patients were still in the ER.
“These defendants are accused of blatantly violating their HIPAA obligations and illegally trolling through confidential patient records. Their alleged actions led to patients who were seeking treatment for injuries unwittingly being victimized again with the illegal release of their personal information and medical records," said DA Richard Brown, in a statement.
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CMS Silence on ICD-10 Holds Healthcare Hostage

Scott Mace, for HealthLeaders Media , April 8, 2014

CMS Administrator Marilyn Tavenner firmly vowed only weeks ago that there would be no ICD-10 delay. Now that an undefined delay has been announced, she remains silent on ICD-10's next steps.

The hives-inducing Washington-DC-based drama, ICD-10 Held Hostage has entered its second week.
This first week has been good news for a variety of FUDbusters and others hawking products meant to cut through the fear, uncertainty and doubt following the stealthy legislative blitz that delayed CMS's requirement for providers to use ICD-10 starting October 1.
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FDA Opens Public Comment Period for New HIT Strategy

APR 6, 2014
The public will get a chance to comment on a proposed risk-based regulatory framework for health information technology developed by the Food and Drug Administration in coordination with the Office of the National Coordinator for Health IT and Federal Communications Commission. 
In an April 7 Federal Register notice, the FDA announced the availability of the draft report and website location where it can be downloaded as well as a docket where stakeholders may provide comments. The public has until July 7 to submit comments either electronically or in writing.
"FDA, ONC, and FCC invite interested persons to submit comments on this report," states Bakul Patel, senior policy advisor for the FDA's Center for Devices and Radiological Health, in the notice. "We have established a docket where comments may be submitted. We believe this docket is an important tool for receiving feedback on this report from interested parties and for sharing this information with the public."
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FDA goes for 'light touch' on health IT

Posted on Apr 04, 2014
By Eric Wicklund, Editor, mHealthNews and Diana Manos, Senior Editor
A widely anticipated report from the U.S. Food and Drug Administration and other agencies may finally clear the air on how healthcare IT – and mHealth in particular – will be regulated.
The Department of Health and Human Services' Office of the National Coordinator for Health IT and the Federal Communications Commission joined the FDA in drafting the report, which was mandated under the Food and Drug Administration Safety Innovation Act of 2012, often referred to as FDASIA. The report now goes on to Congress.
Dan Haley, vice president of government and regulatory affairs and assistant general counsel at athenahealth, said he sees “a lot of good language,” in the report. That language was taken from an industry collaboration of 100 or more experts, including athenahealth, led by the Bipartisan Policy Center.
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Telehealth framework goes beyond just tech

April 7, 2014 | By Susan D. Hall
A framework for evaluating telehealth programs must consider socioeconomic aspects--not just the technological--argue researchers in an article published online in Telemedicine and e-Health.
Costs, benefits, barriers and outcomes, including clinical outcomes, are among the integral socioeconomic factors at play in telehealth implementations, they say.
The framework's key characteristics include implementations that are loosely coupled and easy to use, describe a wide range of telehealth programs and can be expanded to meet future needs. 
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Enjoy!
David.

Thursday, April 17, 2014

Easter - Anzac Day Break - Back On The April 27, 2014

Unless there is important breaking news I plan to have a short break from the blog till Sunday 27 April.

Hopefully we will all be rested and ready to face the draconian budget Mr Hockey is clearly planning.

Enjoy the days off!

David.


Wednesday, April 16, 2014

Pre - Budget Review Of The Health Sector - 16th April 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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Hockey must work an economic miracle

Rob Burgess 11 Apr, 5:32 PM
If ever a Treasurer has had a spinning-plate trick on his hands, it's Joe Hockey. When he returns from his G20 discussions in the US, Hockey will need every ounce of skill to keep the sticks and plates spinning lest one should fall, bringing the economy down with it.
What are the plates? In no particular order, the main ones are: the housing market, the Aussie dollar, business and consumer confidence, business investment, the jobs market and immigration.
Spend too long spinning one, and the others lose momentum. It really will be an extraordinary achievement if Hockey can pay attention to them all, and avoid a once in a generation tumble in living standards.
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State health ministers claim bureaucracies out of line

STATE governments are concerned that health bureaucracies established by the former federal Labor government are straying beyond their charter and flouting the intent of approaches agreed at the Council of Australian Governments.
Federal, state and territory health ministers meeting in Brisbane yesterday were understood to have voiced concerns about several national bodies and asked their advisory body to investigate their activities.
The independent agencies were established by the Rudd-Gillard governments to drive the health reform process. They include the Independent Hospital Pricing Authority, the Australian National Preventive Health Agency, the National Health Funding Body and the National Health Performance Authority.
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Pharmacy central to the community

The Guild’s Pharmacy Under Threat campaign is reaching a vital stage.
No one at the Guild is under any illusion about the difficulty of the task. We know the Government is broke and the Minister has said there is no money to address the impact of the pre-election changes to price disclosure on pharmacies.
However this is not about money. It is about breaching the Community Pharmacy Agreement with Australia’s 5300 community pharmacies.
For that reason, the Guild’s National President George Tambassis has made clear to the Minister personally that the Guild will continue to campaign until this injustice is satisfactorily addressed.
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Peter Dutton considers plan to withhold family tax benefits if children aren't immunised

April 11, 2014
An expert has warned the Federal Government that withholding tax benefits from families who choose not to immunise their children is unlikely to achieve real change.
Federal Health Minister Peter Dutton will discuss the issue when he meets with his state counterparts in Brisbane today.
The minister vowed to tackle the problem while touring the New South Wales north coast, where some communities have low childhood vaccination rates.
Mr Dutton says it might be time for the Government to take a tougher stance, adding that immunisation is "very important" for children and the wider community.
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Commonwealth considers withholding payments to immunisation objectors

April 10, 2014
The Federal Government is considering withholding tax benefits from families in the region who choose not to immunise their children.
Federal Health Minister, Peter Dutton, will discuss the issue with his state counterparts in Brisbane tomorrow.
The minister vowed to tackle the problem while touring the north coast, where some communities have childhood vaccination rates below 50 per cent.
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Union fears Guild report may spark redundancies

10 April, 2014 Nick O'Donoghue
Employee pharmacists are being encouraged to make sure they know their rights redundancy rights following the Pharmacy Guild of Australia’s recent Employment Expectations Report.
The report predicted as many as 2200 pharmacist jobs could be axed this year, as pharmacies struggle to manage the impact of price disclosure.
However, Dr Geoff March, Professional Pharmacists Australia president, warned that “unscrupulous pharmacy operators” may use the Guild’s forecast as an excuse to cut staff, only to re-hire pharmacists on lower wages.
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GP in court win over super clinic

8th Apr 2014
THE department of health has been court ordered to review a district of workforce shortage (DWS) application it rejected for a $10 million GP super clinic in Queensland.
The Townsville-based centre is expected to open in June, but operator Dr Evan Nicholls has been running an interim super clinic service nearby employing four international medical graduates (IMGs).
In 2012, the department refused to allow him to maintain the arrangement at the new clinic just 2km away, which would have maintained the IMGs’ eligibility for provider numbers.
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Healthcare put at risk as patients shy away from cost

Date April 10, 2014 - 1:01AM

Lucy Carroll

Health Reporter

Treatment delays: Patients are being put off visiting GPs because of expensive medical fees and long waiting lists.
Year-long waiting lists and high medical fees are causing people in NSW to stop or delay treatment, health professionals say.
A  Bureau of Health Information report shows that despite NSW having one of the best healthcare systems in the world, 15per cent of patients put off GP visits, filling a prescription and getting basic medical tests because of out-of-pocket expenses.
One third did not see the dentist because they could not afford to.
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The Australian Medical Association blasts consideration of a fee for visiting emergency departments

Louise Yaxley reported this story on Wednesday, April 9, 2014 18:10:00
DAVID MARK: The Australian Medical Association is heavily critical of an idea to impose a charge for people who present at hospital emergency departments with minor problems.
The rapidly rising cost of health means the Federal Government's considering new measures in the budget to make Medicare more sustainable, including the emergency charge.
The AMA says charging people for some visits to emergency departments won't save money and could instead drive up health costs by deterring people from seeking help until a problem is severe.
The Opposition's already on the attack.
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Health Minister Jack Snelling wants plans to charge hospital emergency fees for minor ailments scrapped

  • SUE DUNLEVY AND BRAD CROUCH
  • The Advertiser
  • April 09, 2014 10:58PM
THE architect of the controversial $6 GP fee proposal, Tony Abbott adviser Terry Barnes, says patients with minor ailments attending emergency departments should be charged $36.
The possible charge, floated as a measure to deter people from avoiding the proposed Medicare co-payment for GP services by presenting at emergency departments with minor ailments, has been flatly rejected by South Australian Health Minister Jack Snelling, who will demand the scrapping of any plans to charge public-health patients when he meets federal and state counterparts on Friday.
“We spend tens of millions of dollars on avoidable admissions to hospital, conditions that would not be there if people had good access to GPs,” he said. “It is already hard for many people to access a GP. Whacking an extra cost to see a GP and then to a ED won’t help people. I will not be blithely going along with my Liberal colleagues on this.”
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Doors set to open on new GP super clinic

By Kate Stephens
9 April, 2014
The company building a multi-million-dollar GP super clinic in north-west Queensland says the facility is due to open in weeks.
Federal Health Minister Peter Dutton has halted funding for three super clinics across the country and is reviewing others.
The Mount Isa clinic was first announced by the Labor government in 2007, and Kinetic Health, which is now Sonic Youth Plus, was awarded $5 million to build the facility.
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Riverina MP says Narrandera GP Superclinic is funded, but can't rule out cuts in the future

April 9, 2014
The Member for Riverina says the government's decision to reduce funding for Labor's GP Superclinic program, will not impact local facilities.
Federal Health Minister, Peter Dutton, announced yesterday the government was suspending construction funding for three clinics.
Under the $650m scheme 60 clinics were funded around the country, including one at Narrandera, opening in 2011.
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'Hospital tax' a Labor scare: Dutton

11:42am April 9, 2014
The Abbott government has accused Labor of mounting a "disgraceful and alarmist" scare campaign over reports patients who crowd emergency departments with minor ailments may be charged.
The government is reportedly considering a plan to deter people from visiting emergency departments by charging them if they show up with minor complaints such as stubbed toes or common colds.
The proposal would come as part of the possible introduction of a $6 Medicare co-payment, which many believe would lead to hospital overcrowding, News Corp Australia reported on Wednesday.
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Time to adopt NZ health insurance model

Mark Fitzgibbon
Try to think of an industry in which highly qualified operators have clients willing to pay them for services rendered but in which government says no. And it’s not the production of crystal methamphetamine?
Sadly, the answer is healthcare with both doctors and consumers the losers.
Thankfully, led by Health Minister Peter Dutton we’re now having a discussion on the absurdity of current commercial restraints imposed upon doctors and health insurers. In a nutshell, existing laws restrain insurers from paying or contributing towards mainstream medical services provided by GPs, as well as those provided outside a hospital by specialists (i.e. those services with a Medicare scheduled benefit).
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Federal Government moves to dismantle Labor's GP super-clinic program

By political reporter Anna Henderson
Posted Tue 8 Apr 2014, 2:22pm AEST
The Federal Government is moving to dismantle Labor's GP super-clinic program by trying to claw back money from centres that are yet to be built.
GP super-clinics with longer opening hours, more staff and broad medical services were a major plank of Labor's health policy in government, with $650 million earmarked for 60 clinics.
But Health Minister Peter Dutton has criticised the slow building process and the cost of the scheme.
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Darwin super-clinic dumped as federal Health Minister Peter Dutton moves to claw back funds

Posted Tue 8 Apr 2014, 3:22pm AEST
Federal Health Minister Peter Dutton says he will talk with the Giles Government about ways to improve health services in the Northern Territory after dumping a planned GP super-clinic in Darwin's northern suburbs.
The former federal Labor Government set aside $5 million for the project in 2010 but it has never got off the ground.
Mr Dutton says super clinics around the country have failed to reduce hospital waiting times and the money would be better spent on hospital beds.
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8 April 2014, 2.41pm AEST

Rationing care vs increasing taxes – the health system sustainability myth

IIn the lead-up to the May budget, the seemingly inexorable rise in health spending has unleashed a “sustainability panic”: rhetoric that health system costs are out of control and drastic measures are…
Stephen Duckett
Director, Health Program at Grattan Institute
In the lead-up to the May budget, the seemingly inexorable rise in health spending has unleashed a “sustainability panic”: rhetoric that health system costs are out of control and drastic measures are needed to make the system affordable.
Sustainability panic is often used to justify shifting the burden of controlling health spending from the wider society to a vulnerable few – people with poor health who frequently go to doctors and hospitals, for example, or those with high needs and potentially shortened life expectancy. Proposals to limit access to care or to introduce co-payments for doctor visits would fall heavily on these groups.
Rationing health care is seen as a potential solution to the presumed cost explosion; the alternative being tax increases or some other unpalatable solution.
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Doctors' contracts dispute: AMA urges doctors to consider signing as changes made

By Ashleigh Stevenson
Posted 7 hours 25 minutes ago
The Australian Medical Association (AMA) says changes to the Queensland Government's controversial new contracts for doctors should address some major concerns.
Doctors have been threatening to quit the state's public hospital system en masse over the proposed contracts.
The State Government says sticking points regarding rosters and unfair dismissal have been addressed in an addendum that will be rolled into the agreements.
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'Profitability' clause concession in Qld contract dispute

8th Apr 2014
QUEENSLAND doctors will be spared from worrying about the profitability of their hospital under a state government concession on contracts.
Senior medical officers have threatened to quit over the individual contracts, which need to be signed by 30 April.
But in a move to end the long-running dispute, the government has offered to remove an existing clause where doctors could be sacked if their work impedes the profitability of their local health service.
Lobby group Keep Our Doctors feared medicos would think twice before keeping patients in for longer, or doing a costly experimental treatment.
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Super clinics scrapped

8th Apr 2014
THE company contracted to deliver a super clinic in Darwin is assessing its future and legal rights today after it was told by the Department of Health that the project has been suspended.
The Darwin super clinic is one of three projects suspended by the Coalition in what is understood to be a broader move to recoup up to $27 million in allocated but unspent super clinic funding.
Operators of the $7 million Perth-based Rockingham GP super clinic and the $15 million Wynnum super clinic in Brisbane – both in the planning and development stages – have also been advised by the department that their funding has been suspended.
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Super clinics will be scrapped: Labor’s $650 million ‘dangerous’ healthcare ‘disaster’ abandoned

  • April 08, 2014 12:00AM
·  exclusive simon benson national political reporter
THE federal government has suspended funding to three GP super clinics promised under Labor’s bungled $650 million rollout and will audit a dozen more after it was discovered that they had been sitting on millions of dollars of taxpayers money since 2010 without a sod being turned.
The Daily Telegraph has learned that Health Minister Peter Dutton has ordered that funding of $25 million be suspended to at least three of the clinics, in Darwin, Rockingham south of Perth and Brisbane, and will seek to recover the money.
All three super clinics were promised by Labor in 2010, yet construction has not started on any of them.
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Comment:
The drumbeat suggesting a tough budget has been building. The final report of the Commission of Audit (COA) has been handed to Government and as I predicted we are starting to see some hints and leaks.
Economically we now have the Treasurer as well as both the Reserve Bank Governor and the Secretary of The Treasury saying we have very serious budgetary problems - and we can be sure all three have seen the COA.
Really it seems to me the only question is just how big the cuts are and where they will fall. I suspect the answer is pretty big and everywhere! If the leaks are to be believed the age pension and the health sector are in line for a major shakeup.
To remind people there is also a great deal of useful discussion here from The Conversation.
As usual - no real news on the PCEHR Review.
More next week.
David.

Three Interesting Privacy Related Events Are Happening For Privacy Week Next Month - May 2014.

I was let know about these earlier today.
There are 3 very important privacy events happening in May to celebrate Privacy Awareness Week. Two of them are in Sydney and there is one in Brisbane.
The events on data breaches and vulnerabilities would definitely be of interest  to those who read this blog.
Dates and links are below.
6 May After work Presentation  - Data breach - Sydney -http://pams.com.au/iapp/StaticContent/Images/140508_iappANZ_Data_Breach_Sydney.html
These are always good sessions so it is worth considering going along.
David.

Tuesday, April 15, 2014

Is This The First Leak On The Outcome Of The PCEHR Review? I Wonder.

This appeared today in the AFR.

eHealth scheme considered for cuts

Joanna Heath
The Abbott government is considering ­publishing a review into the previous government’s eHealth scheme before the budget, prompting speculation the $1 billion program is in line for cuts.
Health Minister Peter Dutton has previously signalled his opposition to the scheme, which allows patients to opt-in to a personal electronic record of their medical history, calling the rollout under Labor a “scandal”.
The government was handed the results of the review in January this year, with its authors left in the dark about a release date. Freedom of information requests to obtain the report have been refused.
“We thought it was going to be mid-January, then mid-February, then April,” said panel member and Australian Medical Association ­president Steve Hambleton.
“eHealth is really on hold at the moment in Australia . . . everything is waiting on clarification as to the direction.”
The report is understood to ­recommend the eHealth system be retained but with changes made to its operation. Mr Dutton was ­unavailable for comment on ­Monday. After a slow start in uptake criticised by Mr Dutton, 1.5 million Australians were signed up for ­personal eHealth records by April 9.
More here:
This would seem to support the conclusion that eHealth may survive but not in its present form as suggested in yesterday’s blog here:
What do you think?
David.

A New Paper On A Digitally Enabled Health System From The CSIRO. A Trifle Unrealistic I Believe.

The report was released a week or two ago.
Here is a report on the paper.

Data Role

Technology will be a key factor controlling the exponential rise of healthcare costs in Australia’s future, according to the newly-released CSIRO paper, A Digitally Enabled Health System. 
The paper was released during the Health-e-Nation 2014 Summit, and Dr David Hansen, who is CEO of the Australian e-Health Research Centre (AEHRC), a CSIRO and QLD government joint-venture, says that it will be a talking point that spurs future research collaborations.
“There’s been a lot of downloads of the document,” he says. “We have had serious numbers of hits on it.”
Launched under CSIRO’s Digital Productivity and Services flagship, the report outlines digital remedies for key healthcare issues in Australia’s health system and outlines benefits through improved service quality and patient centricity.
Dr Hansen says that a key driver in future health research will be data, with clinical ontology playing a “huge role.”
“There is a real maturing, with the personally controlled electronic health record bedding down,” he says.
“We are also seeing hospitals really recognising that their data is a key asset to them and starting to use it in different ways to improve services and to support research into best practice and into clinical research,” he says.
The Digitally Enabled Health System report calls patient-centric data “the lifeblood of tomorrow’s health system,” and notes that currently, adverse medication reactions account for around three per cent of al hospital admissions, with about half of these preventable.
 Lots more here:
Here is a direct link to the report.

A digitally-enabled health system

What will our healthcare system look like, once the full potential of the digital era is harnessed?
  • 26 March 2014

Downloads

Australia's health system faces significant challenges including rising costs, an aging population, a rise in chronic diseases and fewer rural health workers. Treasury estimates even suggest that at current rates of growth, and without significant change, health expenditure will exceed the entire state and local government tax base by 2043. We need to look at new ways to make the health system work smarter. Digital technologies and health service innovation promise that.
This report A Digitally-enabled Health System looks at how the Australian health system can reduce costs and deliver quality care.
Some of the technology identified in the report includes telepresence robots taking rural health workers on city rounds, wireless ID wristbands monitoring patients in real time, mobile health apps assisting with at-home rehab and smart software that knows what patients will be turning up to emergency departments, 6-12 months in advance.
More is found here:
It is worth downloading the report to see how impractical some reports can be and how the theoreticians can rather miss the obvious issues.
To me the 2020 vision is probably early by a decade at least - see page 21 to see a proposed scenario.
My reason for saying this is simply based on the time it has taken to get to where we are in mid-2014 from the serious start to hospital and GP automation which got seriously underway in the late 1990s.
After 15 years we still do not have advanced level of automation in most hospitals and it seems very unlikely to me this vision will happen much before 2030. This is because it seems to me the report just ignores the scale of the change management and cost issues that will be associated with a transition to this proposed vision.
It also strikes me that by 2020 the technologies being appropriate to be deployed may be very different to those discussed here. Remember the iPad was only introduced in March 2010 - all of just 4 years ago - and who would have seen their impact coming!
The report also seems to somehow skate over the necessary basic IT infrastructure which is by no means generally in place as needed.
In summary a nice glossy brochure which I suspect is rather narrow in focus and not really addressing the basic gaps we presently have. Walking properly before you run is a sensible motto, and we are barely yet upright so far!
David.