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, May 07, 2014

An Interesting Set Of Requirements For Quality And Effective Use Of EHRs. Great Summary That Show Just How Far The Present PCEHR Falls Short.

This appeared a little while ago:

Case for dropping MU Stages 2 and 3

Posted on Apr 28, 2014
By Dale Sanders
Federal meaningful use requirements are well intentioned, but like a teacher who “teaches to the test,” the federal meaningful use program created a very complicated system that might pass the test of meaningful use stages, but is not producing meaningful results for patients and clinicians.
As reported on April 14, 2014 in MedScape (free log-in required), a formal study published in the April 2014 issue ofJAMA Internal Medicine shows no correlation between quality of care and meaningful use adherence. This study validates what common sense has told many of us for the last few years.
…..
Below are the simple but effective Core Principles of EMR Utilization that we developed. These principles played a huge part in the progressive value of Cerner and Epic on the Northwestern campus and laid the foundation for a relatively easy qualification of Northwestern under the federal meaningful use program.
Core Principles of EMR Utilization
Encounters
·         All patient appointments/visits are to be documented in the EHR as an encounter.
·         Visit encounters should be closed by the attending physician within 48 hours of the patient visit.
Medications
·         All medication prescriptions and refills must be documented in the EHR, including those ordered in a telephone encounter.
·         Medications are to be reviewed at every patient encounter, in accordance with the individual specialty’s standard of care.
·         Every effort should be made to maintain a valid and complete list of patients’ current medications in the EHR, including end dates, discontinuing medications no longer being taken, and removing duplicate medication entries.
Problem Lists
·         All chronic, persistent patient diagnoses or complaints should be documented on the Problem List in the EHR, with the exception of highly sensitive diagnoses such as those associated with mental health care.
·         Problems should be documented using the most specific term applicable to the problem, ex: mild intermittent asthma vs. asthma.
·         The Problem List should be reviewed and updated at every patient encounter, in accordance with the individual specialty’s standard of care, and problems not currently clinically relevant should be filed to history and marked as resolved.
Allergies
·         Allergy lists must be actively maintained for validity and completeness for all patients, including marking as reviewed when no new allergies are reported. The allergy list must be reviewed during any encounter in which a medication is ordered.
Orders
·         All patient orders must be documented in the EHR.
Progress Notes
·         All patient encounters should have an accompanied progress note that appropriately documents the history, physical, and decision-making in a way that is succinct and minimizes redundant content.
·         If dictating, notes must include the patient’s name and medical record number, the date of the encounter, and the attending physician’s name to ensure timely documentation.
In Basket
·         Patient results and messages should be reviewed within 72 hours of receipt, and In Basket coverage should be assigned when clinicians are unable to respond within that time frame.
…..
The full article is found here:
While the purpose of this article was rather US orientated in terms of the US Meaningful Use program we keep hearing Australians using the term around the PCEHR etc.
My point is that as a summary set of requirements for a useful EHR this is the minimum needed for a useful EHR (for the clinicians and the care and safety of their patients) and that the PCEHR gets nowhere near it. Minister Dutton said recently that the EHR he wants needs to be useful for clinicians - so here is a good spot to start!
Meet this list with the new design and you might just get somewhere Minister. It is the minimum that needs to be in place for an EHR to actually be useful  to clinicians.
David.

Tuesday, May 06, 2014

Article Draft - It Seems The Computerised Heart Of The Australian Health System Is Dangerously Close To A Heart Attack.

During the last week of April - and just prior to what are expected to be some fairly significant budget cuts to the Health System (which will have been confirmed before you get to read this I strongly suspect) - we have seen some quite concerning news emerge regarding some computer systems which are crucial for the overall health system.
The systems I am talking about are those huge and complex systems that are operated by the Department of Human Services and which help support the doctor payments of Medicare billing, the systems supporting the PBS, Centrelink and possibly the PCEHR  as well as a range of registries covering such things is paediatric vaccination and so on.
The systems which are part of providing payments to doctors and pharmacists have become utterly critical to the cash flows and operations of these services. Loss of these systems for even quite brief periods of time may very well result in considerable disruption of these services.
As background parts of these core computer systems were initially installed in the mid-1980s and use IBM System 360 compatible mainframes. The software used to support these systems has been developed in a data-base tool called Model 204 (http://en.wikipedia.org/wiki/Model_204) which is written in IBM System 360 Assembler - the most basic of computer language for IBM mainframe computers. This software is even older having begun its useful life in 1972. It is fairly inflexible software but in part makes up for this by being very efficient in the processing of transactions - which is something that Centrelink / Medicare do vast numbers of daily processing payments and so on to millions of people. Why the age of both the hardware and software is important is that there are now vanishingly few people with the skills to maintain and update the software and hardware and fundamentally both are now well past their ‘use-by’ dates!
Inevitably what happens with software systems of this age is that either they must be updated as requirements change - think MBS payment rates, legislative change and rules and Centrelink payment rules etc. - and inevitably the lack of flexibility and skills means all sorts of tricks and workarounds are developed to keep the system working. These ultimately  become so difficult and costly to maintain that, even if the old hardware can keep being maintained, a replacement needs to be planned and undertaken.
The scale is the issue was made clear by The Treasurer in late April, 2014.

Centrelink computer broken: Hockey

JOE Hockey has warned of a shock multi-billion-dollar hit to the budget to fix the 31-year-old Centrelink computer system, which is in “bad shape” and a drag on productivity that is holding back crucial policy change.
Human Services Minister Marise Payne said the system, based on 1980s technology, was also hampering the government’s efforts to cut red tape and shift Centrelink into the digital world.
The Treasurer said the biggest surprise he had received since coming into power was the ­deterioration in government infra­structure, particularly the Centrelink computer system in Canberra, which would cost “billions” to improve.
Mr Hockey, who is preparing a structural overhaul of welfare and payments in the budget next month, said changes were being stymied by the system.
“My overwhelming concern is that it is inhibiting the capacity of the government, to some degree, to roll out policy that properly ­addresses the problems in the economy and the budget,” he told radio station 3AW.
Centrelink’s Income Security Integrated System is vital to the delivery of $400 million in social security payments every day.
The link to the full article is here:
The size of the task is made clear by reports that it is estimated that it will cost $12 million to develop the business case for the system update. The replacement of the systems themselves is believed to be likely to cost a billion dollars plus.
This update will clearly be one of the largest and most mission critical projects ever undertaken in Australia with any significant disruption to payment flows resulting in issues for the national economy.
As Mr Hockey points out above Government policy is already being stymied by system inflexibility.
All we can hope for is that a replacement core transaction system can be planned, specified, procured and successfully implemented before the unreliability and inflexibility of the present system reaches levels that are unacceptable or worse. In recent time system outages have been by no means rare. See here for a recent example:
What is required is what amounts to a technical heart transplant for the very core of the Health System and the Community Support System.
The track record of Government in delivery of major IT projects has frequently been one of cost overruns and delays (from Governments of both major political persuasions) and the risks (technical, financial and cultural) are really enormous. Clearly we have reached the time when the replacement has to be undertaken but you really have to hope the string and chewing gum holding the current system together can survive long enough for the transition to be delivered successfully and without additional risk caused by excess haste.
I have to say that while I am sure planning for this upgrade has been going on for a while it does seem a little worrying that Government have only now started to develop the Business Case for a transition to a new system.
I note in passing that there are also concerns with the security of the access portal to these systems with the site at www.my.gov.au having been recently been cited as being insecure.
While all this is a long way from what is traditionally talked about as e-Health it is an absolutely vital part of Australia’s eHealth Infrastructure providing the part of the base for both the Personally Controlled Electronic Health Record  (PCEHR) and the Individual Health Identifier (IHI) service among others.
Comments welcome:
David.

Monday, May 05, 2014

Weekly Australian Health IT Links – 5th May, 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

An interesting week with the Health Minister speaking about the PCEHR and its future and the release of the National Commission of Audit.
Certainly seems money will be tight for the next few years and that health is in for a bit of a pounding!
Actual Budget due in just a week!
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Not in the public interest: Govt won’t release PCEHR report

30th Apr 2014
A FREEDOM of Information request to obtain a long-awaited report on the rollout of the personally controlled electronic health record (PCEHR) has been rejected on the grounds its release is not in the public interest.
The request to obtain the report on the troubled rollout of the $1 billion system – which has been in the health minister’s possession since December – was filed by Australian technology website Delimiter.
A letter rejecting the request said that to release the report under Freedom of Information would expose the analysis of the issues and recommendations within it “prematurely… to scrutiny”, given decisions were still being made.
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Health Minister Peter Dutton to let private health pay for seeing doctor

  • May 01, 2014 1:24AM
  • By Sue Dunlevy National Health Writer
  • News Corp Australia
GENERAL Practitioners could be paid more to treat the sickest patients under a major overhaul being planned by the Federal Government.
And private health funds will for the first time be allowed to fund GP care under the changes, to be announced by Health Minister Peter Dutton today.
The government will also pledge to proceed with the troubled $1 billion e-health record system, which has been ignored by GPs and patients alike since it was launched almost two years ago.
In a speech to The George Institute in Sydney later today Mr Dutton will outline a plan for a new advanced payment model for doctors.
“The Government is totally committed to rebuilding general practice,” he will say.
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Dutton confirms Govt will keep PCEHR

Changes to rollout flagged.

Federal Health Minister Peter Dutton has confirmed the Government will keep the controversial personally controlled electronic health record (PCEHR) scheme following an audit into the $1 billion project.
"The government remains committed to an electronic health record," he said at Sydney's George Institute for Global Health today.
"It is absolutely essential to have a record, so that we can provide tracking and advice around every intervention and the success or otherwise of those interventions."
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Health Minister Peter Dutton to boost private insurers in primary health care

Joanna Heath
Health minister Peter Dutton will commit to keeping the $1 billion e-health system and outline a major overhaul in primary care in Australia in a landmark pre-budget speech to be delivered on Thursday.
In the speech, Mr Dutton hints at providing incentives for GPs to focus on the chronically ill and greater involvement of private health insurers in creating care plans to keep them out of the hospital system.
“The government is totally committed to re-building general practice. No hare-brained super clinic programs for marginal seats thought up on a government jet, but providing greater support to our primary care network, and we will do that not just through funding, but through a greater concentration of our doctors’ efforts on those with the most need,” Mr Dutton will say.
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Privatise NBN, cut start-up funding and appoint a chief digital officer: Commission of Audit

Date May 2, 2014 - 7:17PM

Lia Timson

ANALYSIS
The National Commission of Audit, a report commissioned by Treasurer Joe Hockey and Finance Minister Mathias Cormann last year, was handed down on Thursday. It cannot be accused of overlooking technology and the impact of digital strategies on the national budget.
It made sweeping recommendations regarding the use and ownership of ICT, most of which, perhaps unsurprisingly, reflect the Coalition’s earlier digital policy and technology policies adopted in the UK.
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Address to the George Institute for Global Health

Minister for Health, Peter Dutton's address to the George Institute for Global Health on 1 May 2014.
Page last updated: 01 May 2014
1 May 2014
Acknowledgements:
  • Professor Vlado Perkovic, Executive Director, George Institute Australia
  • Jo Degney, Manager Philanthropy and Partnerships, George Institute
My first words must be to congratulate the Institute for its ongoing work in this country and around the world to improve health outcomes.
The Institute is remarkable in many ways.
Its research focus is on health innovations that provide quick, simple and effective improvements especially in relation to chronic disease and injury.
-----

Opposition urges government to take security of citizens' data seriously

Date April 29, 2014 - 2:13PM

Ben Grubb

The opposition has called on the Abbott government to take the security of people's private e-health, Medicare, child support and other government records seriously after it was revealed flimsy security was used to protect a critical government website.
Opposition human services spokesman Doug Cameron said on Monday night that Fairfax Media's report on the security of the myGov website was concerning.
If your family medical history is disclosed, you can never get that back – there is no refund 
Security expert Troy Hunt
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Diet to dialysis, hospital patients on the record

AUSTRALIA’S first fully integrated digital hospital will contain 310km of fibre-optic cable and offer patient tracking, ­machine-based record keeping, electronic food ordering and new-age medication dispensing in a near paperless environment.
UnitingCare Health in Queensland executive director Richard Royle said the 100-bed St Stephen’s hospital at Hervey Bay, 300km north of Brisbane, would open in early October and integrate with the federal government’s personally controlled electronic health record — something he knows intimately.
Mr Royle recently chaired the Coalition government’s review of the PCEHR system.
The report has not been made public.
Medical imaging, X-ray equipment, insulin pumps and renal dialysis machines are among items connected to the software system. Data from anaesthetic machines and blood pressure machines is automatically recorded into the patient’s record.
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Should consumers have online access to their health records?

Consumer access to electronic health records may not be far off. In the not-so-distant future people will look up their file from home or a mobile device. They will also be able to add comments to their doctor’s notes.
The Australian PCEHR allows limited access, but the US OpenNotes record system has gone a step further by inviting consumers to read all the doctor’s consultation notes.
Pulse+IT magazine reported that 18 percent of Australian doctors believes consumers should be able access their notes; 65 percent would prefer limited access and 16 percent is opposed to any access at all.
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Can health consumers trust us with their private data?

One of my favourite episodes of the SF series Battlestar Galactica begins during peace time: the Cyclon war is long over and old battle ships are decommissioned – like the Galactica. The ship is transformed into a museum.
However, the decommissioning ceremony has barely finished as a new Cyclon attack begins. Modern spaceships are quickly destroyed by a fatal computer virus that uses the fleet’s network. Because the old, bulky Battlestar Galactica is a standalone ship and not equipped with networked computers, it escapes the attack and plays a vital role in the search for the mythical planet earth.

How secure are healthcare services?

In a Wired article titled It’s insanely easy to hack hospital equipment, Kim Zetter gives a frightening account of security issues in a US hospital with networked medial records, surgery robots, drug infusion pumps, bluetooth-enabled defibrillators, x-ray and imaging databases, and temperature settings of refrigerators storing blood and drugs.
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eHealth NSW CEO Michael Walsh starts work

Michael Walsh starts this week in the joint role of Chief Executive and Chief Information Officer of eHealth NSW following the NSW Government’s announcement last year that the organisation would be established as a separate identity.
Mr Walsh says that the organisation’s Executive Council, chaired by Secretary of Health NSW Mary Foley, is the peak Information and Communication Technology Committee appointed by NSW Health and will set strategy and advise on policy and standards.
“I will also be working very closely with Local Health Districts, pillars and NSW Health as we build on and leverage the significant work already underway in the delivery of eHealth public health programs in NSW,” he says.
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FDA approves sleep apnoea implant

2nd May 2014
US regulators have approved a first-of-its-kind implant that can help ward off moderate to severe sleep apnoea.
The Inspire Upper Airway Stimulation therapy, which has been given the green light by the US Food and Drug Administration, is designed for patients unable to benefit from available therapies.
The device contains a small neurostimulation generator that is surgically implanted in the chest, along with a lead that stimulates a nerve that runs from the ear to the jaw, and another sensing lead that goes to the chest.
Once implanted, the device can be activated before night-time sleep with a remote control.
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Bionic eye trial 'really promising'

Date May 1, 2014 - 7:51AM

Bridie Smith

Seeing little more than blob-like shapes as she navigated her way towards a target on the far wall was a major thrill for Dianne Ashworth. She has been blind for more than 20 years.
This week she reached a milestone. For the first time since losing her sight Dr Ashworth was able to walk and navigate her way without relying on her guide dog.
‘’It’s been amazing,’’ she said. ‘’The more I’ve been doing it, the more natural it feels.’’
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3D-printed cast could heal bones 40% faster

Date April 30, 2014 - 12:06PM

Lucy Kinder

A Turkish designer has created a medical cast using 3D printing which could heal broken bones up top 40 per cent faster.
A 3D-printed medical cast could help bones to heal up to 40 per cent faster.
The black cast, known as the Osteoid, uses an ultrasound system that makes bones heal more quickly.
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Digital pics ubiquitous in general practice

1 May, 2014 Amanda Davey
The use of camera phone images by patients to document their illness may be fraught with medicolegal risks but anecdotally, at least, most GPs appear to welcome the practice.
A qualitative study looking at GPs’ experiences with patient-initiated camera phone images found that digital photos not only aided the doctor in diagnosis and management, but also helped broaden their understanding of the patient’s health and wellbeing.
“Almost all the GPs had been shown clinical images of skin lesions including rashes, moles and ulcers,” the researchers from the University of Western Sydney wrote in the British Journal of General Practice.
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The future of brain implants

  • Gary Marcus and Christof Koch
  • The Wall Street Journal
  • May 02, 2014 12:00AM
WHAT would you give for a ­retinal chip that lets you see in the dark or for a next-generation cochlear implant that lets you hear any conversation in a noisy restaurant, no matter how loud?
Or for a memory chip, wired directly into your brain’s hippocampus, that gives you perfect ­recall of everything you read? Or an implanted interface with the internet that automatically translates a clearly articulated silent thought into an online search that digests the relevant Wikipedia page and projects a summary direct into your brain?
Science fiction? Perhaps not for much longer. Brain implants today are where laser-eye surgery was several decades ago. They are not risk-free — and make sense only for a narrowly defined set of patients — but they are a sign of things to come.
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Medical tourism broker Jens Raun seeks financial lifeline for comparison website

Date April 30, 2014 - 12:30AM

Sylvia Pennington

Want to have a joint replaced, teeth straightened or a new set of boobs but don't have time to wait around – or the cash to get the work done in Australia?
IT consultant and medical tourism broker Jens Raun is hoping to tap the rising global demand for cut-price overseas treatment with an online marketplace to allow patients to shop around internationally for elective procedures.
Currently a participant in the Telsta-backed Muru-D digital accelerator program, Raun is seeking angel funding to get his Medical Tourism Metasearch business off the ground.
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National Commission of Audit urges govt to dump ageing welfare payments system

Outsourcing of the Income Security Integrated System viewed by the commission as a “high risk undertaking”
Byron Connolly (CIO) on 01 May, 2014 15:09
The National Commission of Audit has recommended the Government dump a 30-year old Income Security Integrated System used by state and federal government agencies to calculate and administer $400 million in social welfare payments each day.
The recommendation comes just a week after treasurer, Joe Hockey, told Neil Mitchell of 3AW that the Centrelink system needed replacing.
It also comes two days after the Department of Human Services (DHS) – which runs Centrelink – experienced an outage that affected Centrelink and Child Support online services.
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History repeats in government’s Centrelink overhaul

HISTORY is about to repeat itself as the Abbott government embarks on a mammoth project to replace Centrelink’s core IT infrastructure central to the ­delivery of $150 billion in social security payments annually.
Joe Hockey all but gave the green light when he told radio station 3AW last week that the welfare agency’s 31-year-old mainframe system was “in bad shape” and would cost “billions” to upgrade.
The news sparked fond memories for Kevin Noonan, who in his younger days played a vital role in the original design of the system in the 1980s.
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Australian Medicines Terminology v2.55

AMT v2.55 is the April 2014 version of Australian Medicines Terminology (AMT).
  • The 28 April 2014 release of AMT contains all the Australian marketed products that are included on the Schedule of Pharmaceutical Benefits including the Repatriation Pharmaceutical Benefits Schedule (RPBS).
  • This release includes products that become available as PBS products on 1 May 2014.
  • 88 new products have been added since the last release bringing the total number of products to 16972.
AMT v2.55 builds upon the work of the previous AMT versions which had multiple interim releases and extensive external consultation.
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Australians' private government details at mercy of hackers, say IT security experts

Date April 28, 2014 - 7:20AM

Ben Grubb and Noel Towell

The private records of millions of Australians – including their doctor visits, prescription drugs, childcare and welfare payments – are at the mercy of cyber criminals because of flimsy IT security around a critical federal government website, IT security experts warn.
And they say the risk will increase from the middle of the year, when the government will make it compulsory for Australians to use the my.gov.au website to lodge their electronic tax returns, potentially also exposing their financial and banking records to hackers.
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Centrelink, Child Support suffer systems outage

Date April 28, 2014 - 2:06PM

Ben Grubb

A systems outage affected Centrelink and Child Support customers on Monday.
Australians were unable to access key online government services including Centrelink and the Child Support website on Monday, as the sites experienced technical issues leaving users and staff without access.
The outages also appeared to affect Centrelink offices, with people reporting they were turned away at a Brisbane office due to the systems outage.
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New NBN may limit tele-health potential

April 28, 2014
NBN plan unable to deliver tele-health: Clare
Slower upload speeds under a mixed NBN model will make unsuitable for many ‘tele-health’ applications, according to opposition communications spokesman Jason Clare. “NBN Co has started consulting with its wholesale customers on the product set that will be available on its fibre to the node deployment,” he said. “While the product set will attempt to mirror the FTTP products, there is no product that will guarantee an upload speed above 1 Mbps.” A 2011 paper, Potential Telehealth Benefits of High Speed Broadband, from Monash University research revealed that clinical-grade video-conferenced consultation required uploads of 1.2 to 2.5 Mbps. The Minister and his new management team have consistently focused on the question of download speeds and ignored the importance of upload speeds.
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Athena Software and Sinapse Achieve PCEHR E-Health Certification for Penelope Case Management Software

Waterloo, ON (PRWEB) April 28, 2014
Australian users of Penelope, a web-based case management software application developed by Waterloo, Ont. tech firm Athena Software, can now connect their client records to the Personally Controlled eHealth Record System (PCEHR).
PCEHR is the Australian government's initiative to provide a secure online summary of an individual's health information. 
The full integration and connectivity between Penelope and PCEHR is a joint effort by Athena and Sinapse, a Melbourne-based consulting firm who are Athena's partners in Australia.
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Space ark planned for a dying planet

  • Kaya Burgess
  • The Times
  • April 28, 2014 10:31AM
BRITISH scientists and architects are working on plans for a "living spaceship" like an interstellar Noah's ark that will launch in 100 years' time to carry humans away from a dying Earth.
Researchers around the UK are working with colleagues from the USA, Italy and the Netherlands on Project Persephone, investigating new biotechnologies that could one day help to create a self-sustaining spacecraft to carry people beyond our solar system.
The craft would incorporate into its structure organic matter such as algae and artificial soil, using the Sun's energy to produce biofuel and a sustainable source of food. It would need to keep a few thousand people alive for generations on a one-way mission to find a new world to inhabit. Rachel Armstrong, a senior architecture and design lecturer at the University of Greenwich, is leading the project.
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Enjoy!
David.

Sunday, May 04, 2014

Minister Dutton Reflects Pre-Budget On The Health System and The PCEHR.

This speech was given last week.

Address to the George Institute for Global Health

Minister for Health, Peter Dutton's address to the George Institute for Global Health on 1 May 2014.
Page last updated: 01 May 2014
1 May 2014
Acknowledgements:
  • Professor Vlado Perkovic, Executive Director, George Institute Australia
  • Jo Degney, Manager Philanthropy and Partnerships, George Institute
My first words must be to congratulate the Institute for its ongoing work in this country and around the world to improve health outcomes.
The Institute is remarkable in many ways.
Its research focus is on health innovations that provide quick, simple and effective improvements especially in relation to chronic disease and injury.
The funding model is also unique – effectively raising funds by providing first class management of large scale clinical trials, usually for other organisations, and also attracting considerable funding from the Australian Government.
Since 2010, the George Institute has won around $6.5 million dollars in competitive grants from NHMRC, including research scholarships, project grants, and Global Alliance for Chronic Disease grants.
It makes me proud as Australia’s Health Minister to see Institutes like the George and others in this great city and around the country, leading the world in cutting edge research.
Our medical research workforce is second to none in the world, and it is an aspect of our health system that doesn’t receive the recognition and funding it deserves.
My intent is to make sure we change this into the future.
At the moment our country is rightly focusing on changes that will need to take place in our health system so that we can make it sustainable in to the future.
It is obvious that, with an ageing population, and the enormous future cost of emerging medical technologies, genomics and personalised medicines, we need to show the leadership to make changes today so that we can strengthen Medicare and the health system more generally for tomorrow.
That will mean as I said before the election and indeed since, the Government is totally committed to re-building general practice. No hair brained super clinic programs for marginal seats thought up on a Government jet, but providing greater support to our primary care network, and we will do that not just through funding, but through a greater concentration of our doctors efforts on those with the most need.
It will concentrate not just on remuneration, but on scope of practice and advanced payment models, including greater support from the private insurers.
It means rolling out an e-health record with practical application and a genuine desire to work with and not against doctors.
And it is a discussion about how we improve our health system to ensure we will always care for those without any means, whilst at the same time asking those with a capacity to pay to contribute fairly.
Lots more of the quite long speech is here:
There is coverage here:

Dutton confirms Govt will keep PCEHR

Changes to rollout flagged.

Federal Health Minister Peter Dutton has confirmed the Government will keep the controversial personally controlled electronic health record (PCEHR) scheme following an audit into the $1 billion project.
"The government remains committed to an electronic health record," he said at Sydney's George Institute for Global Health today.
"It is absolutely essential to have a record, so that we can provide tracking and advice around every intervention and the success or otherwise of those interventions."
But he also flagged a number of changes to the rollout of the PCEHR - which was initiated by the former Labor Government - that he promised to detail further in the lead up to the 13 May federal budget.
He accused the former Government of spending "over a billion dollars" on the PCEHR to achieve less than 20,000 "meaningful" registrations to use the tool.
"I'm going to change that," he pledged. "The problem with the electronic health record is that the previous government fought with doctors, they didn't work with them."
Here is the link:
While the speech was largely devoted to saying that the health budget was growing too quickly and that ‘targeted’ medical research was a very good thing there was a mention of electronic health records that I mentioned last week. See here:
The brief remarks were as follows:
(in the context of strengthening and rebuilding General Practice).
“It means rolling out an e-health record with practical application and a genuine desire to work with and not against doctors.”
Given this is obviously a carefully planned and researched set piece speech we must take the published words seriously to understand what is intended to be communicated, and I am not sure I saw what the press report said in the published speech.
What I read is the following:
1. The specific PCEHR is not mentioned at all. This suggests just continuing with the PCEHR Program as it is, is not very likely - or Minister would presumably and probably have said so.
2. Whatever is to be done needs to be practical - and presumably effective.
3. Whatever is planned needs to have the support of the clinical community.
4. There needs to be a genuine desire to work with clinicians - which would have to suggest that anything that is to be done could hardly be undertaken by the Halton led collection of DoH  e-health bureaucrats and the Gonski / Fleming led NEHTA both of which have worked very hard indeed to annoy and frustrate clinicians at every turn - to the extent that the clinical leads for NEHTA just bailed out - despite the relatively high pay.
If I read this correctly, major and radical change is on the way.
What do you think?
David.

AusHealthIT Poll Number 216 – Results – 4th May, 2014.

Here are the results of the poll.

Do Medicare Locals Make A Valuable Contribution To E-Health In Australia?


Yes - They Really Help With Important Initiatives 50% (60)

Probably 13% (15)

Neutral 7% (8)

Probably Not 2% (2)

No - They Are Ineffective In Supporting The Really Valuable Initiatives 21% (25)

I Have No Idea 8% (9)

Total votes: 119

Very interesting - high participation coming later in the week with a swing in the view expressed. Looks like someone alerted some of the MLs about the poll so they could vote.

Final outcome 63% MLs good for E-Health and 23% not so good with 15% being on the fence.

Again, many thanks to all those that voted!

David.