Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Thursday, August 14, 2014

Review Of The Ongoing Post - Budget Controversy 14th August 2014. It Is Sure Going On and On!

Budget Night was on Tuesday 13th May, 2014 and the fuss has still not settled by a long shot.
It is amazing how the discussion on the GP Co-Payment just runs and runs.
Here are some of the more interesting articles I have spotted this eleventh  week since it was released.
Parliament has now got up for the Winter Recess we can take a breath and see where we are.
The main fun this week has been to watch Mr Hockey wander around the country trying to drum up support for his budget and being told, essentially, to just start again.
We also saw the announcement that the Human Services planned to get out of service delivery by outsourcing all the payment functions. This sounds a little like getting rid of core Government activity to me.
We sure do live in interesting times!
As an add-on a few links on Ebola Virus, the last of which is very encouraging! It is a terrifying disease….
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General.

Medibank moves into GP care to push ‘quality’ deals

Sean Parnell

AUSTRALIA’S largest health fund, the government-owned Medibank Private, has extended its level of protection and support for members, declaring better quality care the key to making the system financially sustainable.
Despite the Abbott government wanting the private sector to play a greater role, Health Minister Peter Dutton has ruled out inviting insurers to take part in negotiations with the Australian Medical Association and senators over the plan for a $7 co-payment.
Medibank Private, which is to be sold, has followed the lead of Bupa and signed a quality-based funding agreement with a hospital network, Healthe Care, imposing financial disincentives for unplanned readmissions and adverse events. It plans to negotiate similar deals with the larger networks.
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Long lens strategy to secure budget

David Crowe

VOTERS will be warned of a crushing load on the nation’s finan­ces in a new report aimed at sharpening debate on spending cuts as Joe Hockey steps up ­efforts this week to pass his budget reforms.
The Abbott government will bring forward the Treasury analysis of the strain on the budget as it struggles to defeat objections to $40 billion in savings on pensions, welfare, health and education.
As the Treasurer tries to sway more crossbench senators to back his plans, he is also hoping to use the long-term Intergenerational Report to convince voters to ­accept unpopular budget cuts.
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Nursing homes plan to build on-site GP clinics

Date August 4, 2014 - 6:59PM

Julia Medew

Health Editor

An increasing number of aged care facilities are trying to overcome a shortage of high quality medical services by building permanent GP clinics on their premises. 
For years, experts have complained that residents of aged care facilities are getting inadequate medical care, partly because there are not enough incentives for GPs to travel from their clinics to attend elderly patients and continue an ongoing relationship with them. 
In many cases, this means locum GPs are frequently called to care for residents after hours, or they are sent to hospital for potentially unnecessary investigations and futile care, particularly at the end of life.  
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Bulk-billing unsustainable: Dutton

5th Aug 2014
HEALTH Minister Peter Dutton has said current GP bulk-billing rates aren’t sustainable and should be confined to the most needy, as dissent in the Liberal-National Party coalition over co-payment reforms spilled into the public arena.
Asked about dissenting LNP backbenchers’ concerns over the impact of the co-payment on pensioners, Mr Dutton said the government needed to stick to its main message that the reforms were necessary and would strengthen Medicare.
“Look, I think there’s always worry with change, and I think we have to continue explaining what we are doing,” he said on Radio 2UE on Monday.
“I think when we explain to people that we are retaining bulk-billing, but bulk-billing rates at the moment of 83% just aren’t sustainable, and if we can narrow that down to the most in need, I think we can make Medicare stronger.
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Health experts rally over budget

6 August, 2014 Amanda Davey
Australian public health experts have upped the ante in a bid to further highlight health inequities in the 2014 Federal Budget.
Among other things, they argue the policies put forward by the Abbott government will affect preventive health as well as universal access to affordable health care.
“What has the majority of the Australian population done to deserve such a brutal cull of services …?” asks Sharon Friel, Professor of Health Equity at the Regulatory Institutions Network, Menzies Centre for Health Policy.
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Coalition rethinks Medicare, uni rises

Andrew Tillett The West Australian August 7, 2014, 5:15 am
Senior ministers have signalled they are willing to water down contentious higher education reforms and the $7 Medicare co-payment in a bid to salvage key Federal Budget measures.
After the Abbott Government abandoned its election promise to dilute race hate laws, Education Minister Christopher Pyne and Health Minister Peter Dutton both said they would be prepared to compromise with Senate crossbenchers.
Despite describing his tertiary education package as a "well-oiled machine", Mr Pyne indicated he would negotiate over the proposed increase to the interest rate on student debts.
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Medical payments to go private

Joanna Heath
More than $30 billion in Medicare and pharmaceutical benefit payments a year is likely to be outsourced, cutting the Department of Human Services in half and reshaping the delivery of government services.
The decision – a key recommendation of the Commission of Audit – could allow Australia Post or one of the big four banks to step in to calculate and process health payments and absorb Medicare retail outlets.
It aligns with the government’s plans as part of the budget process to reduce the size the public service and make government services more efficient.
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Crossbenchers Ricky Muir and John Madigan attack Joe Hockey's budget

Date August 8, 2014

Heath Aston

Political reporter

Joe Hockey's budget roadshow has hit more potholes, with resistance to key measures from crossbencher Ricky Muir and claims by John Madigan that the budget lacks ''logic, heart and hope''.
The Treasurer was in Ballarat to meet Senator Madigan on Thursday and was due to sit down with Senator Muir on Friday.
The Australian Motoring Enthusiast Party senator will meet Mr Hockey without the support of his chief of staff, Glenn Druery, and policy adviser, Peter Breen, both of whom he sacked in the past week amid turmoil in his office.
In a statement, Senator Muir outlined concerns at the sections of society that would be most affected by the budget.
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Specialist Fees.

7 August 2014, 2.44pm AEST

Health budget: GP care isn’t the problem, costly specialist care is

Author

Peter Sivey

Senior Lecturer, School of Economics at La Trobe University
The opening of eight new medical schools in Australia in the past decade has seen a massive increase in the number of new doctors entering the workforce. The number of new junior doctors graduating in Australia doubled between 2004 and 2011. But while fears of an overall shortage of doctors seem assuaged, we don’t have the right mix of doctors.
A recent trend is the increasing specialisation of the medical workforce. In 1999, 45% of Australian doctors were general practitioners (GPs) but this proportion had fallen to 38% by 2009. Similar trends can be observed in the United States and United Kingdom.
This trend is concerning because primary care, provided by general practitioners, is the most efficient and equitable type of health care, particularly preventive care and the management of chronic disease. These components of GP-provided care have the potential to improve health outcomes, lower costs and reduce the need for future more costly interventions.
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Call to cap specialists’ fees gathers support

7th Aug 2014
THE former Howard government adviser who reignited the co-payment debate is back. In his sights: exorbitant out-of-pocket expenses being charged by overpaid specialists.
Terry Barnes has called for the fees that surgeons and other specialists can charge to be capped at their AMA-recommended rates. And if they charge too much they should be refused access to Medicare, he told Medical Observer.
"If the AMA schedule is considered fair and reasonable, then any out-of-pocket in excess of that is, by definition, unreasonable," Mr Barnes said.
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GP Co-Payments.

AMA demand for seniors’ fee exemption could cost $2b

Joanna Heath
The Abbott government faces a budget hit of up to $2 billion if it agrees to a demand from doctors that pensioners be exempt from the $7 medical payment, which is designed to discourage people going to the doctor with minor complaints.
The Australian Medical Association put a modified version of the scheme to Health Minister Peter Dutton on Thursday. It proposes a significant watering down of coverage for the measure and refuses to budge from the AMA’s opposition to any cut in the Medicare rebate for doctors.
This leaves the government with a choice between significantly less budget savings to secure the group’s support, and by extension the support of some crossbench senators, or covering almost every Australian and entrenching opposition to the charge.
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Coalition MPs break ranks on $7 GP charges

Date August 4, 2014

Latika Bourke

National political reporter

EXCLUSIVE
The proposed $7 GP co-payment needs to be scrapped for pensioners, at least three of the government's own MPs say.
This comes as a new survey showed two-thirds of households thought their financial position would worsen over the next year because of the budget.
Students, pensioners and single parents are among those who feared the worst effects.
Queensland Liberal National MP George Christensen said he had been conducting a series of forums across his electorate, and the feedback on the GP payments had been "overwhelming".
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'Soften blow' of GP fee by reducing co-payment for medicines on PBS, Senator David Leyonhjelm to Joe Hockey

Date August 4, 2014 - 11:10AM

Latika Bourke

National political reporter

One of the key crossbench senators will tell Treasurer Joe Hockey to "soften the blow" of the proposed $7 GP fee by reducing the Pharmaceutical Benefits Scheme co-payment by the same amount.
Liberal Democrat Senator David Leyonhjelm is meeting Mr Hockey in Sydney on Monday where he will urge the
Treasurer to also dump the planned $20 billion Medical Research Fund, which would be partly funded by the GP fee.
The Pharmaceutical Benefits Scheme co-payment increased from $36.10 to $36.90 in January this year. Senator Leyonhjelm said reducing the PBS co-payment to $30 would send a price signal to patients but at the same time improve the GP fee's saleability to the electorate.
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Govt MPs want GP co-payment changes

  • August 04, 2014 3:15AM
  • AAP
AT least three government MPs reportedly believe the controversial proposed $7 GP co-payment should be scrapped for pensioners.
FAIRFAX Media reports that Queensland Liberal National George Christensen has received "overwhelming" negative feedback on the issue after conducting a series of forums across his electorate.
"Politically it would be a good move if we exempt pensioners or people born before 1956," Mr Christensen has told he Sydney Morning Herald.
"It will be no surprise to the prime minister, the treasurer or anyone else that the GP co-payment isn't popular. Overwhelmingly, the feedback on the issue is that you must exempt pensioners."
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Govt didn’t consult on co-payment: AMA

4th Aug 2014
THE AMA has reaffirmed its opposition to the proposed co-payment for medical services after Health Minister Peter Dutton wrongly claimed he had consulted AMA leaders on the idea before last year’s federal election.
Mr Dutton told a press conference in Brisbane on Friday that he had discussed the issue with then AMA president Dr Steve Hambleton and current president Associate Professor Brian Owler ahead of the September 2013 election.
The claim was circulated on social media before the AMA picked it up and called for a correction, leading Mr Dutton to amend his statement.
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Health Minister Peter Dutton says government will not back down on proposed $7 Medicare co-payment

  • 4 hours ago August 06, 2014 5:33PM
  • AAP
HEALTH Minister Peter Dutton insists the Medicare co-payment is a “sensible change” to the health system which will pass parliament.
But he won’t get any support from Labor, after Opposition Leader Bill Shorten told a 200-strong rally outside Old Parliament House in Canberra that the plan would be fought “to the death”.
The government is struggling to find support on the Senate crossbench for the $7 co-payment which is to go into a new medical research fund.
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Dutton insists $7 co-pay plan is a winner

7 August, 2014 AAP
Health Minister Peter Dutton insists the $7 co-payment is a "sensible change" to the health system that will get through Parliament.
The Federal Government is struggling to find support on the Senate crossbench for the policy, which the health minister says will help make Medicare sustainable.
The Palmer United Party has joined Labor in condemning the idea that is intended to be implemented from July next year.
And at least three of the government's own MPs have publicly voiced concern about the budget measure, arguing for exemptions for pensioners and the elderly.
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Medicare Locals.

Medicare Locals spent money on fines, gifts

6 August, 2014 Paul Smith
Medicare Locals used public money to pay parking fines and speeding tickets, and to buy farewell gifts for employees, a new report claims.
Professional services firm Deloitte was commissioned by the Federal Government to carry out a detailed audit of six Medicare Locals.
Deloitte's report said that some money allotted to Medicare Locals programs had been spent on parking and speeding tickets, employer entertainment, farewell gifts and office amenities.
Neither the Medicare Locals involved nor the amount of "inappropriate expenditure" are listed in the Deloitte report.
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Pharmacy, PBS and Medicine Issues.

August is ‘month of mapping’: Guild

4 August, 2014 Christie Moffat
The Pharmacy Guild of Australia is encouraging its members to access a business tool to help monitor the impact of PBS reforms and pricing on their business.
ScriptMAP is a program developed by the Guild, designed to provide detailed information on PBS reforms and pricing, and includes a customised analysis of the effects of these reforms on a member pharmacy.
The report accesses the best available information and is based on each individual dispensing mix sourced from dispensary software, in order to provide a clear picture on the impact of changes that will occur to PBS pricing and pharmacy remuneration.
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Pharmacies should become a ‘concierge service’ for elderly: Quilty

6 August, 2014 Christie Moffat 1 comments
Pharmacies need to focus on positioning themselves as a “personalised medication concierge service” to the elderly, according to a senior Guild figure.
Writing in Pharmacy Guild of Australia newsletter Forefront, executive director David Quilty said that the Guild, along with the Government and other health insurers, saw significant potential for pharmacies to take a lead role in ensuring that older Australians continued to live independently in the community for as long as possible.
“The time is right for a pharmacy-led, personalised medication concierge service that increases medicine adherence rates and reduces the likelihood of unnecessary hospitalisation and premature nursing home admissions,” Mr Quilty said.
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PBS reforms to cost pharmacies $90,000

Date August 9, 2014 - 10:44PM

Julieanne Strachan

Reporter for The Sunday Canberra Times.

Pharmacists are axing free services and cutting jobs because of reductions to the Pharmaceutical Benefits Scheme prices paid by the Federal Government, the industry has said.
As many as 124 jobs are expected to be lost in the ACT and pharmacists have been warned their profits will drop by an average of $90,000 this financial year.
Some businesses are considering an end to Sunday trading, scrapping free home delivery of medications to elderly patients and ending free blood pressure checks, The Pharmacy Guild of Australia has said.
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Ebola.

Health, safety preparations in place to deal with Ebola cases, says Health Minister Peter Dutton

Date August 8, 2014 - 8:38PM

Alexandra Back

The Department of Health has moved to allay fears of the Ebola virus' spread to Australia, after the World Health Organisation declared west Africa's epidemic an international health emergency.
Minister for Health Peter Dutton said on Friday that Australia is fully equipped to deal with any suspect case of the virus should it arrive in the country.
"The announcement that World Health Organisation has declared the west African Ebola virus outbreak as a Public Health Emergency of International Concern does not change the risk to Australia, which remains very low," Mr Dutton said.
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Ebola vaccine to be trialled next month, may be available by 2015

Date August 10, 2014 - 6:53AM
The World Health Organisation says clinical trials of a preventative vaccine for the Ebola virus may begin next month and made available by 2015.
The vaccine, made by British pharmaceutical company GlaxoSmithKline, will first be rolled out in the United States and African countries.
The WHO's head of vaccines and immunisation, Jean-Marie Okwo Bele, said he was optimistic about making the vaccine commercially available by next year.
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Comment:
It seems the fuss is not yet settled - to say the least.
Lots to browse with all sorts of initiatives going rather pear shape - think security, sanctions and so on!
To remind readers there is also a great deal of useful health discussion here from The Conversation.
Also a huge section on the overall budget found here:
Enjoy.
David.

Wednesday, August 13, 2014

Is The Telstra eHaaS Obsolete Before It Is Even Implemented - One Wonders.

I published a blog last week on the eHaas.
You can review this blog here:
Specifically I wrote this:
“My other reaction is what is said regarding the Common Information Model (CIM) sounds very ambitious and rather ahead of what I understand to be the ‘state of the art’. There is a long history of such initiatives taking a very long time to reach their objective - if ever!”
An e-mail I had during the week from Thomas Beale confirmed my worst fears:
“There are other problems with eHaas. It's based on the HL7 RIM, which dead now. It appears they have not done their domain research.”
Tom also provided a link to some commentary he has written in the area of sematic overreach:

RDF for universal health data exchange? Correcting some basic misconceptions…

Something called the “Yosemite manifesto on RDF as a Universal Healthcare Exchange Language” was published in 2013 as the Group position statement of the Workshop on RDF as a Universal Healthcare Exchange Language held at the 2013 Semantic Technology and Business Conference, San Francisco. Can such grand claims be true?
I’m not sure if either the slide above or the original reference are reliable at the moment, so I’ll reproduce the text here:
  1. RDF is the best available candidate for a universal healthcare exchange language.
  2. Electronic healthcare information should be exchanged in a format that either: (a) is an RDF format directly; or (b) has a standard mapping to RDF.
  3. Existing standard healthcare vocabularies, data models and exchange languages should be leveraged by defining standard mappings to RDF, and any new standards should have RDF representations.
  4. Government agencies should mandate or incentivize the use of RDF as a universal healthcare exchange language.
  5. Exchanged healthcare information should be self-describing, using Linked Data principles, so that each concept URI is de-referenceable to its free and open definition.
I’m sure the signatories’ hearts are in the right place, but unfortunately the universal claims made here don’t stand up to scrutiny.
The basic claim is that we should all be using RDF for healthcare data exchange, or else a format that can map to it. I’ll quote the justification for this (my bolding):
Lots more here:
Again we are seeing people suggest that things are simple and straightforward when those who have been in the game for a long time know the absolute opposite is true.
You only have to visit Tom’s blog (link above) or Grahame Grieve’s blog (www.healthintersections.com.au) to see just how complex and difficult things actually are!
While I can’t prove it, I suspect the difficulties I and these other commentators note are a good part of the reason why real progress in e-Health seems to be so hard - and equally why the PCEHR Review is really struggling to work out anything like a sure fire way to actually fix the system.
All this is a lot harder than most think!
David.

Tuesday, August 12, 2014

It Is Looking Like Any Introduction Of A Medicare Co-Payment Will Be A Technical Nightmare!

I am starting to see information from DoH on just how they are hoping the still uncertain Medicare Co-Payment will work.
An article appeared on the topic here a month or so ago:

GP co-payment IT system 'a big ask'

Deputy Editor, Technology
Sydney
TAXPAYERS will have to pay hundreds of millions of dollars to build a centralised database for 25 million people that would update in real time to cater for the Abbott government’s proposed $7 medical co-payment scheme, IT experts say.
The government has proposed that people pay $7 each time they visit a GP, get an X-ray or a blood test from July next year. A patient who visits a doctor and needs a pathology test and an X-ray will be slugged with $21 in upfront fees.
The $7 fee is applicable to everyone except concession card holders and children under 16 who will pay for the first 10 services combined.
The controversial plan has drawn the ire of consumers and many in the healthcare fraternity who say it marks the demise of universal access to healthcare in Australia.
One of the biggest challenges with the proposal is there is no way to determine — in real time — the number of times a patient has made a co-payment.
The federal Department of Human Services, which runs Medicare, declined to say how long it would take to develop ­special software or a portal to provide the real-time information and how much it would cost.
Jorn Bettin of IT consultancy IBRS, said given the fragmented nature of health IT systems and the multitude of different healthcare providers, it would be ­“extremely hard to develop a system that reliably tracks all visits of healthcare service providers”.
“In terms of costs, the underlying platform will cost several hundred million dollars to develop and roll out. Adding a feature that tracks $7 payments is the easy part,” Mr Bettin said.
“Given recent news about government budgets and NEHTA (National E-health Transition Authority), it is questionable to what extent it is realistic to assume that such a platform will be available in a timely manner for the payment proposal to be implementable,” Mr Bettin said.
When asked how GPs, patients and the respective labs would be able to identify the number of co-paid services in real time, a DHS spokeswoman said the department was “designing the technical solution for the implementation of co-payment policy as outlined in the federal budget”.
Lots more here:
That the delay is likely to be a problem is confirmed by this from DoH.
“It is foreseeable that there may be some delay between the date of service, the lodgement and processing of the Medicare claim. This may result in the DHS system, at a particular point in time, only recognising that 10 or less patient contributions have been charged when in fact the patient has been charged 11 or more in a calendar year (with a number of claims yet to be submitted to DHS or processed by DHS). To mitigate this situation, the claiming channels will also be enhanced so that providers have the option to declare that the provider has obtained information that provides a reasonable belief that the patient has been charged at least 10 patient contributions in the calendar year.”
The other obvious issue is just how the practice management billing systems are going to need to be modified, how much this will cost the software providers and just how much it will be given to them to fund the change.
Of course all this will be made more complicated if there are to be changes in the core Medicare and PBS systems following the EOI we noted a few days ago.
I think you can expect a lot more discussion of the potential issues.
Surely it would be simpler for all if the Senate just rejects the co-pay plan and thinks of other ways to fund the health system?
Some fundamental reform of the health system would seem to be a much better, but much harder way to proceed.
David.

Monday, August 11, 2014

Weekly Australian Health IT Links – 11th August, 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

Quite a lively week with the Department of Health managing to demonstrate that they are utterly clueless about the online world and how it all works - witness the hopeless badly designed attempts at using SurveyMonkey on the PCEHR as well as reports of the PCEHR adoption being basically stuck.
Clearly the biggest news of the week is the DoH asking for Expressions of Interest to operate the payment systems for Medicare and the PBS. This will be a just ginormous IT Services contract if it happens and will cost a pretty penny indeed - as I am sure it already is while being run in-house.
Elsewhere the NBN review suggests it was comprehensively bungled and that the reality of the Star Trek vision comes closer!
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Online survey to review e-health launched

5th Aug 2014
THE Department of Health has launched an online survey to capture feedback from GPs and other stakeholders as it prepares to implement recommendations from a review of the personally controlled electronic health record (PCEHR).
The review ordered late last year by Health Minister Peter Dutton came up with 38 recommendations to tackle shortcomings and make electronic records more effective for doctors and patients.
The survey, which targets healthcare providers, patients and software vendors, focuses largely on the recommendation that the PCEHR should transition to an opt-out model from 1 January next year, meaning Australians would be required to notify government if they did not want a record. 
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PCEHR survey bungled: critics

6th Aug 2014
THE health department has been accused of bungling a survey intended to capture feedback from GPs and other stakeholders about the personally controlled electronic health record (PCEHR).
MO readers criticised the survey's wording and functionality, with e-health blogger Dr David More complaining that his attempts to complete it were stymied by basic bugs.
Questions that should have allowed multiple answers to be ticked only allowed one answer, and for a period of time yesterday one question asked respondents which they liked best out of "Option Apple", "Option Banana" and "Option Cherry" – a default placeholder question used by the web survey provider SurveyMonkey. 
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PCEHR survey faces privacy backlash

Fran Foo

THE Privacy Commissioner is looking into complaints an online e-health survey run by the government breached several privacy principles.
The Department of Health is seeking feedback from healthcare providers, consumers and medical vendors on the Royle review into the troubled $1 billion personally controlled e-health record system.
In her letter to Mr Pilgrim, Australian Privacy Foundation health committee chair Juanita Fernando said survey participants using the SurveyMonkey online tool are not assured their comments will remain confidential.
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Concerns over PCEHR survey privacy quelled

Fran Foo

THE Department of Health and SurveyMonkey have moved to dispel fears a government-commissioned online e-health survey breached several Australian privacy principles.
Health is seeking feedback from healthcare providers, consumers and medical vendors on the Royle review into the troubled $1 billion personally controlled e-health record system.
US-based SurveyMonkey is hosting the survey on its online platform.
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RDF for universal health data exchange? Correcting some basic misconceptions…

Something called the “Yosemite manifesto on RDF as a Universal Healthcare Exchange Language” was published in 2013 as the Group position statement of the Workshop on RDF as a Universal Healthcare Exchange Language held at the 2013 Semantic Technology and Business Conference, San Francisco. Can such grand claims be true?
I’m not sure if either the slide above or the original reference are reliable at the moment, so I’ll reproduce the text here:
  1. RDF is the best available candidate for a universal healthcare exchange language.
  2. Electronic healthcare information should be exchanged in a format that either: (a) is an RDF format directly; or (b) has a standard mapping to RDF.
  3. Existing standard healthcare vocabularies, data models and exchange languages should be leveraged by defining standard mappings to RDF, and any new standards should have RDF representations.
  4. Government agencies should mandate or incentivize the use of RDF as a universal healthcare exchange language.
  5. Exchanged healthcare information should be self-describing, using Linked Data principles, so that each concept URI is de-referenceable to its free and open definition.
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GPs wary of e-health mental health tools

6 August, 2014 Kate Aubusson
GPs need evidence-based help to navigate through the available online psychological services to treat mental illness, say the developers of a program that provides this assistance.
While UK GPs have embraced e-mental health services for treating anxiety and depression, GPs in Australia are still unsure about the effectiveness of online psychological services, according to the Black Dog Institute in Sydney, which is spearheading a new GP education program.
"GPs are often slow to take up anything new and it often works in their favour — they wait to see the evidence of efficacy and the side effects involved before trying any new treatment," said GP, and mental health expert at the Black Dog Institute, Professor Jan Orman.
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Telehealth uptake fails to meet targets

8 August, 2014 Sam Worrad
Only one fifth of the multi­million dollar telehealth budget designed to bring specialist care to rural Australia has been spent, new figures suggest.
The original goal was to fund 495,000 telehealth consultations by mid-2015. But in March this year, only 169,602 services had been delivered in the three years since the scheme was launched.
Although the federal health department emphasises that MBS claims for the consults are rising, its annual report shows that in 2012/13 only $10 million of the $58.2 million budget for telehealth consultation was spent.
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Aged care nurses can drive e-health

By Natasha Egan on August 6, 2014 in Health & medical, Industry, Technology
Aged care’s first certified e-health nurse in Australia is calling on her counterparts to get the skills they need to provide care in the digital age.
Donna Barton, a registered nurse working as a health informatics manager with a Sydney-based aged care provider, has recently attained the Certified Health Informatician Australasia (CHIA), which was co-developed by Australia’s health informatics bodies HISA, ACHI and HIMAA.
As reported by Australian Ageing Agenda ahead of the program’s launch in July last year, the CHIA aims to demonstrate that health informatics professionals, such as clinicians, allied health workers, health information managers, nurses and ICT professionals, have the skills they need to carry out their role safely and effectively.
Ms Barton told AAA that cementing gaps in her knowledge was one reason she decided to get certified.
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Craig Cook: New medical administration system (EPAS) should stand for exasperating patients and surgeons

  • Craig Cook
  • The Advertiser
  • August 06, 2014 11:48PM
I HAVE been a little under the weather of late but things are not as bad as the new state medical administration system would have you believe.
It thinks I’m dead.
That declaration caused quite a bit of mirth at the Repatriation Hospital recently as I booked in to see my specialist.
The ladies on the front counter hadn’t seen anything quite so drastic as an unexplained fatality but they all recounted tales of intense frustration with the new Enterprise Patient Administration System (EPAS).
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Psychiatric patients' records being aired in court

Date August 8, 2014 - 8:00AM

Harriet Alexander

Psychiatrists are handing their patients' confidential records to the courts amid threats of jail, under a flourishing practice by solicitors of issuing "dirt digging" subpoenas.
Some patients have been powerless to prevent details about their past sexual abuse or childhood trauma being aired in court, even in matters where they are not a party to the legal proceedings, a paper published in Australasian Psychiatry says.
The authors claim that solicitors are seeking unfettered access to patient records in civil and criminal cases, regardless of their relevance.
"It appears to have become particularly commonplace for subpoenas to be used during family law proceedings for 'fishing expeditions' to 'dig up dirt' on estranged spouses," the paper says. "These subpoenas typically ask for the entirety of the patient's psychiatric records."
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For patients to be informed & empowered, they need access to medical records

| Aug 07, 2014 3:33PM |
Patients are often urged to take greater responsibility for healthcare decisions – but this is easier said than done when access to medical records is not consistently available.
Consumer health advocate Anne Cahill Lambert’s recent experience illustrates some of the barriers faced by people seeking access to their records.
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Start-up health.com.au in $100m health kick

Fran Foo  Deputy Editor, Technology Sydney

AN online private health insurance start-up is poised to crack the $100 million revenue mark this financial year after a little more than two years in business in a multi-billion-dollar industry.
Health.com.au founder and CEO Andy Sheats said the company would delay plans for an initial public offering next year because it was performing well enough and an IPO was not ­required.
Mr Sheats said the company would instead look to the private equity market to raise $100m, and had appointed Pier Capital as ­financial adviser for the capital-raising.
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Data storage could be used to fight 'general crime', Tony Abbott says

Date August 6, 2014 - 9:26AM

Latika Bourke

National political reporter

Controversial plans to store phone and internet logs of everyday Australians would include capturing a person's web browsing history and could be used to fight "general" crimes and not just in terror cases, Prime Minister Tony Abbott says.
The Coalition government wants to proceed with a plan to have "metadata" stored for two years, which ASIO boss David Irvine has described as "absolutely crucial" in monitoring and disrupting local terror cells.
Mr Abbott has likened the information to that included on the "front of an envelope".
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Computer games may ease elderly depression, study finds

  • AFP
  • August 06, 2014 7:47AM
BRAIN-boosting computer games may be as effective as, or even better than drugs in treating severe depression in some elderly people according to trial results.
A group of 60-to-89-year-olds, for whom anti-depressants had not worked, perked up after four weeks of playing computer games that had been developed to improve brain fitness, scientists wrote in the journal Nature Communications.
The programs were developed to test a theory that the ageing brain can be regenerated through intense practice — regaining lost learning and memory function and improving decision-making, which can in turn alleviate depression.
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EOI for Medicare-PBS Payment Services

The Australian Government allocated funding in the 2014-15 Budget to go to the commercial market calling for Expressions of Interest from the private sector to provide claims and payment services for Medicare (MBS) and the Pharmaceutical Benefits Scheme (PBS).
Page last updated: 08 August 2014
8 August 2014
The Australian Government allocated funding in the 2014-15 Budget to go to the commercial market calling for Expressions of Interest from the private sector to provide claims and payment services for Medicare (MBS) and the Pharmaceutical Benefits Scheme (PBS).
The Government is committed to cutting red tape in the health system and is seeking to streamline and simplify systems for patients, doctors and other health providers.
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Glasses raised to Dr Lambert’s eHealth as he leaves hospital

By JANICE HARRIS
Aug. 4, 2014, 3:30 a.m.
THE doctor who has been at the forefront of introducing new technology across the Western NSW Local Health District is leaving Orange.
Dr John Lambert, who has been based out of Orange for the last 12 years in the role of intensive care specialist and critical care director, has been appointed chief clinical information officer for the newly created eHealth division of NSW Health which is launching a new electronic health strategy across the state.
He came to Orange in 2002 after his final year of advanced training in intensive care at Royal Prince Alfred Hospital  to take up the dual role for the Mid Western Area Health, now Western NSW Local Health District (WLHD).
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Google Glass a sight for poor eyes

Chris Griffith
IT’S not often Google Glass is unleashed on the streets of Australia.
Last week, we headed out from the search engine giant’s Sydney office in Pyrmont doing just that. My aim was to test Google Glass installed with an Aussie app ­designed to help the visually ­impaired.
In Australia, Google has been in cahoots with three main Glassware developers.
Townsville’s Safety Culture is building apps for workplace safety and Small World Social in Victoria is cobbling Glass apps to support new mothers learning to breastfeed.
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IBM's cognitive computer chip apes brain architecture

Date August 8, 2014 - 11:59AM

Geoffrey Mohan

Computer science is getting stunningly close to granting the wish of the Scarecrow, not to mention the needs of the modern soldier.
The Pentagon has long sought what the Wizard of Oz could not manufacture: a brain, or at least an electronic cognition machine that operates as closely as possible to the speed and efficiency of the human cortex.
A coalition of IBM's research institutes and several universities and government labs delivered a preliminary answer Thursday to that request: a 5.4-billion transistor chip with one million programmable neurons and 256 million synapses. The TrueNorth chip is the size of a postage stamp and is more than 1,000 times as energy efficient as a conventional chip, according to a study published online Thursday in the journal Science.
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Labor’s NBN ‘rushed, chaotic’, says audit

Annabel Hepworth & Mitchell Bingemann

BIG taxpayer-funded infrastructure projects worth more than $1 billion could face stringent new hurdles after a landmark audit has found the policy process for developing Labor’s National Broadband Network was “rushed, chaotic and inadequate”.
In a devastating critique into the formation of Australia’s biggest infrastructure projects, former Productivity Commission head Bill Scales has found the NBN Co set up to develop the high-speed internet network was given a job that only a “well-functioning, large and established” telecommunications company could do under the tight time­tables for the rollout. For a start-up, it was an “impossible assignment”.
Mr Scales said he was told that some of those involved in the first 12 months of the NBN Co were “making it up as they went”, while others related a “salutary anecdote” that, in the early days of NBN Co, ‘‘all we had (to guide us) was the press release and a bunch of business cards”.
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NBN Co was not fit for purpose: Scales report

Date August 5, 2014 - 9:19PM

Matthew Knott

Communications and education correspondent

Cost blowouts and delays in the rollout of the national broadband network show that infrastructure projects - including a second Sydney airport - should be subject to a public cost-benefit analysis, the country's peak infrastructure body says.
In a review of the policy process that led to the creation of the network, former Productivity Commission chairman Bill Scales said all public infrastructure projects worth over $1 billion should be subject to a cost-benefit analysis, with the results made public before the project starts.
All infrastructure projects promised at an election should also be costed by the Productivity Commission or Infrastructure Australia, Mr Scales recommended.
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SpaceX founder Elon Musk fears artificial intelligence

Elon Musk, the founder of SpaceX and Tesla, says that artificial intelligence (not nuclear war) is what he fears the most.
Musk made this comment about artificial intelligence (AI) after reading the book “Superintelligence” by Nick Bostrom. To be released on September 1, 2014, the Bostrom book deals with a future in which machines become more intelligent than humans.
Bostrom theorizes whether such a world (one in which artificial intelligence, or AI, is smarter than humans) will be good or bad for humans; that is, will it eventually save or destroy humanity.
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NASA tests ‘impossible’ microwave engine that produces fuel out of empty space — and finds that it works

  • August 04, 2014 11:52AM
 ‘I CANNAE break the laws of physics” Star Treks’ famous engineer “Scotty” would retort. But NASA has. They’ve produced something from nothing, and perhaps opened a way to the stars in the process.
Scotty has to eat his hat: And the new microwave propulsion system has been named the “Cannae Drive”.
An initially sceptical NASA decided to test a widely criticised concept from inventor Roger Sawyer — even though established thinking said it wouldn’t work.
It did.
The engine appears to produce propulsion through electricity. And nothing else.
The usual expectation is that thrusters need to eject some kind of mass in order for the old law of physics “equal and opposite reactions” to kick in. For example rocket propellant is burnt and ejected from a thruster in order to propel a rocket upwards.
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Enjoy!
David.

Sunday, August 10, 2014

This Is Going To Be The Mother Of Health Related Computer Projects If It Happens. The Risks Are Stratospheric!

This announcement appeared from the Minister For Health last week.

EOI for Medicare-PBS Payment Services

The Australian Government allocated funding in the 2014-15 Budget to go to the commercial market calling for Expressions of Interest from the private sector to provide claims and payment services for Medicare (MBS) and the Pharmaceutical Benefits Scheme (PBS).
Page last updated: 08 August 2014
8 August 2014
The Australian Government allocated funding in the 2014-15 Budget to go to the commercial market calling for Expressions of Interest from the private sector to provide claims and payment services for Medicare (MBS) and the Pharmaceutical Benefits Scheme (PBS).
The Government is committed to cutting red tape in the health system and is seeking to streamline and simplify systems for patients, doctors and other health providers.
The Department of Health currently contracts the Department of Human Services to deliver the collection and payment system which remunerates doctors and other health professionals.
The current IT systems that manage the claims and payments processes are dated and in need of a substantial upgrade. In these circumstances it is good process to review and test existing and alternative systems.
The market test will determine the level of private sector interest and capability in providing those IT services for both the Department of Health and the Department of Veteran’s Affairs.
The EOI does not include the face-to-face services provided by Medicare.
The EOI process will inform the Government whether the commercial sector can deliver greater efficiency, flexibility and agility to the MBS and PBS processes.
The commercial sector may be able to provide a better service to Australians at a lower cost to the taxpayer, if so patients, doctors and the Government will reap the benefits and savings.
Commercial organisations already provide services to government involving large amounts of data and transactions.
The Department of Health is now seeking Expressions of Interest through advertisements in the media which provide information and details of the EOI process.
The EOI will close on August 22.
The release is found here:
There is coverage of this release here:

Department of Human Services set to broken up and privatised

Date August 8, 2014 - 9:15AM

Noel Towell

Reporter for The Canberra Times

The federal government’s biggest department, Human Services, looks set to be broken up and some of its key functions privatised.
The Commonwealth is moving to outsource $29 billion in annual Medicare and Pharmaceutical Benefits Scheme payments, in a decision which would cut the 30,000-strong department in half.
Jobs in the Department of Veterans' Affairs will also be in the firing line as the Health Department looks to outsource nearly $2.5 billion in veterans’ benefits currently administered by DVA.
The moves were recommended in the Abbott Government’s Commission of Audit and raised the prospect of more radical shakeups in the bureaucracy contained in Tony Shepherd’s report being brought into effect by the government.  
More here:
And here:

Medical payments to go private

Joanna Heath
More than $30 billion in Medicare and pharmaceutical benefit payments a year is likely to be outsourced, cutting the Department of Human Services in half and reshaping the delivery of government services.
The decision – a key recommendation of the Commission of Audit – could allow Australia Post or one of the big four banks to step in to calculate and process health payments and absorb Medicare retail outlets.
It aligns with the government’s plans as part of the budget process to reduce the size the public service and make government services more efficient.
In an advertisement in today’s The Australian Financial Review, the Department of Health calls for com­panies to express interest in providing claims and payment services for the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS), the second-biggest responsibility of the Department of Human Services after welfare payments.
It follows the allocation of $500,000 in this year’s budget, largely unnoticed, for market testing.
“We’re determined to put into place a 21st-century payment system that will be more efficient for patients and doctors,” Health Minister Peter Dutton said. “It will reduce red tape for doctors and streamline their administrative processes and, we believe, deliver a ­saving to the taxpayer.”
The contract is likely to be highly complicated. The new provider would have to be capable of processing a ­collective $29 billion of claims from 600 million transactions a year conducted for the Department of Health, and nearly $2.5 billion in claims from 33 million transactions for the Department of Veteran’s Affairs.
More here:
As I said in the title of the article this is going to be an absolutely huge transformation if it happens and the risks are just enormous.
The current systems have been in place for a very long time and you can read all about it here:
Any system that is this old and has been in place for so long will be, by now tweaked and modified to death and it is very unlikely that anyone really fully knows the systems in depth. You can also be sure there is no complete written specification of just what these systems do.
Equally, over time all sorts of systems have been linked and interfaced into the core system and just how all these have been made to work will almost certainly have been lost in the ‘mists of time’!
Additionally is has to be very unlikely that there is anything available commercially that will be more that ½ of the required solution.
Last remember the data held in these two (Medicare and PBS systems) are needed for all sorts of reporting to Government, as well as supporting a range of research which needs to be conducted securely and safely as it involves real patient information.
I would be genuinely amazed if this project does not take 3-4 years, cost a few billion dollars, and have a close to even odds of failing if not worse.
Good luck to anyone to winds up tendering for this, recognising that the project has to succeed or the Government will have to revert to quills and ink at some time in the next few years. This is a classic example of being between a rock and a hard place while at the same time really not being able to find some reasonably safe way of navigating the needed change out from under the falling rock!
Heaven help us with this - given how central these systems are so central to the overall health system.
David.

AusHealthIT Poll Number 230 – Results – 10th August, 2014.

Here are the results of the poll.

Do You Think Telstra Has The Expertise and Health Understanding To Make A Positive Impact On Australian E-Health?

For Sure 7% (5)

Probably 11% (8)

Neutral 7% (5)

Probably Not 44% (31)

No Way 29% (20)

I Have No Idea 1% (1)

Total votes: 70

73% seem to think that Telstra is probably not up to it in terms of e-Health.

Again, many thanks to all those that voted!

David.