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, October 29, 2014

I Wonder If There Is A Hint About NEHTA’s Future In This Job Advertisement?

This advertisement appeared a few days ago.

Senior Policy Advisor

NEHTA-Sydney, Australia

23 October, 2014

Job description

Status: Fixed term until June 2015
The Policy team at NEHTA are vital in developing and delivering consistent national policy frameworks which support eHealth into the future. The Policy team provide specialist advice on governance issues and key to the role is to engage with jurisdictional representatives.
As Senior Policy Advisor you will provide specialist policy advice to key stakeholders internally and externally.  In this busy role you will work closely with other QA and product and implementations teams and assist with a variety of ehealth projects and initiatives.

Desired Skills and Experience

To be successful in the role you will have extensive experience in resolution and mitigation of risks and issues and have the ability to develop sound, implementable recommendations for action. You will possess superior communication skills and must have experience with policy briefings, and recommendations and research reports for senior audiences. 
If you are a team player and enjoy working in a close team that supports each other and the broader business and have a passion for ehealth reform then this role will be well suited to you.

About this company

The National E-Health Transition Authority Limited (known as NEHTA) was established by the Australian, State and Territory governments to develop better ways of electronically collecting and securely exchanging health information.
In setting its requirements, NEHTA considers the most suitable standards and specifications from Australia and around the world, adapting them if necessary to suit the Australian context. If the necessary standards, specifications or infrastructure do not already exist, NEHTA is tasked to commission them.
eHealth brings together the technologies of unique identification, authentication and encryption to provide the foundations and solutions for the safe and secure exchange of healthcare information. NEHTA continues to lead the uptake of eHealth systems of national significance and to coordinate the progression and adoption of eHealth by delivering urgently needed integration infrastructure and standards. Working with key stakeholders including consumers, healthcare providers, the healthcare industry, the information and communications technology industry, policy makers and funders who have all played a role in building the eHealth record system now in operation, NEHTA offers a range of resources to support usability of eHealth products including the national system.
The link is here:
Honestly, closely reading this made my head hurt.
First just what is it that NEHTA has all these teams implementing etc. that need Policy Advice - bit late for that I would have thought.
Second it is interesting there is no mention at all, by name, of the PCEHR or myEHR.
Third I really wondered just what NEHTA had done for usability on the world’s most unusable PHR?
Last is there a sunset for NEHTA hinted at the date of termination - June 30, 2015? (8 months away)
Enquiring minds would like to know!
David.

Tuesday, October 28, 2014

At Least One Blogger Suggests The Expert Vibes Are Suggesting It Is Time To Call Time On The PCEHR.

This post from Dr Edwin Kruys appeared last week.

The Australian PCEHR: Success or failure?

Call me naive, but I was hoping that somewhere in Australia IT-people would be working day and night to fix the PCEHR, based on the abundant feedback from doctors and consumers. I had a rude awakening when I read this article in Australian Doctor Magazine: PCEHR: Patients may see test results before GP.
Sorry? Diagnostic imaging & pathology results may be uploaded to someone’s eHealth record, before they have been reviewed by or discussed with the requesting doctor? This doesn’t sound like an improvement. Worse, it flies in the face of the 2014 PCEHR review recommendations to make the system ‘more usable, and able to deliver meaningful use.’
So where are we at with the PCEHR? I asked four leaders in the field about their thoughts: Has it been a success or a failure? Can it still be improved and if so, how?

Let’s get the basics right first: Frank Jones

Dr Frank Jones, President of the Royal Australian College of General Practitioners: “The concept was always good, but it failed to engage with front line medical professionals and was hijacked by lawyers. I am also really unhappy with the government’s plan to upload results if not viewed by the requesting doctor after seven days – a disastrous situation!”
“The other thing that is never talked about and that people outside GP-land are unaware of, is that GPs can already access their practice patients’ notes, anywhere, anytime. GPs leading the way again – in many ways this has diminished the value of a PCEHR at a front line GP level.”
“Lets get the basics right first: Initially we need the information such as active relevant medical issues, allergies and OTD medications.”

In its present form a failure: Brian Morton

Dr Brian Morton, Chair of the AMA Council of General Practice: “In its present form as a GP I would have to say it’s a failure. There is no recognition nor remuneration for GPs to spend the time to prepare and submit the data which must be done with the patient present. Professional clinical input to the design process has not been given the status needed to make PCEHR workable and relevant to medical practice.”
“Privacy and consumer political correctness have over-ridden safe principles of health care. The very poor uptake of the PCEHR is evidence of this. If we are to reap the benefits then recognition of the cost of data entry needs to be made.”
“Remove and prevent data which is not clinically relevant for care, for example Medicare billing data, as medical assumptions cannot be safely made based on a billing event. Identify clearly in the record that data has been removed or data hidden; the ability to over-ride the control of this is inadequate for safe care. Start the use of PCEHR with small and focused data entry such as active medical history.”
“Make a Medicare item number for the initial entry of data and an item for review yearly by the patient’s usual GP. Enable the functionality of automatic loading of diagnostic imaging & pathology data to the PCEHR when it is received and reviewed by the requesting provider. For example in our software: when it is transferred from inbox to patient record.”
----- (My comments omitted! All readers would know what I would say )

Effectively dead: David Glance

Dr David Glance, Director Centre for Software Practice, University of Western Australia: “I would say that the PCEHR is effectively dead – there is some interesting commentary here. The liberal government has not killed it but they haven’t supported it actively either. Nor have they put forward any other strategy. So given the financial climate we are in now, I don’t expect that to change.”
“I fundamentally believe that Australia has a basic structural issue when it comes to implementing central strategies around eHealth. We are still lagging in electronic record adoption in our hospitals and public health services and to a lesser extent within the specialist community. Until that changes, any shared electronic health record will always have gaps and be less than useful.”
“Clearly NEHTA needs to be disbanded and something else put in its place. It was self-serving, bureaucratic and pretty hopeless when it came down to it.”
“With regard to opt-in/opt-out, I would say that opt-out is always a better option with a far easier access mechanism than was implemented for the PCEHR. But given how awful the implementation was, the point was moot. Talking of the implementation, given what we know about user interface, you would have thought that the interface to the PCEHR could have been a lot better than it was.”
Read the full post here:
Seems the academics and the docs are not impressed!
I hope those doing the Audit of NEHTA read closely!
David.

Was Asked For A Few Points On NEHTA For The Review Being Done For Victorian Government. Here Is What I Said.

The terms of reference for the short review were:

Terms of Reference are:

  • review and assess the extent to which NEHTA delivers for Victoria on its intended objectives as documented in relevant national agreements, strategies and agendas;
  • review and assess the efficiency and effectiveness of NEHTA for Victoria, in general, including identifying areas of risk in the national agenda (e.g. duplication of effort, unnecessary burden);
  • assess possible new governance arrangements for the national E-Health agenda in light of the findings of the Commonwealth review of the PCHER;
  • assess the net benefits to Victoria, particularly in light of its state contribution to the funding NEHTA, to participating in the national E-Health agenda through NEHTA.

Here is what I wrote:

-----


Core Points On The Over 9 Years Of NEHTA.

NEHTA was founded 5 July, 2005

1. NEHTA has consumed well over $650M - with a good 40% spent on consultants - over the last 9 years. They have used their market dominance to stifle criticism and distort development of e-Health in Australia.

2. There have been hundreds of specifications and reports produced - remarkably few of which have actually been implemented.

3. There have been at least 2 reviews identifying the failures on NEHTA (BCG and Deloitte) and these have essentially been ignored.

4. There is a deep disconnect between all well informed e-Health practitioners and academics and NEHTA given NEHTA’s consistent record of ignoring expert advice they don’t agree with.

5. NEHTA management has been unsupervised for virtually all of the last 9 years with no real e-Health expertise on the Board to Review what management was doing.

6. There is no evidence I can find - after almost a decade - that any positive difference has resulted from NEHTA’s existence.

7. The NEHTA Designed and Implementation Managed PCEHR has been a $1Billion failure with both clinician and consumer rejection after almost 2 and a half years since going live.

Overall there is only one recommendation. This is that NEHTA’s activities be reviewed for value to the health sector and e-Health community. Those activities which add value should be continued within an inclusive (clinical, industry, jurisdictions, consumers etc.) entity that is well governed, transparent and led (expert leadership is crucial), and the rest of the activities should be ceased and NEHTA disbanded. Specifically none of the current senior executive group should have any further involvement.

This all needs to happen in the context of a revised, properly consulted and agreed National E-Health Strategy.

It really is that simple!

-----

I did also mention the blog had a little supporting information.

I wonder what will happen next?

David.

 

Monday, October 27, 2014

Weekly Australian Health IT Links – 27th October, 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

This week was all about Telstra’s announcements and the continuing lack of any information from the Government as to what is going on in e-Health in OZ.
It will be very interesting to see just the Government is up to in Medicine and Medical Device regulation and whether e-Health gets tangled up in the review.
-----

Telstra inks eHealth deal with Medgate

David Ramli
Trips to the doctor’s clinic have long been the stuff of childhood nightmares, linked with prickly needles and pungent antiseptic.
But Telstra’s latest deal with a Swiss eHealth provider could soon make them a thing of the past.
Australians wanting to visit the doctor must currently visit a general practitioner in person except in rare cases where remote health care is provided over video links.
But the move by Telstra to team up with Medgate, a major Swiss provider of online healthcare services, would see the telco help connect users and medical professionals over the internet at all hours.
-----

Telstra ramps up health services division

Mitchell Bingemann

TELSTRA is making an aggressive push into the $120 billion a year health care sector and has announced new global and local partnerships with healthcare providers as well as a new service to connect rural and regional patients with GPs.
The telco giant has elevated its health-services division — which was launched in February 2013 — into a stand-alone business unit that will look to tap into the growing health sector as an ageing population and increases in chronic illnesses pressure an already burdened national healthcare system.
The unit, which comes under the remit of Telstra retail boss Gordon Ballantyne, will see Telstra partner with healthcare authorities and providers to deliver services direct into patients’ homes.
-----

Telstra enters e-health space

Telco launches health division to provide video conferencing services to remote communities
Hamish Barwick (CIO) on 22 October, 2014 10:52
Telstra (ASX: TLS) has launched an e-health business division called Telstra Health as it looks to connect patients with doctors via video conferencing, said group executive of retail, Gordon Ballantyne.
“Telstra Health is about connecting you to your doctor, your doctor to your other providers, and having access to care and information where you want, when you want,” he said in a statement.
To do this, the telco has signed a joint venture with Swiss telemedicine company Medgate called Telstra ReadyCare.
According to Ballantyne, the service means patients in remote areas or who need help after hours can talk to GPs via video or phone to receive advice, diagnosis, prescriptions and referrals.
-----

AMA chief slams Telstra eHealth plan

  • AAP
  • October 22, 2014 5:37PM
THE head of the Australian Medical Association has condemned a new Telstra eHealth service, saying it will undermine primary healthcare.
THE ReadyCare service, announced on Wednesday, will connect patients to random GPs via phone and video 24 hours a day, providing advice, diagnosis, referrals and prescriptions.
Telstra says the service will deliver better healthcare to rural and remote Australians who live a long way from their doctor.
But AMA chief Dr Brian Owler says it's a recipe for bad medicine.
-----

PCEHR: Patients may see test results before GP

20 October, 2014 Paul Smith
EXCLUSIVE: A major upgrade of the PCEHR could see patients learn they have cancer, chlamydia or other serious conditions by reading test results posted on the system before they speak to their GP.
In one of the most important changes to the e-health system, the Federal Department of Health has announced that pathology and diagnostic imaging results will start being added to patient’s health records next year.
The upgrade is being sold as a major step in making the $1.25 billion technology clinically useful to doctors.
But there is serious disquiet among GPs who have been consulting with department officials over the upgrade.
-----

Dentists want ‘opt-out’ eHealth record

Dentists have sunk their teeth into the slow and frustrated progress of Australia’s attempt to build a national eHealth system, telling the federal government the scheme needs to be switched to an ‘opt-out’ model and have a name change if participation is to increase.
A bulletin issued by the Australian Dental Association following consultations with the peak body over the future of the Personally Controlled Electronic Health Record (PCEHR) says rather than calling the electronic document a “health record” it should be called a “health summary” to avoid mix-ups.
“The term ‘Record’ risks being confusing for health practitioners and patients alike, the bulletin said.
“It is a summary and not a complete record and so the title “My Health Summary” is more appropriate.”
-----

The Australian PCEHR: Success or failure?

Call me naive, but I was hoping that somewhere in Australia IT-people would be working day and night to fix the PCEHR, based on the abundant feedback from doctors and consumers. I had a rude awakening when I read this article in Australian Doctor Magazine: PCEHR: Patients may see test results before GP.
Sorry? Diagnostic imaging & pathology results may be uploaded to someone’s eHealth record, before they have been reviewed by or discussed with the requesting doctor? This doesn’t sound like an improvement. Worse, it flies in the face of the 2014 PCEHR review recommendations to make the system ‘more usable, and able to deliver meaningful use.’
So where are we at with the PCEHR? I asked four leaders in the field about their thoughts: Has it been a success or a failure? Can it still be improved and if so, how?
-----

#FHIR Updates

Posted on October 24, 2014 by Grahame Grieve
Several FHIR related updates:
Just a note in response to a question from an implementer: we are going through a period of making many substantial changes to the specification in response to user feedback. Right now, the test server (http://fhir-dev.healthintersections.com.au) is far behind – that’s work for next month. This doesn’t affect the DSTU test server (http://fhir.healthintersections.com.au)
-----

What is a ‘standard': legislation or utilisation?

Bert Verhees, a colleague from the openEHR community made this post recently to the openehr-technical mailing list:
OpenEHR is not a standard, it is a formal specification.
 http://www.iso.org/iso/home/standards.htm
 ISO, What is a standard: 
 "A standard is a document that provides requirements, specifications, guidelines or characteristics that can be used consistently to ensure that materials, products, processes and services are fit for their purpose."
I’ve grappled with this question many times over the last 20 years. My current thinking is as follows.
-----

Health: Technology helping older people

Date October 19, 2014 - 10:00AM

Josh Jennings

Having a direct impact on well-being is one of the biggest work highlights for Lisa Paulin.
Paulin is the co-ordinator of older persons and residential aged care at Inner East Melbourne Medicare Local and looks after online and remote health initiatives.
She co-ordinates a small team responsible for addressing local healthcare needs and service gaps through e-health and telehealth initiatives. A big part of her role involves adopting e-health and telehealth technologies (such as video conferencing software) to facilitate remote consultations between aged care providers and healthcare practitioners (such as GPs and specialists).
-----

Potential issue with PCEHR overviews

We have been alerted by the Department of Health about a potential risk identified within the PCEHR system. This is impacting the way a small number of documents can be viewed in an eHealth record.
This issue results in some Medicare, prescription and dispense documents presenting in the Document List but not appearing in the Medicare Overview or the Prescription and Dispense View.
-----
23 October 2014, 4.57am AEDT

Wearable technology will not bring about a health revolution

David Glance
Rumours are surfacing that Microsoft will launch its own smartwatch in the next few weeks. Given that Microsoft Windows Phone accounts for just 2.5% of the world smartphone market, the watch will work with Apple and Android devices as well as Microsoft’s own platform.
What is interesting about this move is that the commentary about the device is focusing on its role in tracking heart rate rather than its other features.
The focus on the health aspects of wearables is part of a general trend amongst technology journalists who predict a “coming revolution in healthcare” as a result of these devices.
-----

Going online for mental health effectiveness: report

The e-Mental Health Alliance has released a report aimed at giving the Australian government and the National Mental Health Commission a comprehensive picture of the range and quality of e-mental health services available in this country. The eMH Alliance was initiated by A/Prof Judy Proudfoot and Prof Helen Christensen from the Black Dog Institute.
“The sector is reasonably small but vibrant,” says Professor Britt Klein, personal chair in psychology and ehealth at Federation University in Ballarat. “The sector has been involved in e-mental health since the late 1990s.”
Federation University was one of the groups involved in putting together the e-Mental Health Services in Australia 2014: Current and Future report.
-----

Fund managers wary of Orion price

5:00 AM Wednesday Oct 22, 2014
Software developer ends speculation on IPO, but some possible investors worry it might set the bar too high.
The ink is barely dry on the announcement of Orion Health's up to $150 million sharemarket listing and fund managers are already talking down the offer's price - even though it is yet to be revealed.
After years of speculation, the Auckland developer of software systems used in hospitals yesterday confirmed it is aiming to float on the NZX and Australia's ASX late next month.
The company is looking to raise between $120 million and $150 million through its initial public offer, which will fund growth in key markets such as the United States.
An entity associated with chief executive Ian McCrae, who founded Orion in 1993 and remains the majority shareholder, is planning to sell $5 million of shares through the offer.
-----

Identity fraud costs nation $1.6bn a year

Brendan Nicholson

AS many as 900,000 Australians suffer financial losses through identity crime each year and that costs the nation at least $1.6 billion.
A report from the Attorney-General’s Department says stolen personal information is used to raise money by organised crime gangs and also helps fund terrorism.
The report, which includes information from 54 commonwealth, state and territory agencies and the private sector, says individual losses range from $1000 to hundreds of thousands of dollars.
The total of “card not present” fraud, where criminals have got hold of numbers but not the plastic, has jumped to $82 million a year.
-----

Expert Panel to Review Medicines and Medical Devices Regulation

The Australian Government has announced an independent review of the regulation of medicines and medical devices.
Page last updated: 24 October 2014

Joint Media Release

The Hon Peter Dutton MP

Minister for Health

Senator the Hon Fiona Nash

Assistant Minister for Health

24 October 2014
The Australian Government today announced an independent review of the regulation of medicines and medical devices.
Health Minister Peter Dutton and Assistant Minister for Health Fiona Nash announced they had appointed an Expert Panel Review of Medicines and Medical Device Regulation.
The landmark review of the ways in which the Therapeutic Goods Administration (TGA) regulates medicines and medical devices will be led by Emeritus Professor Lloyd Sansom AO who will be assisted by Mr Will Delaat AM and Professor John Horvath AO.
-----

Who’s who of Aussie ICT

October 20, 2014
HOTDOC is dedicated to promoting equity and accessibility in Australian healthcare. Its aim is to empower patients and doctors with a simple and convenient way of connecting online. Patients just have to register online and they are ready to book online appointments with clinics.
-----

Privacy complaints jump by 183% in FY14

Complaints rose following publicity about Privacy Act amendments, said the OAIC
Hamish Barwick (Computerworld) on 23 October, 2014 11:01
The Office of the Australian Information Commissioner (OAIC) received 4,239 privacy complaints during FY14, a 183 per cent increase on the 1,496 received in the previous financial year, according to a report.
The OAIC Annual Report 2013-14 put the increase in complaints down to heightened public awareness following the Privacy Act amendments and introduction of the Australian Privacy Principles on 12 March, 2014.
The APPs are designed to protect Australians when they share information with government agencies/departments or private sector companies.
“The focus on the reforms, particularly through the media, raised awareness and acted as a reminder to the broader community of their privacy rights,” said Australian Privacy Commissioner Timothy Pilgrim in a statement.
The OAIC resolved 2,617 privacy complaints during the 2013-14 period, Pilgrim said.
-----
20 October 2014, 12.55am AEDT

Digital death and the digital afterlife. How to have one and how to avoid it

David Glance
In 2012, the UK’s Sunday Times reported that actor Bruce Willis was going to sue Apple because he was not legally allowed to bequeath his iTunes collection of music to his children. The story turned out to be false (and shockingly bad journalism) but it did start a conversation about what we can, and can’t, do with our digital possessions.
It turns out that “possessions” is actually a misnomer. We actually don’t own the music, books and movies we “buy” from Apple and Amazon. As Amazon puts it in its license terms, “Kindle Content is licensed, not sold, to you by the Content Provider”. In other words, we are allowed to read the content but we are not allowed to pass it on.
It comes as no surprise then that 93% of Americans surveyed were unaware or misinformed when asked about what digital assets they were able to pass on in the event of their death.
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Telstra’s $11bn NBN pot off the table, says ACCC’s Sims

Mitchell Bingemann

THE competition regulator has backed calls from Telstra that the regulatory value of its fixed-line assets, rather than payments made to the telco giant by NBN Co, set access prices for its wholesale phone and internet services.
The Australian Competition & Consumer Commission yesterday handed down its decision that would see the $11.2 billion Telstra would receive from its deal to participate in the National Broadband Network excluded from future pricing adjustments.
Rivals including Optus and iiNet had argued the proceeds from that deal should be a factor in determining the access prices wholesale-seekers pay when ­accessing the telco’s network.
But ACCC chairman Rod Sims said the payments would not be ­included in any calculations as the NBN transitioned into its new role as the monopoly provider of the nation’s fixed-line broadband and phone services.
-----

Physical keys give Google services added security

Date October 24, 2014 - 3:30PM

Brian Krebs

People who use Gmail and other Google services now have an extra layer of security available when logging into Google accounts. The company has incorporated into these services the open Universal 2nd Factor (U2F) standard, a physical USB-based second-factor sign-in component that only works after verifying the log-in site is truly a Google site.
The U2F standard is a product of the FIDO (Fast IDentity Online) Alliance, an industry consortium that has been working to come up with specifications supporting a range of more robust authentication technologies, including biometric identifiers and USB security tokens.
The approach announced by Google on Friday essentially offers a more secure way of using the company's two-step authentication process. For several years, Google has offered an approach that it calls "2-Step Verification", which sends a one-time pass code to the user's mobile or land-line phone.
-----
Enjoy!
David.

Sunday, October 26, 2014

What Is Telstra Up To With All These New Activities? The Medgate Partnership Looks To Be A Worry.

In the recent release on their new activities Telstra said the following:

Telstra launches vision for a more connected healthcare system

·         Vision for Telstra Health revealed
·         ReadyCare telemedicine joint venture formed with Swiss company Medgate  
·         Home health care provider Silver Chain selects Telstra Health eHealth platform
·         NT Health partners with Telstra Health to build National Telehealth Connection Service
22 October 2014 – Today Telstra officially launched a new business division, Telstra Health, and outlined its ambition to become Australia’s leading provider of integrated eHealth solutions.
Telstra Group Executive of Retail, Gordon Ballantyne, said Telstra had helped Australians connect for more than a century and looked forward to partnering with industry to help advance healthcare.
“We’ve seen what the digital revolution has meant for other industries and we believe that healthcare in Australia could benefit from eHealth to better serve all Australians.” Mr Ballantyne said.
“Telstra Health wants to be the partner of choice in the health industry to connect patients, healthcare workers, hospitals, pharmacies, government and health funds and build a safer, more convenient way of managing health.”
Mr Ballantyne said eHealth could help solve some of the profound challenges facing the health care industry in Australia.
“Health spend is growing more than twice as fast as our economy to nearly 10% of GDP, from $120 billion in 2010 to an estimated $200 billion by 2020. Aging populations, chronic disease and equal access are just some of the challenges faced in bringing quality healthcare to every Australian across a fragmented system.
“Many Australians have a different experience of the healthcare system because of where they live. Seven million people in rural and regional Australia access GP services at a lower rate than the national average.
“We see our role as integrating eHealth solutions across all care settings to solve these industry challenges. Telstra Health is about connecting you to your doctor, your doctor to your other providers, and having access to care and information where you want, when you want.”
Mr Ballantyne said Telstra Health brought together an experienced team of health experts, and he had appointed Shane Solomon, former CEO of the Hong Kong Hospital Authority who brings 30 years experience in the health sector as Managing Director of Telstra Health.
“Through acquisition and partnerships, the team has assembled 10 of the most innovative eHealth companies from Australia and around the world to create leading integrated eHealth solutions, including the one we’re announcing today,” Mr Ballantyne said.
Telstra Health makes GP consultation more accessible and convenient
Telstra announced a new joint venture with world-leading Swiss based telemedicine company Medgate, ‘Telstra ReadyCare’.
The service will see patients talk directly to GPs over video or phone to receive advice, diagnosis, prescriptions, and referrals. ReadyCare is designed to complement regular GP consultations, with information from a telemedicine GP consultation provided back to the patient’s regular GP to ensure continuity of care. 
Mr Ballantyne said ReadyCare is aimed at overcoming the challenges of distance and availability to provide greater levels of access. It will operate on a 24/7 basis, and address the estimated 2.2 million of emergency department presentations occurring annually that could have been treated by a GP.
Medgate Chief Executive Officer, and President of the International Society for Telemedicine and eHealth, Dr Andy Fischer, was excited to work with Telstra Health to bring the service to Australia.
“There will be a great demand for telemedical consultations in Australia, and I look forward very much to a successful and exciting collaboration with Telstra Health,” Dr Fischer said.
A Clinical Advisory Panel has been established by ReadyCare to oversee clinical guidelines. Dr Chris Mitchell AM, past President of the Royal Australian College of General Practitioners and Associate Professor Dr Bruce Chater, past President of the Australian College of Rural and Remote Medicine have been appointed to the panel.
The full release is here:
A visit to the Medgate web-site was very illuminating:
Essentially what is offered is remote consultation by phone, e-mail or video conference for a fee.
Here is what the Telemedicine Service Offers by phone:

The Medgate Telemedicine Center offers you expert medical advice around the clock. You can even contact our medical team at nights, on the weekend or from abroad.

  • Call Medgate. Reception will take your symptoms and your personal details.
  • Take photos of affected skin sites or eye changes and send them by email or with the Medgate App.
  • The medical team will discuss the ideal treatment with you.
  • If medically required, the Medgate physician will issue you a prescription.
By internet:

You can use the Medgate WebDoctor to ask medical questions online. Our medical team will reply within 24 hours.

The WebDoctor is best suited for general health care questions. For acute health problems (e.g. sudden or severe symptoms) or to make an appointment, call us directly at 0844 844 911.
Or by video-conference:

Talk with a Medgate physician by video link, as if you were sitting next to each other.

You can make use of the netCare service in over 200 pharmacies throughout Switzerland. Your pharmacist will make the initial healthcare assessment. Then the Medgate physician will join over a secure connection. You will be speaking with the physician over a high-definition video system. Depending on the findings, the Medgate physician may issue you a prescription which you can have filled right there at the pharmacy.
There are also two Health Centers
In the Health Centers General practitioners, gynecologists and pediatricians and other specialists work under one roof. The health centers are equipped with the latest medical technology, such as X-rays, ultrasound, MRI, and laboratory light booths. The collaboration with the Telemedicine Center also allows health care around the clock.
Comprehensive primary care
     General and Internal Medicine
     Obstetrics and Gynecology
     Paediatrics
     Complementary and Alternative Medicine
Specialist consultations
(depending on the location)
     Dermatology
     Ear, Nose and Throat
     Ophthalmology
The video (3 mins or so) on the page makes below makes it all very clear. Interestingly they keep an electronic record of all patient encounters with histories etc.
The AMA has reacted to all this:

Owler slams Telstra eHealth plan

23 October, 2014
A new eHealth service announced by Telstra “cynical and inappropriate” and will undermine primary healthcare, says AMA president Associate Professor Brian Owler.
The ReadyCare service, announced on Wednesday, will connect patients to random GPs via phone and video 24 hours a day, providing advice, diagnosis, referrals and prescriptions.
Telstra says the service will deliver improved healthcare to rural and remote Australians who live a long way from their doctor.
But Dr Owler says it's a recipe for bad medicine.
"This is a really cynical and inappropriate way for Telstra to be engaged in healthcare. It's a commercial solution dressed up as a health solution.
"We want people to maintain a regular contact with their GP, not just ring someone out of the blue.
"They can just ring up a number, and get a doctor on the other end that they have no knowledge of or relationship with, and get scripts and other treatments prescribed.
"This is not the sort of vision we have for general practice and primary care."
Dr Owler says the AMA supports telemedicine, but only where a patient already has a relationship with the doctor on the other end of the line.
ReadyCare would undermine doctor-patient relationships and threaten existing medical workforce initiatives, he says, adding that expressed his concerns when Telstra briefed him on the service two weeks before the launch.
More here:
To me there are a zillion issues with all this around access, fees, quality control etc. Additionally it is hard to see just how different this is to the HealthDirect services and similar other than providing some more direct GP access - albeit there is still a triage front end which streams access to appropriate locations.
Given Telstra is a for profit entity - last time I looked - it is hard to know just where savings etc. will flow in the short and medium term.
Lastly, of course, there are all the clinical safety issues around care offered remotely without a prior established clinical relationship. Even with a proper relationship there are safety risks enough let alone without actually seeing the patient!
I would really wonder just what the legal and responsibility framework in Switzerland is that makes this workable and safe?
What do others think?
David.

AusHealthIT Poll Number 241 – Results – 26th October, 2014.

Here are the results of the poll.

Will The Proposed New Primary Health Networks Work Better Than The Old Medicare Locals For E-Health Implementation and Support?

For Sure 5% (5)

Probably 4% (4)

Neutral 25% (25)

Probably Not 28% (28)

No Way 38% (38)

I Have No Idea 1% (1)

Total votes: 101

It seems most don’t think the changes being made by the Government are going to make much of a difference and that similar outcomes can be expected.

Again, many, many thanks to all those that voted!

David.