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, November 06, 2014

Review Of The Ongoing Post - Budget Controversy 06th November 2014. No Sign Of Stopping!

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. Some more this week.
Here are some of the more interesting articles I have spotted this 23nd week since it was released.
Other financial matters are still also bubbling along and now with Parliament not sitting for a few weeks it is even harder to be sure where things will actually land!

General.

Senate standoff over budget savings could trigger more public service job cuts

Date October 27, 2014 - 9:30AM

Phillip Thomson

Public Service Reporter at The Canberra Times.

Low iron ore prices and the Senate stalemate over budget savings could prompt a fresh announcement of further public service job cuts which would hurt Canberra, according to Deloitte Access Economics.
Deloitte Access Economics partner Chris Richardson said the federal bureaucracy would pay the cost of Treasurer Joe Hockey's options being reduced.
"The levers the government can control relate to public service numbers," Mr Richardson said.
-----

Hockey backs Murdoch's comments that low rates make the rich richer

Updated about  28 Oct 2014, 10:58am
It is a harsh critique from an unlikely source. In a speech to the world's most powerful finance ministers and central bankers, News Corp's executive chairman Rupert Murdoch has accused them of making policies to benefit the super rich.
The media baron made the speech two weeks ago at a closed door event in Washington.
In it, he blamed the leaders for increasing inequality, said the ladder of generational progress was now at risk, and warned that a moment of great global reckoning had arrived.
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Joe Hockey says monetary policy exhausted, made ‘rich richer’

Jacob Greber Economics correspondent

Key points

  • Joe Hockey calls for labour-market deregulation and reduced barriers to trade, as well as budget reform, in the face of limits on government spending.
  • He says the Australian economy faces ‘headwinds’, but is not concerned about the growth rate in China, saying it is still strong at its current 7.3 per cent.
Treasurer Joe Hockey has declared the ability of official interest rate cuts to spur economic growth has been exhausted, having mainly had the effect so far of making rich people richer.
Speaking as the Abbott government opened the prospect of changes to the goods and services tax, Mr Hockey said the only mechanism to generate fresh jobs and economic activity was to undertake domestic reforms.
He said the alternative of ramping up government spending was also limited because most countries around the world did not have the money or ability to “put it on the credit card for ever”.
-----

Export price slide set to hit MYEFO

  • AAP
  • 30 Oct, 6:24 PM
Declining national income is another headache for Treasurer Joe Hockey as he prepares for his mid-year budget review.
Mr Hockey told parliament on Thursday that thanks to the opposition, $28 billion of savings were being obstructed in the Senate, some of which were announced by Labor in government.
The government also has to find $630 million for increased national security, as well as the cost of military action in Iraq.
On top of this, revenue - at least for this financial year - is not living up to expectations.
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Abbott's fuel tax stance signals new case-by-case approach

Date October 31, 2014 - 12:00AM

Mark Kenny

Chief political correspondent

When Tony Abbott called for a "mature debate" on the federation including, most heroically, the Goods and Services Tax, the opposition nearly choked on its Weeties. From a government elected on the bluntest mandate in history to scrap taxes, the possibility of expanding the reach of one of the biggest was a stretch.
The fact that recidivist Abbott has a rap-sheet as long as your arm of misdemeanours against the kind of political maturity he now seeks, did not help. Which doesn't make the call wrong. Just harder to cop. Nevertheless there are signs that "Captain Combat" is repositioning in his second year, with his language displaying a more conciliatory tone and hinting at a new tendency to negotiate.
Abbott, it seems, has concluded that a combination of policy substance and a willingness to talk offers the government the best chance of longer-term progress. Who knows whether  all the reflection on Gough Whitlam's courage reminded the incumbent of the fleeting nature of power.
-----

Our ageing population not necessarily bad news

Date November 1, 2014 - 12:15AM

Ross Gittins

The Sydney Morning Herald's Economics Editor

Politicians and economists have been banging on about the ageing of the population for ages, but how much do we actually know about the likely economic consequences? Not much - until now.
We've been told incessantly that ageing spells bad news for the budget - greatly increased spending on pensions and healthcare - with ageing used to help justify the harsh spending cuts proposed in this year's budget.
In truth, it has suited the powers-that-be to exaggerate ageing's effect on the budget. And oldies are right to resent the way ageing has been presented as nothing but a terrible problem. If the fact that we're living longer, healthier lives is a "problem", it's the best kind of problem to have.
-----

Samantha Maiden: Workers should fear Tony Abbott’s creepy taxes

  • Samantha Maiden
  • The Sunday Telegraph
  • November 02, 2014 12:00AM
THINK for a moment about the biggest, nastiest measures in Joe Hockey’s budget, the tough decisions deemed necessary to get the budget back to surplus.
There’s the petrol tax increases that Tony Abbott announced this week would apply from November 10, despite the fact the Senate has rejected the laws.
That will rip $2 billion out of motorists pockets over the next four years. These are the changes that prompted newspapers to dub the PM a “bowser bandit’’. But the increase will cost the average family a modest 40 cents a week.
-----

Australia's stance on tax avoidance out of step says Bill Shorten

Date November 2, 2014 - 12:15AM

Bill Shorten and Andrew Leigh

The "Double Irish Dutch sandwich" sounds like something questionable you'd find on the menu at backpacker-run cafe.
But it's actually a notorious tax loophole in Ireland which allows huge multinational companies to get away with paying tiny amounts of tax through shifting money between multiple countries.
For almost 30 years, some big global firms - including companies operating in Australia - have been using this loophole to pay tiny amounts of tax.
----- 

Transpacific Partnership Trade Agreement.

AMA wants assurance TPP deal won't push up medicine prices

Updated 26 Oct 2014, 4:20pm
The Australian Medical Association (AMA) wants assurances that a Trans Pacific Partnership (TPP) deal will not push up medicine prices.
Federal Trade Minister Andrew Robb is hosting talks with 11 counterparts in Sydney this weekend, as progress towards a multi-lateral trade deal inches closer.
If it is signed, the TPP agreement would cover 40 per cent of the global economy, and include countries like the United States, Canada, Japan, Malaysia, Peru, Chile and Australia.
AMA president Professor Brian Owler said the agreement could be beneficial, as long as it did not inflate medicine costs.
-----

Concern over medicine price increases

October 26, 2014
Doctors in Australia are calling for assurances the Trans Pacific Partnership (TPP) agreement will not push up the price of medicines.
The ABC reports Australian Trade Minister Andrew Robb is hosting talks on the trade deal with 11 counterparts in Sydney - including New Zealand's Tim Groser.
Mr Groser said medicines would not be made more expensive if New Zealand signs up to the TPP agreement.
The TPP involves 12 countries including the United States, Japan and Australia representing 40 percent of all world trade, and would be the biggest trade agreement ever signed.
But Mr Groser said last week that despite the size of the prize, New Zealand's ability to source cheap drugs through Pharmac would not be negotiated away.
-----

Medibank Private Sale.

Australia to list Medibank as state winds back health insurance subsidies

By Byron Kaye
SYDNEY Tue Oct 28, 2014 5:18am IST
Oct 28 (Reuters) - Just as it prepares to list state-owned health insurer Medibank Private, Asia's biggest initial public offering in two years, Australia is quietly unwinding the generous subsidies that had determined the company's fortune over the past decade.
The planned $5 billion privatisation of Australia's biggest health insurer opens for retail investors on Tuesday, and its backers are talking it up as a way to gain exposure to a sector that has enjoyed steady growth thanks to a system of state subsidies as well as the country's ageing population.
While demand is expected to be strong, the rollback of government payments is casting a cloud over the long-term future of the industry as hundreds of thousands of Australians may be forced to drop their private insurance coverage.
-----

Ebloa.

Health Minister Peter Dutton says there is 'no chance' Ebola can spread in Australia as it has in West Africa

Date October 27, 2014 - 7:53AM

James Massola

Political correspondent

EXCLUSIVE
Health Minister Peter Dutton says that even if an Ebola case appears in Australia, it would be contained by our first-class medical system and there was "no chance" it would spread rapidly as it has in West Africa.
Mr Dutton has moved to reassure Australians concerned about the deadly virus while confirming negotiations were progressing with Britain for that country to provide treatment to any Australian who deployed to combat the virus and became infected.
He took aim at Labor deputy leader Tanya Plibersek's "hysterical" calls for Australia to send personnel immediately, suggesting a political split between her and Opposition Leader Bill Shorten over the crisis. Mr Dutton and Foreign Minister Julie Bishop have written to Mr Shorten to ask for a return to a bipartisan approach on the virus.
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Ebola: Australian hospitals well prepared, says Professor Lyn Gilbert

Date October 30, 2014 - 5:39PM

Harriet Alexander

Health reporter

The infectious diseases expert tasked with overseeing Australia's response to the Ebola virus says hospitals are well prepared for the virus despite widespread panic in the community.
Westmead Hospital's Director of Infection Prevention and Control, Lyn Gilbert, declined to comment on whether the federal government should be sending medical staff to West Africa, or on the visa ban on people immigrating from Ebola-affected countries.
But she said local hospitals were well equipped to deal with anybody exhibiting Ebola symptoms.
-----

Ebola hospital to accept Australian workers

Published: 2:58 pm, Friday, 31 October 2014
Confirmation that Australian health workers who help Ebola victims in west Africa will have access to a US field hospital means the government has run out of excuses to act, Labor says.
Deputy opposition leader Tanya Plibersek met with senior US government officials this week to discuss the global response to the outbreak, which has killed more than 5000 people.
She's been told the field hospital, to be based in Liberia, will be available to health workers of any nationality.
'I haven't been given a day, but within days,' Ms Plibersek told ABC Radio on Friday when asked when it would be operational.
-----

Medical Research.

Alzheimer's disease blood test at risk of running out of money

Date October 27, 2014

Scott Hannaford

The Sunday Canberra Times editor.

Work on a simple blood test that could help identify and prevent one of the biggest health concerns facing Australians, Alzheimer's disease, is at risk of stalling due to a cloud over funding.
Since 2006 teams of researchers across the country have been studying more than 1100 Australians at regular intervals, collecting data they hope will pinpoint lifestyle and health factors that lead to Alzheimer's disease. 
Dementia, of which Alzheimer's disease accounts for around 60 per cent of all cases, is the single biggest cause of disability in older Australians, costing the nation at least $4.9 billion a year in direct health and aged care. Around 1.13 million Australians are expected to be suffering dementia by 2050.
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Elite business group lobbies for Medical Research Future Fund with or without $7 GP co-payment

By social affairs correspondent Norman Hermant
October 30, 2014, 7:26 am
An elite group of Australian business leaders is pressuring the Federal Government to push ahead with plans for the Medical Research Future Fund – with or without the controversial $7 Medicare co-payment unveiled in this year's federal budget. 
The co-payment was designed to help pay for the $20 billion medical research fund. But its passage now appears increasingly unlikely.
The members of the Medical Research Future Fund Action Group say Canberra must find the money regardless.
-----

GP Co-Payment.

PM admits thousands to forego tests because of co-payment

28/10/2014
Thousands of potentially deadly illnesses may go undetected until they are well advanced because of the Federal Government’s $7 co-payment for diagnostic imaging services and other Budget measures, it has been claimed.
As the Federal Government continues to struggle to secure the support it needs to introduce its co-payment, Prime Minister Tony Abbott has admitted that there are likely to be a million fewer diagnostic imaging tests each year, many of them for potentially fatal conditions such as breast cancer and liver metastasis, by 2017.
Asked by Opposition Leader Bill Shorten in Question Time last week whether he was aware of estimates there would be 680,000 fewer such tests in 2015-16 and about one million less by 2017, the Prime Minister said that “the short answer is yes and yes”.
-----

Government could sidestep parliament to introduce GP fee

  • October 30, 2014 10:00PM
  • Sue Dunlevy National Health Reporter
  • News Corp Australia Network
THE controversial GP fee could be bought into effect without parliamentary approval in the same way the government this week sidestepped the parliament to introduce petrol indexation.
Health Minister Peter Dutton on Thursday October 30 repeatedly refused to rule out using a regulation to cut Medicare rebates by $5 to achieve the $3.5 billion in savings from the GP fee outlined in the budget.
The government is facing an uphill battle getting Senate approval for legislation to impose the fee which is opposed by the Australian Medical Association and other key health groups.
The Opposition, the Greens and the Palmer United Party say they will not support the fee.
-----

Pharmacy Related Articles.

Pharmacy begins its PR fightback

28 October, 2014 Chris Brooker
After a year of criticism from a range of sources, pharmacy has launched its own campaign to retain the hearts and minds of Australians – and show how it can improve the healthcare bottom line.
The Pharmacy Guild of Australia has launched its ‘Discover More. Ask your Pharmacist’ campaign, which encourages Australians to learn more about the services available in community pharmacies. 
The campaign also aims to demonstrate the savings pharmacy can contribute to Australia’s health budget.
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Give money to GPs, not 6CPA: AMA

31 October, 2014 Christie Moffat
The Government is “better off” investing its money in general practice than paying for the expansion of pharmacist-led services in the Sixth Community Pharmacy Agreement, a senior AMA figure says.
AMA head of general practice Dr Brian Morton (pictured) says that recent moves by the PSA to advocate GP-type services in pharmacies were “disappointing” and “illogical”.
Writing in AMA publication Australian Medicine, Dr Morton argued that proposing to pay pharmacists a consultation fee at the same rate as GPs would only serve to significantly increase the Government’s expenditure on primary health care services.

Pharmacists support consult-linked dispense fee

31 October, 2014 Chris Brooker
Most pharmacists support dispensing fees being differentiated according to the level of patient interaction involved in each consult.
In one of the more surprising findings from the 2014 UTS Pharmacy Barometer, similar numbers of owners and employed pharmacists were in favour of dispensing fee differentiation.
In fact, a higher proportion of owners (66%), than employed pharmacists (64%), endorsed the concept, which had been previously resisted by the Pharmacy Guild of Australia. Even more (72%) of pharmacy managers agreed.
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Medicare Locals.

Northern Melbourne Medicare Local health changes cause confusion

Lexi Cottee

The disbanding of Medicare Local offices and a realignment of health care boundaries are creating confusion in Melbourne’s north.
All resources of the Northern Melbourne Medicare Local (NMML) will be split up under a new health network model, which will double the client catchment area each network will cover.
The federal government is creating six new Primary Health Networks (PHN) from the merging or splitting up of Victoria’s 17 Medicare Locals to form significantly larger and more diverse catchments, with the changes due by July 1 next year.
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Less-than-local replacement for Medicare Locals

28/10/2014
One of the Federal Government’s new Primary Health Networks will span a massive 2.2 million square kilometres under boundaries drawn up by the Health Department.
Federal Health Minister Peter Dutton has announced that 30 Primary Health Networks will be established to replace 61 Medicare Locals as part of the Government’s overhaul of arrangements to support primary health services nationwide.
The overhaul was prompted by widespread dissatisfaction among GPs with the operation of Medicare Locals, and Abbott Government claims that the system established by Labor was top heavy and consumed funds in administration rather than being directed to frontline care.
The AMA has welcomed the move to dump Medicare Locals, and said it was prepared to work closely with the Government to ensure the PHNs were an effective replacement.
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The rural health risks of the transition to Primary Health Networks

Jennifer Doggett | Oct 31, 2014 12:03AM |
The transition from Medicare Locals to Primary Health Networks is one of the most significant challenges currently facing our health system.
The success (or otherwise) of these new primary health care organisations will have far reaching and long term impacts on the health of our community.
The outcomes of the PHNs will also be a test of the Abbott Government’s policy credentials in health, in particular of some of the Government’s ideas around the involvement of private health insurance, the role of the market in health and the measurement of performance.
In this third instalment of the rural health series, Lesley Barclay, Deputy Chairperson, and Dane Morling, Policy Adviser, National Rural Health Alliance (NRHA) discuss the implications of the transition to PHNs for rural communities and, in particular, argue that rural communities have specific primary health care needs which may not be met by some of the possible operators of PHNs, such as private health insurance funds.
-----
Comment:
I also have to say reading all the articles I still have no idea what is actually going to happen with the Budget at the end of the day. Maybe the next few weeks of parliament will clarify things this time but I doubt it.
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, November 05, 2014

Aspen Medical - Flexibility In Person!

This contractor seems to have been asked to largely provide the Australian response to Ebola.

Will that be easier than all the paid recruiting for the PCEHR over many months recently?

I suspect not!

This company is surely the Swiss Army Knife of health policy implementation!

David.
 

Why Do I Have Such A Terrible Sense Of Having Seen It All Before? It Sure Feels Like It!

A couple of articles seem to be just a re-run of what we have seen and been told for years!
First:

Telstra Invests $2 Million In eHealth Partnership With Sydney University Health Researchers

Chris Pash Oct 28, 2014, 7:21 AM
Telstra’s new health business unit and Sydney University’s The George Institute have announced a partnership to explore eHealth solutions for Australia’s straining healthcare system.
Telstra Health has put $2 million into the partnership in the first two years to explore eHealth technologies and services.
…..
Shane Solomon, Telstra Health Managing Director, says he wants to create solutions which are simple for clinicians and patients to use.
The George Institute and Telstra Health’s collaboration will focus on:
  • Shared electronic health records – sharing of information across providers and with patients
  • Electronic decision support systems – systems to support providers and patients to make better decisions about how to manage risk factors and prevent disease
  • Home telemonitoring – monitoring of major risk factors such as blood pressure, blood glucose in the home using wireless technology
  • Patient self-management tools – tools which help the patient better understand their chronic disease and help them adhere to recommended treatment
  • Predictive analytics – using health and other forms of data to predict demand for services.
More here:
Lots of new things being investigated here….
Then we had this:

Hambleton on NEHTA, AMA and Telstra Health

Steve Hambleton has been in the NEHTA chair since June of this year after a successful stint as AMA president. One of the key lessons he’s learned since taking the job is that Australia needs to have a more unified health system if we’re to meet the health challenges of today and tomorrow.
“It’s like having a unified rail gauge,” he says by way of an analogy he frequently comes back to. “You can’t have a unified system if everyone is implementing their own standards, we can’t have an ehealth system unless we’re able to talk about the same things.”
He says that in the nine years NEHTA has been in existence it has been highly successful at the tasks it has been set. There are secure messaging standards, the adoption of SNOMED and other wins, all of which help push the ehealth and health systems in the right direction, Hambleton says.
Much much more here:
And then we saw this - with more funding for e-Health to replace 20 year old PAS systems….

Victoria kicks off $80m eHealth spending spree

Millions allocated in 2012 finally make it to hospitals.
One month out from a state election, the Victorian government has finally emptied the $100 million eHealth piggy bank it set up in 2012, and distributed the funds to hospitals and health services.
Health Minister David Davis this morning announced the winners of the first lot of funds from the $100 million pool, announcing $80 million worth of grants would be drawn from the state’s Innovation, eHealth and Communications Technology Fund.
Davis denied to iTnews that his government had been sitting on the funds in the lead up to a hard-fought election campaign.
He said it had been “steadily and methodically” working on a response to a series of reviews into the state's past health struggles, in order to put together a statewide IT framework, which he released today.
More here:
What has changed since I started the blog almost a decade ago?
As they say “the more things change the more they stay the same”!
David.

Tuesday, November 04, 2014

Despite All The Assurances It Seems The PCEHR Has Had A Few Holes. Just Typical Of DoH To Not Be Up Front Earlier!

This appeared a few days ago:

PCEHR privacy breached twice in 12 months

Users accidentally link to someone else's health record.

The Department of Health has been forced to own up to two inadvertent breaches of the national health records system in the past 12 months, the Information Commissioner has revealed.
Legislation underpinning the Personally Controlled Electronic Health Record (PCEHR) demands that the department notifies the Office of the Information Commissioner of any privacy slip-ups that could impact on the integrity of personal medical data stored in the PCEHR system.
In December last year, the department acknowledged to the OAIC that a technical change had introduced a glitch into the system potentially allowing a handful of healthcare providers to access PCEHR user’s personal health notes without authorisation, for a short window of time.
A health spokesperson did not tell iTnews whether or not it thought the files had actually been viewed, but said “the fact that these notes potentially became accessible to healthcare providers is taken as being viewed, regardless of whether these were actually viewed”.
The department added, however that the error was fixed “within a few hours” of being picked up. It still got in touch with a handful of affected users to let them know what had happened.
The second breach took place six months later in May 2014, and saw some users given the option of linking their MyGov accounts to two PCEHR records, their own and that of a spouse or family member.
More here:
Here is the direct link to the report cited:
Here are the details of the breaches:

Receiving data breach notifications

The OAIC received two mandatory data breach notifications under s 75 of the PCEHR Act.
The OAIC was advised by the System Operator of the first data breach in December 2013. This data breach involved a technical change made to the system that meant that healthcare providers could view consumers’ personal health notes. Investigations by the System Operator identified the cause and a technical fix was put in place to prevent further access. The OAIC reviewed the information provided by the System Operator in relation to the breach and determined that the response was appropriate and that no further action was required.
The System Operator notified the OAIC of the second data breach in May 2014. This breach involved consumers logging into their MyGov account and using their identify verification code (IVC) to access their own PCEHR and link their PCEHR to their MyGov account. In some instances they also accidentally set up access to another consumer’s PCEHR while still logged into their own MyGov account, linking that second consumer’s PCEHR to their own MyGov account. This resulted in the landing page of the first consumer’s PCEHR showing two ‘Open your eHealth record’ buttons, which provided links to open both consumers’ PCEHRs. The System Operator advised that containment strategies had been implemented to prevent similar incidents occurring. It should be noted that the cause of the breach was not related to MyGov. The OAIC sought further information from the System Operator about its response to the breach. The OAIC’s consideration of the data breach notification and the further information provided by the System Operator was ongoing at 30 June 2014.
The OAIC liaised with Health about other incidents relating to the PCEHR system which did not meet the criteria for mandatory data breach notifications under the PCEHR Act. In one of these incidents, an email containing a consumer’s IVC and other personal information was sent to the incorrect email address. The email recipient, however, did not have the other information required to access the consumer’s record. The OAIC provided recommendations to the System Operator about how it could reduce the impact of any future incidents of this type. The System Operator advised that it had implemented the OAIC’s recommendations.
The OAIC also sought legal advice from AGS to clarify the threshold for mandatory notification of data breaches.
----- End Extract
There are only two points worth making I reckon.
First why were these leaks not disclosed as soon as they were identified and fixed?
Second is the total lack of apparent use or interest in the PCEHR! If it was actually being used we would see more than eight questions and no complaints!
Amazing indeed!
David.

Monday, November 03, 2014

Weekly Australian Health IT Links – 03rd November, 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

What a huge week! We have the PCEHR with holes and gathering stuff, we have software that might kill and the NEHTA Chair telling is that NEHTA has been a fantastic success with all it has been asked to do!
Nothing more to say - just get clicking on those links and don’t be too worried if we are seen to be ‘Summoning Deamons’!
-----

Health software brings risk of death

Date October 27, 2014 - 7:12AM

Tony Moore

brisbanetimes.com.au senior reporter

A new software program installed to manage medication doses at nine Queensland hospitals is likely to kill a patient within the next month, a Queensland Health risk report says.
Last Friday's report on the Metavision Intensive Care program advised the state government that the likelihood of the program causing preventable loss of life "is assessed as likely and expected to occur within the next month".
Health Minister Lawrence Springborg confirmed the report, which described the likelihood of a patient death at 60-90 per cent, to Fairfax Media on Sunday.
Concerns over the software were identified in the past month by the directors of the Intensive Care Units at the Princess Alexandra, Royal Children's and Royal Brisbane and Women's Hospital.
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Dosage software deemed 'deadly'

27 October, 2014
A new computer program that helps manage patients' medication at nine Queensland hospitals could prove deadly, a Queensland Health report says.
The risk report says the Metavision Intensive Care program could cause preventable loss of life within the next month, Fairfax Media reports.
The software is designed to regulate doses of medication given to patients but drugs have allegedly been mixed up or continued when they should have stopped.
It was manually overridden by Queensland Health on Friday after the report was published.
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Doctors say critical Queensland Health software bug treatable

A software glitch that hit the system used to dispense medications to hospital patients in Brisbane’s public Metro North Hospital and Health Service has again put Queensland Health’s technology performance in casualty after the state’s Nurse’ union and Labor Opposition hit out at life threatening dangers revealed in an internal risk report.
The computer bugs affected software supplied by iMDsoft for Metro North’s Metavision Intensive Care system and came to light after risk assessment provided to the state government warned there was a 60 per cent to 90 per cent chance of preventable death occurring over the period of a month if left unaddressed.
The serious near miss and subsequent manual intervention has put health services across Australia on alert over how potential problems and associated risks of eHealth systems are managed as most states pursue the big technology rollouts.
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No deaths from buggy health software: Qld health minister

Summary: Queensland's health minister Lawrence Springborg has said that he is not aware of any deaths linked to buggy health software that had been identified as potentially deadly to patients.
By AAP | October 26, 2014 -- 23:24 GMT (10:24 AEST)
Queensland Minister for Health Lawrence Springborg has claimed that he is not aware of any deaths linked to the defective software that manages medication for some of the state's sickest patients.
Queensland Health has reverted to manual systems to check that the correct medication is being doled out to intensive care and other patients after doctors realised that there was a major problem.
A risk report, produced for the government last week, found that there was a 60 to 90 percent likelihood of a patient death within the next month, due to problems with the software, Metavision Intensive Care.
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myGov health records breached in site flaw

  • AAP
  • October 29, 2014 3:29PM
THE private eHealth records of numerous patients have been breached by healthcare providers and other myGov account users.
TWO data breach notifications were received by the Information Commissioner last financial year in regards to the government administrated online health system.
The first allowed healthcare providers to view the personal health notes of consumers following a flawed technical change to the eHealth system, according to the Commissioner's annual report.
The eHealth system operator identified the cause in December and a fix was put in place to prevent further access.
-----

PCEHR privacy breached twice in 12 months

Users accidentally link to someone else's health record.

The Department of Health has been forced to own up to two inadvertent breaches of the national health records system in the past 12 months, the Information Commissioner has revealed.
Legislation underpinning the Personally Controlled Electronic Health Record (PCEHR) demands that the department notifies the Office of the Information Commissioner of any privacy slip-ups that could impact on the integrity of personal medical data stored in the PCEHR system.
In December last year, the department acknowledged to the OAIC that a technical change had introduced a glitch into the system potentially allowing a handful of healthcare providers to access PCEHR user’s personal health notes without authorisation, for a short window of time.
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Australian E-Health records breached twice in the last year

Sick system saw patients peep into two records

By Simon Sharwood, 29 Oct 2014
Australia's Office of the Information Commissioner (OAIC) has released its Annual report of the Information Commissioner’s activities in relation to eHealth 2013–14, complete with a report on two data breaches in the systems used to store personally controlled electronic health records (PCEHRs).
The first was notified in December 2013 and “involved a technical change made to the system that meant that healthcare providers could view consumers’ personal health notes.”
“Investigations by the System Operator identified the cause and a technical fix was put in place to prevent further access,” the report continues, and this response was deemed “appropriate and … no further action was required.”
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Microsoft jumps on wearable technology treadmill with Band and Microsoft Health

Date October 31, 2014 - 6:52AM

NICK WINGFIELD

Microsoft has a place on desks, in living rooms and pockets. Now, like many other big technology companies, it believes it belongs on your wrist too.
The company has created a wrist-worn fitness device, Microsoft Band, and a related online service, Microsoft Health, that will analyse the data from the band and other devices to help people with their fitness goals.
And it's making it available across competitor's operating systems, Apple's iOS and Google's Android.
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No harm in patients seeing results before GP: expert

30 October, 2014 Paul Smith
There is "no evidence" patients will be harmed by reading pathology results on their PCEHR before speaking with their GP, a leading Australian e-health expert says.
This month, Australian Doctor revealed the plan to automatically upload pathology and diagnostic imaging results to the PCEHR after seven days — irrespective of whether the patient had been seen by their GP.
The upgrade is being sold as a major step forward in the clinical relevance of the moribund system.
-----

Fight over PCEHR upgrade continues

28 October, 2014 Paul Smith and Tessa Hoffman
Federal health bureaucrats say calls to allow doctors to curate pathology and radiology reports before they’re uploaded onto the PCEHR could see some patients never getting their results.
From next year, pathology results and diagnostic imaging will be automatically uploaded to the e-health system seven days after the results have been sent to the ordering doctor. The delay is meant to give GPs time to contact patients and discuss the results.
While the upgrade is being sold as a significant win for the PCEHR scheme, there are concerns the results will appear on the system without having been clinically curated, leaving those who access the files the job of tracking down patients if they spot clinically significant results.
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Preparing for the Australia #FHIR Connectathon

Posted on October 27, 2014 by Grahame Grieve
It’s 10 days or so until the Australian FHIR Connectathon, which is Friday. This post is to help people who are preparing for that connectathon. There’s 3 tracks at the Australian Connectathon:
Track 1: Patient resource (Introductory)
This track serves as the simple introductory task for anyone who hasn’t been to a connectathon before, though previous attendees will find it useful for extending their experience and knowledge. The patient scenario is to write a client that can follow this simple sequence.
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Does anyone actually understand what terminology is for?

I really wonder sometimes. A few months ago, an international organisation that has been looking at how to solve the requirement for scalable, sustainable content modelling (research data sets) did some trialling on the use of archetypes. This worked fine as far as it went. I subsequently received an email to do with what they would do, that contained the line
“There has also been talk in our senior management about using SNOMED for this type of requirement”.
More recently, a colleague from Norway posted on the openEHR list various quotes from a Gartner report that was commissioned by the Norwegian government. The one most relevant here is (this comes from a Norwegian report)
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Futuristic plan to set chronic patients free

28 October, 2014 Clifford Fram
A teen with type 1 diabetes goes on holiday with a friend’s family, her doctor confident her remotely managed and monitored insulin pump will switch on and off as needed.
The scenario is similar for a child with severe asthma, a remote monitoring system prompting SMSed instructions for a dosage change.
This is Dr Stephen Oesterie’s vision of healthcare in five or ten years. “Instead of the patient coming to the doctor, we will allow them to stay in their own environment and distribute healthcare to them through the cloud.”
This means patients with chronic conditions might be fitted with miniature implanted sensors and medication pumps linked to supercomputers around the world through the existing mobile phone network.
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Victoria kicks off $80m eHealth spending spree

Millions allocated in 2012 finally make it to hospitals.

One month out from a state election, the Victorian government has finally emptied the $100 million eHealth piggy bank it set up in 2012, and distributed the funds to hospitals and health services.
Health Minister David Davis this morning announced the winners of the first lot of funds from the $100 million pool, announcing $80 million worth of grants would be drawn from the state’s Innovation, eHealth and Communications Technology Fund.
Davis denied to iTnews that his government had been sitting on the funds in the lead up to a hard-fought election campaign.
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The Brave New World of Health Communications

By Sarah Marinos E-Health & Technology Oct 27, 2014
Advances in information and communication technologies bring changes to healthcare delivery for providers and consumers.
On average, only between 14 and 43 per cent of patients complete a cardiac rehabilitation program at hospitals or outpatient clinics after suffering a heart attack. One of the reasons for the dropout rate of patients from these rehabilitation programs is difficult access for those living in regional and rural Australia.
 Today, technology is offering a potential lifeline to heart attack victims by increasing the accessibility and compliance rates of rehabilitation treatments.
The Australian e-Health Research Centre (AEHRC) has developed the Care Assessment Platform – a solution that uses smartphones, the Internet, and information and communication technology tools to enable patients to carry out post-heart attack rehabilitation in their own home.
Patients use a smartphone with customised software to measure and record data such as the amount of physical activity they do, their weight and blood pressure, and to record sleep quality, stress, meals and any tobacco and alcohol use. This data is synchronised daily to a web-portal, where it is closely monitored and assessed by healthcare providers.
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Dr Mario calling: Nintendo and ResMed tie up to track your sleep

Date October 31, 2014 - 11:48AM

Jessica Gardner

Video game maker Nintendo has said it will work with Australian medical device success story ResMed, best known for its products that reduce snoring, on a consumer health product that tracks quality of sleep.
Nintendo boss Satoru Iwata told a briefing that the device would be the first offering from the Japanese company's newly created health division. "By using our know-how in gaming... to analyse sleep and fatigue, we can create something fun," Iwata said, according to Reuters.
The device will be called a QOL Sensor - referring to 'quality of life' - and will measure chest movements, breathing and heartbeat via microwave transmissions. The data will then be uploaded to the cloud to analyse the data and produce visual representations of sleep and fatigue.
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Remote communities to access digital health services as early as 2015

By Isaac Egan and Sharon Molloy
Advances in technology and connectivity have brought about the possibility of online medical clinics for remote and regional areas of Australia, but some healthcare organisations fear that in-person services may suffer as a result.
Last week Telstra announced it will join forces with a Swiss healthcare provider to offer online clinics for remote and regional areas of Australia as soon as next year.
Telstra group executive of retail Gordon Ballantyne says the rapid growth of health spending in Australia makes it a logical decision for the telecommunications giant.
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Telstra Invests $2 Million In eHealth Partnership With Sydney University Health Researchers

Chris Pash Oct 28, 2014, 7:21 AM
Telstra’s new health business unit and Sydney University’s The George Institute have announced a partnership to explore eHealth solutions for Australia’s straining healthcare system.
Telstra Health has put $2 million into the partnership in the first two years to explore eHealth technologies and services.
The new Telstra business unit has already announced ReadyCare to provide over-the-phone GP services including diagnosis, prescriptions and specialist referrals.
This has been criticized by the Australian Medical Association (AMA) as a commercial solution dressed up as a health solution. The AMA says people should maintain regular contact with their GP, not just the odd phone call.
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Hervey Bay facility nation’s first entirely digital hospital

By admin E-Health & Technology Oct 29, 2014
The new St Stephen’s Hospital in Hervey Bay, which opened last week, is the nation’s first entirely digital medical facility.
Partly funded by a $47 million federal government grant, the hospital has completely digitised record and patient management in addition to a digital drug dispensing facility and a capacity to monitor patients during surgeries.
UnitingCare Health executive director Richard Royle told the ABC that embracing digital was the way of the future.
“It is seen generally as the way of the future in health care, no doubt about it, not dissimilarly to if you think about banking 15 or 20 years ago and think about banking today and look at how electronic it is now in banking, the same will apply over the next decade or two with health care,” he said.
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Hambleton on NEHTA, AMA and Telstra Health

Steve Hambleton has been in the NEHTA chair since June of this year after a successful stint as AMA president. One of the key lessons he’s learned since taking the job is that Australia needs to have a more unified health system if we’re to meet the health challenges of today and tomorrow.
“It’s like having a unified rail gauge,” he says by way of an analogy he frequently comes back to. “You can’t have a unified system if everyone is implementing their own standards, we can’t have an ehealth system unless we’re able to talk about the same things.”
He says that in the nine years NEHTA has been in existence it has been highly successful at the tasks it has been set. There are secure messaging standards, the adoption of SNOMED and other wins, all of which help push the ehealth and health systems in the right direction, Hambleton says.
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You don’t have to wait to see a virtual doctor

The idea of telemedicine – healthcare provided using telecommunications equipment – has a lengthy history. Radio News, an American magazine, devoted its cover to a patient at home consulting a doctor in his surgery via a television link as long ago as 1924. When NASA began monitoring astronauts in space in the 1960s, fantasy became reality. It has been touted as healthcare’s future ever since.
But even smartphones and tablets have failed to usher in the telemedicine revolution: most healthcare still happens face to face. Now, enthusiasts think the wait is nearly over.
At an industry conference in Rome this month, participants discussed the problems that must be solved if telemedicine’s day is to come.
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CSIRO News Release - Printed titanium heel has man back on his feet

22-Oct-2014 10:30 AM
CSIRO, St Vincent's Hospital and Victorian biotech company Anatomics have joined together to carry out world-first surgery to implant a titanium-printed heel bone into a Melbourne man.
Printed using CSIRO's state-of-the-art Arcam 3D printer, the heel bone was implanted into 71-year-old Len Chandler, a builder from Rutherglen Victoria, who was facing amputation of the leg below the knee following a diagnosis of cancer of the calcaneus, or heel bone.
St Vincent's Hospital surgeon Professor Peter Choong was aware of CSIRO's work in titanium 3D after reading about our work producing an orthotic horseshoe in 2013, and contacted CSIRO's John Barnes in early June about his vision for a metallic implant which would support the body’s weight.
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Updated: Secure Message Delivery October 2014

Created on Friday, 31 October 2014
A number of documents previously published on the eHealthCollaborate website[1] have now been moved to the NEHTA website.
These documents are:
  • Secure Message Delivery – Conformance Assessment Scheme: the process for assessing the conformance of health software that implements Standards Australia’s 2010 Australian Technical Specifications ATS 5822 E-health secure message delivery, ATS 5821 E-health XML secured payload profiles, and ATS 5820 E-health web services profiles.
  • Secure Message Delivery – Conformance Test Specifications: test cases and test scenarios for secure message delivery.
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Google aims for bloodborne search engine

30 October, 2014
Google is working on a cancer-detecting pill in its latest effort to push the boundaries of technology.
Still in the experimental stage, the pill is packed with tiny magnetic particles, which can travel through a patient's bloodstream, search for malignant cells and report their findings to a sensor on a wearable device.
As many as 2,000 of these microscopic "nanoparticles" could fit inside a single red blood cell to provide doctors with better insights about what is happening inside their patients.
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We are 'summoning the demon' with AI: technologist Elon Musk

Date: October 27, 2014 - 8:59AM

Adario Strange

There have already been several dire warnings from Tesla and SpaceX founder Elon Musk in recent months regarding the perils of artificial intelligence, but this week he actually managed to raise the bar in terms of making AI seem scary.
First, according to Musk, AI was as dangerous as nuclear war. Now Musk is likening the possible battle between humans and computers in the future, termed by some as "the singularity," as a struggle for the soul of mankind itself.
How so? By invoking the one thing even those with little interest in technology fear the most: demons!
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We are alone in the universe: Brian Cox

Date October 28, 2014 - 9:47AM

Tom Decent

This is it: Brian Cox says Earth is the only "advanced technological civilisation" in the galaxy.
The process which led to the creation of humankind on earth was a fluke - and it is highly unlikely it has been repeated anywhere else in the universe.
That is the view of English physicist Professor Brian Cox, who made the  assertion in an episode of BBC's Human Universe
Professor Cox thwarted suggestions alien life was a possibility and said he believed humans were the only form of life in the universe, despite the astronomical number of other planets in the galaxy. 
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Enjoy!
David.

Sunday, November 02, 2014

Automatic Seven Day Posting Of Clinical Results To The PCEHR Proposed. The Idea Lights The Blue Touchpaper With Many Clinicians.

This appeared a few days ago.

No harm in patients seeing results before GP: expert

30 October, 2014
There is "no evidence" patients will be harmed by reading pathology results on their PCEHR before speaking with their GP, a leading Australian e-health expert says.
This month, Australian Doctor revealed the plan to automatically upload pathology and diagnostic imaging results to the PCEHR after seven days — irrespective of whether the patient had been seen by their GP.
The upgrade is being sold as a major step forward in the clinical relevance of the moribund system.
But there are fears that patients will find out they have serious conditions, such as melonoma or chlamydia, by reading through the files on the PCEHR before being contacted by their GP.
The Australaisan College of Health Informatics reviewed research on various systems that allow patients access to results, systems mainly based in the US.
Published in Pulse IT, the review said: "Despite the enthusiasm for direct patient access to laboratory and imaging results, the evidence from existing evaluations of existing patient portals and their impact on the safety, effectiveness and quality of patient care is limited and inconclusive.
"There are major questions about how patients use their record and respond to their results alongside concerns about the impact on authority and responsibility within the current patient-doctor relationship."
And it said caution should be taken in generalising from the results of studies on US system. 
But the informatics college said it is endorsing the seven-day delay model for the PCEHR system, which will be rolled out from next year.
Lots more here:
There are 18 comments following the article which was posted only a few days ago. Reading dispassionately I would have to suggest that the reaction to this article was fairly negative.
The article was triggered by an ACHI Press release which can be found here:
The key paragraphs are as follows:
“ACHI's review found that there was no evidence demonstrating harm and in fact early evidence to suggest some consumer benefits from access to pathology and diagnostic imaging results. "The College acknowledges however the clinical cultural issues, and endorses the suggested seven day delay," A/Prof Pearce said. The current proposal has results being posted after a seven day delay, allowing clinicians time to re-view and contact patients before they get direct access.
Dr Bain noted that the review acknowledged the concerns about the effects direct access might have on GPs" traditional role as gatekeepers and the anxiety that could be experienced by patients reading results before their busy GPs have been able to curate them. "However, for clinicians with modern health informatics systems, this should not represent a barrier to access. The alternative, that all results should be clinically curated, represents an unacceptable work load on busy GPs."
"Our review shows patients value access, but are lacking on information as to why and what patient out -comes might be," A/Prof Pearce said. "Accordingly, ACHI supports the proposed model, with appropriate safeguards. Allowing consumers direct access to pathology results is new technology and must be framed in the context of improving the quality and safety of care.
"This means working with consumers to understand access and health literacy issues as well as targeting those with chronic diseases, where regular pathology is part of the care plan."
The full review report is available on the ACHI website, www.ACHI.org.au.”
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I have to say I disagree profoundly with this.
To me what should happen is when tests are requested the patient should be asked if they want automatic access to the results. If they do, and time is taken to explain what the tests might mean, then early and quick access makes perfect sense. If not then the results should only be posted to the PCEHR once reviewed by the requesting clinician.
Taking both the patient and the clinician out of the loop - and posting automatically is just nonsense.
This is especially so when the ACHI review makes the clear point that "Despite the enthusiasm for direct patient access to laboratory and imaging results, the evidence from existing evaluations of existing patient portals and their impact on the safety, effectiveness and quality of patient care is limited and inconclusive.
Just how a recommendation of this sort is arrived at in the absence of firm evidence of significant benefit is beyond me!
It only takes on suicide of one patient - following misinterpretation of a result they have not asked to have access to - as almost happened with a patient seeing the report of a brain scan - and the finger pointing and blame game would be a wonder to behold.
Bottom line to me is get the patient to agree to access and then risks of harm are dramatically reduced - otherwise try and make the PCEHR sufficiently useable that GP curation of results is easy, quick and painless.
Patient consent and involvement - and not a fixed time limit to post results - is what matters here!
All this haste is, I suspect, is a last gasp, rear guard action to make the PCEHR relevant and this auto-posting without explicit consent approach is badly flawed in my view.
David.

AusHealthIT Poll Number 242 – Results – 2nd November, 2014.

Here are the results of the poll.

Will Telstra Succeed In Creating A Billion Dollar Business In The E-Health Domain?

For Sure 1% (1)

Probably 38% (41)

Neutral 5% (5)

Probably Not 38% (41)

No Way 19% (20)

I Have No Idea 0% (0)

Total votes: 108

It seems most think that (by 57% to 39%) Telstra will struggle to create a large e-Health business in Australia.

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

David.