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 13, 2014

Review Of The Ongoing Post - Budget Controversy 13th 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 24th 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!
The Government response to Ebola seems to be finally lifting off and the war between doctors and pharmacists has gone ballistic. How stupid are these turf wars!

General.

Tony Abbott's personal approval up, but major policies unpopular: Fairfax Ipsos poll

Date November 3, 2014

James Massola and Heath Aston

EXCLUSIVE
Prime Minister Tony Abbott's personal approval has surged with voters over the past three months, while the Coalition has also clawed back support but still narrowly trails Labor in the two-party preferred vote.
The first Fairfax Ipsos nationwide poll shows Mr Abbott and Opposition Leader Bill Shorten are now tied as preferred prime minister, but, worryingly for the government, three key planks of its policy reform agenda are deeply unpopular with voters.
A whopping 64 per cent of voters opposed deregulating the setting of university fees, with just 28 per cent in favour. Forty per cent of voters supported Mr Abbott's signature paid parental leave scheme and 54 per cent opposed it. 
And 41 per cent of voters backed a rise in the GST in exchange for income tax cuts – an idea that came into sharp focus last week as Mr Abbott called for a debate about the federation and tax system – while 52 per cent opposed the idea.
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PM claws back from budget lows

Phillip Coorey Chief political correspondent
Prime Minister Tony Abbott and his Coalition government have clawed back to their strongest position since the controversial May budget but would still struggle if an election were held today.
The inaugural Fairfax/Ipsos national poll, which follows recent policy wins in the Parliament and a strong standing on the world stage, shows Mr Abbott closing the gap to match Bill Shorten as preferred prime minister and making strong gains in terms of personal approval.
On a two-party preferred basis, the Coalition trails Labor by 49 per cent to 51 per cent. It has pulled a 5 percentage point lead in the primary vote at 42 per cent to 37 per cent. The Greens are on 12 per cent while Clive Palmer’s Palmer United Party rates just 3 per cent nationally.
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Tasmanian hospitals dangerous and patients dying, nurses tell funding inquiry

ABC
November 4, 2014, 8:20 pm
Tasmanian's hospitals are operating under dangerous conditions and nurses believe patients have died because the system is overstretched, a Senate inquiry has been told.
The inquiry has been warned by a federally-funded health care provider that Tasmanians will be worse off under looming state and federal funding cuts.
The Labor-dominated inquiry is investigating the impact of Commonwealth funding cuts on hospital and health services.
It is estimated the Federal Government is cutting more than $2 billion from Tasmanian health funding over the next 20 years.
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Stage set for big bank showdown with Hockey

Date November 5, 2014

Clancy Yeates

Banking reporter

The stage is being set for a showdown between Joe Hockey and four of the most powerful corporations in the country.
In one corner is a Treasurer facing the prospect of finishing the year without passing key budget measures because they're simply too unpopular.
In the other, corporate titans with millions of customers and hundreds of thousands of small shareholders accustomed to big dividends: the big banks.
The battle will be over who wears the cost of making the financial system more resilient to economic shocks. At least, that's what looks likely after the salvos fired by the chief executives of Westpac and ANZ Bank in recent days.
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Supermarket promotions undermining public health

7 November, 2014 Christie Moffat
Australia’s two major supermarket chains are using alcohol discounts to entice new customers, undermining public health initiatives to reduce excessive drinking, research reveals.
A new study in the Australian and New Zealand Journal of Public Health examined the alcohol discount offers available across 34 Coles/Bi-Lo and Woolworths supermarkets in Sydney, Melbourne and Brisbane over a one-week period, and found that 33 of the 34 outlets offered “unprompted” alcohol discounts on receipts for a free bottle of wine.
Point-of-sale and off-trade discounts and promotions were often ‘unmeasured’ and had few legislative or regulatory restrictions, the authors said, with bundling discounts becoming increasingly common in Australian supermarkets.
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Medibank Private Sale.

Opposition: Why the Minister should retain veto power over rises in private health premiums

Marie McInerney | Nov 06, 2014 5:59PM | EMAIL | PRINT
The Conversation recently ran this analysis of the draft report of the Federal Government’s Competition Policy Review headed by Professor Ian Harper.
In it, Elizabeth Savage, Professor of Health Economics at University of Technology Sydney, said there were two significant changes to the private health insurance industry that are likely to have an impact on both consumers and the sector.
The first is the removal of regulation that requires ministerial approval for increases in private health insurance premiums, which is tied to evidence of increased cost structures, and its replacement by a “price monitoring scheme”. This will allow increases in insurance premiums only to be subject to competitors’ behaviour in what is a highly concentrated industry. (Top four companies have 75% of policy revenues; the top two – Medibank Private and BUPA – have 56% of the market.)
-----

Ebloa.

Govt to assist Ebola workers

6:55pm, Nov 4
Andrew Greene
The federal government has reportedly reached an agreement that would allow it to send Australian health workers to fight the deadly Ebola virus.
The Federal Government is on Wednesday expected to announce plans to help Australian medical staff fight the Ebola virus in Africa.
The ABC has been told cabinet’s National Security Committee had decided to assist volunteers who want to travel to Ebola hotspots in Sierra Leone.
For weeks the government has refused to dispatch doctors or soldiers to west Africa unless it had “iron clad” commitments from other nations to evacuate medical staff who got infected with the deadly disease.
-----

Tony Abbott ramps up Ebola response with medics and money

AUSTRALIAN medics will be sent to Sierra Leone as part of the nation’s “ramped up” response to help control Ebola in West Africa.
Tony Abbott today announced the government would send Australian volunteers to the African country as part of an agreement with the United Kingdom to manage a 100-bed field hospital, and to care for the Australians if they get sick.
The British-controlled centre will be staffed by Australian-owned medical provider Aspen, but the majority of workers will be locals.
Mr Abbott also announced an additional $24 million to help combat the epidemic.
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Australians could make up just 10% of team to run Ebola hospital in Sierra Leone

Date November 6, 2014 - 9:07AM

Latika Bourke

National political reporter

The Australian government has contributed a further $24 million to respond to the Ebola crisis, including $20 million for a hospital in Sierra Leone. Photo: AP
The number of Australians dispatched to West Africa to treat Ebola patients could be as low as 24 under the federal government's $20 million pledge to staff a hospital in Sierra Leone.
The private company contracted to run the Australian government's response, Aspen Medical said on Thursday it was vital to ensure locals were not "disenfranchised" in foreign efforts to help their domestic fight against the disease.
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Ebola: Tony Abbott to support Australian volunteers' fight in West Africa

Date November 5, 2014 - 6:49PM

Dan Harrison

Health and Indigenous Affairs Correspondent

Australia will step up its response to the Ebola virus by contracting a private company to operate a hospital in Sierra Leone and deploying technical experts to support the international effort.
Prime Minister Tony Abbott announced on Wednesday that Australia would contribute a further $24 million to the international fight against Ebola, on top of $18 million it has already committed.
The latest commitment includes $20 million to staff a British-built Ebola treatment facility in Sierra Leone over the next eight months. 
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Ebola migration ban best for nation, Peter Dutton says

Jared Owens

HEALTH Minister Peter Dutton has rebuffed World Health Organisation concerns about Australia’s suspension of migration from Ebola-affected nations, claiming West African language barriers and funeral rites make those travellers an unacceptable risk.
Isabelle Nuttall, director of WHO’s alert and response department, said the United Nations agency had asked both countries to justify the tough border measures, which she has described as “detrimental and ineffective”.
Australia on October 27 became the first Western nation to suspend migration from Ebola-hit west African nations, and Canada followed suit four days later.
The WHO’s criticism came as the Abbott government announced it would hire Canberra-based Aspen Medical to provide about 240 staff for a 100-bed medical facility being built by the British government in Sierra Leone.
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Aust health firm to manage Ebola unit

AAP NOVEMBER 05, 2014 5:34PM SHARE
ASPEN Medical is not a household name, but it's familiar to thousands of defence personnel who know what to do when a roadside bomb blows off a leg.
THE privately owned firm, based in Canberra and employing more than 2000 people, has been contracted by the federal government to run a 100-bed Ebola treatment centre in Sierra Leone.
It offers medical services to defence, civilian agencies and private firms, including medical evacuation services to resource companies in Australia and the Middle East.
Aspen also provides battle-casualty-care training for defence personnel deploying to the Middle East and Afghanistan.
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Grudging response to plea to send Australian medics to fight Ebola perplexing, embarrassing

Date November 9, 2014 - 12:15AM
EDITORIAL
The reaction was swift. Within a day of the call going out, more than 100 Australian health workers registered their interest in one of the most gruelling jobs in the world, working in a new British-built, Australian-funded Ebola treatment centre in Sierra Leone. Their rapid and selfless response embodies the very best humanitarian spirit. Contrast that with the grudging approach of the Australian government to the Ebola crisis in West Africa.
From the start, the Abbott government has appeared slow to grasp the urgency of the unfolding disaster and to be content with doing the minimum to fulfil Australia's obligations as a global citizen.
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GP Co-Payment.

Co-pay 'windfall' will amount to just 40-cents

6 November, 2014 Paul Smith
The $2 "windfall" the Federal Government promised GPs from its co-payment plan will turn into little more than 40 cents once practices have paid the bureaucratic costs of collecting the cash, the AMA claims.
Under the proposed reform, which is supposed to be in place from next July, Medicare rebates for seeing GPs will be cut by $5, with GPs encouraged to charge a $7 gap.
Federal Health Minister Peter Dutton has sold the policy by claiming the $7 fee will result in a "$2 windfall" for GPs.
But the AMA has commissioned new modelling that suggests the red tape in collecting the payment will leave practices with a fistful of cents rather than dollars.
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$2 windfall for GPs is rubbish: AMA

6th Nov 2014
GPs will be forced to stump up between $1.41 and $1.61 per service to administer the government's proposed $7 co-payment, AMA modelling shows.
The cost estimate, released in an AMA report today, quantifies the red-tape burden of the co-payment on GPs by taking into account things like paperwork, back office time, financial institution fees and cash handling costs. 
The report says that when bad debts are added to the mix, their costs would quickly erode the $2 per service that the government said would be retained by practices under its model. 
"It shows the statements by the government about a $2 windfall for general practice is rubbish," said AMA Council of General Practice chair Dr Brian Morton. 
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Parliament hears Lismore Hospital struggle with health cuts

Chris Calcino | 8th Nov 2014 7:00 AM
THE Northern Star was quoted in New South Wales Parliament as Labor attacked moves to cut $15 billion in Commonwealth funding to the state's health system over 10 years.
Shadow Health Minister Walt Secord called for the Baird Government to oppose the Federal cuts along with the introduction of a $7 Medicare co-payment for visiting a GP.
NSW Health modelling has shown the $7 GP tax would create a 27% per cent increase in emergency department patients who would otherwise see a general practitioner.
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Pharmacy Related Articles.

Pharmacists can perform many of the tasks a doctor normally does, like issuing medical certificates

  • Lisa Herbertson
  • Liverpool Leader
  • November 03, 2014 4:00PM
A new campaign could mean less trips to the local doctor, with pharmacists stepping up to the plate to offer basic medical advise and even medical certificates.
Lillian Chen and her husband Jonathan run Chen’s Pharmacist Advice in Hammondville and Chen’s Pharmacy in Wattle Grove and she said that the benefits of visiting a pharmacy can include less waiting time and no appointments required.
But for those needing a doctor’s certificate it may be of most interest to know that pharmacists can issue certificates (for a fee) for sick leave absence from workplaces for certain conditions.
“It’s called a sickness certificate, and it’s for certain conditions, and can be administered by pharmacists like us,” she said.
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Ownership threats galvanise Guild: Quilty

6 November, 2014 Christie Moffat
Despite confirmation of support from both the Coalition and Labor, the Pharmacy Guild of Australia is continuing to fight the recommendations of the Competition Policy Review.
Also known as the Harper Review, the panel released its Draft Report in September, recommending the removal of community pharmacy ownership and location rules.
Writing in Guild newsletter Forefront, executive director David Quilty said that in the coming weeks, the Guild would submit a comprehensive cost benefit analysis to the Review, to demonstrate that the public benefits of the “highly successful and much trusted” pharmacy ownership rules “far outweigh any costs”.
“If there is one issue that galvanises the Pharmacy Guild, it is pharmacy ownership,” Mr Quilty said.
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Pharmacists want cash for patient interaction

6 November, 2014 Tessa Hoffman and Paul Smith
Pharmacists say they should be paid fees for dispensing medicine based on the time they spend "interacting" with the patient.
In a poll published in the 2014 UTS Pharmacy Barometer, 89% of pharmacists questioned said they wanted a two-tier fee system to better fund clinical services they are providing.
Under the PBS, taxpayers currently pay pharmacists more than $1 billion a year for dispensing.
Calls for time-based dispensing fees have traditionally been rejected by the Pharmacy Guild of Australia, the lobby group for pharmacist owners that negotiates with government over funding for the industry.
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Medicare Locals.

Cross-border health will stay focus: Ley

By BLAIR THOMSON
Nov. 3, 2014, midnight
SUSSAN Ley has moved to hose down concerns about changes to the health system.
Under the new national plan, Albury and Wodonga will be in separate primary health networks divided on state lines.
Hume Medicare Local chief executive David Dart has raised concerns about the impact of the changes and said having the towns in different regions would be a barrier to providing services.
Indi MP Cathy McGowan also raised concerns over the changes with Health Minister Peter Dutton in Parliament.
-----
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. The Reps come back on Nov 14 for a British PM speech and the Senate in the following week. Both rise until the new year on Dec 4, 2014.
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 12, 2014

NEHTA Releases Its 2013-2014 Annual Report. Will This Be The Penultimate Annual Report?

This appeared last week.

NEHTA's Annual Report 2013-14 is now available

Created on Wednesday, 05 November 2014
NEHTA's Annual Report 2013-14 is now available and can be downloaded from here.
The National E-Health Transition Authority was established in 2005 by the Council of Australian Governments (COAG) to help transform Australia’s health system by building the foundations for a national eHealth infrastructure.  
NEHTA is jointly funded by the Australian Government and all State and Territory Governments.
NEHTA's Annual and Financial Reports contain detailed information about its operations during the past financial year as well as an overview of its work programme.
ENDS
For media enquiries contact Alison Sweeney, Manager Media and Public Affairs on 02 8298 2669 / 0414 187 350 or send an email to media@nehta.gov.au
Here is the link:
The report is the usual load of self-promoting nonsense with no useful statistics and a lot of statistics that are meaningless in terms of NEHTA having actually made a difference to the health sector.
What I found fun were these bits.
1. P25
“Clinical safety
All NEHTA products and services are rigorously reviewed prior to release to make sure they are safe, useful and fit for purpose – nothing is released unless the risk is as low as reasonably possible.
A continuous improvement process is in place to identify and quickly deal with any issues that arise in using the national eHealth record system and the Healthcare Identifiers Service.
NEHTA works closely with the Commonwealth Department of Health, the National Infrastructure Operator and the Department of Human Services to assess and monitor risk, and improve safety of the system.”
On a crucial topic like safety we see NEHTA being so vague it is just unbelievable. It is clearly seen as ‘best efforts’ issue as far as NEHTA is concerned. Not good enough in my view.
2.P38
“NEHTA’s long term objectives are:
NEHTA has provided the foundations for eHealth usage in Australia. Optimal usage of eHealth and the Personally Controlled Electronic Health Record (PCEHR) and creating a critical mass is dependent on building on these foundations and working with clinical groups and software vendors to achieve this.
Continued collaboration with stakeholders along with the implementation of medications management and chronic disease management programmes will help drive uptake of the PCEHR towards a ‘tipping point’ of use.
NEHTA’s work will need to be aligned with both the refreshed National eHealth Strategy and the Government’s response to the PCEHR Review recommendations.”
I wonder where comments on review of how well what NEHTA has delivered is working etc. I can find nothing other than some glossy vignettes to demonstrate all the money spent on NEHTA over the last decade has made a difference. I note they are still spending $50M p.a. on consultants.
3. P47
“Going Concern
NEHTA Ltd has funding arrangements with the Federal, State and Territory Governments of Australia until 30 June 2015. It is expected that further funding will be provided to continue the NEHTA work programme beyond the 12 months from the date of this report and as such the financial statements have been prepared on a going concern basis. Should the funding not continue there is material uncertainty as to whether the Company will continue as a going concern and therefore, whether the Company will realise its assets and extinguish its liabilities in the normal course of business and at the amounts stated in the financial report. Due to this uncertainty, NEHTA has set aside cash reserves that would be sufficient to extinguish any remaining liabilities that exist at the time, should further funding not be provided.”
Looks like NEHTA is contemplating its own demise.
4. P56
“e. In February 2013, NEHTA was provided with a press release in which MMRGlobal (MMR) asserted on behalf of its subsidiary MyMedicalRecords that NEHTA and the Australian Government appeared to be infringing two of MMR’s Australian patents and other intellectual property. At that time, NEHTA had not received any contact from MMR asserting an infringement and no claim of patent infringement has been pursued by MMR against NEHTA since the press release was issued in February 2013.
As a result of the assertions made in the press release, NEHTA undertook a thorough investigation of MMR’s Australian patents, which revealed that there was no, nor had there ever been, an infringement of MMR’s Australian patents by NEHTA. That has been communicated to MMR’s lawyers both in the United States and Australia by NEHTA’s solicitors.
At this time, the directors do not expect there to be any significant impact on the Company’s stated financial position as set out in the financial statements read with the associated explanatory notes, as a result of MMR’s assertions.”
Looks like NEHTA is happy MMR does not have a prayer!
All in all worth a browse to see just how much money has been spent for so little outcome.
David.

Tuesday, November 11, 2014

The Consumers Health Forum (CHF) Has A Dummy Spit And Reveals A Distorted View Of The Caring Professions.

We had an interesting, evidence free press release from the Consumer Health Forum (CHF) a few days ago.

Doctors: the health evolution is here, move on or move out

3 November 2014 - 
Many lives and billions of dollars, could be saved by personally-controlled electronic health records yet their full potential is threatened by self-interested doctors who wrongly claim they are putting patients’ interests first.
“There is widespread support for the introduction of a personally-controlled electronic health record, including from consumers, medical leaders and other providers, as revealed in the latest edition of CHF’s journal  Health Voices, published today,” says CEO Adam Stankevicius.  “Australia has already waited far too long for an effective national eHealth system --- more than ten years since government funding began in earnest. 
----- End Extract.
Here is the link to the .pdf.
There is reporting here.

Consumers and doctors clash over health records

Date November 8, 2014 - 6:17PM

Dan Harrison

Health and Indigenous Affairs Correspondent

A patient advocacy group has accused doctors of being motivated by self-interest in arguing against patients having direct access to test results via electronic health records.
Pathology and diagnostic imaging reports will be able to be added to electronic health records in the next update of the system, due later this year. 
Patients will be able to access these results following a seven-day delay, which is designed to give doctors time to manage communication of results with their patients.
But the Royal Australian College of General Practitioners is fighting the change, arguing that patients should not be able to access test results until they have been reviewed by the doctor who ordered them. 
College president Frank Jones said doctors had a responsibility to first check the results of tests they had ordered.
"The College has no issue whatsoever with patients having access to their medical records ... it's how it happens that is our concern," he said.
In a statement this week, the college said it would sometimes be undesirable for patients to find out results before any discussion with their GP in which the doctor could provide contextual advice and support. 
Lots more here:
Also we had this:

College told to ditch self-interest over patients' pathology results

3 November, 2014 30 comments
The RACGP has been told to ditch "self-interest" and stop blocking patients from prompt access to their pathology results.
The row is brewing over the decision to automatically upload virtually all pathology and diagnostic imaging results on to the PCEHR after seven days.
The college fears patients will learn they have serious conditions like melanomas or sexual diseases like chlamydia on the system before the GP has been able to contact them.
But the stance has outraged the Consumers Health Forum of Australia (CHF), which says that full potential of the e-health system is "threatened by self-interested doctors who wrongly claim they are putting patients' interests first".
In a media release entitled Doctors: the health evolution is here, move on or move out, the CHF CEO Adam Stankevicius said: "The RACGP is arguing against patients learning the results of path tests on 'safety' grounds, asserting that patients getting bad news before hearing it from them could be subject to ‘unnecessary distress'.
Lots more here:
I will choose to ignore the suggestion that doctors are pursuing ‘self - interest’ as I have no idea just what interest any doctor would have (except in very unusual circumstances) of not sharing patient results with the patient. What this seems to be is part of some CHF ‘Class War’ against doctors for the most obscure of ‘political’ reasons.
What I am even more amazed about is the first paragraph here:
“Many lives and billions of dollars, could be saved by personally-controlled electronic health records yet their full potential is threatened by self-interested doctors who wrongly claim they are putting patients’ interests first.”
Clearly there is no evidence of any sort that the PCEHR is working and it is at present just blind faith that it will in the future offer benefits that are being suggested.
Having results shared between pathologists, clinicians and their patients is the way it has always worked and it has worked pretty well.
Before just such an outrageous statement and claim for benefit is made - maybe the CHF might like to demonstrate just where the benefits claimed will come from over the present, already electronically enabled systems.
The magical thinking we see from groups like this, and the lack of evidence offered, makes one wonder why anyone would take the CHF seriously.
David.

Monday, November 10, 2014

Weekly Australian Health IT Links – 10th 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


Another fun week with lots happening on the PCEHR / Results front and a huge number of comments on the topic - as well as an interesting poll.

For those interested the ACHI Evidence Review Paper on results access this can now be downloaded from this page (presently the top item):

http://www.achi.org.au/Documents.htm

The debate has provided some useful input. I wonder if anyone from the Government has been reading. I hope so.

Please do respond to this week’s poll. It will provide some useful food for thought I hope.

Note: NEHTA has had a few releases this week - go to www.nehta.gov.au to review.
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College told to ditch self-interest over patients' pathology results

3 November, 2014 Paul Smith
The RACGP has been told to ditch "self-interest" and stop blocking patients from prompt access to their pathology results.
The row is brewing over the decision to automatically upload virtually all pathology and diagnostic imaging results on to the PCEHR after seven days.
The college fears patients will learn they have serious conditions like melanomas or sexual diseases like chlamydia on the system before the GP has been able to contact them.
But the stance has outraged the Consumers Health Forum of Australia (CHF), which says that full potential of the e-health system is "threatened by self-interested doctors who wrongly claim they are putting patients' interests first".
-----

Doctors accused of sabotaging e-health

4 November, 2014 Chris Brooker
‘Self-interested’ doctors are threatening the success of the personally-controlled e-health record program, Australia’s leading consumer group claims.
The Consumers Health Forum (CHF) has come out to criticise a recent statement from The Royal Australian College of GPs “arguing against patients learning the results of path tests on ‘safety’ grounds”.
The RACGP claimed patients getting bad news before hearing it from their GP could be subject to “unnecessary distress”.
However Adam Stankevicius, CEO of the CHF dismissed this view.
-----

Consumers and doctors clash over health records

Date November 8, 2014 - 6:17PM

Dan Harrison

Health and Indigenous Affairs Correspondent

A patient advocacy group has accused doctors of being motivated by self-interest in arguing against patients having direct access to test results via electronic health records.
Pathology and diagnostic imaging reports will be able to be added to electronic health records in the next update of the system, due later this year. 
Patients will be able to access these results following a seven-day delay, which is designed to give doctors time to manage communication of results with their patients.
But the Royal Australian College of General Practitioners is fighting the change, arguing that patients should not be able to access test results until they have been reviewed by the doctor who ordered them. 
-----

The new tech approach to an age-old problem

Monday, 3 November 2014 | By Kye White
As Australians live longer and longer, more sons, daughters and grandchildren are becoming the primary carers for ageing relatives who want to stay at home.
Brothers Tim and Matt were in such a situation and developed Curo, a technology-based elderly care and insights platform in an effort to give families looking after elderly relatives peace of mind.
The Curo platform includes a number of sensors, which can be placed in homes and used to monitor things like movement, sleep, temperature, and whether or not appliances are being used. Those sensors then feed real time data back to a smartphone app which can be monitored by family members.
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South Australia races the clock to iron out ehealth bugs

Open date for high-tech hospital looms.

The South Australian Government will be racing to repair problems with its $422 million EPAS system to ensure it can open the doors to the New Royal Adelaide Hospital on time and avoid the ehealth pitfalls that have delayed its fellow states.
SA’s Enterprise Patient Administration System has been put on hold as the state’s health department works through a number of funding questions and usability complaints.
But the rollout will need to be brought back to life before long if the New Royal Adelaide Hospital – recently described by the state’s auditor-general as “reliant” on the EPAS for its proposed model of operation – is to meet its April 2016 deadline, the Liberal opposition has pointed out.
“As EPAS is the only option on the table for the new Royal Adelaide Hospital it is critical that the Minister finds a solution to its deep seated problems well before the opening of the new Royal Adelaide Hospital,” shadow health minister Stephen Wade said in a statement.
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Death sparks call for GP access to script records

4th Nov 2014
THE death of a Melbourne woman who obtained scripts from seven different GPs has spurred a coroner to call for doctors to have access to patients’ prescription records “as a matter of urgency”.
Victorian coroner Ian Gray said GPs should have access to a real-time prescription monitoring (RTPM) system to stop ongoing damage and deaths from pharmaceutical misuse and inappropriate prescribing.
He also said an effective monitoring system would operate across state borders and should go beyond Schedule 8 drugs.
Judge Gray made the recommendations after conducting an inquest into the death of Anne Christine Brain, who was last seen alive sleeping on a couch at her home in Melbourne’s west on 24 December 2011.
Ms Brain died of intoxication from the combined effects of tramadol, methadone, diazepam, codeine, alprazolam, risperidone, doxepin and metoclopramide, the coroner found.
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Support for crackdown on doctor shopping

6th Nov 2014
AMA Victoria president Dr Tony Bartone has backed a coroner’s call for urgent action on prescription monitoring, saying the state could effectively crack down on “doctor shopping” for less than it spends on road safety campaigns.
The comparison is apt because more Victorians die from overdoses of prescription drugs than in road accidents, the Melbourne GP told Medical Observer.
“We are talking more deaths than the road toll and significantly inferior spending on the problem and the solution,” he said. 
“On that measure alone, this is a very significant project worthy of immediate resourcing and implementation.” 
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How Fast Starter Health.com.au is disrupting Medibank and Bupa

Published 05 November 2014 12:21, Updated 05 November 2014 12:25
Health.com.au co-founder Andy Sheats says disgruntled Medibank Private members represent about a third of the customers the start-up is luring to its low-cost online-only offering.
The government-owned Medibank, which is cruising towards its $4 billion-plus initial public offering in November, controls about 29.1 per cent of the market with 1.6 million policyholders across its brands, Medibank and ahm.
After establishing three years ago, Health.com.au doubled its number of policyholders to 90,000 in the 2014 financial year. Health.com.au was second on the BRW Fast Starters list this year and also ranked in BRW’s 50 Most Innovative Companies in 2014.
Health.com.au co-founder and chief executive Andy Sheats said half of the venture’s new members were customers taking up insurance for the first time. However of customers that switched to Health.com.au from another insurer, about a third come from Medibank and about another third come from the second-largest player, Bupa.
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NEHTA hooks up 267 public hospitals to national e-health system

More than 1.7 million individuals and 7,234 health organisations now registered with the system
Byron Connolly (CIO) on 06 November, 2014 12:22
The National E-Health Transition Authority (NEHTA) said on Thursday that it had worked with CIOs to connect 267 public hospitals and health centres to national e-health infrastructure.
This is just over one-third of about 750 public hospitals across the country.
Most of these providers are in Queensland with 219 of the total connected to the national system. Around half of the 41,632 discharge summaries uploaded to the system have been sent by Queensland Health organisations, NEHTA said in its 2013-14 annual report.
Meanwhile, more than 1.73 million Australians are now registered for an e-health record, an increase of 826,948 over the same period last year, according to NEHTA’s 2013-14 annual report.
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Blind spot in Google Glass

5th Nov 2014
GOOGLE Glass may cause blind spots in the peripheral vision of its wearers and impact driving and pedestrian safety, according to research published in JAMA.
Significant scotomas, or blind spots, were found in all of the participants while they were wearing the head-mounted display systems, but not when wearing control frames of a similar colour and temple width. 
The University of California researchers called peripheral vision “essential for daily activities such as driving, pedestrian safety and sports” but noted that more than 10% of the visual field on the horizontal axis was lost by wearers of Google Glass. 
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Telstra to shake up medical care with eHealth kick

James Riley
November 3, 2014
In launching Telstra’s vast ambition to become a major commercial player in the delivery of health services in Australia, David Thodey sounded more like a health minister than the chief executive of a telecommunication company.
When Thodey made his speech last month, it so comprehensively covered the ideals of the Australian eHealth agenda that it could easily have been mistaken for a speech Peter Dutton should have been making.
There was lots of talk about a health system that is “more connected, more effective and more accessible to everyone.” He spoke of improving services to the bush, reducing hospital and GP visits, cutting back-office cost out of the system and of course saving lives.
These are bread and butter eHealth issues, and as the dominant telecommunications services provider in this country, you would certainly expect Telstra to have a deep interest.
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Getting behind Australia’s med-tech sector

Four hot new technologies have been identified as the future of Australian medical technology by being commended as finalists in the first Janssen Health and Technology Challenge (HaTCH).
Sponsored by pharmaceutical company Janssen, the Challenge’s five judges, were given the job of winnowing through around forty entries, all of whom were eligible for the finalist’s $10,000 prizes. The winner, which is slated for announcement on December 3, will receive an additional $100,000 to take their products to market.
The judging panel was made up from experts including World Medical Association chair, Dr Mukesh Haikerwal, Amit Vohra, the former CEO of General Practice Registrar Australia, Cyrus Allen, a partner at Strativity Australia, Chris Hourigan, chief executive of Janssen Australia, and serial entrepreneur Mike Liubinskas.
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Barriers to open source in the NHS

There is a discussion going on on the NHS Technology Community site on what the barriers to open source are in the NHS, and how to address them. The posts are interesting, but one thing is lacking: a statement of what it is people are trying to achieve, other than solving local problems. I made a post that may interest others more widely, as follows (slightly adjusted here).
I would suggest that if people want to understand barriers to open source in the NHS, they need to understand the supposed need for open source. Is it:
  • to enable in-house developers to add to an existing product?
    • They need access to something like plug-in interfaces to do this. Probably not the main product source (e.g. Intersystems Ensemble, Cerner, ….) though.
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Telemedicine celebrates 10 years of sending images of skin rashes and lesions to dermatologists

Mon 3 Nov 2014, 11:31am
Telemedicine is celebrating 10 years of sending images from a remote location for specialist diagnosis.
The Tele-derm service was been developed by the Australian College of Rural and Remote Medicine and is funded by the Australian Government Department of Health under the Rural Health Outreach Fund (RHOF).
It means dermatologists based in major hospitals can tell the patient quickly if they have just a rash, eczema or even skin cancer, melanoma.
The Dean of Medicine at James Cook University in Townsville, Professor Richard Murray, says you can send a digital image of your skin lesion rather than having to book and attend a specialist.
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Orion Health sets IPO price at top end

  • Business Spectator
  • November 07, 2014 11:05AM
NEW Zealand’s Orion Health has set the final price of its IPO at $NZ5.70 ($5.10) a share, the top end of its indicative range, after a two-day book build.
The software provider raised $NZ125 million in the float, comprised of $NZ120m in new capital and $NZ5m in existing shares sold by an entity associated with founder and chief executive Ian McCrae.
Mr McCrae, who founded the company in 1993, will remain the biggest shareholder and retain around 50 per cent of the company. No other shareholders are selling into the IPO.
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Microsoft Band hands-on: The ultimate multi-platform, multi-function wearable

Summary: Microsoft launched the Microsoft Band late at night, but it turns out they may have delivered one of the best values in wearable technology to date. Matthew has spent the last three days running, walking, and sleeping with it.
By Matthew Miller for The Mobile Gadgeteer | November 6, 2014 -- 14:00 GMT (01:00 AEST)

Microsoft Band

Microsoft surprised all of us with the Microsoft Health and Band announcements last week. Due to the promise of a cross-platform fitness and activity tracker with GPS, basic smartwatch functionality, and more, I immediately went online and ordered one.
I visited the local Microsoft Store to try to buy one on Friday while mine was in transit, but they were sold out. Since my Microsoft Band just arrived on Monday, I haven't spent enough time with it to give you a full review so I'll start off with some first impressions. A full review that includes running, strength training, and more will be coming in a week or two.
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$1.8m deal sees Invigor score yet another acquisition

By Tony Yoo on Nov 6, 2014 3:50 AM

Mobile data analytics provider Amethon to join growing family.

Australian big data solutions provider Invigor has acquired mobile data analytics provider Amethon for $1.8 million.
“The acquisition positions Invigor as provider of real-time competitor and real-time consumer analytics through the combination of Invigor Insights and Amethon platforms,” said Gary Cohen, executive chairman of Invigor – named by CRN in August as one of the five ASX-listed companies to watch.
A statement to the ASX described Amethon as an operator in the mobile data analytics field “delivering subscriber data through advanced network analytics and content tracking solutions”. The platform works with both “telcos and wifi networks”.
Amethon’s portfolio boasts an e-health network contract with a “major local telco” customer that will involve more than $1 million in annual licence fees over the next seven years.
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Artificial malevolence: watch out for smart machines

Date November 8, 2014

Nick Bilton

Ebola sounds like the stuff of nightmares. Bird flu and SARS also send shivers down my spine. But I'll tell you what scares me most: artificial intelligence.
The first three, with enough resources, humans can stop. The last, which humans are creating, could soon become unstoppable.
Before we get into what could possibly go wrong, let me first explain what artificial intelligence is. Actually, skip that. I'll let someone else explain it: Grab an iPhone and ask Siri about the weather or stocks. Or tell her "I'm drunk." Her answers are artificially intelligent.
Right now these artificially intelligent machines are pretty cute and innocent, but as they are given more power in society, these machines may not take long to spiral out of control.
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Artificial intelligence and singularity could mean demise of human control

Date November 9, 2014 - 12:15AM

Sam de Brito

Columnist

One of humanity's great conceits is thinking we are evolution's finished product.
It's an easy hubris to indulge in considering anatomically modern humans appeared 200,000 years ago and we've ruled the roost since. I doubt when we puny-skulled, slightly built types turned up with our crude jewellery and cave paintings, Neanderthals were too fussed. And look where that got them.
It makes you wonder whether the complacency we display about the technology that serves us today might be our ultimate undoing; we underestimate the challenger. We giggle at Siri's mistakes, roll our eyes when Pandora suggests a dud song and pause Call of Duty to go pee.
Rarely, however, do we pause to consider the beachhead artificial intelligence (AI) has already won in our lives.  
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Enjoy!
David.

Sunday, November 09, 2014

I Bet This Goes Badly! Has The Feel Of A Government Department Really Out Of Their Depth.

This popped into the ether from the Department of Human Services on Friday 7 November 2014.
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From: CO.ONLINE.TECHNICAL.SUPPORT.LIAISON
Sent: Friday, November 07, 2014 1:59 PM
To: CO.ONLINE.TECHNICAL.SUPPORT.LIAISON
Subject: Department of Human Services Advice: MEDICARE ELECTRONIC CLAIMING - Patient Contribution Update [SEC=UNCLASSIFIED]

MEDICARE ELECTRONIC CLAIMING – Patient Contribution

The Australian Government Department of Human Services (Human Services) anticipates implementing the Patient Contribution Budget Measure from 1 July 2015.  Implementation is subject to the passing of the necessary legislation. With the proposed introduction of Patient Contributions for general practitioner, pathology and diagnostic imaging services, sites will need to check whether the patient has a concessional status and may choose to charge a patient contribution at the point of service as appropriate. These sites will require changes to their practice management software to transmit claims which include a patient contribution. Vendors who provide software to these sites will be required to develop and implement changes to their Medicare Online software and/or Medicare Easyclaim integrated software to provide the new functionality.
Scope
Subject to legislative changes, from 1 July 2015 the Medicare benefit will be reduced by $5 for all patients for:
  • General Practitioner (GP) consultations in Category 1, Groups A1, A2, A11, A22 and A23;
  • out-of-hospital Diagnostic Imaging (DI) services in Category 5, Groups I1, I2, I3, I4 and I5; and
  • out-of-hospital Pathology episodes containing services in Category 6, Groups P1, P2, P3, P4, P5, P6, P7, P8 and P10.
A patient contribution of $7 will be introduced and this may be charged by the provider.  A maximum of 10 patient contributions per calendar year across in-scope GP consultations, DI services and Pathology episodes will be payable by concessional patients (including children under 16), where the provider charges a patient contribution. If the provider chooses to set their own fee for an in-scope service, the provider has charged a patient contribution if the charge is at least $7 greater than the Medicare benefit. The annual cap of 10 patient contributions is  called the Service Cap.  After 10 patient contributions have been charged the Medicare benefit for concessional patients (including children under 16) for these services will revert to the full amount. All patient contribution amounts charged will be excluded from the Original Medicare Safety Net (OMSN) and the Extended Medicare Safety Net (EMSN).
Changes to legislation will be required to allow providers to charge the patient a $7 patient contribution where patients assign their Medicare benefit directly to a provider.
A Low Gap Incentive (LGI) will also be introduced and paid to providers that accept a concessional patient’s (including children under 16) assignment of Medicare benefit, and charge a patient contribution of $7 only. Once concessional patients reach their annual Service Cap, the provider will continue to receive the LGI where they continue to accept the assignment of benefit (bulk bill), and do not charge a patient contribution.
The bulk bill incentive will also cease for in-scope services for:
  • GP consultations;
  • out of hospital Pathology services; and
  • out of hospital DI services.
The bulk bill incentive will continue to be paid for other GP and Pathology services which are not within scope.
These changes will affect software which supports Bulk Billing and/or Patient Claiming for GP consultations, out of hospital Pathology and out of hospital Diagnostic Imaging services.
The software design will include a verification service that will support medical practices and health professionals in determining when to charge or not charge a patient contribution, including when the service cap has been reached.
Medicare Electronic Claiming Client Adaptor Support Policy (Medicare Online and ECLIPSE)
(This section should be read in conjunction with the Medicare Electronic Claiming Client Adaptor Support Policy released 14 October 2014)
To ensure successful implementation of the Patient Contributions budget measure, the department will be making new logic packs available which will be compatible with the May 2009 Release client adaptor version and above.
A new client adaptor will also be made available in 2015 which will meet the requirements for Patient Contributions and resolve some known issues identified in existing adaptors.
The following client adaptor versions identified in the Medicare Electronic Claiming Client Adaptor Support Policy as N, N-1 and N-2, will be compatible for Patient Contributions:
Adaptor Release                 Version
(back to 2009 - Omitted)
In scope vendors who DO NOT meet the client adaptor minimum supported requirements
Vendors who do not currently have a Notice of Integration (NOI) for a client adaptor version of May 2009 Release or above, will need to upgrade to a supported client adaptor and implement the new logic packs and receive a new NOI.
Vendors in this group have 2 options which are:
1.        Commence an upgrade now to a currently supported Client Adaptor N-1 (June 2014 preferred) and then implement the new logic packs in 2015. This may help spread the development time required and reduce the 2015 NOI process.
2.        Upgrade to the latest release (June 2015) and implement the new logic packs.
In scope vendors who DO meet the client adaptor minimum supported requirements
Vendors who have an existing NOI for a client adaptor version of May 2009 Release or above, will need as a minimum to implement the logic pack changes required for Patient Contributions and receive a new NOI.
You may still choose to upgrade to the latest client adaptor (June 2015), however due to the compressed timeframes, priority will be given to the development, testing and support of vendors who do not currently meet the minimum supported requirements.
Vendors NOT in scope for Patient Contributions
Vendors not in scope for Patient Contributions and who do not meet the minimum supported requirements in the Client Adaptor Support Policy will be given an extension to 1 December 2015 to upgrade their adaptors to a supported, N or N-1, version.
Schedule and Testing
Human Services is currently developing a strategy to streamline NOI testing arrangements for Patient Contributions. Further testing information will be provided as soon as practically possible.
  •  A new NOI will be required for the logic pack changes..
  • Beta CD release is scheduled for January 2015.
  • NOI testing can start utilising the Beta CD as of January.
  • Final CD release is scheduled for release May 2015.
  • Human Services Patient Contribution release is scheduled for June 2015 for a 1 July implementation.
Further Communication

As the Patient Contribution measure is subject to the passage of legislation, Human Services will be working closely with the Department of Health to ensure regular updates are provided to vendors. Human Services will be holding a number of forums to discuss the implementation of this measure. Teleconferences will be arranged in coming weeks so that vendors have the opportunity to raise questions and clarify information.

Human Services is unable to provide any additional information at this time other than what has been provided in this message. Should you have any questions in relation to the implementation of Patient Contributions, please email otsliaison@humanservices.gov.au. Questions will only be accepted by email and individual responses may not be provided. However, your questions are a valuable part of this process and will be used to develop a Q&A that will be distributed to all vendors. We will also endeavour to answer as many questions as possible during the teleconferences.
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Note the lack of additional info - bold!
What is going on here is that providers of practice management software are being asked - in the absence of any certainty as to legislation or timing of implementation - to undertake a major development project with little hope of being remunerated for their time and effort. At the very least funding for all to undertake this work needs to appear and quickly.
Worse than that you will note that the e-mail has no sense of just how this will be implemented - most especially the 11th patient visit cancellation of the co-payment. Just how is this to happen in real time, how are refunds to be made and so the questions go on and on.
The whole unlegislated co-payment idea is tricky, with 10 payment cap more tricky and with no funds to develop the software to implement it is a joke. Note that is all meant to be designed, tested, implemented and working in 7 months (with 2 months lost for the silly season!).
If I was involved I would demand either legislation having been passed (and full funding)  or full financial indemnity for all expenses + a considerable uplift for inconvenience before lifting a finger!
Dream on Government. Just plain ridiculous, as is the whole co-payment policy in my view!
David.

AusHealthIT Poll Number 243 – Results – 9th November, 2014.

Here are the results of the poll.

Should Pathology and Radiology Results Be Uploaded To The PCEHR, And Made Accessible To Patients, Before Review Of The Information By The Patient's Clinician?

For Sure 6% (12)

Probably 4% (8)

Neutral 2% (4)

Probably Not 29% (60)

No Way 58% (121)

I Have No Idea 1% (2)

Total votes: 207

It seems most don’t think that result information should be made accessible to patients before review by the ordering clinician.

Good to see such a clear outcome and lots of votes.

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

David.