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, April 23, 2015

2016 Budget Watch. Parliament Closed Until Budget Day. It’s Coming Very Soon!

Last Budget Night was on Tuesday 13th May, 2014 and it is still not finalised -apparently $27Billion still unresolved!
We now look forward to see what we might see next time. I am sure this will be fun.
In the last few weeks it has been huge with early leaks and a Tax White Paper and a Competition Final Report released. Too much for most to even start to get their heads around!
In the last 10 days or so we have had changes to super, dividend imputation and negative gearing ruled out.
This week the leaks have started in earnest so it begins to get interesting! More news on Super, Pensions and new Taxes are all coming into view!
The pharmacists remain very grumpy also it would seem!
Budget Night is May 12, 2015.
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Articles looking forward and back this week include.

General Budget Issues.

Trade Minister Robb under pressure to reveal details so far of TPP 12-nation pact

  • April 13, 2015 1:15PM
  • Malcolm Farr
IT’S a treaty aimed at including Australia in a powerful trade bloc of 12 nations generating 40 per cent of the world’s economy — and it’s being negotiated in secret.
The proposed Trans-Pacific Partnership (TPP), which has been labelled ‘the dirtiest deal you’ve never heard of’ by Australian action group GetUp, has roused anger and apprehension on both sides of the ocean. Now governments are under pressure to open up the negotiations and reveal what has been decided over the past 10 years.
“Politicians and governments need to have enough self-confidence to be able to have a contest of ideas, rather than doing something in secret and dropping it on the table,” said Liberal Senator Bill Heffernan, who on this occasion shares the views of the Greens.
But so far the government negotiators can only reply: Trust us.
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Why Hockey will have to clean up Costello's superannuation mess in May budget

Date April 14, 2015 - 8:22AM

Peter Martin

Peter Costello's largesse towards superannuants has left a vast hole in the budget.
Call it karma. It has fallen to Joe Hockey to undo two of the stupidest and potentially most expensive decisions ever made by an Australian government.
They were made by the Howard government of which Hockey was a part. But they were driven by its treasurer, Peter Costello, and by the Treasury itself. Costello announced both decisions on budget night 2006 with something of a flourish. They constituted "the most significant change to Australia's superannuation system in decades".
So great was the cost, the Abbott government reportedly considered axing the pension extension in its first budget. 
They would "sweep away the current raft of complexity faced by retirees, increase retirement incomes, give greater flexibility as to how and when superannuation can be drawn down, and improve incentives for older Australians to stay in the workforce".
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Reserve Bank carries the weight of monetary policy while Coalition dithers

But there is only so much the RBA can do to manage the patchwork economy created by the Abbott government
When setting monetary policy, the Reserve Bank of Australia almost always has to deal with conflicting pressures when it decides whether a particular level for the official cash rate is appropriate.
That dilemma has been evident in recent times where the RBA has confronted a generally weak economy with rising unemployment on the one hand, and incredibly strong house price growth on the other.
What to do is the difficult decision for the RBA, as the weakness in the economy would normally mean lower interest rates are necessary while rampagingly strong house prices would normally demand higher interest rates.
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Leaked Federal Government mental health report recommends redirecting $1 billion from acute hospital care to community-based services

A leaked report commissioned by the Federal Government recommends redirecting more than $1 billion in funding from acute hospital care to community-based mental health services.
In Opposition, the Coalition made a review of mental health services a priority and ordered the National Health Commission to conduct a review when it assumed power in 2013.
Former health minister Peter Dutton received the document last November but the review is yet to be made public.
The ABC's 7.30 program has obtained part of the review, which says the current system is poorly planned and integrated and is a "massive drain on people's wellbeing".
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Budget 2015: What we know so far

By political correspondent Emma Griffiths
April 13, 2015
Budget 2015 is shaping up to be a far different beast than last year's broad-scale "budget repair job", if early indications from the Prime Minister and Treasurer are anything to go by.
According to Tony Abbott, Joe Hockey will unveil a "dull and routine" budget on May 12 - one which will not seek to protect the federal coffers at the expense of the household purse.
But there will be changes.
Already we know there will be a centrepiece "families package" targeted at working parents paying for childcare, and a small business tax cut.
Also expected are changes to pensions and a possible spending slowdown for other welfare payments.
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Big Pharma talks up Trans Pacific Partnership but profits trump patients

Date April 17, 2015 - 12:00AM

Deborah Gleeson and Pat Neuwelt

The pharmaceutical industry wants higher profits through longer monopolies and less-regulated markets.
The American business community's spin machine has gone into overdrive as the finish line for the Trans Pacific Partnership negotiations come into view. One of the more over-the-top examples of recent hype is an open love letter to the TPP posted on an American industry lobby  website just before Valentine's Day.
The love letter, posted on the Global Intellectual Property Centre website, seems at first glance simply harmless (though certainly charmless) hyperbole. But in amongst phrases like "I'd be a fool not to cross the Pacific for you" is a demand that strikes fear into the hearts of those concerned with access to affordable medicines. What the pharmaceutical industry is proposing is that it be provided with12 years of absolute monopoly – seven years longer than the current data protection period in Australia – during which  it can charge whatever the market will bear.
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Surfing the budget's ebbs and flows

A tale of three treasurers.
Current Treasurer Joe Hockey, last Friday, gave the Financial Review an extensive interview. He had lots to say on the budget, tax reform and the economy. In modern terms, it was relatively free of repeated cliches, of framing everything in terms of the Labor Party, and remarkably frank about just how difficult the budget task now is. It is often impossible to get every bit of a long interview into print in context but the following exchange is worth recording in full.
Tingle: Can I bring you back to the budget for a moment? I understand what you're saying about the surplus and not wanting to put a date on [a return to surplus] but there has been a deterioration in the bottom line, heavily driven by revenue write-downs, since [the pre-election economic and fiscal outlook].
Hockey: Yes.
Tingle: Are you envisaging that there will actually be a further deterioration this time and/or that you will be able to forecast a swing into smaller deficits within the next four years?
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Apparent Budget Leaks.

Tony Abbott pledges to protect our superannuation: No changes during his term of government and beyond

  • Simon Benson National Political Editor
  • The Daily Telegraph
  • April 16, 2015 12:00AM

Hockey and Costello at odds over tax

TONY Abbott has ruled out any changes to superannuation in this term of government or beyond, allaying fears self-funded retirees would be in the sights of federal Cabinet’s razor gang.
The Prime Minister yesterday killed off any plans to go after high-income earners over super tax concessions following suggestions the government was considering changes in the Budget.
Treasurer Joe Hockey has recently called for bipartisan support for a review of the tax concession arrangements for super contributions for high-income earners.
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Assistant Treasurer Josh Frydenberg rules out superannuation changes in budget

Date April 19, 2015 - 12:15AM

Judith Ireland

National political reporter

EXCLUSIVE
Major superannuation changes have been ruled out by the Abbott government, just weeks ahead of the federal budget, further limiting options to rein in the estimated $45 billion deficit for 2014-15.
This comes on the back of Coalition promises to not change negative gearing and the GST, as well as a tumbling iron ore price, making the budget repair job even tougher.
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Health Budget Issues.

Health programs will continue

By PETA DOHERTY

April 12, 2015, 9:30 p.m.
Funding will remain for GP Access After Hours under the new system.
GP Access After Hours  as well as mental health care and co-ordination programs will continue to be funded under the federal government’s new Primary Health Network system.
Minister for Health Sussan Ley on Saturday announced Hunter Medicare Local and its partners had been successful in a bid to operate the Hunter New England Central Coast Primary Health Network, which will replace Medicare Local from July 1.
Hunter Medicare Local will be part of a consortium with the New England and Central Coast medicare locals and the Hunter New England and Central Coast local health districts to run the new network.
The 61 national government funded Medicare Locals set up by Labor will be replaced by 30 Primary Health Networks.
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Budget 2015/16: To fund or cut health?

13 Apr 2015
By Shadow Minister for Health, Catherine King.
WHILE THE PUBLIC OUTRAGE and political fight over the 2014 budget has been dominated by the GP Tax, other changes made to health in that budget are every bit as damaging.
Principally among these was the decision to abandon Labor’s agreement with the states to fund 50 per cent of growth in the efficient price of hospital based activity over the next decade.
In March’s Intergenerational report, this was the single biggest contribution to the savings claimed by the Abbott Government and yet, it is a complete fraud.
The growth in hospital costs will not magically be lowered by declaring that, from 2017, the federal government’s share of hospital spending will grow each year in line with inflation and not by the 6 per cent or more that is the actual cost of running hospitals.
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Primary Health Networks announced for July 1 go live

The Australian government has announced the winning tenders in the $900 million Primary Heath Networks scheme, which is set to roll out on July 1, 2015.
The 31 Primary Health Networks (PHN) are designed to replace the previous government’s Medicare Locals, said Health Minister Sussan Ley, in a statement. The PHNs will be outcome focused, she said, with the intent of improving frontline services and to create a better alignment with state Local Hospital Networks to ensure better integration between primary and acute services.
“By aligning PHNs with state Local Hospital Networks we also aim to reduce the merry-go-round for many patients with chronic or complex conditions between primary care and hospital treatment,” said Ley.
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Private health insurers win prized stake in GP care; academics, opposition warn of conflict of interest

By medical reporter Sophie Scott
April 14, 2015, 7:08 am
Private health insurers will work directly with GPs and hospitals for the first time, running programs with the aim of keeping patients healthy.
The Federal Government has announced the winners of the 28 new "primary health networks" which will receive up to $900 million in government funds.
Health Minister Sussan Ley said the networks, which replace Medicare Locals, would improve frontline services for patients and better coordination between hospitals and GPs.
But Labor's health spokeswoman Catherine King called it "a deeply disturbing move".
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Medical rebate overhaul could recoup lost savings from ditched co-payment

Government expected to announce audit of fees paid to doctors for performing medical services
Lenore Taylor Political editor
The Abbott government is considering a major overhaul of the rebates it pays doctors for each medical treatment as a means of winning back budget savings lost when it ditched the Medicare co-payment.
Guardian Australia understands health minister Sussan Ley is likely to announce a comprehensive audit of the fees the government pays for each medical service under the medical benefits schedule.
The move could again put the government on a collision course with doctors. It is unlikely to be completed in time for this year’s budget, but estimates of savings from scaling back on unnecessary tests and low value services run to hundreds of millions of dollars a year.

Leaked mental health review is scathing of system's shortcomings and calls for $1b funding shift to community care

Date April 14, 2015 - 6:00PM

Amy Corderoy

Health Editor, Sydney Morning Herald

A radical overhaul of mental health treatment and funding in Australia has been proposed in a leaked review that also says the government should remove $1 billion of mental health funding from state and territory hospitals and redirect it into community care from 2017.
But within hours of the summary of the National Mental Health Commission report being released on Tuesday the government had rejected suggestions it would be cutting money from the state and territories' already cash-strapped psychiatric hospitals, although it said it was still considering the other recommendations of the report. 
The report says the government should also commit to halving the number of people who suicide by 50 per cent over the next decade, and is highly critical of the way mental health care is delivered across the nation, saying it is designed around what works for the system rather than what works for people.
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Call for overhaul of Medicare payments for diabetes patients

Date April 15, 2015 - 12:15AM

Dan Harrison

Health and Indigenous Affairs Correspondent

Exclusive
Medicare payments should be overhauled to improve care for patients with diabetes and other chronic diseases, a panel of experts has recommended.
In a discussion paper to be launched by Health Minister Sussan Ley on Wednesday, the Abbott government's national diabetes strategy advisory group say the current Medicare payment model, in which doctors get most of their income from fees paid for each patient visit, is "unlikely to lead to optimal outcomes".
"The fee-for-service model does not incentivise long-term follow-up or the proactive care of people with chronic conditions," the paper says.
The group, comprising experts from health groups, universities, research institutes and the public service, calls on the government to experiment with different payment models, which combine fee-for-service payments with other payments based on performance and patient characteristics.
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Alternative Medicare funding model proposed by Royal Australian College of GPs

Date April 15, 2015 - 2:00PM

Dan Harrison

Health and Indigenous Affairs Correspondent

Doctors have presented Health Minister Sussan Ley with a blueprint for Medicare reform that pays GPs extra to treat complex patients, provide comprehensive services, and co-ordinate care between different healthcare providers.
The Royal Australian College of General Practitioners delivered its proposals to Ms Ley on Wednesday.
A range of new payments would replace existing Practice Incentive Payments and Service Incentive Payments under the plan.
Under the proposal, as well as receiving fees for services, doctors would receive a loading for treating indigenous patients, patients of low socio-economic status and elderly patients and for operating in rural areas.
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Sussan Ley rules out redirecting $1bn from hospitals to mental health services

Federal health minister dismisses recommendation made in leaked government-commissioned review into Australia’s mental health services
The federal health minister, Sussan Ley, has ruled out redirecting $1bn from inpatient hospital care to community mental health services, as a leaked government-commissioned review had proposed.
Before the 2013 election, the Coalition committed to a comprehensive review of mental health services, which has since been carried out by the National Mental Health Commission.
Its report, which focuses on what the commonwealth can do to improve access to mental health care, was delivered to the government in November but has not been made public.
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AMA hospital report card gives states fuel for fight

Joe Kelly

Tony Abbott will face heightened pressure to reverse cuts of $80 billion to health and education, with a snapshot of public hospital performance handing the states fresh ammunition to press home their case.
The public hospital “report card”, produced by the Australian Medical Association, shows that every state or territory failed to meet the target of having 80 per cent of emergency department presentations seen within clinic­ally recommended triage times.
Premiers and chief ministers, led by NSW Premier Mike Baird, will meet today in Canberra ahead of the Council of Australian Governments meeting to prepare to confront the Prime Minister tomorrow on the cuts to education and health.
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Doctors' group predicts health funding crisis unless federal cuts are reversed

Australian Medical Association public hospital report card shows beds are not keeping pace with population growth and benchmarks are not being met
Lenore Taylor Political editor
Public hospitals are facing a future funding crisis after deep federal government cuts, the Australian Medical Association has warned, boosting the state premiers’ case as they demand the prime minister, Tony Abbott, reverse reductions in health spending in last year’s budget.
The AMA’s annual public hospital report card has found public hospital beds are not keeping pace with population growth and demand, elective surgery waiting times are not improving and emergency department waiting times are improving only slightly and remain below a national target.
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Cancer patients lose free lifesaving drugs

  • REBECCA URBAN and RACHEL BAXENDALE
  • The Australian
  • April 16, 2015 12:00AM
Drug companies are scrapping free access to breakthrough cancer treatments as the time ­between product registration and full approval blows out, potentially risking the lives of thousands of patients.
Novartis Oncology, the cancer division of the Swiss pharmaceutical giant, will no longer provide free access to new drugs that, ­despite having Therapeutic Goods Administration approval, are not listed on the Pharmaceutical Benefits Scheme.
Roche, which is the largest supplier of oncology drugs in Australia, including breast cancer drugs Herceptin and Kadcyla, has confirmed to The Australian that it recently adopted a new policy for providing early access to medicines not yet publicly funded, with most patients now required to pay part of the costs.

AMA warns of hospital funding 'perfect storm' that will lengthen waiting lists

Date April 16, 2015 - 12:15AM

Dan Harrison

Health and Indigenous Affairs Correspondent

Doctors are warning of a "perfect storm" in public hospitals as federal government funding cuts take effect, forcing patients to wait even longer for emergency treatment and elective surgery.
The Australian Medical Association will on Thursday use its annual report card on public hospital performance to warn of the impact of the cuts, which will be discussed by Prime Minister Tony Abbott and state and territory leaders when they meet in Canberra on Friday.
The Abbott government is booking savings of $57 billion over 10 years as a result of dismantling the hospital funding system put in place by Labor, which was based on growth in demand and costs, and from 2017 is moving to a new system in which the Commonwealth's contribution to hospitals is adjusted only for population growth and inflation as measured by the consumer price index.
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Fifty jobs at risk: Medicare Local loses bid

By JOSH GIDNEY

April 15, 2015, 7 a.m.
SIGNIFICANT job losses are likely after the axing of Moruya’s Southern NSW Medicare Local.
The service has failed in its bid to become a national Primary Health Network in a federal shake-up of the sector.
The Government announced last year it would replace Medicare Locals with the networks, forcing services to compete in a tender process.
Staff at the Moruya-based service learned this week their bid had failed, with the contract going to an Illawarra-Shoalhaven consortium.
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Sussan Ley denies budget cuts will open hospital 'black hole'

By political correspondent Emma Griffiths
April 16, 2015
Federal Health Minister Sussan Ley has rejected criticism from the nation's peak medical group that Commonwealth budget cuts will open up a multi-billion dollar "black hole" for hospitals.
In two years, about $50 billion will be stripped from hospital funding, as the Abbott Government locks the rate of spending growth to inflation and population growth.
Hospitals have already been hit by a $1.8 billion cut in last year's budget as earlier funding agreements were scrapped.
In its snapshot of public hospital performance, the Australian Medical Association (AMA) said the system was not coping with the demands and warned the situation would worsen with less funding.
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Mental health - a crisis-driven system in crisis

Date April 16, 2015 - 11:45PM

Lesley Russell

For five months the Abbott government stubbornly refused to release the report from the review it commissioned, as an election commitment, to assess the efficiency and effectiveness of Australia's mental health services. Now that report has 'fallen off the back of a truck" and we are left to wonder why all the secrecy. 
Yes, the report is a damning indictment of a patchwork of services and programs that are failing to meet the needs of Australians with mental illness and mental health problems and that deliver poor returns on the $14 billion spent annually by Commonwealth, state and territory governments. But such findings were predictable: this is the latest in a long series of reports in mental health and why commission a review if there were not recognised problems? 
So the government was presumably not hiding problems and it should not have been shirking actions in response because this report also provides solutions, a roadmap for reform. It outlines strategic directions and practical solutions within existing resources for the next two years, and then for the next decade.
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Sussan Ley’s mental health redesign from ground up

Gina Rushton

Rick Morton

The mental health system is so chaotic and inefficient that it must be redesigned from the ground up, and federal Health Minister Sussan Ley will ask her state and territ­ory counterparts to become part of the solution, reviving a nation­al strategy that has previously floundered.
Ms Ley released the National Mental Health Commission’s 700-page report into the system yesterday and said although it painted a “disturbing” picture of the current system, it provided a way forward.
The report details a $10 billion system — most of that money is spent on welfare payments for the mentally ill — which fails people at every turn, whether they are visiti­ng their GP, attempting to access community support or living in regional and remote areas.
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Trust over health funding flatlines

  • April 17, 2015 4:38PM
  • Karlis Sana
  • AAP
THE Abbott government has been accused of being disingenuous in its commitment to improving mental health services, with state health ministers saying broken funding agreements mean there is now a deficit of trust.
STATE and territory health ministers will work with the federal government on a national approach to mental health, agreeing at a COAG Health Council meeting in Sydney on Friday to develop a coordinated strategy within the next 12 months.
The meeting comes after the release of a major review of Australia's mental health services, which revealed a chaotic and inefficient system that constantly fails the mentally ill.
Federal Health Minister Sussan Ley said on Friday she welcomed the renewed effort among the various jurisdictions to come up with a national mental health plan "that will be lasting".
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RACGP proposes 10 new ways to fund general practice

16 April, 2015 Amanda Davey
The RACGP has released its vision of a new funding system for general practice.
It  includes replacing practice and service incentive payments (PIPs and SIPs) with more targeted payments aimed at both the practitioner and the practice.
This is because PIPs and SIPs are “misaligned and not achieving what they are designed to deliver”, says the RACGP's  working document,  Vision for a sustainable health system.
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Pharmacy Issues.

Public may pay for pharmacy deregulation

15 April, 2015 Meg Pigram
The true public cost of pharmacy deregulation has been now been revealed, the Pharmacy Guild of Australia believes.
In a doorstop interview this morning, Professor Ian Harper, lead author of the Federal government’s recently released Competition Policy Review says Australian patients may have to pay a levy on medicines because of the impact of de-regulation on the pharmacy sector.
“In other words, consumers might be hit with a new tax on medicines to fund the closure of their local pharmacy,” a Guild spokesperson said in response to Professor Harper’s comments.
The Guild said in a statement that they provided the Harper Review Panel with research to suggest the necessary of the current pharmacy model, and any de-regulation will have huge economic loss.
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Pharmacists wary of more competition

Greek Australian pharmacists aren't happy at calls to deregulate their industry in the hopes it will encourage more competition
15 Apr 2015
Helen Velissaris
Calls to deregulate Australian pharmacies to increase competition haven't been met with much support from Greek Australian pharmacists.
An audit conducted by the National Commission of Audit to the Government on the state of the pharmacy industry has suggested removing or softening the location and ownership laws to give consumers more choice.
Currently, the government's location rules prohibit another pharmacy opening 1.5 kilometres from an existing one.
It also prohibits non-pharmacists from owning a pharmacy, meaning only pharmacists may own, run and operate the business.
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Comment:
I also have to say reading all the articles I still have no idea what is actually going to happen with the 2016 Budget (or the Government) at the end of the day.
Nonetheless I am sure there will be lots of fun to observe over the next few weeks.
Enjoy.
David.

Wednesday, April 22, 2015

A Useful Guide To The Use Of Mobile Images In Clinical Circumstances. Think Before You Snap or Share!

This useful document appeared last week:

James Churchill: Mobile images

James Churchill
Monday, 13 April, 2015
ANYONE working in an Australian hospital, health service or clinic will tell you that clinical images are routinely captured and used by doctors and medical students every day, often using personal mobile devices.
But how do you ensure that you are meeting your professional, ethical and legal responsibilities when taking and using these images?
The capture of images of clinical signs, injuries and lesions has been common practice for years for a wide variety of medical practitioners, ranging from GPs to geriatricians and everyone in between.
Clinical images can improve professional referrals, particularly in regional, rural and remote settings where specialist services may be limited, and have long been used for non-clinical purposes such as teaching, training and research.
However, there is concern that many doctors have an inadequate understanding of their significant legal, professional and ethical obligations regarding the use of clinical images.
Pitfalls for doctors are common at almost every step of the process, including obtaining adequate consent and documentation, quality and de-identification, secure storage, transmission and ownership. Few systems exist for integration of clinical images into medical records.
Additional complexities arising from the capture of images on personal mobile devices can also prove difficult for doctors to navigate, including ensuring adequate quality for decision making, appropriately managing device features such as automatic cloud backups and the inadvertent recording of metadata such as image location.
Protection of patient confidentiality is central to doctors’ longstanding professional and ethical codes of practice. Legally, under the new Australian Privacy Principles that came into effect in March 2014, significant financial penalties apply for breaches in confidentiality of medical records, as well as to various state and territory legislation that applies to public hospital records.
The AMA Council of Doctors-in-Training has collaborated with the Medical Indemnity Industry Association of Australia to develop Clinical images and the use of personal mobile devices: a guide for medical students and doctors.
More here:
The list of possible pitfalls covered in paragraphs 6 and 7 are really enough to give anyone pause and it certainly seems to me the document mentioned in the last paragraph is critical reading!
Think before snapping seems the be the maxim!
David.

Tuesday, April 21, 2015

This Really Is A Travesty and Needs To Be Addressed Quickly For The Sake Of The Health Sector In General.

We had this appear last week.

Still no decision on Royle report

Fran Foo

The Abbott government has yet to decide on the future of its troubled $1 billion Personally Controlled Electronic Health Records system almost 500 days since a review into the PCEHR was conducted.
Doctors were fiercely against adopting the PCEHR for various reasons, including security and privacy concerns, and a poorly structured incentive scheme for clinicians.
On December 20, 2013, then health minister Peter Dutton confirmed receiving the report from the review team, led by UnitingCare Health Group executive director Richard Royle. The review had delved into significant concerns about the progress and implementation of the PCEHR.
The Royle report was said to have provided a “comprehensive plan for the future of electronic health records in Australia”.
Mr Dutton said the government would consider the review recommendations, including changing the system to an opt-out model, and would respond in “due course”.
The Department of Health then began consulting with stakeholders on the implementation of the review’s recommendations, aided by Deloitte. The purpose was to “influence the system design, implementation schedule, and the planning for communication, education, and risk management,” Deloitte told stakeholders last year.
However, the government has nothing to publicly show for its work to date and Health Minister Sussan Ley is making no apologies.
…..
More than two million consumers have an e-health record, including 171,117 first registered as newborns. Clarifying media reports over PCEHR figures, a spokeswoman for Health said as of late March more than 5000 general practices registered, with 10,811 individual clinicians have been linked to the PCEHR by their registered organisation.
She said on average 500 unique healthcare providers viewed documents on the system each month.
The full article is found here:
Leaving out the political blame game which we so often seem to see these days (read the full article for all that!) it is clear that given there are about 91,000 medical practitioners in Australia ( with 35% GP and 35% Specialists so 60,000 + active clinicians) the usage of  500 of 60,000 possible users per month is hard to describe as active (less than 1%).
Here is the source of the stats:
Just where is the proper audit and evaluation that provides some really useful facts about the value and clinical impact of the PCEHR. The best - which is totally anecdotal is found there - and for such an expensive project is hardly adequate.
Someone needs to quickly admit that having been operational for almost three years the time to cut the PCEHR loose has well and truly arrived! That might just be Ms Ley! The time has really come!
David.

Monday, April 20, 2015

Weekly Australian Health IT Links – 20th April, 2015.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

Quite an interesting week with Telstra Health steaming along with the PCEHR remaining in a total funk.
Visiting the NEHTA website news area is interesting at present will all sorts of PR announcements and no real substance coming out. I wonder what there will be in the Budget for NEHTA and the PCEHR. Your guess is as good as mine!
It is good news that the Doctorinspector web site seems to have shut down or been shut down. I wonder which?
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Telstra launches first eHealth product

  • David Swan
  • April 16, 2015 2:15PM
Telstra has launched MyCareManager, its first eHealth product after months of speculation and millions of dollars in acquisitions.
MyCareManager is an eHealth product developed to improve care to people recently discharged from hospital, bringing in in capabilities from the various companies Telstra has acquired over the past 18 months.
The telco said MyCareManager will allow clients, family members and carers to be more involved in the treatment and monitoring of their illness or injury through an online portal, telemonitoring through wireless health devices and video conferencing. 
The solution was developed by community care specialists and Telstra Health subsidiary HealthConnex and includes capabilities from Get Real Health, Entra Health Systems and Pexip.
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Telstra Health unveils telemonitoring service

Product will allow carers to deliver services to patients in remote areas
Telstra Health has launched a telemonitoring service called MyCareManager designed to help disability, community and residential aged care providers deliver services to patients from a distance.
Clients can be monitored through wireless and Bluetooth enabled devices including glucometers, thermometers, blood pressure monitors, pulse oximeters and spirometers. Carers can monitor a number of vital signs, get real time information and alerts on any changes or out of range readings and intervene early to reduce the need for hospital admission.
According to Telstra Health managing director Shane Solomon the service can keep people connected through their recovery.
“It means community and residential care providers can reduce travel time and costs, increase productivity and improve the continuity of care. Just as importantly it provides the tools for clients to feel more involved in the delivery of their care and engage with the help they need, when they need it,” he said in a statement.
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Integrated home care solution launched

By Natasha Egan on April 17, 2015 in Technology
Telstra health has launched an e-health solution for the aged and community care and disability sectors that includes a self-service portal and telehealth monitoring platform for clients.
MyCareManager features an online portal for workers, clients and families, telemonitoring through wireless health devices or manual input, web-based videoconferencing with any internet-enabled device, and an integration engine that allows information sharing with a service provider’s existing clinical, service and client management systems.
It has been designed for applications such as consumer directed care, chronic disease, medication and wound management and remote medical consultation and aims to increase efficiency, productivity and care collaboration capability for service providers and improve visibility and engagement for clients to help them self-manage their health.
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Still no decision on Royle report

Fran Foo

The Abbott government has yet to decide on the future of its troubled $1 billion Personally Controlled Electronic Health Records system almost 500 days since a review into the PCEHR was conducted.
Doctors were fiercely against adopting the PCEHR for various reasons, including security and privacy concerns, and a poorly structured incentive scheme for clinicians.
On December 20, 2013, then health minister Peter Dutton confirmed receiving the report from the review team, led by UnitingCare Health Group executive director Richard Royle. The review had delved into significant concerns about the progress and implementation of the PCEHR.
The Royle report was said to have provided a “comprehensive plan for the future of electronic health records in Australia”.
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Built on Interoperable Platform, Not Tethered, Empowering Patient With a Single Point of Access to Family Health Records Across Care Settings
SYDNEY, Aust., April 14, 2015 – InterSystems, the global leader in software for connected care, today announced HealthShare Personal Community, a patient engagement solution built on the interoperable InterSystems HealthShare® health informatics platform.  InterSystems unveiled Personal Community at the annual HIMSS (Healthcare Information and Management Systems Society) conference in Chicago.
Personal Community is a configurable, vendor-neutral patient engagement solution for healthcare providers that gives patients an easy-to-understand, comprehensive view of their health information. It supports services such as appointments, prescription refills, provider-patient dialogue and patient education. Because Personal Community is built on the HealthShare interoperable foundation, it provides patients as well as their authorised representatives a single point of access to electronic medical records in multiple formats and from many care settings – removing the hassle of managing multiple portals and passwords.
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Tumour diagnosis by smartphone

John Ross

US scientists have harnessed the technology used to create holograms in converting smartphones into cancer laboratories.
Boston researchers say their system — the latest attempt to transform mobiles into hi-tech diagnostic tools — can screen tumour samples in 45 minutes, producing results that rival state-of-the-art molecular profiling facilities for $US1.80 ($2.37) a test.
Reporting on their proof-of-concept study this morning in the Proceedings of the National Academy of Sciences, the team says the system could overcome “pathology bottlenecks” in remote areas and developing countries, accelerating recovery rates through rapid diagnosis.
“The platform we have developed provides essential features at an extraordinarily low cost,” said co-author Cesar Castro of Massachusetts General Hospital and Harvard Medical School.
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Figure 1: 'Instagram for doctors' offers medical 'porn' for the public

Date April 14, 2015 - 8:23PM

Kate Aubusson

A new wave of apps dubbed 'Instagram for doctors' is making it easier for medical professionals to capture and share images of their patients' most fascinating and perplexing ailments with their colleagues.
But as apps such as Figure 1 grow in popularity, unwitting patients risk becoming the freak show of the internet age.
The allure of grotesque medical pictures has piqued the curiosity of the general public. Anyone can freely browse the medical images uploaded by doctors around the world, suggesting the built-in security measures designed to protect patient identity might not go far enough.
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Damning audit for Victorian government ICT spending

35 per cent of projects over budget, nearly half running late
Victoria's auditor-general, John Doyle, has released a damning report on government ICT spending in the state.
Not only are government agencies unable to demonstrate that are realising the expected benefits from IT projects, they are also in general unable to provide in-depth reports on how much IT projects actually cost.
The audit, released today, found that government ICT spending was significantly greater than previous estimates.
The state government spends around $3.02 billion a year on ICT — a 2010 industry report had estimated the government was spending only $1-$1.5 billion per year.
Around 35 per cent of the 1249 projects analysed for the audit went over budget, the report found. Close to a third of those are not completed.
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IT spending by Victorian government agencies slammed as spending balloons to $3 billion

Date April 15, 2015 - 5:06PM

Benjamin Preiss

Victoria's auditor-general has slammed agencies for a lack of accurate information and accountability amid ballooning IT costs.
The cost of information technology has skyrocketed to more than $3 billion a year in Victorian government agencies and entities, a new report has revealed.
Victoria's financial watchdog has lashed out at the lack of accurate information and accountability amid the ballooning costs paid by taxpayers.
On Wednesday, Victorian auditor-general John Doyle reported that between 2011/12 and 2013/14 information and communications technology expenditure had reached an average of $3.02 billion a year. That figure was between two and three times one published estimate in 2010.
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Monash doctors trial transcranial magnetic stimulation on depressed teenagers

Date April 19, 2015 - 12:15AM

Julia Medew

Health Editor

In a world first trial, Melbourne doctors have started beaming magnetic fields into the brains of depressed teenagers in the hope it will treat their illness and improve their cognitive function.
Head of Child Psychiatry at Monash Health, Michael Gordon, said his team was recruiting 40 adolescents with severe depression to see if 20 sessions of magnetic stimulation over four weeks would improve their mental health.
While the technique, known as transcranial magnetic stimulation, has been effective for about 35 per cent of adults whose depression does not respond to other treatments, it has only been tested on 19 adolescents across the globe. 
The treatment involves placing a figure eight-shaped coil on the patient's scalp  at the front of their head. Over about 25 minutes, it delivers magnetic pulses to the frontal lobe of the brain thought to control depression. 
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NEHTA Chair Dr Steve Hambleton on why an eHealth record is important for Australians with asthma

Created on Friday, 17 April 2015
In the Autumn 2015 edition of Asthma Australia's publication, Asthma Update, NEHTA Chair Dr Steve Hambleton explains why if you suffer from asthma an eHealth record is important.
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Exclusive: Controversial doctor-rating website taken offline

17th Apr 2015
A MYSTERIOUS doctor-rating website that used information from AHPRA’s register of practitioners without permission has disappeared from the web.
As first reported by Medical Observer, the DoctorInspector website billed itself as an “open crowdsource doctor rating website” and created profiles for many Australian health professionals, including GPs, pharmacists and even radiographers.
The profiles included AHPRA numbers and educational histories, as well as a star rating system and reviews.  
AHPRA received a number of complaints about the site, which did not accept responsibility for the accuracy of its information and gave those who were rated no means of correcting records, challenging inaccurate reviews, removing their profiles or contacting the site’s owner.
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IBM's Watson Health division will incorporate patient data from Apple

Health care data stored on Watson Health Cloud will be de-identified, said IBM
IBM's Watson supercomputer can be used in many verticals, but healthcare arguably gets the most attention. So much medical data, from patient history to physician notes to medical journals, remains unstructured, making it difficult for machines to interpret it. Watson's capabilities, recently dubbed cognitive computing, can parse data, combine it with treatment guidelines ...
The health information your Apple Watch collects could eventually end up in IBM's Watson cloud computing platform, where medical researchers and doctors can tap it in the course of their work.
On Monday, IBM launched the Watson Health business unit, which will focus on providing the health care community with the analysis tools required to make sense of the many forms of data used in clinical care.
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Apple's ResearchKit released to medical researchers

Apple's ResearchKit framework for collecting medical and health research data via iPhones is now generally available to researchers and developers.
Introduced in March with a small selection of apps from institutions including Icahn School of Medicine at Mount Sinai, Massachusetts General Hospital, Stanford, and UCLA, the open source ResearchKit is intended to help researchers collect data on a larger scale than has previously been possible.
More than 60,000 iPhone users enrolled in asthma, breast cancer, cardiovascular disease, diabetes and Parkinson's disease studies during the first few weeks that the initial apps were available.
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Get Real Health and Tribridge Announce New Partnership to Bring Patients a Personalized Care Management Solution

April 14, 2015 8:11am   Comments
InstantPHR® Will Be the Patient Engagement Component of Tribridge's New Product, Health360
Rockville, Maryland (PRWEB) April 14, 2015
In an effort to bring more complete, personalized care management solutions to healthcare providers, Get Real Health is partnering with Tribridge to provide a patient engagement platform for the technology services firm's new product, Health360. Get Real Health's flagship product, InstantPHR®, will be the patient engagement component of Health360, a CRM-powered suite of solutions to address care coordination, customer experience, customer engagement, and provider network management. Its comprehensive, scalable care management solution integrates with existing systems to collect, analyze and report on customer intelligence across all channels.
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Lawyers smell blood in electronic medical records

The inherent issues with EMRs - and for the healthcare professionals required to learn them - hasn't been lost on lawyers
As electronic medical records (EMRs) proliferate under federal regulations, kludgey workflow processes and patient data entry quality can be problematic.
The inherent issues with EMRs - and for the healthcare professionals required to learn them - hasn't been lost on lawyers, who see the potential for millions of dollars in judgments for plaintiffs suing for medical negligence.
Keith Klein, a medical doctor and professor of medicine at the David Geffen School of Medicine at UCLA, described four such cases where judgments reached more than $7.5 million because the data contained in an EMR couldn't be trusted in court.
Klein, who spoke at the Healthcare Information Management Systems Society (HIMSS) conference here today, said he has served as a legal expert in more than 350 medical lawsuits in state and federal courts. And while medical malpractice cases have so far focused on physicians and hospitals, Klein said technology vendors are next on the list.
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Dwarf planet Ceres gets weirder as Dawn sends back new data

Date April 15, 2015 - 9:21AM
It was first classified as a planet, then an asteroid and then a "dwarf planet" with some traits of a moon, but the more scientists learn about Ceres, the stranger it becomes.
And new observations of the sphere of rock and ice circling our sun between Mars and Jupiter have added to the mystery, researchers said on Monday.
Astrophysicists have been looking to a $US473 million ($623 million) mission to test theories that Ceres is a water-rich planetary "embryo" - a relic from the birth of the solar system about 4.5 billion years ago.
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Earth ate a Mercury-like body early in its history, study finds

Date April 16, 2015 - 10:44AM

Amina Khan

A Mercury-like body smashed into a young Earth and gave our planet's core the radioactive elements necessary to generate a magnetic field, two Oxford geochemists say.
Without that magnetic field, there would be no shield to protect us from the onslaught of radiation constantly bombarding Earth from space, making the existence of life as we know it impossible, scientists say.
The study, published in the journal Nature, offers insight into how Earth's magnetic field, and perhaps its moon, came to be.
Our planet is thought to have formed from small rocky bodies like the ones in the asteroid belt today, study co-author Bernard Wood, a geochemist at the University of Oxford, said in an interview. It's a theory that fits quite well with what's been studied on Earth, though it's not a perfect fit, he said.
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Enjoy!
David.

Sunday, April 19, 2015

Article Draft - Can Telstra Have A Significant Impact In E-Health When So Many Others Have Failed?

Everyone in Australia recognises Telstra as the previously Government owned telecommunications monopoly that was privatised a little over a decade ago, while being opened to competition. However it has still remained the dominant provider of fixed line, internet and mobile services while at the same time expanding its reach as a provider of cloud services and also increasing its role as a provider of support services to the National Broadband Network (NBN) for a very considerable sum. It is presently one of Australia’s largest companies with a market capitalisation of more than $75 Billion and annual turnover of more than $33 Billion
Much less well known is that in the last 2-3  years Telstra has been steadily developing a presence in the E-Health space. At the time of writing (mid-April 2015) Telstra had made over 15 investments in e-Health related companies - many of which have been purchased outright - and has formed a separate operating unit termed Telstra Health.
You can read all about Telstra Health from this link:
What is interesting recently is that Telstra Health has, as it has made these acquisitions and formed its various partnerships, has begun to much more clearly articulate a business strategy and some business objectives. As a listed company we can be sure Telstra’s motives are financial not charitable.
They identify what they describe as a six point strategy.

Our six-point strategy

We’re focusing on key health segments and building an eHealth ecosystem to address six of the biggest challenges facing the Australian healthcare system.
·         Consumer Control - Providing people with greater control of their health and wellness
·         Connectivity - Increasing access to healthcare regardless of location
·         Admissions - Reducing hospital and aged care admissions
·         Integration - Improving integration of health information
·         Pharmacy - Creating a safer, efficient and more convenient pharmacy system
·         Efficiency - Improving efficiency and productivity across the system
With these in mind there does emerge a pretty clear and logical rationale for the various acquisitions that have been made - although I would have to say some have a much clearer basis than others. The good thing is that many of the acquisitions have been successful in their own right in delivering relevant and useful clinical and  other support services and that many of the developers have been very much engaged in and understanding of the health sector at large. Sadly, in some ways, their size, and financial capability, has allowed them to ‘pick the eyes’ out of the best available in Australia which outcome might just stifle innovation in the future.
As an observer of the e-Health space for now over thirty years I have seen all sorts of entities attempt to develop an engagement with the health sector and make a sustained and profitable (from their perspective) venture within the sector. It would be fair to say, I believe, that, when considered over years, most organisations have run both hot and cold on the possibilities for them in the sector with very few, if any, being able to develop clearly sustainable and long term businesses, indeed before this present initiative Telstra has itself had different forms of engagement with the health sector over the last two or so decades. It is notable that the current push has considerable commitment at the level of the soon to retire CEO (David Thodey) who has mentioned e-Health frequently over the years as a significant growth engine for the company - with suggestions that the goal is to build a health / e-health business with annual revenues of $1 Billion over the next five years. Clearly it is only at this scale could the goal of making a significant commercial difference be achieved. With that said it is clear Telstra has not been afraid to invest for growth in the sector with the announced venture / acquisitions clearly amounting to many tens of millions.
The key issue that flows from all this is just how they will be able to generate the sort of returns on investment and margins that a commercial entity requires. They clearly recognise - from these three paragraphs - that there may be some considerable challenges.
“We’ve seen what the digital technology revolution has done to meet challenges in other industries. We believe Australia’s healthcare system can benefit significantly from a successfully implemented, connected eHealth system, reducing the reliance on multiple face-to-face interactions and removing an often siloed approach to care.
It’s a huge job, so we’re working with government, providers, patients and healthcare funds to deliver a connected future with improved productivity, safety, convenience, and quality control.
It’s not about selling products, rather working with you to understand your challenges and develop solutions that will create brilliant new opportunities for Australia’s health system. Our products are our capabilities and it’s how we connect them, and the various parts of the system, that will make us truly successful.”
Here is the link:
Many before them have noticed this potential opportunity and challenge but very few have succeeded!
If they are to succeed they will really need to develop deep expertise and relationships with the sector and be patient, while at the same time realising that success will only come from establishing truly stable and worthwhile revenue streams by offering services that are sufficiently differentiated and worthwhile that they will be valued. Initially I suspect they will be met with considerable scepticism and that their ‘big business’  character may be a barrier to successful engagement.
I noticed  that in the recent announcement of the successful tenderers for the replacement of the Medicare Locals that Telstra Health was involved in the successful bid for the Brisbane North Metro Network. (Note e-health is one focus of the new Primary Health Networks). Is this a pointer to at least part of how Telstra is seeking engagement (and revenue)?
Another pointer to the underlying strategic direction is the recent announcement of MyCareManager. This application is an e-health solution for the aged and community care and disability sectors that includes a self-service portal and telehealth monitoring platform for clients. Here Telstra deploys both its network capacities as well as specific health functionality in a total solution package for a target market.
Read all about it here:
There is an interesting recent article from the leader of the initiative found here:
To me the jury is still out as to just how successful this initiative might be in the future but with Telstra’s scale and reach anything is possible, think maybe the PCEHR (or a replacement) being run in the cloud on Telstra’s network, Telstra taking over provision of basic e-Health infrastructure services,  provision of GP and / or hospital computing as a service or even taking over NEHTA. Some such outcomes are possible and I am sure can’t be ruled out! I will certainly watching with interest.
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Comments welcome.
David.

AusHealthIT Poll Number 266 – Results – 19th April, 2015.

Here are the results of the poll. 
Should Pharmacists Be Selling Patient Prescription Information Data To 'Big Pharma" Marketing Companies?

Yes 2% (1)

Possibly 2% (1)

Neutral 8% (5)

Probably Not 18% (12)

No Way 71% (46)

I Have No Idea 0% (0)

Total votes: 65

The vast majority (89%) seem to think this is a big no-no!

Good to see such a good number of responses!

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

David.