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, June 04, 2015

2016 Budget - I Really Suspect Will Be A Powerful Slow Burn Of Horror, As The Senate Seems Set To Be Difficult Again.

June 4 Edition
Budget Night was May 12, 2015.
Since then the selling has been at full throttle and we have all gradually come to grips with what it means for all sorts of groups. The selling now seems over and we are into the hard graft of getting what is proposed through the parliament.
The most important news this week came from this release.

Introduction of the Medical Research Future Fund Bill 2015

The Australian Government is focused on ensuring Australia’s best and brightest medical researchers remain at the forefront of developing treatments and cures.
Page last updated: 27 May 2015

Joint Media Release

Hon J B Hockey
Treasurer

Senator the Hon Mathias Cormann
Minister for Finance

Hon Sussan Ley
Minster for Health

27 May 2015
The Abbott Government is focused on ensuring Australia’s best and brightest medical researchers remain at the forefront of developing treatments and cures that will improve the lives of Australians and millions of people around the world.
Today, we introduce legislation to create the $20 billion Medical Research Future Fund – the biggest endowment fund of its kind in the world.
The Medical Research Future Fund is a landmark Coalition Government initiative. This is a game-changer for Australia and for Australians.
Subject to the passage of the legislation, the Medical Research Future Fund will be established from 1 August 2015.
The Fund will receive an initial contribution of $1 billion from the uncommitted balance of the Health and Hospitals Fund. In addition, the estimated value of savings from the Health portfolio will be contributed until the Fund reaches a target capital level of $20 billion, projected, to be in 2019-20.
The first $10 million in additional medical research funding is to be distributed in 2015-16 and over $400 million is estimated for distribution over the next four years.
The Fund will be invested and managed by the Future Fund Board of Guardians, which has a proven track record in managing investment portfolios on behalf of the Government and maximising returns over the long term.
The Government will separately establish an expert advisory board to provide advice on the medical research strategy and priorities to inform how annual distributions from the Medical Research Future Fund are to be spent.
----- End Release.
So there you have it - the Research Future Fund is being funded from savings made in the rest of the system - i.e. patient care, doctors pay, efficiencies etc.
The other worrying development is the increasing discussion that a recession is on the cards in the next year or two. That would make a serious mess of any budget projections!
Here are the other articles I found helpful this week.

General Budget Issues.

Abbott hits the campaign trail, bearing gifts for all

Phillip Hudson

Whether he calls an early election or not, Tony Abbott is in campaign mode. Since the budget the Prime Minister has visited nine marginal seats in six states, including electorates where he would not have been very welcome just a few months ago.
Four of the visits have been to Queensland where he was asked to stay away during January’s state election because he was considered “ballot box poison”, but with the demise of Campbell Newman the federal Coalition is getting a more positive response.
It helps that this year’s post-budget roadshow is all about giving away money with $5.5 billion for small business tax breaks unashamedly aimed at a voting bloc now known as “Tony’s tradies”, $4.4bn for families and childcare and a $5bn infrastructure loan scheme for northern Australia.
-----

‘Hidden hit’ in Abbott Government’s ‘fair’ budget: poorer to be worse off

  • May 25, 2015 7:02AM
  • news.com.au
IT has been labelled the Budget’s “hidden hit”.
As the Abbott Government enjoys a bump in the polls for its self-styled “fairness” approach, new economic modelling suggests Australia’s poorest families and those with children will actually be hit hardest if Budget measures pass parliament unamended.
The Labor opposition commissioned the National Centre for Social and Economic Modelling (NATSEM) analysis which reveals the poorest families would lose about seven per cent of their disposable income.
-----

NATSEM analysis shows federal budget to hit the poor hardest, while rich benefit

Date May 25, 2015 - 7:24AM

Gareth Hutchens

Families on lower incomes will be hit hardest by the budget, new modelling shows.
Families with children on the lowest incomes will bear the brunt of the federal government's budget cuts, while high income families will actually see their disposable incomes increase slightly over the next four years. 
New analysis from the National Centre for Social and Economic Modelling has shown how the government's budget consolidation - for the second year in a row - is being made at the expense of the less well-off.
-----

Scott Morrison opens door to welfare deal with Senate

David Crowe

The federal government has opened the door to a compromise on a $3.6 billion cut to family tax benefits, amid an escalating ­political fight over budget savings, with Tony Abbott hitting back at new claims his reforms will punish households on average incomes.
A deal on petrol excise is also in prospect as the Greens make it clear they would consider a mod­ified version of the government’s tax increase, after formally deciding to block the $2.4bn measure in its current form.
The Australian has been told that changes to Family Tax Benefit Part B have been canvassed in meetings with crossbench senators to secure the legislation, scaling back a change that would halt payments to households when their youngest child turns six.
-----

Today’s budget winners may lose tomorrow

A crisis is building up in Australian government finances. It’s not an immediate crisis, as Joe Hockey claimed in his budget speech a year ago, lamenting the legacy Labor governments have left him. But if strong action isn’t taken, we’re on track for a doozy of a budget problem in a decade or so — and it’s already complicating long-term investment planning, especially preparation for retirement.
Currently, government debt is comfortably low. But it’s rising quickly. The combination of weak political leadership, a populist Senate and the public calling for more government spending but without higher taxes, leave us with the prospect of unsustainably high budget deficits over the medium term and longer.
Check the gaps between what politicians have promised and what they’ve delivered — and then consider the perceptive warning in the final quote:
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Joe Hockey's populist push on GST exposes the problem with politics

Date May 27, 2015 - 12:16PM

Mark Kenny

Chief political correspondent

ANALYSIS
In the perennial tussle between policy and pragmatism, the latter is usually preferred by politicians whose personal polling points to peril.
Abbott, who praised Hockey in the Liberal party room over the budget, must surely be frustrated. 
This pathetic principle explains the perverse policy improvisation by Treasurer Joe Hockey on Q&A on Monday night when he preferred narrowing rather than broadening the goods and services tax through the exemption of tampons and related intimate products. 
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I wasn’t panicking about the economy … until now

10:00pm, May 29, 2015
Jason Murphy
New figures from the ABS paint a grim picture of the Australian economy.
This graph makes my tummy turn into a knot.
It shows how much money business in Australia expects to invest. Businesses invest in new trucks, new computers and new buildings. Investment is what makes businesses grow, what makes the economy grow.
The white columns are spending plans, the grey columns are cold reality. Looking at those last two small white columns, we see business is terrified.
-----

Joe Hockey waiting on a tradie miracle

Date May 29, 2015 - 6:00PM

Michael Pascoe

The Business Week that was

The end of Capex shock week saw a new world of nightmares open up for Treasurer Joe Hockey. Michael Pascoe comments.
It's not even three weeks old, but after a happy birth, Joe Hockey's second budget has been sent to the sick bay by the latest private fixed capital expenditure data.
Various budget clinicians are shaking their heads, some even daring to offer a gratuitous R-word diagnosis, albeit couched more softly and somewhat oddly as "recessionary".
-----

Deficit decade: Tony Abbott's $100 billion black hole

Date May 29, 2015 - 6:21PM

Mark Kenny

Australia faces more than decade of uninterrupted deficits according to an updated assessment by the independent Parliamentary Budget Office that shows Senate intransigence will carve a $100 billion black hole out of revenue between now and 2025-26.
Savings not realised as a result of parliamentary gridlock suggest the budget prediction of a near fiscal balance by 2018-19 is overly optimistic because it is based on budget repair initiatives that have not been legislated and, in many cases, are unlikely to ever pass the Parliament.
The PBO's assessment lists out the proposals such as welfare cuts and major higher education reforms already factored into the current budget projections as savings but which are not yet approved, in a table entitled "unlegislated measures carried forward from the 2014-15 budget".
-----

Federal changes to hospital funding will 'cost 8000 doctors and nurses'

Date May 30, 2015 - 4:16PM
Queensland Health Minister Cameron Dick has slammed federal government changes to public hospital funding, saying they will take more than 8000 doctors and nurses out of the state's health system.
Mr Dick says changes to the way the federal government will fund hospitals from 2017/18 will remove the equivalent of 8337 jobs for doctors, nurses and health practitioners from the Queensland health system by 2024/25.
He told the Australian Medical Association's national conference in Brisbane on Saturday the change would shift the burden of Australia's ageing population on to states and territories.
-----

Tony Abbott still struggling to get Senate support for budget measures

Date May 31, 2015 - 12:15AM

Adam Gartrell

Almost three weeks into its budget sales job the Abbott government is still struggling to secure Senate support for some of its key proposals, leaving billions of dollars of savings in doubt.
The government's age pension changes, childcare package, cuts to paid parental leave and plan to impose a one-month wait for the dole all still face an uncertain fate in the upper house.
While crossbench negotiations are set to ramp up even further in the coming weeks, it looks increasingly likely the government will be forced to abandon or heavily amend some of its plans. The latest crossbench talks come after the Parliamentary Budget Office warned Senate intransigence could carve a $100 billion black hole in revenue in the next decade.
-----

Health Budget Issues.

Medibank scraps GP Access program

22 May, 2015 Flynn Murphy
Medibank will scrap its controversial GP Access program on 31 July.
The trial, which at its peak operated in 26 IPN GP clinics, guaranteed Medibank-insured patients GP appointments within 24 hours, no out-of-pocket expenses and free after-hours GP access.
It was attacked for setting a precedent that critics argued would erode clinical autonomy and undermine universal access to healthcare.
-----

Medibank dumps GP access trial

Date May 25, 2015 - 11:56AM

Dan Harrison

Health and Indigenous Affairs Correspondent

Medibank has abandoned a controversial trial which gave its members preferential access to GPs.
The nation's largest private health insurer has announced the GP Access pilot, which guaranteed Medibank members same day GP appointments and after hours home visits with no out of pocket costs, would cease on July 31.
The trial had been the subject of fierce controversy since its launch in October 2013, with consumer advocates arguing the move eroded universal healthcare because people with private cover would get a better standard of care than those without insurance.
-----

Medibank Private seeks answers for cost blowouts

Sean Parnell

Australia’s largest health insurer, Medibank Private, wants to know how surgery can cost more than 70 per cent more in one hospital than in others.
The health fund is calling for an industry-wide program to improve quality and efficiency after its analysis of 2014 admissions shows significant variations in hospital provider charges, prostheses charges and medical provider charges, even taking into account complications and averaging the top 5 per cent and bottom 5 per cent of bills.
The analysis found an appendectomy, for example, cost between $7500 and $12,500 in a metropolitan hospital (67 per cent difference), and between $7500 and $11,000 in a regional or remote hospital (47 per cent difference). A hip replacement cost between $29,000 and $49,500 in a metropolitan hospital (71 per cent), and between $29,000 and $44,000 (52 per cent) in a regional or remote hospital.
-----

Brian Owler: Budget of discontent

Brian Owler
Monday, 25 May, 2015
THE 2015 federal Budget is getting a much better reception than last year’s model, with opinion polls showing it has given the government a popularity boost.
But the health announcements in the Budget have received a much cooler response, due mainly to the lingering effects of the freeze on Medicare patient rebates, which will stay in place until 2018.
  
Winter is coming. For doctors and patients, it could be a very long one.
The big problem with this year’s health budget is that the small target approach has been completely overshadowed by last year’s devastating blows to the heart of the health system — the copayment, now gone, the massive cuts to public hospital funding and, of course, the rebate freeze.

After-hours PIP cash amounts revealed

25 May, 2015 Paul Smith
The Federal Government has revealed what it will pay practices for offering after-hours care under the revamped  Practice Incentives Program.
Under the reformed scheme, there will now be five tiers, rather than the three tiers used under the previous after-hours PIP that was scrapped in 2013.
The payments will be linked to the number of patients on the practice's books, which will be calculated using Standardised Whole Patient Equivalents (SWPEs).
-----

Government defends health funding changes

Health Minister Sussan Ley insists changes need to be made to Medicare and public hospital funding before the system reaches a crisis point.
Ms Ley denied on Friday the government was "pulling the rug" out from public hospitals but says efficiencies need to be found with unnecessary presentations costing $3 billion a year.
She told the Australian Medical Association's national conference in Brisbane the government wanted to work with doctors but needed to look at the health system maturely and clean it up.
-----

Pharmacy Issues.

PM told to act on deregulation

25 May, 2015 Chris Brooker
One week on from the in-principle signing of the Sixth Community Pharmacy Agreement and media reports are already calling for the government to implement a pharmacy reform agenda.
A report in the Australian Financial Review is questioning why the 6CPA contains a planned two year review of pharmacy location rules and remuneration structures.
Author Alan Mitchell contends that “both the problem and the answer are pretty obvious”. In other words, deregulation.
He says the Pharmacy Guild of Australia should have used Prime Minister Tony Abbott’s (pictured) current political weakness to “secure a more generous exit subsidy for the less economically efficient pharmacists.” 
-----

PBS changes: drug prices to drop, push for generics

Date May 27, 2015 - 1:05AM

Dan Harrison

Health and Indigenous Affairs Correspondent

EXCLUSIVE
Consumers will pay up to 50 per cent less for many common medicines under changes to the Pharmaceutical Benefits Scheme to be announced by Health Minister Sussan Ley on Wednesday.
The changes are also expected to save the budget about $3 billion over five years by encouraging consumers to choose cheaper, identical generic versions of off-patent drugs and less expensive similar drugs.
Ms Ley will introduce legislation to enact the changes on Wednesday after inking five-year deals with the Pharmacy Guild and the Generic Medicines Industry Association. Negotiations with the patented medicines industry, represented by Medicines Australia, were still underway on Tuesday night, but it is understood Ms Ley is determined to also implement changes to how patented drugs are priced, with or without the industry's agreement, given these are the most expensive drugs on the PBS.
-----

Sixth Community Pharmacy Agreement is solid outcome: Quilty

Once implemented, the 6CPA will provide a more certainty for community pharmacies to continue investing, employing and high quality health care for the next five years, says David Quilty.

The Guild national executive director wrote in this week’s edition of Forefront that the Guild believes the 6CPA represents a solid outcome for the profession.
“Like previous community pharmacy agreements, the 6CPA covers the issues of pharmacy remuneration for dispensing Pharmaceutical Benefits Scheme and Repatriation Pharmaceutical Benefits Scheme prescriptions, pharmacy wholesaler remuneration including the Community Service Obligation, Pharmacy Location Rules and professional programs and services,” Quilty writes.
-----

Agreement pros and cons

27 May, 2015 Chris Brooker
Pharmacists will be incentivised to offer patients cheaper generic medicines, the Health Minister has revealed.
However, the newly signed 6CPA will see pharmacists offered the controversial $1 ‘optional’ patient co-payment discount.
Health Minister Sussan Ley announced today the signing of landmark agreements with both the community pharmacy sector (the 6CPA) and the Generics Medicines Industry Association (GMIA).
-----

Guild wins $1bn for pharmacist patient care

Pharmacists have won more than a billion dollars from the Federal Government for a major expansion of their role in patient care.
Despite her warning of a fiscal meltdown if spending is not controlled, Health Minister Sussan Ley (pictured) will sign the 6th Community Pharmacy Agreement on Wednesday, which will see pharmacies get $1.26 billion for “professional services”.
Double the funding under the previous agreement, the new deal will see pharmacies receiving payments for providing dose-administration aids, advice to prevent medication adverse events and payments for home medication reviews.
-----
  • May 27 2015 at 3:28 PM
  • Updated May 27 2015 at 8:16 PM

Pharmacy Guild wins $2.8b at the cost of drug makers

Drug makers will bear the brunt of around $6.6 billion in savings to be channelled into new drugs and higher returns for pharmacists – who will not face any full-scale assault on their competitive position – under a pharmaceuticals deal finally struck by the Abbott government.
Health Minister Sussan Ley said the deal would deliver "cheaper medicines, a more competitive pharmacy sector and greater investment in new medicines and patient support services" as part of the package.
But consumer groups immediately warned it meant patients would pay billions of dollars more for prescriptions. The pharmaceutical industry greeted the deal with a sullen, if resigned, assertion that it had gained assurances about certainty in price changes for agreeing to the cuts.
-----

The price of hundreds cheap medicines will rise by 40 per cent under new pharmacy deal

  • May 28, 2015 12:30AM
  • Sue Dunlevy
THE price of antibiotics, blood pressure pills and hundreds of other medications will rise by over 40 per cent from July 1 as a result of an Abbott Government agreement with chemists.
The price rise for consumers and taxpayers results from a government decision to replaced the 15 per cent mark up component of a chemist’s fee with a flat $3.49 “administration and handling fee”.
This new fee will drive up the price of low cost drugs such as antibiotic amoxycillin from $8.29 per script to $11.75 per script. Hundreds of other low cost drugs that cost the government less than $23 a script will also be affected.
General consumers will pay the extra out of their own pocket but when a pensioner buys the medicine the taxpayer will pick up the extra tab.
-----

New drug deal will sweeten PBS fix

Stefanie Balogh

The government will bank $3.7 billion in savings from its reforms to the Pharmaceutical Benefits Scheme, arguing that the drive to encourage Australians to switch to generic drugs is part of the push to make medicines more affordable.
Health Minister Sussan Ley, who has now finalised the $18.9bn sixth community pharmacy agreement, said the package would deliver $6.6bn in savings over five years but $2.8bn would be reinvested in the pharmacy sector, including pharmacy-run primary care programs.
The agreement, which was revealed by The Australian, averts a war with powerful drug companies, which have agreed to a one-off 5 per cent discount on the price paid by the government after a medicine has been on the PBS for five years.
-----

AMA wants GPs paid to hire pharmacists

28th May 2015
THE AMA wants the government to pay general practices up to $187,500 a year to employ pharmacists as part of a new funding model that would save the health system $1.56 for every dollar invested.
A Pharmacist in General Practice Incentive Payment (PGPIP) plan unveiled by the AMA today would pay clinics $25,000 a year per 1000 Standardised Whole Patient Equivalent (SWPE) for hiring pharmacists for a minimum of 12 hours and 40 minutes per week.
Rural loadings up to 50 per cent would apply in the same way as for the Practice Nurse Incentive Programme (PNIP).
-----
It is going to be very interesting to see what happens to the polls and consumer confidence over the next 2-3 months - especially if we see the Senate knocking more savings back as is seeming likely! Already there was a small drop in confidence this week.
Enjoy.
David.

Wednesday, June 03, 2015

It Seems Clear The Department Of Health Has No Idea What It Is Going To Do With E-Health - But Is Just Rushing To Fix The System Without Really Knowing How.

Having had a look at the Legislation Discussion Paper Issued a few days ago I was left with a feeling of extreme vagueness as to what was to happen in the future.
You can read a discussion around this paper on the Blog dated 31 May 2015.
The discussion paper can be found here:

Over the last week of so the Department conducted some Post-Budget Briefings in Sydney, Melbourne and Canberra as was reported here:

Well I have had reports back from a range of attendees from these sessions - including one conducted for Vendors - and it is utterly clear they have no idea of any detail, or methodology to move forward with spending all that money.

The most worrying feedback is that attendees were told - that while the obvious thing to do was establish the new Governance mechanism via the New E-Health Commission and then plan what is to be done the claim made was that it was all so urgent that the Department will do all the planning and just let us all know what they have decided!!

Given the fiasco this has been to date that claim would seem to be just stupid!

It is also clear from other responses at the sessions they have no idea how to really improve the useability of the PCEHR and have no idea how clinicians can be convinced to really engaged and keen on the system.

Overall the impression was that the Department thinks that the PCEHR is ‘a good thing’ but is not sure why…

Not good at all. As confirmed at Senate Estimates yesterday!

I think we now can be sure we have a strategy and evidence free initiative consuming our taxes and deferring indefinitely any benefits that might be derivable from a proper and considered e-Health implementation!

David.

Tuesday, June 02, 2015

Live Blog - Senate Estimates June 2 2015 - Much Delayed Start On E-Health.

Began 12:15pm and Lunch @ 12:25pm
Paul Madden taking most questions - Peter Fleming gets involved after lunch.
Labor Senator trying To Protect Baby! (Senator Moore) - No questions from Senator Di Natale
Current State Of Play:
2, 242,823 Registered Individuals. (No mention of record usage etc,)
No Target for Registrations  since mid 2013 - new since last Estimates not known
Approximately 10,000 records per week have been created.
Promotion - little recently - now have funds to proceed for 3 years will be doing more
Outcomes of PCEHR Review announced in Budget with funding announced of $485M over 3 years
What has been happening before funding was given?
The Dept. nave been maintaining looking for errors etc. etc. since began.
Have a workforce that monitors all the functions security etc..
Review - recommended increased participation so we are to have trials of what to do.
Decision has been to trial opt-out at 2-5 sites.
Form of trials - 2-5 sites - have not chosen yet - will be consulting on locations as well as education of GPs and consumers and other providers etc.
Plan to trial with about 1 million being opted in.
Terms of trial not determined - do not have evaluation plan as yet - still to be developed.
Back @ 13:25pm
Looking at minimum 2 and maximum of  5 trial sites.
Planned Process.
By September 2015 sites selected  and education,  communications and training for providers and consumers to be planned and underway.
Actual trials to start early 2016.
Option will to opt out will be open for a few weeks following notification of populace
Then all those who have not opted out will have a record created will have six weeks to set their security on an empty record.
Two weeks later load data with aim for trial sites to be live July 2016.
Not clear how long the actual operational trail will last, and when evaluation will be done and what will be evaluated.
Site Selection for Pilots - Target areas of innovation and use of technology - and GPs using technology.
If people decide to opt out later after - record will be deleted.
Still do not have trial design. Due a few weeks and after more consultation.
Funding.
$140M was provided for 2014-2015 for ops
3 years funding of operation and re-development takes to 18/19 - $427M for this
Program with come back in 2017 to Government with trail results, recommendations and request more ongoing funding.
Operational funding grows as system use grows. (also as more enhancements are done etc.).
There is a marginal increase in funding and confidence for 3 years.
Hospital Access
399 Public Hospitals - Private Sector has been asked to link to HI and then PCEHR.
Sen McLucas - NT thinks their system is better than PCEHR - they are in transition from their older record that they like. Not sure they have enough connectivity in remote areas. (Consent needed for both NT and PCEHR so presently a bit messy) (NT docs use both records).
Eventually all will be switched to PCEHR.
Doctors are still not convinced re PCEHR and they see it as a chicken and egg - until lots are using the record not much value.
Incentives
There are plans for some incentives to get more complex patients with a shared record - this will cost - due to start next year - did not hear anything about funding this.
Plan is to have on-line and physical face to face training - to start late 2015 to get ready for incentives on 2016.
In passing was noted that 1100 pharmacies are registered for PCEHR (that is about 1 in 5).
Opt - In Trials (rest of country)
Still thinking how best to foster usage while trials run etc.
Will run trials in opt-in mode - ask PHNs to try and encourage registration - rather than clipboard and assisted as it was pretty costly.
Assisted Registration was costing $38 per person (so to do population would cost $760M so not going to happen).
Trial Cost
Trials are to cost about $50M. (Operations and enhancements $427M)
End @13:54
Comment - overall seem to be making it up as they go along and just thrilled to have all this money to spend! Note also just no comment or information on just how much usage the system is seeing in terms for records accessed etc.
E&OE!
David.

Monday, June 01, 2015

Weekly Australian Health IT Links –1st June, 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

A very quiet week on the surface but the Government has been busy as is covered on the blog elsewhere.
Again we see Telstra getting a fair bit of coverage in e-Health.
Rural health also get a lot of coverage and the place of the Internet and e-Health in the Bush.
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Telstra puts doctors on call with ReadyCare

Marie Hogg

Telstra’s latest addition to its e-health portfolio is set to marshal the resources and skills of full-time doctors to deliver ­convenience-driven healthcare through a ­mobile app and telephone service.
ReadyCare, poised for release on July 1, will provide 24/7 access to a GP consultation via a secure video service, and is built on a Swiss online model by joint-venture partner and healthcare provider Medgate.
Telstra’s head of Consumer and Tele-Health Services Wayne Liubinskas told The Australian that ReadyCare flipped the GP healthcare model on its head.
“The current consumer experience is that you have to go see a doctor at a time that really works for them as opposed to what works for you as a consumer,” Mr Liubinskas said. “ReadyCare is really about getting access to the care. We see it coming together in a concept of a consumer gateway which allows (the) consumer to access all different parts of the healthcare platform.
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Is it time to rethink the possibilities for rural health?

| May 28, 2015 9:40AM | EMAIL | PRINT
Jennifer Doggett reports from Darwin: 
‘Possibilities’ was the theme of the final day of #ruralhealthconf, and the ideas put forward by the keynote and concurrent session speakers challenged delegates to broaden their horizons and re-think narrow conceptions of rural health.
From the forces of globalisation, to the impact of domestic economic policies, to the need for reform of local funding arrangements, speakers outlined the forces that will shape our health system in the future and the possibilities these create for rural and remote health.
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What will it take to improve rural health? Internet, internet, internet…

| May 26, 2015 3:08PM | EMAIL | PRINT
Jennifer Doggett reports:
One of the most important outcomes from the National Rural Health Conference in Darwin will be a set of recommendations for action to improve health services in rural and remote areas and to overcome some of the barriers to good health.
These recommendations will be developed via a collaborative and structured process open to all delegates.  This process centres around the ‘Sharing Shed’, an online portal through which Conference delegates can propose recommendations to the full body of delegates, with every individual delegate being able to express a view on all ideas proposed by providing comments and by ranking or weighting separate recommendations.
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Chip implants beneath the skin bring a new meaning to 'pay wave'

Date May 30, 2015 - 12:00AM

Hannah Francis

Technology Reporter

Micro-chip implants for making payments and locking doors are the next frontier, but are the pitfalls worth it?
Most tech-heads like to tinker with the inner workings of iPhones or clapped out VCRs.
But Amal Graafstra is different. For the last 10 years, he's been busy hacking into his own body.
His US company Dangerous Things specialises in manufacturing rice grain-sized computer chips designed to be implanted inside the delicate webbing between the thumb and forefinger.
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Hospital tests lag time for robotic surgery 1,200 miles away from doctor

A Florida hospital has successfully tested lag time created by the Internet for a simulated robotic surgery in Ft. Worth, Texas, more than 1,200 miles away from the surgeon who was at the virtual controls.
Next, the hospital plans to test lag times for remote robotic or "telesurgery" in Denver and then Loma Linda, Calif.
The experiment wasn't performed on live patients, but rather on virtual patients using a machine called "Mimic Simulator." The training hospital was taking a first step in testing Internet lag time between when a surgeon moves a remote robotic instrument and when it reacts.
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NEHTA

Project Manager

  • Fixed term contract position to 31 December 2015
The National E-Health Transition Authority (NEHTA) was established by the Council of Australian Governments (COAG) to develop better ways of electronically collecting and securely exchanging health information. NEHTA is the lead organisation supporting the national vision for eHealth in Australia.
NEHTA is currently seeking people with a desire to make a difference to health outcomes, who are passionate about the use of eHealth to meet these goals and have the relevant experience to deliver solutions in a highly complex stakeholder and technical environment.
As a Project Manager within NEHTA you will be responsible for the Clinical Document and Template Service projects and all products aligned with the approved Delivery Work Programme.  The role will facilitate and coordinate the implementation initiatives to ensure they are consistent with the NEHTA strategic plan and have acceptance by the Australian Health Industry. 
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2015 Healthcare IT Check-Up Shows Progress (And Some Pain)

The Accenture Doctors Survey 2015 shows that use of many healthcare IT functions is on the rise, but some capabilities are still not part of the regimen.
For more information, please download the full report.
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Telstra Corporation Ltd ready to rumble on e-health

By Mike King - May 27, 2015 | More on: TLS
Telco giant Telstra Corporation Ltd (ASX: TLS) is hardly the first company that springs to mind when you are talking about e-health.
You might consider companies like Primary Health Care Limited (ASX: PRY) and its network of medical centres, or hospital operators like Ramsay Health Care Limited (ASX: RHC) and Healthscope Limited (ASX: HSO) to be more likely candidates.
But Telstra is approaching e-health seriously and plans to utilise its vast networks and telecommunications infrastructure to deliver e-health services to customers in future.
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DHS data centre consolidation almost completed

Canberra data centre will save $24.5 million in leasing costs says Department of Human Services
A new data centre has been opened in Fyshwick, Canberra, which will be shared by federal government agencies including the Department of Human Services (DHS).
The opening of the new data centre marks the near completion of the department's data centre consolidation program. It has consolidated seven data centres down to two facilities.
According to Minister for Human Services Marise Payne the consolidation will save taxpayers $24.5 million in leasing costs over the next decade.
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Harvard medical professor: Big data and analytics help cure cancer

Summary: One of the world's top healthcare CIOs explains how data and predictive analytics can benefit patients and improve health care delivery.
By Michael Krigsman for Beyond IT Failure | May 30, 2015 -- 19:10 GMT (05:10 AEST)
In almost every industry, aggregating data on a large scale and running predictive analytics have the power to improve our lives. With healthcare, this power is magnified because conclusions drawn from analytics can directly affect patient health and well-being.
Unfortunately, discussions of so-called big data applications often are filled will vendor hype and sales hyperbole. It's a shame because there are many practical lessons and examples to illustrate the value of predictive analytics.
One of these use cases came forth during a CXOTalk discussion with the one of the foremost healthcare CIOs in the world, Dr. John Halamka. He described a personal situation demonstrating how data and analytics can overcome certain limitations of traditional health care.
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The AMT v20150531 May 2015 release is now available for download

Created on Friday, 29 May 2015
The AMT v20150531 May 2015 release is now available for download from the NEHTA website.
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Orion Health widens FY loss

Software firm Orion Health has seen its full-year loss blow out to more than $NZ60 million, but has reported an uptick in revenue and remains confident of its position in the multi-billion dollar health IT market. 
In the full year to March 31, Orion posted a net loss of $NZ60.004m ($55.923m), a significant decline on the loss of $NZ1.137m a year earlier. 
Orion said the result largely reflected the company’s strategy to increase investment in new product development as well as building service delivery capacity to meet customer demand.
Revenue in the period was $NZ164.072m, a 7.2 per cent increase on the previous year.
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This is how much data breaches are costing

Date May 28, 2015 - 11:36AM

Bill Rigby

A new study says data breaches are costing companies millions.
The cost of data breaches is rising for companies around the world as sophisticated thieves target valuable financial and medical records, according to a new study.
The total average cost of a data breach is now $US3.8 million ($4.9m), up from $US3.5 million ($4.5m) a year ago, according to the study by data security research organisation Ponemon Institute, paid for by International Business Machines (IBM).
The direct costs include hiring experts to fix the breach, investigating the cause, setting up hotlines for customers and offering credit monitoring for victims. Business lost because customers are wary after a breach can be even greater, the study said.
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Google's new finger control technology is straight out of a science fiction movie

Alexei Oreskovic, Matt Weinberger May 30, 2015, 2:30 PM
The days of swiping a finger against a glass screen might soon seem as antiquated as dialling numbers on a rotary telephone.
If Google has its way you won’t need to touch a screen at all anymore. 
The company’s lab for advanced projects showed off new technology on Friday that lets users move their fingers in the air to control objects in the virtual world.
It’s called Project Soli, and it uses radar waves to detect precise finger movements or finger “micro-motions.”
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Enjoy!
David.

Sunday, May 31, 2015

The Department Is Conducting Some More Non-Consultation On The PCEHR And Its Successor. Looks Like A Power Grab To Me!

This arrived a couple of days ago.
Subject: Have Your Say on eHealth Legislation [SEC=UNCLASSIFIED]
Date:        Thu, 28 May 2015 05:20:52 +0000
From:       ehealth legislation

Have your say on eHealth legislation: Discussion Paper

An Electronic Health Records and Healthcare Identifiers: Legislation Discussion Paper has been released and your comments are invited.   This paper is available at www.ehealth.gov.au.
The discussion paper outlines proposed changes to the legislative framework of the personally controlled electronic health record (PCEHR) system and Healthcare Identifiers (HI) Service.  The paper covers issues of governance, opt-out trials, obligations of participants in the PCEHR system, and handling of healthcare organisations’ healthcare identifiers.  It also proposes a change of name to the more user-friendly ‘My Health Record’.
These proposed changes should not be considered final.  During the legislative development process further changes can arise as the result of consultation with the public, healthcare sector and government agencies, privacy impact assessments and legislative constraints.  The proposals are also subject to Government decision and Parliamentary agreement.
The purpose of the paper is to encourage discussion and feedback within the community and healthcare sector about the proposed legislative changes.
You can have your say on the Electronic Health Records and Healthcare Identifiers: Legislation Discussion Paper by emailing your submission to ehealth.legislation@health.gov.au or by uploading it at www.ehealth.gov.au.  Alternatively, you can send your submission to:
PCEHR/HI Discussion Paper Feedback
Department of Health
MDP 1003
GPO Box 9848
CANBERRA ACT 2601
The period for making submissions closes at 5:00 p.m. (Australian Eastern Standard Time) on Wednesday 24 June 2015.
Please be aware that we may collect your personal information when you make a submission.  For more information about how we handle this information go to the Department of Health’s Privacy Policy.
You can find out more about the discussion paper by reading the fact sheets for individuals and healthcare providers that are published with the discussion paper on www.ehealth.gov.au.
Yours sincerely
(Signed)
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Here is the summary of what it is all about:

Electronic Health Records and Healthcare Identifiers: Legislation Discussion Paper

Overview

The Australian Government is proposing changes to the personally controlled electronic health record (PCEHR) system, including renaming it the My Health Record system, and the Healthcare Identifiers Service, in response to reviews of each system undertaken in 2013.
The Electronic Health Records and Healthcare Identifiers: Legislation Discussion Paper outlines proposed changes to the legislative frameworks of the PCEHR system and Healthcare Identifiers Service that would support the Government’s proposals.   
This paper is intended to provide a plain English description of the proposed legislative changes, and a brief analysis of why the changes are needed.  It covers issues such as the establishment of the Australian Commission for eHealth, changing the name of the PCEHR system to the My Health Record system, opt-out trials, obligations of participants in the PCEHR system, and the handling of healthcare organisations’ healthcare identifiers.
The purpose of the paper is to encourage discussion and input from the public on the proposed changes.
You can find out more about the paper by reading the fact sheets for individuals and healthcare providers.

Why We Are Consulting

The purpose of this consultation is to seek feedback from the community to inform the development of legislative changes
These proposed changes should not be considered final.  During the process of legislative development further changes can arise as the result of consultation with the public and government agencies, privacy impact assessments and legislative constraints.  The proposals are also subject to Government decision and Parliamentary agreement. 

Here is the direct link and download page.

The document is about 32 pages (3 pages of abbreviations at bottom!) and it is really what is missing rather than what is explained here.
To me there were two very interesting parts of the document:

First it seems there seems to have been some consultation on the PCEHR Review (that I seemed to have missed) and which came up with some interesting findings
“Stakeholders expressed strong support for the continued operation of a national shared electronic health record system and for the findings of the PCEHR Review.  In particular, there was strong support for the move to an opt-out system accompanied by an effective public awareness and education campaign, and for retention of the current personally controlled nature of the record. 
Key learnings from the consultations are described below:
  • Individuals and clinicians want to see more representation of their voices and experiences in the ongoing design and implementation of the PCEHR system.  They don’t necessarily want a seat on the board of the governing body but do want to ensure that there are mechanisms by which different perspectives, impacts and expertise can be fed into the governance process through effective consultation.
  • There is considerable uncertainty in the clinical and vendor community about the future of the PCEHR system.  More concrete actions are required to get stakeholders involved in progressing the adoption of the PCEHR system as an ongoing element of the Australian health system.
  • Consultations highlighted that knowledge and understanding of the PCEHR system is patchy at best across all stakeholder groups and is particularly poor amongst the general public.  While awareness is better amongst healthcare providers, the perception of the PCEHR system is quite poor, and its benefits are not generally understood nor accepted at the current time.  Awareness raising will be particularly important ahead of any proposed introduction of an opt-out model.
  • In general, individuals understand when the purpose and intent of the PCEHR system is carefully explained.  This suggests that an information campaign that is benefits-focused and clear about what they need to do will be necessary.
  • Like the general public, clinicians need to see the benefits of the PCEHR system and they need to understand that there is a pathway to improving the functionality and utility of the existing system.  They also need supporting materials in order to assist them in discussing the impact of the opt-out model with individuals because the consultation suggests that many individuals will turn to their general practitioner for advice.
  • While the majority of stakeholders strongly supported the move to an opt-out model, concern was raised about precisely how an opt-out model might be designed and implemented.  Careful design of the opt-out model will be required to manage stakeholder concerns and to ensure stakeholders clearly understand how and why the opt-out model will be introduced.
  • While many individuals did not consider that they would necessarily use the access controls and notifications provided in the PCEHR system, they all acknowledged the need for these controls to be retained.  Individuals stressed the need for simple mechanisms.
  • Meaningful use of the PCEHR system for healthcare providers will be driven by the utility and content of the PCEHR.  This will require a focus on improving the usability of the PCEHR system, addressing accessibility issues for those segments of the healthcare provider community such as allied health practitioners who aren’t well served with PCEHR compliant software solutions, and a concerted effort to drive provider participation.
  • Most stakeholders were comfortable with the types of content that the PCEHR system can currently hold, however there was concern that very little of this content is being uploaded.  It is therefore important to drive population of PCEHRs.
  • The introduction of the PCEHR system into clinical practice requires a complex registration process, implementation of new software capabilities and changes to clinical practice.  To enable individuals and healthcare providers to start using the PCEHR system they will need access to local support capabilities that will provide the on-the-ground help they need.
  • The current roll-out of the PCEHR system seems to have bypassed the private hospital sector.  Getting this sector more involved, understanding its drivers and involving its representation in clinical advisory committees will be necessary to ensure completeness of coverage and benefit for individuals.
  • Vendors consider that greater use can be made of international standards rather than having to adopt standards specifically designed in Australia.  They also want more stability around standards, and want to know in advance when they will be introduced or changed and what they will contain so they can plan their business accordingly”.
So, in summary the Department has been told the system does not actually work very well and no one really understands or wants it! What is missing from this document is any suggestion of just how all this will be fixed!
Second is that the document proposes as little change as possible in the transition from NEHTA and they really want to control everything:

3.2.1     Establishment of ACeH

ACeH will be established as a new corporate Commonwealth entity through rules made under the Public Governance, Performance and Accountability Act 2013 (PGPA Act) and the PGPA Rules.

Timing of ACeH establishment

ACeH is proposed to commence operations from July 2016.

Disbanding current arrangements

The PCEHR Act currently provides that the System Operator must have regard to advice and recommendations provided by the Jurisdictional Advisory Committee (JAC) and the Independent Advisory Council (IAC), and that the Minister must consult IAC and JAC before making any PCEHR Rules.
JAC and IAC will be abolished as part of the new governance arrangements and this will require amendments to the PCEHR Act and PCEHR Regulations to remove all provisions associated with their establishment, operation and the need for the Minister to consult with JAC and IAC before making PCEHR Rules.
Under the new governance arrangements, the roles of JAC and IAC will respectively be performed by the new ACeH Jurisdictional Advisory Committee as recommended by the PCEHR Review, and an independent assurer reporting directly to the Minister. 

Transition to new arrangements

As recommended by the PCEHR Review, an implementation taskforce will be established (administratively) from July 2015 to oversee and advise on the design, establishment and transition to the new national eHealth governance arrangements, including transitioning functions from NEHTA.

ACeH functions

ACeH will assume responsibility for governance of all national eHealth operations and functions, including:
(a)    responsibility for PCEHR system operational activities as the PCEHR System Operator, currently undertaken by the Department of Health; and
(b)   broader eHealth system operations now managed by NEHTA.
The Department of Health will retain responsibility for national eHealth policy.

ACeH Board

To achieve broader eHealth end-user representation in the governance of eHealth, it is proposed the ACeH Board and its advisory committees will include individuals with expertise such as: 
(a)    healthcare provision;
(b)   consumer of health services;
(c)    IT systems and innovation including health informatics;
(d)   governance;
(e)   clinical safety; and
(f)     privacy and security. 
Representatives of jurisdictions and the Commonwealth will also be included on the Board.  The Commonwealth Minister will appoint an independent chair in consultation with all states and territories.

ACeH staff

It is anticipated that ACeH would employ some staff under Australian Pubic Service (APS) conditions and other staff under non-APS conditions.   The Rules establishing ACeH could make provisions for such employment arrangements.
The CEO, with the approval of the ACeH Board, would determine employees’ terms and conditions, as well as the engagement of consultants to assist in ACeH performing its functions.
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So the Department will now call all the policy shots and the new Board will just be operational and also loaded up with Jurisdictional bureaucrats! The mass move of staff from NEHTA to ACeH seems to be on!
While time will tell I suspect there is little good going to come out of this - and that more power will trickle to the Department who have shown over the last few years they are strategically useless and lacking insight into what is needed!
Pretty sad.
David.