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, July 23, 2015

2016 Budget -Hockey Returns And Rules Out All Tax Changes Except Land Tax!

July 23 Edition
Budget Night was May 12, 2015. We now await economic and  activity data reporting to see how successful it was.
Parliament has risen so we are in for a few quiet weeks.
There is a real sense that we are now seeing policy paralysis about balancing the Budget from all sides. It really is getting pretty sad.
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Here is some other of the recent other news and analysis.

General Budget Issues.

Another Coalition dead-end on tax reform

Date July 15, 2015
The GST's too hard, super and negative gearing are off the table - seems like property tax is the last hope. But don't hold your breath.
EDITORIAL
Hear hear to this: "Surely it is not beyond the capacity of us as a country to have a sensible, mature debate about long-term tax reform more generally."
Treasurer Joe Hockey has rarely uttered a more responsible statement, although he has hinted before that he's up for tax reform in the interests of productivity and budget sustainability.
Now Mr Hockey should just try convincing his Prime Minister.
Hear hear to this from Mr Hockey as well: "Australians are prepared to support tax reform that is good for the economy and fair for the country."
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Rivals join forces in the nation’s economic interest

Rivals joining forces can precipitate effective change, which is why The Australian and The Australian Financial Review have come together to lead a one-day economic summit in Sydney next month to attempt to reach a consensus approach to tackling the major challenges facing the national economy and the federal budget. The National Reform Summit will draw together about 80 delegates including business, trade union, community and policy leaders. Its goals will be to rise above the partisan politics that have stymied crucial fiscal reform and find common ground on economic and social policy reforms to improve the quality of life of present and future generations. The co-ordinators, former federal Labor trade minister Craig Emerson and the Menzies Research Centre director Nick Cater will bring knowledge, experience and different viewpoints to the event.
The usefulness of opening up economic discussion was demonstrated by the Hawke government’s National Economic Summit in 1983 and its Tax Summit in 1985. Those events, like the Accords with the trade union movement that tied wage improvements to productivity increases, helped modernise the economy and position the economy for decades of growth. The policy discussions at the time showed Australians why economic reform was needed if we were to maintain and improve prosperity in a more competitive world.
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Treasurer Joe Hockey says Australia's economy has not been affected by China's stockmarket crash or Greece's financial bailout

Date July 14, 2015

Gareth Hutchens

Treasurer Joe Hockey says Australia's economy has not been affected by the huge losses on China's sharemarket or the threat of Greece leaving the eurozone, despite billions of dollars being wiped from the value of Australian shares in recent weeks.
He said he welcomed the bailout agreement between Greek and European leaders that will keep Greece in the eurozone, but which economists warn will worsen Greece's economic depression – where unemployment is already at 26 per cent.
Speaking on Tuesday, Mr Hockey said the government's economic plan was still "on track" because the impact of Greece's sovereign default and bank shutdowns on Australia's economy had been "minimal," while China's stockmarket crash had not been severe enough to convince Treasury to change their forecasts for Chinese growth in the Commonwealth budget.
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Bozo Joe Hockey lies again on super, negative gearing

at 12:22 pm on July 16, 2015
After admitting in May that superannuation reform was inevitable in the interests of budget sustainability, Treasurer Joe Hockey has once again ruled-out ever changing superannuation tax settings. From Money Management:
Addressing a PWC Tax Reform Forum, Hockey said that not only was the Government going to stick to its promise not to “engage in adverse or unexpected changes to superannuation in our first term of government” but also stated “we have no plans to increase superannuation taxes into the future”.
“During a period of low global interest rates, which can have a significant impact on superannuation balances — plus the volatility in the world economy — why would a government want to increase taxes on super?”…
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Mount Druitt v Potts Point: Analysis reveals true impact of Abbott government's two budgets

Date July 17, 2015 - 1:37AM
EXCLUSIVE
Nine out of 10 suburbs worst affected by the combined impact of the Abbott government's two budgets are in Labor-held seats.
New analysis has for the first time shown the impact of Treasurer Joe Hockey's fiscal policies in every suburb of Australia, revealing a compelling story of winners and losers based on geography and political leanings.
The country's worst-affected suburb is western Sydney's Mount Druitt, which recently shot to national attention after it became the focus of a controversial SBS documentary about the effects of entrenched poverty.
Households in Mount Druitt will lose an average $1066.10 in the 2018-19 financial year, according to the analysis.
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Tony Abbott's rash high-wire attack on fairness is missing a safety net

Date July 18, 2015 - 2:28AM

Peter Hartcher

Sydney Morning Herald political and international editor

The Prime Minister's attack on the Australian sense of fairness is a rash high-wire act and it isn't a crowd pleaser.
Inequality is natural. Managing it is political. Recent increases in inequality have made the subject one of the biggest political issues in the world.
Tony Abbott missed this turn of events. It was probably the single greatest policy mistake of his prime ministership.
He came to power with the view that "in the end we have to be a productive and competitive society and greater inequality might be inevitable".
We do indeed have to be a productive and competitive society. But greater inequality is neither inevitable nor desirable. 
Abbott might have picked up the cue three months after taking power when Barack Obama described rising inequality as "the defining challenge of our time".
Or from Pope Francis, who, around the same time, criticised those who "continue to defend trickle-down theories" of wealth from the 1980s while "the excluded are still waiting".
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Health Budget Issues.

More doctors in tax office’s sights

Serkan Ozturk
The tax office has confirmed it will be investigating any doctor who has received a lump sum payment for selling their practice to an organisation, following a ruling on what should be considered income.
Last month, the Australian Tax Office (ATO) ruled that money Primary Health Care paid for buying up practices was tax-deductible, resulting in an anticipated windfall of $130 million for the corporate.
About 200 GPs who received an up-front payment from Primary of between $300,000 and $500,000 face potential demands for taxes of as much as $200,000 on these payments.
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Queensland budget 2015: Light at end of the waiting list

Sean Parnell

Patients waiting the longest for specialist appointments have been offered new hope in a Queensland budget that seeks to address ­problem areas before health funding gets tight.
Treasurer Curtis Pitt outlined a 4.1 per cent increase in health ­expenditure for 2015-16, with a commensurate increase in procedures and several targeted injections of funds.
Regional hospitals will benefit from $180 million in refurbishments and more nurses will be employed, while a $361m “outpatient long-wait reduction strategy” will slash the so-called “waiting list for the waiting list”.
While the Palaszczuk government expects to maintain performance levels for elective surgery and emergency department waits next year, it has yet to determine how the success of its outpatient strategy will be judged.
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Cutting GST on tampons will cost $120 million over four years, Joe Hockey letter shows

Date July 15, 2015

James Massola

Exclusive
A leaked letter from Treasurer Joe Hockey to state and territory treasurers has confirmed that removing the goods and services tax on tampons and other sanitary items will cost $120 million over four years.
Mr Hockey has confirmed the change remains on the table, though he has cautioned there needs to be unanimous agreement from the states before the change goes ahead.
The leak of the letter comes as the Treasurer prepares to address a PricewaterhouseCoopers tax reform forum on Wednesday in which he will set out the six key principles that will guide the government's pursuit of tax reform.
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Medibank involved in 'schoolyard bully' tactics: private hospitals

Date July 16, 2015 - 8:37PM

Sarah Whyte

Health and Indigenous affairs correspondent

Private insurance giant Medibank says profit is not behind its push to dramatically reduce hospital costs, after being accused of being a "schoolyard bully" and becoming an industry "pariah" by private hospitals.
Under new insurance conditions, Medibank will no longer cover 165 "highly preventable adverse events" that occur to patients in hospitals, claiming it will eliminate mistakes that hospitals and doctors are making.
The list, obtained by Fairfax Media, shows that the insurer will not cover infections following a procedure or fractures while in hospital, while the number of "events" has increased from 20 to 165.
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Pharmacy Issues.

The right model: Moodie's Pharmacy

15 July, 2015 Meg Pigram
The development of professional services has given one pharmacy the scope to expand and integrate into the wider primary healthcare system.
 Paul Jones, owner of Moodie's Pharmacy in the central west NSW town of Bathurst, can provide an insider's guide to the establishment and ongoing management of professional services.  
"You need two pharmacists as you can't do professional services and check scripts but I also think pharmacies will need to amalgamate and get bigger -- sometimes it can take you 30-40 minutes to do a service," Mr Jones said.  
"The big three for pharmacies looking to expand into professional services are to have a consultation room, two pharmacists and to ensure you have software like GuildCare to record it," he said.  
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Waiting for the government

17 July, 2015 Chris Brooker
A review of current HMR funding arrangements should be at the forefront of the planned review of 6CPA professional service programs, the Pharmacy Guild of Australia believes.
Guild executive director David Quilty told Pharmacy News the Guild was keen to see a timetable on the planned reviews, which are written into the 6CPA.
As reported by Pharmacy News leading clinical pharmacist Debbie Rigby is advocating increasing the current cap of 20 reviews per month per accredited pharmacist, to 20 per week.
Her comments follow the publication of a major Australian systematic review which found that each HMR led to an average 3.6 fewer medication-related problems. Overall, it found HMRs resulted in a 45% reduction in hospitalisations and a 9.1% reduction in overall medication costs.
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It is going to be very interesting to see what happens to the polls and consumer confidence over the next 2-3 months. With the pollies away in their electorates things should be stable for a while. Last week, probably because of issues and Greece, China etc. it just fell off a cliff!
Enjoy.
David.

Wednesday, July 22, 2015

I Can See Many More Issues Emerging in This Area Pretty Soon Now! Wearables Are Only To Become More Common.

This appeared a little while ago.

Wearable Technology - Privacy - 9 July 2015

Australia July 9 2015
There is a proliferation of wearable technology as mainstream consumer products. The ways in which these new technologies record, quantify and track our physical parameters are unprecedented. For example, when synched with sensors in wearables and smart phones, apps for Apple and Android devices offer medication reminders, fertility cycle tracking, blood glucose monitors and even ECG monitoring, which connect to phones with Bluetooth capabilities. This is a trend known as the 'quantified self'.
This means that wearables and smart phones now serve as mechanisms for storing vast amounts of personal information, and there are concerns that companies may be at risk of breaching privacy protection laws by using and commercialising that personal information.
1. Collection of personal or sensitive information
The extent to which privacy compliance will affect wearables and apps will depend on whether their operation involves the collection, use, handling or processing of Personal Information or Sensitive Information.
  • Personal Information is broadly defined under the Privacy Act 1988 (Cth) as information or an opinion about an identified individual or an individual who is reasonably identifiable from that information. There is no requirement that information be "private" or "confidential" to fall within the scope of Australian privacy laws.
  • There is also a risk that data collected by wearables or health apps could constitute Sensitive Information, which includes health, genetic or biometric information about an individual, or information about an individual's race, ethnicity, religious beliefs, sexual preference or practices, or criminal record.
As a general rule, medical and health technology companies should always query whether the collection of certain types of information is necessary. In basic terms, if data is not collected the functionality of the wearable device is not subject to the Privacy Act.
2. Different forms of using and commercialising "wearable data"
Given the commercial, clinical or other value of collecting and analysing data, we are seeing rapid developments in the commercialisation of data collected from wearables and mobile phone apps. Relevant examples include:
Medical practitioners
  • In December 2014, the University of New South Wales announced a new project which aims to make these devices secure and trusted enough to transfer the information collected into the mainstream healthcare system.
  • Secure, remote medical monitoring would assist practitioners to improve diagnosis and care for their patients at a significantly reduced cost. However, security is still a vital concern that must be dealt with before wearable data can be employed on a large scale by the healthcare system.
Insurance providers
  • AIA Australia offers life insurance premium discounts as a reward for customers who take part in the AIA Vitality Program and share their wearable data.
  • Members earn "vitality points" by providing the results of their AIA Vitality health review, as well as proof of exercise (in the form of pedometer results from their Fitbit devices).
  • Whilst health insurers are prohibited from offering cheaper insurance to "healthier" customers, the Vitality program is a community program to tackle a "chronic illness epidemic" which will ultimately lower health premiums.
  • Medibank Private has also developed a program that encourages customers to share their wearable data.
  • Customers who provide proof from their wearable device of walking 10,000 steps per day will receive the equivalent of $100 worth of Flybuy points.
  • Medibank issued a statement in late 2014 confirming that it did not use the wearable data to adjust pricing or deny services.
  • In general, more insurance companies are moving towards individualised risk assessment and risk profiling, and, conceivably, one day in the future, this "wearable data" could affect how insurance premiums are calculated.
More here:
This is a fascinating article that provides a lot of food for thought. Well worth a close read!
The potential impact in the health sector and the implications for e-Health are very significant I believe.
David.

Tuesday, July 21, 2015

At First Read This Sounds Like a Very, Very Serious Issue. I Wonder What Is Going On With Patient Electronic Records Being Altered?

This appeared a few days ago.

SA Health inquiry into how medical records linked to patient death disappeared from Lyell McEwin Hospital database

  • BRAD CROUCH MEDICAL REPORTER
  • The Advertiser
  • July 15, 2015 8:41AM
SA Health will investigate itself over claims that confidential medical records critical of management and linked to a patient’s death were deleted by a bureaucrat.
The Opposition has demanded an independent investigation of the incident at Lyell McEwin Hospital and warned that the “calculated deletion” of the medical record puts the entire system’s integrity in question and has ramifications for future legal proceedings.
SA Health chief executive David Swan, under direction from Health Minister Jack Snelling, has appointed SA Health chief medical officer Professor Paddy Phillips to review the incident, which is likely to take about six weeks.
“If we’re got a problem in our system we want to know about it so we can deal with it,” Mr Swan told 891 ABC radio today.
“It seems it was a deliberate act to remove that part of the record, but the reason why they came to that decision will be part of the review.”
Mr Swan said it was his inititial understanding that “a senior clinician and management” were involved in the decision to wipe the record but this would be examined by Professor Phillips.
That claim has infuriated Lyell McEwin staff, who told The Advertiser they were unable to access the system to delete records. They said a check of the metadata showed it was tampered with by a “super-user” who had access beyond the authorisation of doctors.
The scandal erupted after new software linked to the troubled EPAS system that records patients’ details electronically was installed at Lyell McEwin’s radiology department in May. Within three weeks, the delay in checking scans had blown out from same-day service to 1900 scans in the queue, including one of a man whose scan was examined only after he died.
Mr Swan today told 891 ABC Adelaide there was no suggestion the patient’s death was linked to the delay in checking the scans but this would be investigated by Professor Phillips.
He publicly invited a radiologist who raised the issue yesterday on ABC Radio to participate in the investigation by Professor Phillips.
The radiologist, Dr Paul Newbold, was advised of the death on June 30. That night, he was called back to work by an Emergency Department doctor to perform a CAT scan on an elderly man with a minor head wound.
Dr Newbold decided the expensive scan was not warranted. He later decided to do the scan but discovered a bureaucrat — not a clinician — had ordered the scan be done.
In his medical records of the incident, Dr Newbold was critical of the executive “who stuck her nose in” and he also recorded the possible link between the separate death and the software problem.
Three days later he found out that his medical record of the CAT scan patient — which included his complaint about the bureaucrat and also the software problem linked to the separate patient death — had been deleted.
Dr Newbold yesterday vented his anger on ABC radio. “This is very dangerous and very sinister. It is unheard of,” he said
Lots more here:
There are so many issues raised here that it is hard to know where to being and it is probably unwise to say too much until we have the results of the enquiry.
Clearly the biggest issue to me is that of trust. If clinicians cannot be sure when they record information in an EHR it will both be safe and unaltered then the game is totally over. The medico-legal implications in all this are just terrifying!
We can now all sit back and see what comes from the investigation. I hope it is a quality, thorough and careful review! I wonder whether an independent expert panel might not be a better idea?
David.

Monday, July 20, 2015

Weekly Australian Health IT Links – 20th July, 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 good week with seemingly an increasing recognition that unless the Government gives some serious attention to the various submissions on the PCEHR and how it might be fixed or abandoned.
It is going to be very interesting to see just what comes out in due course from DoH. With the trials on opt-out to be happening very soon there is some urgency to sort out just what exactly be trialled. The current PCEHR manifestation is hardly a working model worth trialling.
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SA Health inquiry into how medical records linked to patient death disappeared from Lyell McEwin Hospital database

  • BRAD CROUCH MEDICAL REPORTER
  • The Advertiser
  • July 15, 2015 8:41AM
SA Health will investigate itself over claims that confidential medical records critical of management and linked to a patient’s death were deleted by a bureaucrat.
The Opposition has demanded an independent investigation of the incident at Lyell McEwin Hospital and warned that the “calculated deletion” of the medical record puts the entire system’s integrity in question and has ramifications for future legal proceedings.
SA Health chief executive David Swan, under direction from Health Minister Jack Snelling, has appointed SA Health chief medical officer Professor Paddy Phillips to review the incident, which is likely to take about six weeks.
“If we’re got a problem in our system we want to know about it so we can deal with it,” Mr Swan told 891 ABC radio today.
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Telehealth app developer ResApp breathes easy on relisting

The company behind an inventive telehealth app ResApp, which allows doctors to diagnose a host of respiratory diseases through a smartphone, is relisting on the ASX today.
The technology, undergoing testing at Joondalup Hospital in Western Australia, allows doctors to diagnose respiratory diseases such as pneumonia, bronchitis and asthma through a cough into a smartphone.
Users cough into the phone’s microphone from up to two ­metres away, and ResApp’s algorithms analyse the sound of the cough using machine-learning technology licensed from the University of Queensland. The app looks for signatures in that cough and matches those signatures to respiratory diseases.
Currently, doctors use the sound signature via a stethoscope, but by enabling diagnoses through smartphones ResApp enables doctors to consult online or over the phone, or patients could even diagnose themselves. A worker could for example use the app at home in the morning before deciding whether to go to work.
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Emergency+ app arrives on Windows Phone

More than 98 per cent of smartphone users can now use state emergency services app
The NSW government has launched a Windows Phone version of the Emergency+ app developed to help Australians call the right number for help in emergency and non-emergency situations.
The app was introduced in December 2013 for iOS and Android devices and has been downloaded more than 270,000 times.
With the launch of the Windows Phone version, over 98 per cent of smartphone users in Australia have access to the app, according to the government. NSW Police assistant commissioner Peter Barrie said that the app uses the GPS function of smartphones to pinpoint the caller’s exact location, which can then be passed on to emergency services.
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Exclusive: Govt keeps GP after-hours helpline

14th Jul 2015
THE federal government has backed away from a decision to axe its After Hours GP Helpline to cater for Australians who can’t see a GP outside regular hours. 
Medical Observer has confirmed the much-criticised phone service will be revamped to play a safety-net role in the overhaul of after-hours primary care.
Health Minister Sussan Ley told MO the government remains committed to providing doctors with incentives to see patients face to face after hours, not just over the phone.
“This is simply an added safety support net to make sure in the event a doctor is not available during unsociable hours face to face they will still have access to one over the phone,” she said.
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Converged infrastructure to underpin desktop virtualization at Mater Health

End in sight for health-care provider's migration from Windows XP to Windows 7
Ease of deployment and management makes it likely that an increasing proportion of Mater Health Services' virtual desktops will be delivered courtesy of converged infrastructure.
The IT team at the organisation late last year deployed its first appliance from CI vendor Nutanix, said Peter Nomikos, IT services director at the health-care provider.
"We got our first block just before Christmas and we installed it in two hours," Nomikos said.
"We were impressed by that, clearly. We put some synthetic load on, did a number of tests to prove its capabilities and its performance, and we were very, very impressed."
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The Danish health IT solution: small-scale brilliance

When his wife attended a conference in Copenhagen, Adelaide GP and RACGP board member Dr Daniel Byrne took the opportunity to find out why Denmark is one of the world leaders in the use of e-health.

One of Australia’s problems is the reliance on paper documents. For example, almost every healthcare organisation designs their own referral forms and we still fax and post a lot of documents. In Denmark a ‘one-letter solution’ was introduced years ago: one electronic form used by thousands of health organisations.
“No patient ever left the surgery with any paper,” said Dr Byrne. “It seemed very well organised with a great e-health network. No faxes were used as everything is connected via secure networks – prescriptions, referrals, pathology and radiology ordering, even email consults.”
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Practice Managers Brett McPherson and Narelle Supanz on why data cleansing is so important

Created on Thursday, 16 July 2015
In The Australian Association of Practice Management (AAPM) The Practice Manager magazine, Practice Managers Brett McPherson and Narelle Supanz explain why data cleansing is important and having clean patient data is good practice that will stand practices in good stead when they start uploading to the eHealth record.
First published in The Practice Manager magazine, Issue 2, 2015.

New eHealth Services for Healthcare Providers and Software Vendors

Created on Tuesday, 14 July 2015
The National E-Health Transition Authority (NEHTA) has released a number of new eHealth services for healthcare providers and software vendors.
NEHTA CEO Peter Fleming said that the foundations for a nationally connected eHealth system had been built and the new services will make it easier for healthcare providers and software vendors to connect to and use eHealth.
"The foundations are there and are being used across the country in GP clinics, hospitals, pharmacies and other medical practices. Ultimately, we all want to see a critical mass of providers who are connected and meaningfully using eHealth to deliver better healthcare for patients.  These new services will help achieve this," Mr  Fleming said.
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TeleXHealth wins Hack Aging event

Elderly people can use automated phone service to share health information
A system that helps elderly people share information about their health via an automated telephone service was the overall winner of IBM and HealthXL's 'Hack Aging' event held in Melbourne over the weekend.
The information is then digitally recorded, analysed and tracked on a dashboard, and can be accessed via a mobile application by the patient, their doctor, family or carer.
Developers TeleXHealth will work with clinicians and community care providers in Melbourne's Northern Health hospital network to refine and complete a prototype of their solution for trialling with patient groups.
In addition, the team will be invited to present their offering to 100 digital health professionals at the next quarterly HealthXL global gathering to be held in Munich during September.
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News Round Up

16 July, 2015 Chris Brooker
E-health made easier
The National E-Health Transition Authority (NEHTA) has released a number of new e-Health services for healthcare providers and software vendors.
NEHTA CEO Peter Fleming said the new services will make it easier for healthcare providers and software vendors to connect to and use e-Health.
“Ultimately, we all want to see a critical mass of providers who are connected and meaningfully using e-Health to deliver better healthcare for patients. These new services will help achieve this,” Mr Fleming said.
Among the new initiatives are:
  • A new automated application tool for healthcare providers to use when registering for eHealth. The new eHealth online forms service provides customer support, tips and advice for healthcare providers.  
  • On demand eHealth training. This service will enable healthcare providers to familiarise themselves with the eHealth functions in their software.
  • Conformance, Compliance and Declaration for Software Vendors. This will improve the timeliness and affordability of connecting to the PCEHR for vendors by leveraging existing software development and processes within vendors and implementing organisations. 
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Check on your phone for signs of depression

  • Oliver Moody
  • The Times
  • July 16, 2015 12:35PM
Doctors could monitor people’s mobile phone use for signs of depression, according to a study that has shown it to be a more accurate indicator of the condition than a daily happiness questionnaire.
The data, which was collected by smartphones, shows a marked difference between the lives of people who are depressed versus those who do not suffer from the condition.
Scientists found that people who had been diagnosed with depression spent four times longer using their smartphones each day than people who were not depressed.
Sohrob Saeb, a computer scientist at Northwestern University near Chicago, devised a program called Purple Robot, which kept tabs on the mobile phone use — excluding phone calls — of 40 people in the study, 14 of whom had been diagnosed with depression.
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Tech Talk: Help for rural communities

15 July, 2015 Serkan Ozturk
CSIRO camera to help GPs screen for eye disease
GPs in rural and isolated areas could be screening for eye disease in the near future following a successful Federal Government–funded trial of a new low-cost retinal camera.
The Remote-I platform, developed by CSIRO, captures high-resolution images of the retina, which can then be uploaded to a cloud server over satellite broadband to be reviewed by an ophthalmologist.
The trial involved 1300 people and was carried out in remote rural areas of WA and Queensland. It identified 68 people as being at high risk of going blind, while eight were found to have severe diabetic retinopathy.
“This kind of low-cost technology could be beneficial to their practice in rural and remote areas,” said CSIRO trial leader Professor Yogi Kanagasingam.
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GP tool to assess suicide risk

16th Jul 2015
A NEW, free suicide risk assessment tool available to GPs is designed to better capture the spectrum of suicidality and predict future suicidal behaviour.
Dr Keith Harris (PhD), adjunct senior fellow at the University of Queensland’s school of psychology, began developing the Suicidal Affect-Behaviour-Cognition Scale (SABCS) after four of his colleagues ended their own lives within one year.
Most other tools don’t capture affect, or the feeling of wanting to die, instead focusing on behaviour and cognition, he says.
But affect plays an important part in assessing someone’s future suicidality, and the intent to suicide needs more attention, he says.
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Get elderly patients online

Charlotte Mitchell
Monday, 13 July, 2015
GPs should routinely ask their older patients to set up a personally controlled electronic health record to help them share medical information with their families, according to the chair of the National E-Health Transition Authority.
Dr Steve Hambleton, who is also a Queensland GP, said that in his experience only a couple of patients have ever declined the chance to register for a personally controlled electronic health record (PCEHR).
“From a GP point of view, we do want a patient to share information with their family, especially as they get older and develop more illnesses”, Dr Hambleton told MJA InSight.
He was commenting on US research that found elderly patients often shared control of their personal health information and decision making with family and friends, but the sharing involved complex issues, even under the most well-meaning circumstances. (1)

Should elderly patients be encouraged to have an e-health record that is shared with family and friends?

Choices
Yes – it’s essential 27% (15 votes)
Maybe – only with trusted people 42% (23 votes)
No – it’s a patient’s decision 31% (17 votes)
Total votes: 55
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Wearable Technology - Privacy - 9 July 2015

Australia July 9 2015
There is a proliferation of wearable technology as mainstream consumer products. The ways in which these new technologies record, quantify and track our physical parameters are unprecedented. For example, when synched with sensors in wearables and smart phones, apps for Apple and Android devices offer medication reminders, fertility cycle tracking, blood glucose monitors and even ECG monitoring, which connect to phones with Bluetooth capabilities. This is a trend known as the 'quantified self'.
This means that wearables and smart phones now serve as mechanisms for storing vast amounts of personal information, and there are concerns that companies may be at risk of breaching privacy protection laws by using and commercialising that personal information.
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E-health, which vaporises out in public

13th Jul 2015
IT’S NOT often I start a column with a direct Hansard quote, but South Australian Liberal senator Anne Ruston provided pure gold during last month’s budget estimates hearing on NEHTA’s e-health.
Senator Ruston: My questions are around e-cigarettes or e-vaporisers, or whatever they are supposedly called.
Chair: I was told it was e-health.
Ruston: Is that not the right place?
Chair: This is e-health.
Ruston: Brilliant. That was quick.
At that point, Ruston sat down, but I would gladly have tagged into the ring.
Chair: And you are…?
Me: Coleman, an e-health expert.
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Orion Health Named a Leader in IDC Health Information Exchange MarketScape Report

Company Recognized for Strength in Population Health, Comprehensive Platform and Robust Integration Technology
July 16, 2015 12:16 PM Eastern Daylight Time
BOSTON--(BUSINESS WIRE)--Orion Health™, a population health management and healthcare integration company, today announced that it has been named a leader in the IDC MarketScape report, titled “U.S. Health Information Exchange Platform Solutions 2015 Vendor Assessment.” Orion Health is one of only seven vendors evaluated in the report, all of which were selected based on their market share, market penetration, and growth potential.
“U.S. Health Information Exchange Platform Solutions 2015 Vendor Assessment.”
This IDC MarketScape report, which provides an evaluation of the leading health information exchange (HIE) technology vendors in the healthcare industry, specifically highlights Orion Health’s Healthier Populations Solution Suite, a comprehensive set of interoperability and data aggregation tools including the following products.
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Data from Pluto and its moon reveal strange new worlds to scientists

Date July 18, 2015 - 8:19AM

Eric Berger

An image recorded by NASA's New Horizons spacecraft shows a heart-shaped feature on the surface of Pluto that scientists have named the "Tombaugh Regio" after Pluto's discoverer Clyde Tombaugh.
After collecting an enormous treasure trove of photos and scientific information during its triumphant fly-by of Pluto this week, the New Horizons spacecraft began sending a trickle of data back to Earth on Wednesday.
It was more than enough.
Only a few hours of data out of a cache that will take 16 months to fully transmit home provided scientists with tantalising clues and mysteries about Pluto and its largest moon, Charon.
After looking at just 1 per cent of Pluto's surface, the scientists found mountains of ice towering 3350 metres above the dwarf planet. On Charon, they observed a canyon chiselled 10 kilometres deep into the moon's surface. Earth's own Grand Canyon is but 1.6 kilometres deep.
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Enjoy!
David.

Sunday, July 19, 2015

NEHTA’s Chairman Beats The Drum Of E-Health. Gets A Trifle Carried Away I Would Suggest!

This appeared a few days ago.

Get elderly patients online

Charlotte Mitchell
Monday, 13 July, 2015
GPs should routinely ask their older patients to set up a personally controlled electronic health record to help them share medical information with their families, according to the chair of the National E-Health Transition Authority.
Dr Steve Hambleton, who is also a Queensland GP, said that in his experience only a couple of patients have ever declined the chance to register for a personally controlled electronic health record (PCEHR).
“From a GP point of view, we do want a patient to share information with their family, especially as they get older and develop more illnesses”, Dr Hambleton told MJA InSight.
He was commenting on US research that found elderly patients often shared control of their personal health information and decision making with family and friends, but the sharing involved complex issues, even under the most well meaning circumstances. (1)
The research was based on group discussions with patients aged over 75 years and with individuals who assisted an older family member, finding broad support for sharing personal health information with caregivers if it would benefit the older patient. However, concerns were raised about autonomy and control, respect for preferences, micromanagement and snooping, and unintended information disclosure.
An accompanying commentary said the study highlighted the importance of developing user-centred software that met the information sharing needs and preferences of older patients and their families. (2)
Dr Hambleton told MJA InSight that Australia’s approach to information sharing was “the envy of nearly every other country in the world”.
He said the PCEHR allowed a patient to give a nominated family member, or an authorised representative, access to their medical information.
“The PCEHR is an extraordinary achievement. It’s an easy opt-in, opt-out resource that has standardised information, standardised nomenclature, standardised medical terminology”, he said.
Lots more here:
Before discussing elders and the PCEHR let is consider these three paragraphs - the bold especially.
“Dr Hambleton told MJA InSight that Australia’s approach to information sharing was “the envy of nearly every other country in the world”.
He said the PCEHR allowed a patient to give a nominated family member, or an authorised representative, access to their medical information.
“The PCEHR is an extraordinary achievement. It’s an easy opt-in, opt-out resource that has standardised information, standardised nomenclature, standardised medical terminology”, he said.”
I look forward to the list of countries that have expressed envy of the fiasco that is the PCEHR and as for the PCEHR being an “extraordinary achievement” I am just left wondering if the NEHTA Chair has been spending too much time listening to the NEHTA and DoH propagandists. What rubbish!
Here is a report covering the study mentioned by Dr Hambleton.
Posted July 10, 2015 - 4:33pm

Study shows elderly want to control what health information family sees


By LISA RAPAPORT
REUTERS
Elderly patients may be willing to let family members access their medical records and make decisions on their behalf, but they also want to retain granular control of their health information, a study suggests.
“Respecting and preserving the autonomy of the elder is critical,” said lead author Dr. Bradley Crotty. “Elders and families should have honest discussions about preferences for information sharing and decision-making, and share these conversations with healthcare providers.”
To understand how patients over 75 and the family members who care for them think about sharing medical information, Crotty and colleagues held separate focus groups in 2013 and 2014 with 30 elders and 23 caregivers.
The elderly participants came from different residential settings - including assisted living and skilled nursing facilities - run by Hebrew Senior Life, an academic health care organization affiliated with Harvard Medical School.
Caregivers were adult children, spouses, or other relatives of residents, and they didn’t have to related to the elderly subjects in the study.
The majority of study participants were white. Most residents and caregivers in the study were women and had college or graduate degrees.
Most of the elderly patients were older than 81. A third of them rarely, if ever, used the internet, while 60% went online daily or almost every day.
Many differences of opinion emerged as the two groups talked about sharing access to the elderly patients’ health records, the researchers reported online July 6 in JAMA Internal Medicine.
Caregivers felt that having information would decrease their stress, but patients wished to maintain control of the information to avoid burdening their children or loved ones with their illnesses and problems.
Many family members also thought having access to elderly patients’ records would make it easier for them to help coordinate care, appointments and communications with the rest of the family. But patients worried that this access would cause anxiety in their children.
The more independent elderly patients didn’t like the idea of losing control of their decision-making abilities and having to rely on their children. They were willing to share information, but reluctant to cede control of the information flow or give up the ability to make their own choices about treatment.
If they did have to give up control, elderly patients wanted this to happen gradually, starting perhaps by only sharing information in an emergency rather than as a routine on a day-to-day basis.
More here:
The issue with this from the perspective of the PCEHR is the complexity of granting access of others to your PCEHR (If you have one) and the fact that the access is rather binary - either your representative can see all of the record or basically no record.
The complexity can be read about from these links:
Here is an explanation of the PAC.

What is a PAC

Personal Access Code (PAC) is a code generated by you in the eHealth system and that you will give to your Nominated Representative and/or Full Access Nominated Representative to access your eHealth record.
(I can see many older citizens going through this!)
A moment of thought will see just how potentially complicated, open to abuse and privacy invasive the PCEHR approach to all this might be.
Sharing health information with family can be both very good and potentially very harmful - and requires a great deal of individual thought as well as extremely granular control in the hand of the individual to decide what the family can access or not! It is clear individual control is something many elders want. As for how different providers fit in to all this there is a set of even more complex discussions waiting!
Reading the now obsolete Concept of Operations of the PCEHR from late 2011, I am not at all sure what older citizens are likely to want and need is even possible - let alone in existence at present!
Capacities of this sort need to be designed in from the ground up I believe.
David.

AusHealthIT Poll Number 279 – Results – 19th July, 2015.

Here are the results of the poll.

Are You Expecting The Government Will Make Major Changes For The Better To The PCEHR Following All The Good Ideas From Submissions Made By ACHI, APF, CHF etc.

Yes 3% (4)

Maybe 9% (14)

Neutral 4% (6)

Probably Not 48% (73)

No 36% (54)

I Have No Idea 0% (0)

Total votes: 151

Seems a very large majority think little will change. Pretty sad that. I hope we are proved wrong.

Good to see such a great number of responses!

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

David.