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, August 20, 2015

2016 Budget -Parliament Back And It Just Seems To Go From Bad To Worse On Non-Economic Matters.

August 20 Edition
Budget Night was May 12, 2015. We now await economic and  activity data reporting to see how successful it was. Interestingly there are some early indications the small-business stimuli might be working. Certainly JB HiFi and Harvey Norman seem to have been doing well recently.
Parliament has come back on 10th August - so we can expect things to warm up at from now! Sadly the economy has not been a hot topic - Same Sex Marriage and The Union Royal Commission dominated all last week!
Well at least Spring is just around the corner - you can tell as the birds are waking up earlier each day and the daily top temps seem to be slowly rising!
This article gives the background:

Good government needn't be a punchline, Tony Abbott

Date August 14, 2015 - 9:29PM

Peter Hartcher

Sydney Morning Herald political and international editor

The leadership of the most successful conservative government in the Western world had a close-up look at the Abbott government a year and a half ago. 
The Prime Minister of New Zealand, John Key, and half a dozen of his ministers came to Sydney for a joint cabinet meeting with his Australian counterparts. It was a friendly exercise, full of shared interests and personal warmth.
The Australian prime minister’s office is a crucible of crisis, waging a full-time operation just to keep Abbott in his job for even a single term. 
Abbott greeted Key publicly "not just as a brother, but as soul mate. I do welcome him as someone, not just as a friend, but in very significant ways already a political mentor".

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Since this article was published we seem to be having an astonishing amount of leaking against the Government by its own Cabinet. To the uninformed eye, right now, there is a sense of policy chaos which makes the mess in e-Health seem relatively trivial!
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Here is some other of the recent other news and analysis.

General Budget Issues.

Tax rates must fall, says Treasurer Joe Hockey

David Crowe

Australia is suffering an “unsustainable risk” from high personal taxes that must be brought down to encourage growth and boost jobs, Joe Hockey will declare today in a move to set a reform agenda for the next election.
Putting tax relief on the table if the Coalition holds power, the Treasurer will warn that personal income taxes are so high they threaten to discourage workers and weaken the economy. Mr Hockey will also sharpen the debate on the GST by insisting state revenue be “aligned” to the spending needed on government ser­vices, an argument that underpins calls for a rise in the consumption tax from 10 per cent to 15 per cent.
“We cannot afford to have a tax burden that stifles growth and costs jobs,” Mr Hockey writes in The Australian today, singling out the $185 billion income tax take.
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Easy tax reform: axe capital gains discounts

Date August 11, 2015 - 12:00AM

Peter Martin

It appears that capital gains and negative gearing tax concessions are on the nose with everyone except the Prime Minister.
How on earth did we come to be lumbered with a tax rule so bad it is disliked by the Treasury, the Reserve Bank, the Business Council, the Council of Social Service, the Organisation for Economic Co-operation and Development, and both of Tony Abbott's most trusted business advisers?
And why on earth is Abbott still clinging to it?
The  story of how we came to be saddled with a system that taxes wages at twice the rate of profits made from trading real estate is an epic tale of revenge, incompetence, bloody-mindedness and gullibility. Along the way it has forced Treasurer Joe Hockey to set income tax rates higher than he should and fed an explosion in house prices by supercharging negative gearing.
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Why Joe Hockey may have delivered his last budget

11:00pm, Aug 13, 2015
Rob Burgess Economics commentator
ANALYSIS: This question is increasingly being asked – will the government dare hand down a third budget before going to the polls?
While other big stories have tended to squeeze out economic debate in recent weeks – the demise of speaker Bronwyn Bishop, the marriage equality debate and on Thursday more stories of terror and counter-terror relating to Islamic State – the data has been telling an alarming story.
The slump in wages growth is the big one. From fairly consistent growth of around four per cent, private sector wage growth has fallen to 2.2 per cent in the latest ABS data.
When public sector wage increases (2.5 per cent) are factored in, the overall pay increase is 2.3 per cent, which is just a whisker ahead of the latest annual trimmed-mean inflation reading of 2.2 per cent. The ‘trimmed mean’ smooths out sudden spikes or slumps in prices that are expected to be short term, with petrol prices being the best recent example.
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Joe Hockey sees jobs, growth on track after 2015 budget

David Uren

David Crowe

Joe Hockey has good reason to be pleased with the performance of the economy since his second budget was delivered three months ago. Retail sales are going well, consumers are happy and businesses say trading conditions are the best they’ve been since the brief bounceback after the global financial crisis.
The buoyant economic performance, particularly in NSW and Victoria, is being achieved despite tumbling prices for Australia’s exports and evidence that large swaths of the Chinese economy are in a recession that its government is battling to contain.
Although China’s problems are rippling through Asia, they have not yet disturbed the buoyant climate in Sydney and Melbourne. There are echoes of the Asian financial crisis of the late 1990s when Australia was expected to be sucked into the regional vortex of recession, but instead lifted its growth rate above 4 per cent.
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Australia’s growth path assured, says Joe Hockey

David Uren

David Crowe

Joe Hockey believes the economy has developed a “prosperity moment­um” that will deliver the government’s budget targets and maintain growth through to the next election and beyond.
In an exclusive interview with The Weekend Australian, the Treas­urer said he was confident the economy would not be blown off-course by events in China, saying his talks with Beijing’s leading economic officials had convinced him they would do “whatever it takes” to keep growth going.
Mr Hockey said the house price boom, government spending on infrastructure, small-business tax cuts and the fall in the Australian exchange rate were all helping to deliver economic growth.
“I’m still confident about our forecasts from the May budget and I remain more bullish about the region and the global economy than others,” he said.
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Competition is the key to a brave new Australia

Date August 15, 2015 - 7:56AM

Ross Gittins

The Sydney Morning Herald's Economics Editor

Under its newish secretary, John Fraser, Treasury has a new slogan. It is proud to be "fiscally conservative, market-oriented and reform-driven". So just what reform does Treasury advocate?
Well, in a speech last week Fraser spelt it out. But first he noted that the key element of market-oriented reform is that it almost always involves heightening competition. He illustrated the point by summarising what happened during the golden age of micro-economic reform in the 1980s and '90s.
Competitive pressures drive innovation and investment.  
John Fraser, Treasury Secretary
When business speaks of the need for Australian firms to be more competitive, it usually means  the government should do something that makes it easier for firms to compete with their foreign rivals.
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Health Budget Issues.

Changes to commonwealth health cost share ‘to hurt states’

Sean Parnell

The commonwealth contribution to the cost of running public hospitals hit a “historical low point” in the last year of the federal Labor government but the incoming Coalition jeopardised an agreed plan to help share the states’ financial burden.
While federation talks are considering a number of long-term structural reforms to the health system, an analysis prepared for the states warns that the Abbott government’s funding changes will impact on patients in the short term.
The states will use the analysis at a meeting of health ministers in Darwin today to urge federal Health Minister Sussan Ley to back a more immediate examination of funding issues and not rely on federation talks to solve the problem.
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Spending cuts imperil the health of all

Date August 10, 2015 - 9:00PM

Michael Thorn

Public health activists despair of the prospects of an adequate strategy to tackle chronic disease, described as "Australia's greatest health challenge" by the government's Reform of the Federation White Paper. And it is probably our own fault.
That's not to say the odds aren't stacked against us, the Abbott government having almost entirely dismantled Australia's national preventive health system.
It terminated the $370 million National Partnership Agreement on Preventive Health which funded various programs, including the successful public health campaign behind Ararat's transformation from being one of Australia's fattest towns. (The exposure of the Assistant Minister for Health's chief of staff's conflicts of interest saved front-of-pack food labelling from a similar fate.)
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Push for health reforms to fight chronic illness

Sean Parnell

Policy experts, health insurers, academics, professional colleges and consumer groups have called for urgent health funding ­reforms to better support people with chronic illness and ensure best use of limited budgets.
Amid ongoing federation talks and the Abbott government’s consideration of further Medicare reforms, the George Institute for Global Health Australia has used a roundtable meeting of more than 30 key stakeholders to reach consensus on the areas with most pressing need.
The stakeholders want funding reforms to aim for “high-­quality, effective and efficient healthcare” — not simply pumping more money into an often criticised system — with an ­immediate focus on those with chronic and complex conditions, along with people who are disadvantaged.
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Poor mental health dragging our economy down

Date August 11, 2015 - 9:00PM

Ross Gittins

Ross Gittins tries to dispel some of the common myths surrounding mental illness with help from the OECD report, Sick on the Job.
Don't take this as implying that I condone the misuse of taxpayers' money, but the almighty to-do over politicians' "entitlements" reminds me that small things annoy small minds.
If you think the odd unnecessary $5000 helicopter ride constitutes the worst of the wastage of our money – or that it makes much difference to the $430 billion the federal government spends each year – you haven't done enough thinking.
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Govt urged to radically expand PIP payments

Paul Smith12 August, 2015
A revamp of the Practice Incentives Program that would see practices handed lump sum payments to manage chronic disease patients is being touted by Australia's largest health groups.
In a paper released on Wednesday, the George Institute for Global Health says there is an urgent need for new funding models.
While the paper — Investing in Healthier Lives — floats the idea of pay for performance depending on patient outcomes, its main focus is the rollout of so-called capitation payments.
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Medical Research Fund Issues.

Greens to support Medical Research Future Fund in parliament

Jared Owens

Greens senators are likely to support the Abbott government’s Medical Research Future Fund in parliament today, following last-minute haggling between the government and party leader Richard Di Natale.
The Greens were concerned that National Health and Medical Research Council funds might be “gouged”, with funding to the sector increasingly shifted to the MRFF for no real benefit.
However, a senior Greens source said, Senator Di Natale had held “productive conversations” with the government and was “reasonably happy” with the outcome.
“There are still a couple of issues they’re dicing back and forwards but on balance we’re likely to support it,” the source said.
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Medical Research Future Fund Bill Passes

The successful passage of the Government’s legislation to establish the Medical Research Future Fund will significantly strengthen Australia’s standing as one of the global leaders in the field of medical research.
Page last updated: 12 August 2015
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Coalition's $20bn medical research future fund cleared by Senate

Twenty amendments made to legislation – including rules over how money would be spent – means House of Representatives must now reconsider it
Australian Associated Press
The Abbott government’s $20bn medical research future fund has cleared the Senate despite concerns about the potential for its funding decisions to be politicised.
The government says the fund will be the largest of its kind in the world, firming Australia’s position as a leader on medical research.
It made 20 amendments to its legislation, including stronger controls over how the money would be distributed, meaning it must go back to the House of Representatives for approval.
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Medical Research Future Fund finally gets Senate approval

Jared Owens

The Medical Research Future Fund — a signature initiative of the Coalition’s first budget that Treasurer Joe Hockey hoped would help find cures for cancer and dementia — has finally passed the Senate, despite the government’s dumping the GP co-payment that had been ­designed to bankroll it.
The MRFF now will be funded through reduced health spending and about $1 billion left over from the Health and Hospitals Fund designed by the Rudd government to upgrade health infrastructure, until its balance reaches $20bn in 2020.
It will be managed by the ­Future Fund and any interest it generates will be distributed to medical research, beginning with $10 million this year and a further $390m in the next three years.
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Concerns about how grants will be allocated from Medical Research Future Fund

Michael Edwards reported this story on Thursday, August 13, 2015 08:26:22
MICHAEL BRISSENDEN: Doctors are welcoming the establishment of Australia's medical research fund but concerns persist about how the grants will be allocated.
The Government says the multi-billion-dollar-program will strengthen Australia's standing as a global leader in research.
The fund is the largest of its type in the world.
Labor is concerned, though, that the grants process will be open to political interference.
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Medical fund changes a 'stuff up': Labor

AAP
The federal government has been accused of stuffing-up draft laws for its much-vaunted Medical Research Future Fund.
Parliament's lower house on Thursday rejected a government amendment passed in the Senate on how research funding would be dispersed, because constitutional rules mean the upper house can't make laws appropriating revenue.
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Concern over control of medical research fund

Alice Klein13 August, 2015
Legislation establishing the Medical Research Future Fund has passed the Senate, with most financial backing to come from hospital funds in the wake of the abandoned GP co-payment.
The fund will initially receive $1 billion from the uncommitted balance of the Health and Hospitals Fund, while future contributions will come from 2014/15 budget cuts to the health portfolio until the balance reaches $20 billion.
Following the Medical Research Future Fund Bill's successful passage through the Senate on Wednesday, Federal Health Minister Sussan Ley said the fund would support research that enabled game-changing medical innovations and improve the health of Australians.
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Pharmacy Issues.

Loophole closure deadline

11 August, 2015 Chris Brooker 
An investigation into PBS dispensing by non-approved pharmacies will only have remit to investigate breaches that have occurred since December 2014.
A Department of Health spokesperson has confirmed to Pharmacy News that the planned investigation would only cover cases since a legislative loophole was closed late last year.
The Department is also encouraging pharmacists to report colleagues that may be breaching regulations.
“From 1 December 2014, the Minister for Health introduced a new condition of approval in the National Health (Pharmaceutical Benefits) (Conditions of approval for approved pharmacists) Determination 2007 (Conditions of Approval),” the spokesperson said.
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Pharmacy consolidation on the agenda

11 August, 2015 Chris Brooker 
Pharmacies will increasingly be consolidated into large retail groups as the profession adapts to changing professional structures, former Pharmacy Guild of Australia (Qld) president Terry White believes.
Mr White (pictured), founder of the Terry White Chemists group, says it is clear the industry was experiencing the start of significant consolidation.
“The future of pharmacy lies in what we as an industry can do for the health of the
nation,” Mr White said. “A national solution requires a national approach and as we move towards that point it has become clear that more and more pharmacies will need the support of a national retail brand with the right retail infrastructure to move forward.”
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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 back will be interesting to see what makes the big news economically.  We are seeing reasonable consumer confidence now so I hope the pollies coming back does not kill it! There has to be a risk after last week.

There is some policy reform work that has been being discussed in the last few days but I fear it will all disappear without trace!
 
Enjoy.
David.

Wednesday, August 19, 2015

The CSIRO Is Working To Make Some Useful Contributions To Electronic Healthcare.

This appeared a few days ago.

Healthcare’s technology revolution means a boost for jobs in IT

August 7, 2015 2.16pm AEST
Eye testing in remote areas of Australia with the images stored and set via satellite to city-based specialists. CSIRO, CC BY-NC
Author David Hansen CEO, Australian e-Health Research Centre at CSIRO
We tend to think about our healthcare sector as a leader in the development and use of advanced medical technology and biotechnology, such as expensive imaging machines or devices that we implant into patients.
But in many aspects of conducting the business of healthcare, our healthcare system is still in a pre-digital era. For example, healthcare may be the last sector where significant amounts of communication are still done via fax and regular post.
This is not to say that significant changes are not happening. Radiology is increasingly using digital technology but the interpretation of these images is still manual. Electronic health and medical records are also being introduced widely but there is little communication between collectors.
The digital revolution in healthcare that is currently slowly unfolding will use data and technology to improve the healthcare of patients. It will also increase safety and quality, and improve efficiency in the health care system.

The eyes have it… remotely

One example of how technology can be used to deliver better healthcare is a recent trial by CSIRO and our partners that provided screening for eye diseases among people in remote parts of Western Australia and Queensland.
Using the nbn’s satellite broadband service, we screened more than 1,200 people in their communities for diseases such as diabetic retinopathy. This disease often causes irreversible blindness, and it affects the Indigenous population at nearly four times the rate of the non-Indigenous population.
Local health workers were trained at capturing high-resolution images of a patient’s retina with a low-cost retinal camera. These images were stored then uploaded over the NBN satellite to ophthalmologists in Brisbane and Perth.
The screening program identified 68 patients who were at high risk of going blind, including those with macular edema. In the most case these patients received treatment locally. However, some patients needed transfer to major hospitals for immediate treatment.
Once patients were identified as being at risk of significant eye disease, they were provided with care plans that involved local follow up consultations and regular screening the tele-eye care screening program.
For diabetic patients this included advice on controlling their diabetes, which improves their overall health as well as reducing the risk of blindness.

We have the technology

Overall, the trial showed the effectiveness of providing a “store and forward” tele-ophthalmology service using satellite broadband. These types of services have previously been held back by unreliable broadband services and the lack of digital systems in our health services to interact with them.
Reliable broadband connectivity together with increased use of digital systems by health services means that these methods of health service delivery can now become the normal way healthcare is provided.
But for these tele-enabled models of care to really take off, patient data must be shared between providers. At the moment, different healthcare providers – GPs, specialist doctors and emergency departments at local hospitals – all separately collect information about the same patients.
This means that the services that a patient receives are generally uncoordinated. With the increase in chronic diseases, such as diabetes and eye-disease, coordinated care will lead to better health outcomes.
For providers to share data requires their computer systems to be able to send and receive data, and make sure that the data is added to the correct patient’s electronic record.
This is where the type of algorithms that power search engines such as Google – semantic web and information retrieval technologies – can be tailored for healthcare systems. Shared properly, the data can be used to make sure that patients receive appropriate services.
Sharing this data will also mean that there is a bigger volume of data about a patient with each healthcare provider. This will require computers to do more to analyse the data and alert patients, clinicians and health care providers when there should be follow up action.
The full article is here and is freely distributable from the Conversation.
Good news for once - after all the other nonsense we have seen this week!
David.

Tuesday, August 18, 2015

Is This Madness Or Arrogant Hubris? I Have No Idea! Either Way Someone Has Really Lost the Plot!

This appeared last week:

MyEHR to National eHealth Record Transition Impact Evaluation

Created on Tuesday, 11 August 2015
At the COAG Health Council meeting in Darwin on 7 August 2015, Health Ministers received a presentation on an evaluation of NT’s My eHealth Record service undertaken by the National eHealth Transition Authority.
My eHealth Record has been operating in the Territory for ten years and as such, provides a unique opportunity to analyse the operation of an eHealth record in the Australian context. Like the national personally controlled electronic health record (or PCEHR) system, My eHealth Record captures summaries of information from healthcare events in an electronic record that is under the control of the healthcare consumer and is able to be accessed by providers that they later visit.
For the first time in Australia, we have strong evidence of the benefits of eHealth records in bridging the gaps in information that occur as patients move between different healthcare providers in the public and private sectors. The evaluation provides a clear case in support of the national PCEHR system.
The evaluation showed that eHealth records reduced the time clinicians took to find information, and supported improved clinical decision-making and continuity of care for patients. The evaluation also provides insights into how an eHealth record evolves and is taken up by the community and by healthcare providers. These are valuable learnings for the national PCEHR system.
Here is the link to the release
Now the evaluation shows the NT system is working well. So what is NEHTA’s plan?
They have a transition project to move away from the working and useful system - that has taken 10 years to really work to the unproven PCEHR.
Here is the slide from the presentation!

M2N Transition Impact Evaluation project

  • The MyEHR-to-National (‘M2N’) Transition Project is transitioning the existing MyEHR Service over to the National eHealth Record System (PCEHR)
  • At the request of the M2N Project Steering Committee, NEHTA is conducting an evaluation of the impact of the transition
  • A pre-and post-implementation evaluation approach is being used
  • Phase 1 has been completed prior to transition; it comprised qualitative analysis of n=94 in-depth interviews, and quantitative analysis of close to 15 million system transactions covering 10 years
  • This presentation is an overview of phase 1 results
(Slide 5)
The reasons for doing this are found in the first paragraph :

Implications for the M2N transition

Transitioning to the national eHealth record system offers a number of advantages, e.g.
·         Cross jurisdictional data exchange
·         Additional functionality, with atomised data
However, there were some issues raised that require consideration:
·         Anxiety about the transition, including re-registration
·         Concerns about effect on clinical workflow, e.g. arising from policy differences relating to identifying individuals and accessing records
·         PCEHR system not yet having equivalent breadth and depth of content
These issues are capable of being mitigated by current change management activities
(Slide 45)
So we have a working system that is being migrated to a vastly more expensive unproven non-working system. We also see the benefits seem trivial at best!
I wonder just what geniuses dreamt this up - especially before the PCEHR is proven to be successful.
Surely you leave the working system in place until the PCEHR catches up - if ever - and then plan a migration?
The present plan seems like utter madness to me!
David.

Monday, August 17, 2015

Weekly Australian Health IT Links – 17th August, 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 really active week with all sorts of things going on. Too much to summarise - Read On!
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Slow progress on e-health causing medication misadventures

Date August 16, 2015 - 12:15AM

Harriet Alexander

Health Reporter

The hospitalisation of thousands of people each year could be prevented if their health providers shared information electronically, but they can't because their software systems do not talk to each other.
About 230,000 people are admitted to Australian hospitals every year as a result of medication misadventures.
The federal government's top advisor on e-health said poor communication between nurses, GPs, emergency staff, pharmacists and other health professionals resulted in thousands of preventable hospitalisations and deaths because patients were doubling up on medication or taking the wrong drugs.
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DHS herding people on to an imperfect system in myGov

Date August 11, 2015 - 12:17AM
COMMENT
Over the past few weeks I have been employed casually with the Department of Human Services, answering calls for the Online Self-Services and myGov helpdesk. Casuals are being employed in call centres to provide assistance and promote these online services. After two weeks of training and one week taking calls I resigned because I felt I could not provide genuine service. In many cases I also felt I could not provide real solutions to callers' problems.
Another DHS worker wrote on this site in May that many vulnerable people were having difficulties getting through to services because phone lines are jammed with calls about simple issues. I agree that a good online service could solve some of these difficulties. But at the moment sites like myGov are far too cumbersome. Some people are also uncomfortable using computers or live in areas of slow internet speeds. There seems to be little consideration now for people not wanting to use online services.
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Health e-record opt-out trials to cost $51 million

Price tag for million-person experiment revealed.

The Department of Health has revealed it expects trials of opt-out electronic health records to cost $51 million over the next four years.
Health received a pool of $485.1 million in the 2015 budget to pay for a renewed push to create personal electronic health records, which has been rebranded My Health Record.
The government revised its approach to the rollout of health records in the aftermath of Richard Royle’s investigation into the lower-than-expected take-up of the former PCEHR.
The budget allocation will pay for the continued operation of My Health Record and the transition to new governance arrangements following the abolition of NeHTA.
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Doctor imposters can use AHPRA to kill off anybody

10 August 2015
POROUS online security processes mean anyone can impersonate a doctor and declare someone dead, an IT expert warns.
New computerised systems for births and deaths are replacing traditional paper forms that require sign-off from a doctor and a funeral director.
The problem, says Chris Rock, of Melbourne-based IT security firm Kustodian, is that the new systems often don't require log-ins.
They typically need simple information readily available on the online AHPRA register, such as name, registration number and practising address.
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  • Aug 12 2015 at 10:02 AM

Telstra's Shane Solomon spearheads Australia's e-health revolution

by Jemima Whyte
Shane Solomon quickly switches to the personal when explaining Telstra’s ambitious plans to revolutionise the country’s health system.
He’s usually busy, running a division that employs more than 850 people, in a business that he hopes will at least double its revenue every year. And so the married father of four, a former hospital executive and healthcare adviser, often goes for months without visiting his GP to renew his prescription for Lipitor, a cholesterol-lowering drug.
Life threatening? Hopefully not. But Solomon says it places him alongside others for whom 100 million repeat prescriptions are written each year, mainly for four main chronic-disease drugs.
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Primary Health Care examines software partnership with Apple, Telstra, Google

Date August 12, 2015 - 9:33PM

Carrie LaFrenz

Primary Health Care has talked to technology giants including Google, Apple and Telstra about potentially backing a spin-off of its Medical Director software business, as the company hunts for new revenue streams in e-health. 
Chief executive Peter Gregg, who reported a 19.1 per cent rise in full-year net profit to $136.5 million on Wednesday, hopes to boost Primary's position in the booming e-health market through its clinical management software that covers more than 60 million patient consultations each year.
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  • Aug 13 2015 at 5:03 PM
  • Updated Aug 13 2015 at 6:01 PM

Four things we learned from reporting season Thursday

Hints of Andy Penn's vision for Telstra 

New Telstra chief executive Andy Penn has started off on a pretty good note with investors, delivering a profit in line with expectations and a higher dividend. But perhaps the key with this result is the clues it gives us about the sort of Telstra that Penn wants to build, even as some are saying Telstra isn't really a phone company anymore.
First, he wants Telstra to dominate in Australia, particularly in mobile, where its numbers keep going despite the saturation of the market. Second, the company's e-health push appears to be very much Penn's baby, and an attempt to show how Telstra can use its expertise to grab a slice of a booming market.
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Virtual Dementia – see things through their eyes

A virtual reality tool that allows dementia carers to understand more about how people with dementia see the world has scored a global win in Microsoft’s Imagine Cup.
Microsoft’s Imagine Cup  is a global student technology program and competition that provides opportunities for students across all disciplines to team up and use their creativity, passion and knowledge of technology to create applications, games and integrates solutions that can change the way we live, work and play.
A team of four Swinburne Multimedia graduates, who now operate as Opaque Multimedia, won US$50,000 as part of the World Citizenship Award to continue developing their software.
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Hacking for Better Health

on August 7, 2015 at 8:00 am
The healthcare sector has much to gain from the new developments in eHealth and soaring popularity of lifestyle apps contained in mobile and wearable devices. The question is, what to do with this data to help patients? A community of IT enthusiasts have come together to help connect the dots via a national hackathon writes Dr Maia Sauren.
What is a hackathon?
“Hacking” is the (legal) process of creative problem solving. A hackathon is an event where people come together to collaboratively solve problems, often using software or other technologies. You might have heard it described as a hackday or a codefest.
What happens at a hackathon?
Participants typically form teams of 2-5 people, gather their laptops, and work on finding solutions to a problem. The event might run for a few hours or a whole weekend. Often participants compete for prizes, either as money, goods or simply prestige.
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MyEHR to National eHealth Record Transition Impact Evaluation

Created on Tuesday, 11 August 2015
At the COAG Health Council meeting in Darwin on 7 August 2015, Health Ministers received a presentation on an evaluation of NT’s My eHealth Record service undertaken by the National eHealth Transition Authority.
My eHealth Record has been operating in the Territory for ten years and as such, provides a unique opportunity to analyse the operation of an eHealth record in the Australian context. Like the national personally controlled electronic health record (or PCEHR) system, My eHealth Record captures summaries of information from healthcare events in an electronic record that is under the control of the healthcare consumer and is able to be accessed by providers that they later visit.
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HotDoc Bookings

Take control over the Patient Booking Experience

Continuity of care and patient loyalty is a hallmark of HotDoc’s service. While other online bookings providers use a directory model that pits local clinics against each other, HotDoc promotes your website as the front door to your practice.
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New app to tackle NT youth suicide

David Swan

Samsung has announced the first winner of its Adappt app development competition — In the Zone, an indigenous youth support app to tackle mental illness and youth suicide rates.
In the Zone, developed by 24 year old NT Young Achiever of the Year Pritika Desai, will offer mindfulness tools, the ability for young people to draw their mood to share with their peers, and information on nearby support resources.
Ms Desai said she came up with the concept to help normalise the discussion around mental health.
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'They're in denial': MyGov users vent anger

Date August 11, 2015 - 6:32AM

Noel Towell

The Commonwealth government is "in denial" over the performance of its online service portals, with MyGov coming in for savage criticisms from frustrated users of the system.
Centrelink and Medicare clients from around Australia reacted with anger and disbelief after the giant Department of Human Services denied last week that there were any problems with MyGov.
"I always seem to get a message that access is unavailable, try again later or words to that effect," one user told The Canberra Times.
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Mandatory data breach notification still on government's agenda

Government still intends to enact a mandatory data breach notification scheme before the end of the year but it is being close-mouthed on timing
The government has confirmed it is still planning to legislate a mandatory data breach notification scheme before the end of the year.
The legislation will compel organisations to notify people when their privacy is potentially compromised by a data breach.
The report of the Parliamentary Joint Committee on Intelligence and Security's (PJCIS) data retention inquiry recommended the introduction of a mandatory data breach notification scheme by the end of 2015.
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Web-based CBT potential

Charlotte Mitchell
Monday, 10 August, 2015
AUSTRALIA is at the forefront of using multimodal cognitive behavioural therapies to treat mental health disorders, but experts say there is not a “one size fits all” solution. 
Dr Jennifer Randles, member of the section of psychotherapy for the Royal Australian and New Zealand College of Psychiatrists, said while web- and app-delivered cognitive behaviour therapy (CBT) had great potential in managing a range of conditions, it was unrealistic to think the therapy would be able to help everyone. 
“It takes a certain type of patient for CBT to work”, she said, saying it was usually not suited to patients with more severe problems. 
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Healthcare’s technology revolution means a boost for jobs in IT

August 7, 2015 2.16pm AEST
Eye testing in remote areas of Australia with the images stored and set via satellite to city-based specialists. CSIRO, CC BY-NC
Author David Hansen CEO, Australian e-Health Research Centre at CSIRO
We tend to think about our healthcare sector as a leader in the development and use of advanced medical technology and biotechnology, such as expensive imaging machines or devices that we implant into patients.
But in many aspects of conducting the business of healthcare, our healthcare system is still in a pre-digital era. For example, healthcare may be the last sector where significant amounts of communication are still done via fax and regular post.
This is not to say that significant changes are not happening. Radiology is increasingly using digital technology but the interpretation of these images is still manual. Electronic health and medical records are also being introduced widely but there is little communication between collectors.
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Mobile Health may be the answer for Australia, but is Australia ready?

August 10, 2015
In spite of the tremendous development of hospital infrastructure, Australia currently only has about 4 beds per thousand and a medical workforce of approximately 70,000 working clinicians. A key issue in Australian healthcare is access to timely and quality care, a problem that can potentially be addressed by enhancing and improving communication between providers and patients using mobile health (mHealth).
Frost & Sullivan estimates almost 15,000,000 Australians are connected through a smartphone. The increased rate of smartphone penetration among healthcare professionals, coupled with the Australian government initiatives are factors driving mHealth growth in Australia.
Frost & Sullivan’s new research, Analysis of Mobile Health (mHealth) Market in Australia, finds that in the market was worth US$1.4 billion in 2014. It is estimated to rise to US$2.18 billion in 2019 at a compound annual growth rate (CAGR) of 9.3 percent during this period. The study covers clinical and non-clinical segments mHealth apps and services, but not devices.
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Surgeons print out 3D body implant for spinal operation

Richard Guilliatt

Australian surgeons have cured a patient’s chronic spinal problem with a 3-D printed titanium implant in what could be a major breakthrough in the treatment of back pain and other orthopedic complaints.
The patient, 38-year-old Amanda Gorvin of the NSW central coast, says she is “100 per cent” free of chronic back pain since the custom im­plant was inserted four months ago to straighten her spine.
“I’ve got my life back,” said Ms Gorvin, who had become depressed after 30 years of pain from a back problem she had been told was inoperable.
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International Centre for Radio Astronomy Research study finds the universe is dying - but don't panic just yet

Date August 11, 2015 - 8:25AM

Marcus Strom

Journalist

The evidence is in: the universe is cactus.
After a wild youth about six or seven billion years ago, the universe is slowly dying. But you needn't book your table at the restaurant at the end of the universe just yet – the old age of the cosmos is likely to be very long and drawn out. 
How do we know this? Professor Simon Driver at the University of Western Australia and his colleagues have, for the first time, produced the first fully empirical measurement of the energy output of the universe.
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GAMA study shows universe dying but billions of years before the lights go out

Mitchell Bingemann

First the bad news: our solar system, the Milky Way galaxy and ­indeed the entire cosmos is on an intractable journey to a very cold, very dark slumber as the billions upon billions of stars fade to nothingness.
The good news? There’s at least another 100 billion years before the last of the universe’s gas-burning stars twinkle for the last time.
That’s the conclusion of an international team of astronomers from the Galaxy and Mass ­Assembly Survey after their wide­ranging spectroscopic survey of 221,373 galaxies discovered the universe is emitting about half as much energy as it was two billion years ago.
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Comet, Philae skirt past the Sun with Rosetta in tow

Date August 14, 2015 - 6:57PM
A comet hosting the Philae robot and orbited by the Rosetta spacecraft has zipped by past the Sun with all systems go, the European Space Agency says.
The comet 67P/Churyumov-Gerasimenko, which scientists say may help unlock the mystery of the origins of life on Earth, came within 186 million kilometres of our solar system's star on Thursday, the agency said.
Pictures taken from Rosetta's navigation camera showed that 67P was "very active" as its surface was buffeted by solar wind and heat, said Sylvian Lodiot, the engineer in charge of the spacecraft at ESA's European Space Operations Centre in Germany.
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Enjoy!
David.

Sunday, August 16, 2015

It Really Is A Pity We Don’t Have Any Real Leadership In E-Health. Some In-Depth Understanding Might Help As Well.

This article appeared earlier today:

Slow progress on e-health causing medication misadventures

Date August 16, 2015 - 12:15AM

Harriet Alexander

Health Reporter

The hospitalisation of thousands of people each year could be prevented if their health providers shared information electronically, but they can't because their software systems do not talk to each other.
About 230,000 people are admitted to Australian hospitals every year as a result of medication misadventures.
The federal government's top advisor on e-health said poor communication between nurses, GPs, emergency staff, pharmacists and other health professionals resulted in thousands of preventable hospitalisations and deaths because patients were doubling up on medication or taking the wrong drugs.
Steve Hambleton has called on the IT companies contracted to work on the billion dollar national health database to make their messaging systems compatible, or the government's $500 million dollar e-health scheme cannot move forward.
Professor Hambleton, who chairs the National E-Health Transition Authority, said the six major e-health companies who have designed internal messaging programs have said it would take them three months to make their systems inter-operable.
"Each individual company has built their own set of users and they're all talking to each other internally but they're not talking to the other systems," Professor Hambleton said.
"They keep telling us they can do it and we go, 'OK, when?'
"We've got the IT, we just have to use it better and use it more and one of the elements is messaging. They're just not doing the work that we require to get the system rolling."
Lots more here:
There are a few issues with all this:
First the clinical messaging providers are hardly involved in the PCEHR and are certainly not being paid the huge sums of money spoken about in the article. Unless I am badly mistaken the key GP system providers are pretty much all able to share a clinical summary securely with the PCEHR - it’s just that to date most GPs don’t seem to want to be bothered to use the government system.
Second clinical messages can be already shared between providers.
Here is the NEHTA announcement from 2013:

Australian eHealth a step closer with successful trial of Secure Message Delivery

Created on Friday, 17 May 2013
The Australian healthcare industry is one step closer to fully adopting technology in health ('eHealth'), with healthcare providers successfully trialling electronic information transfer and sharing.
Five healthcare messaging vendors - Argus Connect, Global Health, Healthlink, LRS Health, and Medical Objects - collaborated with General Practices, the National E-Health Transition Authority (NEHTA) and associated government agencies to develop Secure Message Delivery (SMD) capabilities.
According to NEHTA's Head of Clinical Leadership and Stakeholder Management, Dr Mukesh Haikerwal AO, the success of the Project represents an opportunity for improved effectiveness and better health care.
"The progress that has been achieved by this Project will mean any medical practitioner – be they a public or private GP, specialist or surgeon – will be able to share information over time through online secure messaging.
"We can see that this technology is available, it does work and all healthcare providers will have the ability over time to connect across a wide range of clinical information systems.
It will increase electronic clinical information exchange between healthcare professionals, decrease the use of paper based communication and importantly provide more timely and accurate patient health information."
Here is the link

Maybe if the NEHTA Chair and DoH provided some funds and support to the small businesses involved here (the GP system providers and the secure message providers) and actually knew how to distinguish between problems and solutions around drug side effects, clinical messaging and the ‘billion dollar’ database  systems we might get somewhere.

To suggest all the problems - or even a majority of the problems - with medication errors relates to e-health communication deficiencies is just fanciful. Quality prescribing systems, clinical decision support and so on are way more important than communication between providers - not, of course, that it should be ignored. Medication errors are a multi-headed problem that needs a wide range of improvements to address.
 
It is also important to realise that the PCEHR is only one pretty poor part of the e-Health ecosystem and right now is more of a problem that a solution.

Additionally the technologies to do what is actually needed to facilitate communications between clinicians and hospitals already exist. What is needed is to provide the rationale and incentives for adoption and use via leadership, persuasion and demonstration of benefit. Blaming the technology providers is a classic ‘blame the victim’ approach.

The key problem is we have a ginormous public e-Health database which no-one feels has a great deal to offer without fundamental changes which is draining huge resources and a small private e-Health sector which brims with capability and just needs a little encouragement and support.

It is a great pity that we don’t have balanced coherent supportive advocacy and leadership that sees the big picture and fosters real clinician friendly progress!
David.

AusHealthIT Poll Number 283 – Results – 16th August, 2015.

Here are the results of the poll.

Which Organisation Best Represents The Interests Of Those Working In and Concerned About The Future Of E-Health?

The Australian College Of Health Informatics (ACHI) 23% (29)

The Health Informatics Society Of Australia (HISA) 6% (7)

The Health Information Management Association of Australia (HIMAA) 1% (1)

NEHTA 9% (11)

The E-Health Branch Of DOH 0% (0)

All Of The Above 35% (44)

None Of The Above 17% (22)

Some Other Organisation 5% (6)

I Have No Idea 5% (6)

Total votes: 126

I will leave readers to take what they want from the poll. It was the most split vote I have ever seen. ACHI, All Of The Above And None Of the Above seem to feature but no real clarity seems to emerge.

I have a feeling the poll may reflect reader affiliations - so will ask the question at some point.

Good to see such a great number of responses!

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

David.