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, September 17, 2015

2016 Budget -Parliament Almost Over for A Few Weeks and The US Federal Reserve Soon To Decide On US Interest Rates. Oh And A New Prime Minister

September 17 Edition
The big economic news this week  continued to be market turmoil which seems to have eased a bit (maybe) but certainly has not have finally stabilised as yet. They won’t until we hear from the US Fed at 4am on Friday morning our time.
Budget Night was May 12, 2015. It now seems to have been forgotten and in the Press we seem to be hearing just a little more about recession.

Interestingly the new PM has made the economy - along with innovation - as the key area where we need a great deal more work. I am sure we will see more details over the weekend and be clearer how things will play out next week.
I wonder is the man who inspired the ABC Show Rake on the money?

Art bares city's soul as strippers bear bad news

Date September 12, 2015 - 9:00PM

Charles Waterstreet

Sydney barrister and author

The first line of workers to feel the incoming credit crunch are strippers. A number of my friends in the industry are complaining that they have been earning half, even quarter of what they had been earlier in the year. It's not just the Kings Cross lockdown, it's city wide. Strippers have replaced taxi drivers as the canary in the coal mine of the cash crunch. If there's spare money to spend, men and women go to strip clubs and splash it around, everyone makes money when liquidity is high. One friend whinged that her leg garter would not hold coins as that is what some customers  are now reduced to. When strippers take coins, you know the credit squeeze is coming.
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Well at least it is Spring!
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Here is some other of the recent other news and analysis.

General Budget Issues.

Hockey: global growth would be much slower if not for Australia's leadership

Date September 7, 2015 - 9:38AM

Gareth Hutchens, Colin Brinsden AAP

Treasurer Joe Hockey believes global growth would much slower today if it had not been for Australia's G20 leadership last year that saw world leaders agree to a two per cent growth target.
He has also warned that the Chinese government will not renegotiate its free trade agreement with Australia if Labor successfully blocks the agreement, following similar warnings from Trade Minister Andrew Robb.
Speaking after a two-day G20 finance ministers meeting in Turkey on Sunday, Mr Hockey said global leaders were frustrated by the fact that the International Monetary Fund had downgraded its world growth outlook this year.
"(But) world growth would be lower if not for our leadership and determination last year to have a two per cent target and to roll out a global infrastructure initiative," Mr Hockey said.
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Julie Bishop advised PM: sack Joe Hockey

  • The Australian
  • September 6, 2015 6:36PM
Tony Abbott is standing by his comment that no minister has ever approached him about dumping his treasurer, Joe Hockey, despite a report Julie Bishop did just that before Christmas.
The Sunday Telegraph reports senior government sources have confirmed that late last year the foreign minister raised the idea with the prime minister, who firmly rejected it.
Mr Hockey tonight labelled the report as “gossip”.
“I’m focused on helping to create more jobs in Australia and working with other countries on global growth,” the treasurer said tonight from Istanbul after attending a G20 finance ministers meeting.
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Coalition auditor for 2013 election costings breached standards

Date September 7, 2015 - 7:21AM

Peter Martin

Economics Editor, The Age

EXCLUSIVE
Two years on from the Coalition's 2013 election victory, one of the three experts who "independently verified" its campaign costings has been found guilty of breaching auditing standards.
Len Scanlan, a former Queensland auditor general, has been penalised by CPA Australia for failing to uphold professional standards in the work he did for the Coalition.
But in an unusual move reported on the CPA website on May 25 the disciplinary tribunal found there were "exceptional circumstances" involving his work for the Coalition's Joe Hockey and ordered his name not be published.
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Here's who to blame for our coming recession

Date September 7, 2015 - 12:15AM

Ian Porter

The aims behind forcing car makers to close were superficial, and the ramifications will be dreadful.

Joe Hockey: world growth slower if not for us

The treasurer made the claim about Australian leadership at the 2014 Brisbane G20 as world finance ministers met in Turkey to discuss the world economy
Don't waste any time worrying about it: Australia is heading into a recession. There are several indicators pointing in this direction, but what will guarantee the slide into the economic doldrums will be the fallout from the Abbott government's first policy "initiative".
The current bleak backdrop has set the scene. The number of negative economic indicators seems to grow every time a new set of statistics is released.
Real average wages are falling, unemployment is up, the quality of work is declining (fewer full-time jobs), the terms of trade have moved adversely, manufacturing is so parlous we may soon even lose our ability to make steel, capital investment has slumped, and the banks are forced to invest in a wildly overheated property market because there's no industrial expansion to speak of.
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5:55pm September 8, 2015

Majority disapprove of Joe Hockey as federal treasurer

AAP
Joe Hockey. (AAP)
More than half of Australians disapprove of the job Joe Hockey is doing as treasurer, even after his better-received second budget in May.
The latest weekly Essential Research online poll found that less than a third think he is doing a good job.
At a 52 percent disapproval rating, Mr Hockey's standing is even weaker than the 44 percent recorded in August 2014, just months after his poorly received first budget.
Even one in five of his own coalition supporters gave him the thumbs down.
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Abbott government reduces budget black hole by $30 billion over next decade

Date September 8, 2015 - 8:56PM

Gareth Hutchens

The Abbott government has reduced its budget black hole by $30 billion over the next decade after its deal with Labor to reintroduce fuel excise indexation.
But Australia continues to face more than a decade of uninterrupted budget deficits, with $74 billion worth of budget repair initiatives still sitting unlegislated — from three previous budgets.
An updated assessment by the independent Parliamentary Budget Office shows the government is facing a cumulative $74 billion budget shortfall between now and 2025-26 after failing to win support for controversial savings measures in the Senate.
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Elective surgery waits are higher in NSW for cataracts, hips and knees

Date September 9, 2015 - 12:15AM

Harriet Alexander

Health Reporter

Hospital waiting lists for surgery such as cataract extraction and joint replacement are longer in NSW than the national average. Photo: Peter Braig
The waiting time for some elective surgical procedures in NSW is more than double the Australian average and three times higher than comparable countries.
NSW patients wait significantly longer for cataract extractions, knee replacements and hip replacements – non-urgent surgeries that are considered the canaries in the coal mine when hospital resources are stretched.
But NSW compares well against other countries for gall bladder and prostate surgery, with 97 per cent of procedures are performed on time, according to a Bureau of Health Information report released on Wednesday.
On the whole, people from NSW were among the most positive about their health care, with 54 per cent saying that the system performed well.
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Sniping at Joe Hockey ignores a good economic record

David Uren

Joe Hockey should feel some sympathy for Wayne Swan, who was pilloried for poor performance throughout 2010 despite Aus­tralia, alone among advanced ­nations, having pulled through the global financial crisis without a recession.
The sniping about Hockey is at odds with Australia’s relatively good economic performance, considering the collapse of the mining boom, which has been far more severe than anticipated.
Although the Coalition’s polling is consistently bad, recent research by Essential Media Communications shows 40 per cent of voters still think the Coalition is best able to manage the economy, compared with 24 per cent favouring Labor and 5 per cent the Greens. There has been little material change in these proportions since early last year other than a steady rise in the number who “don’t know”, who now total 31 per cent.
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From restaurant to pharmacy, penalty rates are making impact

Date September 11, 2015 - 2:45PM

Nick Toscano

Erin Gibbons gets a $10 an hour boost from working Sundays as a casual waitress at a restaurant in Elsternwick. 
The 27-year-old already works most afternoons and nights but says the extra money helps manage her bills and living expenses without needing to quit hospitality or sacrifice her scarce downtime by taking on a second job.
Most importantly, she says, Sunday penalty rates make up for the things in life she misses out on.
"I can tell you, I'm the only person in my family and in my friendship group who works Sundays ... most people still work Monday to Friday," she says.
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Health Budget Issues.

GP networks face hurdles

Charlotte Mitchell
Monday, 7 September, 2015
REPLACING Medicare Locals with Primary Health Networks represents a golden opportunity to address problems in the health system — provided there is cooperation between all levels of government, GPs and health organisations, according to GPs and health policy experts.
Associate Professor Suzanne Robinson, director of health policy and management at Curtin University, told MJA InSight that GPs were the “cornerstone of primary care” and that some Medicare Locals “did a great job in engaging general practice”.
However, she said the Primary Health Networks (PHNs) and GPs needed to work together with state governments and other health providers to “really focus on the needs of the patient population”.
Professor Robinson was commenting on research published this week in the MJA which found that the experience of Medicare Locals provided valuable lessons for the new PHNs in Australia. (1)
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Mike Baird says GST increase can fund health and also deliver tax cuts

Date September 7, 2015 - 12:15AM

Sean Nicholls

Sydney Morning Herald State Political Editor

NSW Premier Mike Baird says the extra revenue from lifting the GST to 15 per cent could help cover the looming shortfall in national health funding as well as deliver personal income tax cuts, in an apparent bid to keep the fledgling reform push on track.
On Friday, South Australian Premier Jay Weatherill said a GST increase could either fund tax cuts or healthcare but not both.
His comments came after Prime Minister Tony Abbott flagged using the GST increase to fund income tax cuts before the next federal election.
Mr Baird first proposed increasing the GST from 10 to 15 per cent ahead of last month's Council of Australian Governments meeting in Sydney, to cover an estimated $35 billion annual shortfall in national health costs by 2030 following the federal government's cuts to state funding.
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It fought off the government’s GP fee, and now the AMA wants its own

  • 10 hours ago September 08, 2015 10:00PM
  • Sue Dunlevy news.com.au
EIGHT months after defeating the government’s unpopular $5 GP fee, the Australian Medical Association now wants doctors to introduce their own.
The AMA wants the rules changed so doctors can bulk bill Medicare for a medical visit and then charge patients a gap fee on top.
“This would cut red tape, reduce upfront costs for some patients,” the AMA says in
its submission to the government’s primary health care reform process.
Currently if a doctor wants to impose a gap fee they have to charge the patient the full fee, up to $80 upfront, and the patient has to claim the $37 rebate from Medicare.
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Working together

8 September, 2015 Meg Pigram 
GP clinics that employ pharmacists could receive up to almost $190,000 in government funds under new proposals.
However, there are concerns the integration and expanded scope of practice will offer minimal remuneration benefits to pharmacists.
Others in pharmacy have expressed concerns they will be relegated to performing more administrative tasks.
The Pharmacist in General Practice (PIGPP) scheme is a proposal presented to the Federal Government by the AMA, with PSA endorsement, advocating a funding program to integrate non-dispensing pharmacists within general practices.
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South East Sydney Local Health District makes staff redundant after $20 million budget blowout

Date September 12, 2015 - 5:00PM

Amy Corderoy

Health Editor, Sydney Morning Herald

One of the busiest health districts in Sydney will make staff redundant after a budget blowout that has seen it record a $20 million deficit, Fairfax Media can reveal.
The deficit comes as the south-eastern Sydney health district has seen huge increases in patient numbers, and recently was so overwhelmed by emergency cases one of its major hospitals was put on unofficial bypass by the ambulance service because it was too full to accept patients.
It is now asking staff to accept voluntary redundancies, but it says they will be restricted to only about 50 "non-clinical staff" and will not affect patient care.
Health Services Union secretary Gerard Hayes said it was ridiculous to claim getting rid of staff would not affect patient care.
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The shocking dental health of the mouths of children growing up in outback towns

September 12, 2015 9:55pm
Sue Dunlevy National Health Reporter News Corp Australia Network
EXCLUSIVE
PEER inside the mouth of a child in the bush and you’ll find double the number of decayed, missing or filled teeth that you’d find in a city kid. It’s the scarred smile that underlines the shame of this nation’s dental policy.
We’ve got a Child Dental Scheme that provides $1,000 worth of dental care for kids but the 7 million people who live in the bush, where there are no dentists, rarely see a cent of this.
The Royal Flying Doctor Service has a plan to fix it, it wants $10 million diverted from the child dental scheme so it can buy new semi-trailers fitted with dental chairs and it wants to deliver more flights to outback towns.
RFDS chief says this money could buy an extra 100,000 dental treatments a year in the bush.
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Health Insurance Issues.

The scam that's adding $100 a year to your health fund premiums

September 10, 2015 10:00pm
Sue Dunlevy National Health Reporter News Corp Australia Network
IT’S the pricing scam that means you’re paying $100 a year more for your health insurance and a group of community health funds wants reforms to fix it.
When you have surgery in a private hospital your insurer is paying up to 70 per cent more for prostheses like hip and knee replacements than public hospitals pay.
The scam is adding at least $530 million a year to the cost of health insurance, says Hirmaa, which represents eighteen private health insurers which are member-owned and not-for-profit.
And taxpayers are also being slugged because they cover 30 per cent of the cost of health insurance.
Health Minster Sussan Ley yesterday pledged to look into the issue.
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Calls for review into private health care as insurance premiums increase and benefits are slashed

  • September 11, 2015 10:00PM
  • Sue Dunlevy News.com.au
HEALTH bodies are demanding a radical review of the private health system as health fund premiums skyrocket, hospitals price gouge and funds slash benefits.
Australian Medical Association president Professor Brian Owler demanded federal government intervention yesterday as he revealed NIB had removed over 225 items from its schedule of medical benefits.
He attacked Medibank over its attempt to exclude 165 treatments from hospital contracts and said the fund was no longer covering spinal fusion and bariatric surgery under its Private Basic and Standard Hospital policies.
The changes were serious enough to “warrant strong and swift intervention by the Federal Government before consumer confidence in the private sector is undermined, such that people drop their private cover altogether and/or turn to the public hospital sector for treatment,” Professor Owler said.
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Pharmacy Issues.

Pharmacies help reduce unnecessary hospitalisations

A report published in the Medical Journal of Australia today confirms the potential for community pharmacies to make a significant contribution to reducing the cost of unnecessary hospitalisations, says the Guild.

A study conducted by researchers at the University of South Australia and the BUPA Health Foundation shows that as many as one in four older hospital patients could have avoided admission had their medication and health risks been better managed.
The researchers concluded that a quarter of hospital admissions were preceded by ‘sub-optimal care’, with up to $300 million being spent per year to treat elderly patients who were not on the correct drug regime.
This new report builds on the strong evidence that adverse medicine events account for thousands of hospital admissions per year, the Guild says.
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Working together

8 September, 2015 Meg Pigram 
GP clinics that employ pharmacists could receive up to almost $190,000 in government funds under new proposals.
However, there are concerns the integration and expanded scope of practice will offer minimal remuneration benefits to pharmacists.
Others in pharmacy have expressed concerns they will be relegated to performing more administrative tasks.
The Pharmacist in General Practice (PIGPP) scheme is a proposal presented to the Federal Government by the AMA, with PSA endorsement, advocating a funding program to integrate non-dispensing pharmacists within general practices.
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Patient advocacy key to future viability: Panayiaris

Pharmacy needs to make the case that it should remain viable because it delivers equitable community healthcare, Nick Panayiaris, SA Guild president, told the Friendlies’ Conference in Adelaide.

Panayiaris sits on the Guild‘s Pharmacy Viability Committee which negotiated the 6CPA.
He told delegates that 6CPA negotiations were tough and some issues have yet to be resolved such as the $1 copayment discount.
“It is documented in the Agreement that we do not support this; however we had to compromise because we were told it could be $3. And also the big stick in front of us was the Location Rules… it wasn’t fun at times.
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Pharmacy’s ‘perfect storm’

10 September, 2015 Chris Brooker 
Pharmacy training standards are being hit by a ‘perfect storm’ of cuts and changes to employer funding programs and overregulation, the Pharmacy Guild of Australia believes.
As revealed by Pharmacy News Guild officials recently addressed the Senate Standing Committee on Education and Employment, as part of its’ ongoing inquiry into ‘the operation, regulation and funding of private vocational education and training (VET) providers in Australia’.
Under questioning from senators Sue Bond, head of the Guild Pharmacy Academy, said cuts to employer training subsidies in the 2014-15 Federal budget, combined with cuts and changes to state and territory funding, had led to declining training standards among staff.
When asked by Senator Arthur Sinodinos (Lib, NSW) if the situation was “a perfect storm”, Ms Bond agreed.
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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 present market chaos. I hardly see it improving in the short term. Maybe this time next week things will be clearer.
Enjoy.
David.

E-Health Legislation Alert!

This appeared this morning:


Bills of the current Parliament

Although every effort is made to ensure the accuracy of bills homepages, the authoritative sources for verifying the progress of bills are the House of Representatives Votes and Proceedings and the Journals of the Senate.

Health Legislation Amendment (eHealth) Bill 2015


Type
Government
Originating house
House of Representatives
Status
Before Reps
Portfolio
Health

Summary


Progress of bill For committee reference information, please see the Notes section at the end of this page.
House of Representatives
Introduced and read a first time
17/09/15

Second reading moved
17/09/15




Text of bill
  • First reading
MS-WordPDFHTML
Explanatory memoranda
  • Explanatory memorandum
MS-WordPDFHTML
Second reading speeches

Proposed amendments
No proposed amendments have been circulated.
Schedules of amendments

Bills Digest

David.
 

Wednesday, September 16, 2015

This Is An Interesting View Of The Future Of e-Health Over The Next Decade - And More.

This appeared a few days ago:

The era of virtual medicine is finally here

Chris Pash Sep 10, 2015, 10:30 AM
The intersection of technology and medicine is creating a more efficient and convenient world.
For decades futurists have been predicting giant leaps forward in the quality and speed of healthcare delivery through advances in technology.
If you look around in 2015, through advances such as telehealth, body parts created with 3D printers, medical service delivery in remote areas, and the use of big data to diagnose illnesses or forecast future demand for services, the age of virtual medicine is decidedly upon us.
Why go to the trouble of making your way to a doctor’s surgery, and then spending an afternoon in a waiting room, when you could be working or recuperating in bed? Online services can have you talking direct to a GP via online video link in just a few clicks. And you haven’t even left home or the office.
The doctors can email a medical certificate, make a note on your file and prescribe medicine, all online. The connection between GP and patient is just the first step into the world of networked healthcare.
While access to GPs online is now a reality, the services are still small. Out of 140 million GP visits a year in Australia, only about 20,000 or so are virtual.

Only getting started

David Glance, director of the University of Western Australia’s Centre for Software Practice, says the virtual market will take time to develop as users adapt, and there is huge scope for more adoption and improvement.
“The promise of e-health has yet to live up to the hype as a panacea for our ageing, overweight and increasingly sickly population,” he writes in the Conversation.
However, he says it will definitely be part of the solution in delivering more efficient services.
According to David Hansen, CEO of the eHealth Research Centre at the CSIRO, Australia’s national science agency, much of the healthcare sector has catching up to do.
“Healthcare may be the last sector where significant amounts of communication are still done via fax and regular post,” he says. “This is not to say that significant changes are not happening.”

Big data analytics

The federal government is creating digital medical records for all in Australia. This project, supported by state health departments, means there will be a mountain of data about the health needs of Australians.
“We’re going to see the big data analytics,” says Hansen. “An example where we’ve done some work is our patient admission prediction tool. This predicts, based on historical data, how many patients are going to turn up in the emergency department and how many will go on to need a bed.”
Lots more here:
What I liked in this article was the frank admission that to date we really have not had all that much success demonstrating the potential we all imagine exists in e-Health. How true it is and how this makes the nonsense claims of proponents of non-sense schemes like the PCEHR even more silly. If only we could see e-Health policies based on what was proven to work how much better the health system would be!
The rest of the series also looks like fun…go here:
David.

Tuesday, September 15, 2015

Do You Really Think The Health Ministers Have a Clue About The Potential Consequences Of The Decisions Regarding Opting Out Of The PCEHR?

Last week we had the Communique from the most recent Health Minister’s Meeting

COAG Health Council Communique - 7 August 2015

The Federal and State and Territory Health Ministers met in Darwin today at the COAG Health Council to discuss a range of national health issues. The meeting was chaired by Jack Snelling, Minister for Health, South Australia.
Page last updated: 07 September 2015
PDF printable version of COAG Health Council Communique - 7 August 2015 (PDF 292 KB)

7 August 2015

The Federal and State and Territory Health Ministers met in Darwin today at the COAG Health Council to discuss a range of national health issues. The meeting was chaired by Jack Snelling, Minister for Health, South Australia.

Major items discussed included:

Changes to eHealth Records

Ministers discussed proposed changes by the Australian Government to eHealth legislation to support delivery of the My Health Record and the establishment of the eHealth Commission. The amendments are aimed at bringing forward the benefits of a connected national eHealth system, aimed at providing improved health outcomes for consumers through national sharing of information and a more efficient health system.

Included in the draft legislation will be the implementation of the opt-out trials, to be conducted in some states and territories where participants will automatically receive an eHealth record unless they choose to opt out if they do not wish to have one. Under present arrangements, people have to specifically enrol to receive an eHealth record. Ministers were invited to nominate potential trial sites.
The full communique is here:
What I really wonder is how in a meeting that probably went for 2-3 hours could sufficient detail be provided regarding the e-Health records be provided to enable the Ministers to actually make informed decisions on a matter to complex as a move to ‘opt out’ and the risks to privacy, data-integrity and the way the disadvantaged and non-tech savvy are treated.
I can almost bet there was a 5-10 minute presentation of the plans at a high level - two minutes of discussion and the big tick was delivered.
Has anyone access to the briefing the Ministers were given? Would be fun to read!
David.

Monday, September 14, 2015

Weekly Australian Health IT Links – 14th September, 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 rather quiet week - headlined it would seem by more DoH hopelessness.
Other than that we have the fun of a serious critique on what is happening with the NBN and rather old news that the Government seems to be still steaming on with the opt-out PCEHR.
Have a good week!
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GPs slam govt's new aged care website

Tessa Hoffman and Paul Smith | 7 September, 2015 | 
GPs are calling the Federal Government website for aged care referrals ‘unsafe’ and ‘insecure’, saying it is delaying help to some of Australia’s most vulnerable patients.
The MyAgedCare site, launched in July, was meant to make it easier for doctors and nurses to make referrals for aged care assessment team (ACAT) assessments and Home Care Packages.
But it has emerged that the site does not conform to national secure message delivery standards. It has been lambasted by doctors who claim its poor design makes the referral process more onerous than ever and increases the risk of referrals disappearing into a cyberspace black hole.
Adelaide GP Dr Chris Bollen (pictured) says the site is laborious.
“These patients have some of the most complicated clinical problems you deal with in general practice. They are frail, and they obviously need these assessments to access services and care at a very vulnerable time,” he says.
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Govt admits to botching aged care website

Tessa Hoffman | 8 September, 2015 |
The Federal Government has admitted its new online aged care referrals system is flawed and has caused longer waits for vulnerable elderly patients to access vital services.
The new MyAgedCare website, launched on 1 July, was supposed to simplify referrals for aged care assessments and Home Care Packages.
But it has faced a barrage of criticism from GPs, who have labelled it unsafe and clunky.
Criticisms include that the three-page online form for aged care assessment team assessments is clunky and time-consuming because it does not marry up with practice software, forcing GPs to enter three pages of data manually, and it does not conform to national secure message delivery standards.
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Telstra Health Just Got Bigger In Asia

Telstra Health, which is a division of Telstra Australia, now has a bigger market presence in Asia. The company is installing their hospital electronic medical record systems in Thailand and Malaysia.
Telstra Health’s CloudMed Arcus Hospital Information System (Arcus) has been deployed already at Tung Shin Hospital’s Traditional Chinese Medicine and Western Medicine wings, at Penang Adventist Hospital, and at the Sunway Medical Centre group. Telstra Health is delivering the system to Thailand’s Khon Kaen University Hospital as well through a distributor. Arcus is an integrated patient care system that is expected to improve operations significantly.
But this is just the start. The company hopes to have a stronger presence in the Asian market soon.
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Positive disruption: healthcare, ageing and participation in the age of technology

4 September 2015
Australia is on the cusp of two of the greatest disruptive transformations in history: the ageing of the population and a technological revolution. How the nation manages with both of these prospects will determine its fortune.
These two phenomena will cause a ripple effect across the Australian economy and society, but Australia is now at the point where it can choose how it will react and rectify the exposed problems and inefficiencies caused.
It is expected that productivity growth will slow in coming years, in part due to Australia’s working age dependency ratio dropping from 7.3 in 1974- 75 to just 2.7 by mid-century. But the advent of health innovations and lifestyle changes for many Australians has resulted in longer life expectancies, and a greater level of health for a greater proportion of life. This translates into a longer period of time spent in retirement in an active and healthy state for many Australians.
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The era of virtual medicine is finally here

Chris Pash Sep 10, 2015, 10:30 AM
The intersection of technology and medicine is creating a more efficient and convenient world.
For decades futurists have been predicting giant leaps forward in the quality and speed of healthcare delivery through advances in technology.
If you look around in 2015, through advances such as telehealth, body parts created with 3D printers, medical service delivery in remote areas, and the use of big data to diagnose illnesses or forecast future demand for services, the age of virtual medicine is decidedly upon us.
Why go to the trouble of making your way to a doctor’s surgery, and then spending an afternoon in a waiting room, when you could be working or recuperating in bed? Online services can have you talking direct to a GP via online video link in just a few clicks. And you haven’t even left home or the office.
-----

Electronic Health Records Software Often Written without Doctors' Input

The reason why many doctors find EHRs difficult to use might be that the software wasn't properly tested, research suggests
September 9, 2015
By Kathryn Doyle
(Reuters Health) - The reason why many doctors find electronic health records (EHR) difficult to use might be that the software wasn't properly tested, researchers suggest.
Current guidelines and industry standards suggest that new EHR software should be tested by at least 15 end users with a clinical background to make sure they are usable and safe before they get federal certification.
But a new study finds that many certified products did not actually conduct this user testing, or did so without clinical testers.
Despite the guidelines, "there's no explicit requirement for end user testers to have a clinical background," said Raj M. Ratwani of MedStar Health in Washington, D.C., who worked on the study.
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COAG Health Council Communique - 7 August 2015

The Federal and State and Territory Health Ministers met in Darwin today at the COAG Health Council to discuss a range of national health issues. The meeting was chaired by Jack Snelling, Minister for Health, South Australia.
Page last updated: 07 September 2015
7 August 2015
The Federal and State and Territory Health Ministers met in Darwin today at the COAG Health Council to discuss a range of national health issues. The meeting was chaired by Jack Snelling, Minister for Health, South Australia.
…..

Changes to eHealth Records

Ministers discussed proposed changes by the Australian Government to eHealth legislation to support delivery of the My Health Record and the establishment of the eHealth Commission. The amendments are aimed at bringing forward the benefits of a connected national eHealth system, aimed at providing improved health outcomes for consumers through national sharing of information and a more efficient health system.
Included in the draft legislation will be the implementation of the opt-out trials, to be conducted in some states and territories where participants will automatically receive an eHealth record unless they choose to opt out if they do not wish to have one. Under present arrangements, people have to specifically enrol to receive an eHealth record. Ministers were invited to nominate potential trial sites.
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Mobile apps that collect health data: will they be put under the privacy spotlight?

Australia, European Union September 8 2015
Privacy protection is emerging as an important issue for mobile health apps. Users need to trust that the health apps they are using have safeguards in place to protect their personal heath data.
Without these safeguards, companies that market health and medical apps risk falling foul of the law as well as losing the confidence of their consumers.
Reflecting privacy concerns, European authorities have increased their focus on the data protection implications of ‘mobile health’. It’s quite possible Australian regulators will follow Europe’s lead.
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Patient privacy: when should medical practitioners disclose a patient’s confidential information?

Australia September 9 2015
In Ez and Ey, 1 the Privacy Commissioner held that a medical practitioner breached the National Privacy Principles (NPP) by disclosing a patient’s medical information to a police officer.
This decision was determined based on the Privacy Act 1988 (Cth) (the Act), prior to its reforms on 12 March 2014. The Australian Privacy Principles (APP) have now replaced the NPP (except for ACT).  It seems unlikely that the Commissioner’s findings would have differed if the matter was determined in accordance with the amended Act.
Background
Following a neighbourhood dispute, the patient contacted his local police station.  The police attended the patient’s house and reported that the patient explained his concerns in a   ‘highly excited and at times paranoid fashion’.  The patient also admitted to suffering Post Traumatic Stress Disorder and an anxiety disorder.
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What patients think when you pull out your mobile phone

9 September 2015
ALMOST three-quarters of patients and carers approve of doctors using smartphones and other mobile devices in hospitals, as long as it’s for patient care and not personal use, a survey shows.
The results, published in the Internal Medicine Journal, are based on responses from 70 patients and carers (a 90% response rate) at two Sydney teaching hospitals. 
Respondents were given six open-ended questions about whether a mobile device had been used by medical staff, if permission was asked, what the patient thought it was being used for, if they thought it was useful for health care and how they felt about it.
On the positive side, patients realised doctors could research something related to care, discuss their condition with another doctor, discuss it with the patient if they called from home, or use a diagram to explain their condition as well as use it as a teaching aid. 
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Top marks for dementia carers app

10 September 2015
BAYLOR University Medical Center in the US has created Dementi Assist for carers of patients with dementia.
The app opens with an explanation of the aims – to provide possible causes for the most common behavioural expressions by a person with dementia and to provide suggested actions to take to achieve the best outcome. 
There is a menu of behaviours including aggression/anger, agitation/anxiety, apathy, confusion psychosis and resistance to feeding, bathing and dressing. 
Choosing one of these behaviours directs the carer to choose the area – physical, emotional, social or environmental or a combination – which they feel may be contributing to the behaviour. This then provides information on triggers related to these and strategies which can be taken to ameliorate the situation.
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Bionic eye researchers hope to raise $10m to stay in the game

Sarah-Jane Tasker

The bionic ear — a cochlear implant — is one of Australia’s great medical device success stories and now a group of dedicated researchers are hoping to replicate that feat with a bionic eye, giving sight to thousands.
A private consortium of researchers from Sydney and Melbourne have spent almost $50 million of government money over the past five years developing the concept but as they head into further clinical trials next year they are hoping to raise $10m from investors to stay in the race to commercialise the device.
Robert Klupacs, chairman of Bionic Vision Technologies, which was created to commercialise the product, said a new large-scale manufacturing industry could be developed in Australia if their dream becomes reality.
“I want to be the next cochlear ... and we could be,” he told The Weekend Australian.
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Soprano Design in deal with Britain’s NHS

Supratim Adhikari

Australia’s Soprano Design has secured a deal with one of the world’s largest publicly funded health providers, Britain’s ­National Health Service, with the Sydney-based company rolling out its secure healthcare mobile messaging capability across hundreds of health centres.
Soprano’s Mobile Enterprise Messaging Solution (MEMS) met stringent criteria to win the tender. The platform is expected to facilitate more than 20 million messages a month ­between healthcare workers and patients.
The multi-million-dollar rollout of MEMS is now under way across hundreds of primary and secondary care facilities in ­England and Scotland, with deployment completed in Queen Victoria Hospital in Sussex and Royal Surrey County Hospital.
Soprano’s chief executive, Horden Wiltshire, said MEMS provided a secure communications platform for health providers and patients.
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Qld Health asks for $227m to replace patient admin system

By Paris Cowan
Sep 9 2015 6:00AM

Prepares to kick off mammoth IT project.

Queensland Health has put a tentative $226.6 million price tag on the replacement of its ageing patient administration system, and wants confirmation from the state government that the money will be provided quickly so the work can kick off in haste.
The hospital-based corporate information system (HBCIS) is used in all the state’s public hospitals to keep track of patients and their treatments. It is one of the biggest and most mission critical systems operating in the Queensland Health system.
The health department had previously placed the replacement cost at closer to $440 million.
Queensland parliament’s health and community services committee looked into the state of HBCIS in 2014 and found it would likely take around seven years to replace the system, which drops out of vendor support at the end of this year.
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The NBN: why it's slow, expensive and obsolete

Date September 8, 2015 - 6:53PM

Rod Tucker

COMMENT
The Abbott Coalition government came to power two years ago this week with a promise to change Labor’s fibre to the premises (FTTP) National Broadband Network (NBN) to one using less-expensive fibre-to-the-node (FTTN) technologies, spruiking its network with the three-word slogan: "Fast. Affordable. Sooner."
But with the release in August of the 2016 NBN corporate plan and in the light of overseas developments, it is clear that the Coalition's broadband network will not provide adequate bandwidth, will be no more affordable than Labor's FTTP network and will take almost as long to roll out.
With the benefits of two years' hindsight since 2013, let's look at the Coalition's performance against each of the three assertions in their 2013 slogan.
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Emeritus Professor slams Coalition NBN as 'bad deal'

The Coalition’s NBN has come under intense attack from the University of Melbourne's Emeritus Professor Rod Tucker who says the broadband network is so slow it is obsolete before it’s in place and Australia has got a “bad deal”.
Professor Tucker slams the coalition government’s NBN in a public lecture he will give at the University of Melbourne tonight, saying that fibre to the node technology will guarantee that Australia is an Internet backwater, and “our world our ranking could fall as low as 100th by 2020."
“The Coalition Government came to power in 2013 with a promise to change Labor's fibre to the premises (FTTP) National Broadband Network (nbn) to one using less-expensive fibre to the node (FTTN) technologies, spruiking their network with the three-word slogan: 'fast, affordable, sooner'.
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Enjoy!
David.

Sunday, September 13, 2015

Now Here Is A Comment (Or Two) That Really Need More Comment and Exposure!

This popped up a few days ago:
It was a comment posted on a blog I posted on the apparent shambles we have seen with the DHS aged care portal.
Here is the original blog:
Here are the comments

Karen Dearne said...

Well this portal's lack of functionality is not due to a lack of money ... a quick check of AusTender shows that around $24 million has been spent on it to date.
The Department of Social Services, which inherited this project from DoHA, has recently increased the value of its contract with service provider APIS to $12.8m, for the period Jan 2014 to June 2016; this started out at $4.26m so that's good going just 18 months into a 2.5-year contract.
APIS has been paid a further $5.6m for its work on this project, dating back to 2012. DoHA was responsible for almost all of the development work and contracts.
PwC pocketed $4.6m for change and benefits management; KPMG got $324,000 for "provision of options" for linking the service and Healthcare Management Advisors received $241,450 to develop a cost model for aged care assessment through the gateway (a DSS contract).
McGrathNicol did the probity advisory services for $148,500; Oakton helped out with additional support for $225,300, while a Talent business analyst earned $91,000 for six months work along with a Clicks recruit who made the tea for $19,300.
Interestingly, ThinkPlace Unit Trust was paid $79,420 to create an operational blueprint for the gateway in early 2013, another $32,180 in June to finalise the operations manual "to reflect increased scope", and in July another $32,180 to get it out the door, presumably.
Seems as though they didnt bother asking any doctors, aged care people or consumers....
BTW, a quick search of tenders for "portal" or "gateway" puts this one right up there with most expensive. And it doesn't work. Genius! From the people who brought us the PCEHR
A second comment followed which also contained more than a germ of truth:

Dr Ian Colclough said...

Seems as though they didn't bother asking any doctors, aged care people or consumers....
I often wonder whether those responsible for such healthIT fiascos (heaven knows there is no shortage of them) have any idea who they are developing such systems for. Is it possible they have no idea what and who comprise their target market and potential users.
Or is it simply that they are just incapable of engaging with end users to ascertain their needs, incapable of asking questions or incapable of interpreting any information that is received if they do ask questions. Or perhaps it's simply that the air these people exist in is so rarefied that their brains, if they have any, are deprived of the vital oxygen required to sustain life
Amusingly we have now had DHS confess they messed up:

Govt admits to botching aged care website

Tessa Hoffman | 8 September, 2015 |
The Federal Government has admitted its new online aged care referrals system is flawed and has caused longer waits for vulnerable elderly patients to access vital services.
The new MyAgedCare website, launched on 1 July, was supposed to simplify referrals for aged care assessments and Home Care Packages.
But it has faced a barrage of criticism from GPs, who have labelled it unsafe and clunky.
Criticisms include that the three-page online form for aged care assessment team assessments is clunky and time-consuming because it does not marry up with practice software, forcing GPs to enter three pages of data manually, and it does not conform to national secure message delivery standards.
Last week, the RACGP hit out at the Department of Social Services (DSS), saying mistakes could have been avoided if it had consulted with grassroots GPs when developing the site.
In a statement sent to Australian Doctor on Monday, the DSS acknowledges the site’s shortcomings and says it wants to further develop MyAgedCare to assist GPs, who it says are integral to aged care.
“The department acknowledges there have been some implementation issues with the MyAgedCare rollout, including longer wait times and delays in referrals being issued.
“We are committed to improving the current approach to referrals by developing a web form specifically designed for GPs and other health professionals to make referrals, which is expected to be available in 2016," the statement said.
More here including DSS statement.
Yet again we have a Government Health related web-site that has cost lots (thanks Karen for all these fantastic details) for what is very simple functionality.
Dr Colclough is dead right - there is severe oxygen starvation surrounding the people giving us all such rubbish! I wonder will things ever improve?
David.

AusHealthIT Poll Number 287 – Results – 13th September, 2015.

Here are the results of the poll.

Are You Expecting The Government To Make A Meaningful Positive Response To The 137 Submissions On The PCEHR And IHI Legislation? See here: http://www.ehealth.gov.au/internet/ehealth/publishing.nsf/Content/consultation-submissions


For Sure 3% (2)

Probably 8% (5)

Neutral 11% (7)

Probably Not 42% (26)

No Way 34% (21)

I Have No Idea 2% (1)

Total votes: 62

Very clear response - there is very little trust from the readers that the submissions will be taken seriously.

Good to see such a great number of responses!

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

David.